DRYVIT SYSTEMS, INC. SHORT TERM DISABLITY INSURANCE PLAN
|
2015
|
050342070
|
2016-02-17
|
DRYVIT SYSTEMS, INC.
|
152
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-01-01
|
Business code |
325500
|
Plan
sponsor’s DBA name |
DRYVIT SYSTEMS, INC.
|
Plan sponsor’s mailing address |
1 ENERGY WAY, WEST WARWICK, RI, 028932389
|
Plan sponsor’s
address |
1 ENERGY WAY, WEST WARWICK, RI, 028932389
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-02-17 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-02-17 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DRYVIT SYSTEMS, INC. - SHORT TERM DISABILITY PLAN
|
2014
|
050342070
|
2015-01-23
|
DRYVIT SYSTEMS, INC.
|
145
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2014-01-01
|
Business code |
325500
|
Sponsor’s telephone number |
4018224100
|
Plan
sponsor’s DBA name |
DRYVIT SYSTEMS, INC.
|
Plan sponsor’s mailing address |
1 ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan sponsor’s
address |
1 ENERGY WAY, WEST WARWICK, RI, 02893
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-01-23 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-23 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DRYVIT SYSTEMS, INC. SHORT TERM DISABILITY PLAN
|
2013
|
050342070
|
2014-01-16
|
DRYVIT SYSTEMS, INC.
|
138
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2013-01-01
|
Business code |
325500
|
Sponsor’s telephone number |
4018224100
|
Plan
sponsor’s DBA name |
DRYVIT SYSTEMS, INC.
|
Plan sponsor’s mailing address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan sponsor’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-01-16 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-16 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DRYVIT SYSTEMS, INC. SHORT TERM DISABILITY PLAN
|
2012
|
050342070
|
2013-03-12
|
DRYVIT SYSTEMS INC.
|
138
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
325500
|
Sponsor’s telephone number |
4018224100
|
Plan sponsor’s mailing address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan sponsor’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Number of participants as of the end of the plan year
Active participants |
138 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-03-12 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-03-12 |
Name of individual signing |
JEFF WELLEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DRYVIT SYSTEMS, INC. - SHORT TERM DISABILITY PLAN
|
2010
|
050342070
|
2011-03-08
|
DRYVIT SYSTEMS, INC.
|
135
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
325500
|
Sponsor’s telephone number |
4018224100
|
Plan
sponsor’s DBA name |
DRYVIT SYSTEMS, INC.
|
Plan sponsor’s mailing address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan sponsor’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan administrator’s name and address
Administrator’s EIN |
050342070 |
Plan administrator’s name |
DRYVIT SYSTEMS, INC. |
Plan administrator’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893 |
Administrator’s telephone number |
4018224100 |
Number of participants as of the end of the plan year
Active participants |
135 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-03-08 |
Name of individual signing |
DENNIS DALLMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DRYVIT SYSTEMS, INC. - SHORT TERM DISABILITY PLAN
|
2010
|
050342070
|
2011-03-09
|
DRYVIT SYSTEMS, INC.
|
135
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
325500
|
Sponsor’s telephone number |
4018224100
|
Plan
sponsor’s DBA name |
DRYVIT SYSTEMS, INC.
|
Plan sponsor’s mailing address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan sponsor’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan administrator’s name and address
Administrator’s EIN |
050342070 |
Plan administrator’s name |
DRYVIT SYSTEMS, INC. |
Plan administrator’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893 |
Administrator’s telephone number |
4018224100 |
Number of participants as of the end of the plan year
Active participants |
135 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-03-09 |
Name of individual signing |
DENNIS DALLMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DRYVIT SYSTEMS, INC. SHORT-TERM DISABILITY PLAN
|
2009
|
050342070
|
2010-03-26
|
DRYVIT SYSTEMS, INC.
|
176
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
325500
|
Sponsor’s telephone number |
4018224100
|
Plan
sponsor’s DBA name |
DRYVIT SYSTEMS, INC.
|
Plan sponsor’s mailing address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan sponsor’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893
|
Plan administrator’s name and address
Administrator’s EIN |
050342070 |
Plan administrator’s name |
DRYVIT SYSTEMS, INC. |
Plan administrator’s
address |
ONE ENERGY WAY, WEST WARWICK, RI, 02893 |
Administrator’s telephone number |
4018224100 |
Number of participants as of the end of the plan year
Active participants |
142 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
142 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-03-26 |
Name of individual signing |
DENNIS DALLMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|