WEST BAY DERMATOLOGY, LTD. 401(K) PLAN
|
2015
|
050515239
|
2016-04-11
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SOUTH COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Signature of
Role |
Plan administrator |
Date |
2016-04-11 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY, LTD.
|
2015
|
050515239
|
2016-04-11
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SOUTH COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Signature of
Role |
Plan administrator |
Date |
2016-04-11 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2015
|
050515239
|
2016-04-11
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Signature of
Role |
Plan administrator |
Date |
2016-04-11 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2014
|
050515239
|
2015-09-04
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Signature of
Role |
Plan administrator |
Date |
2015-09-04 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2013
|
050515239
|
2014-05-27
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Plan administrator’s name and address
Administrator’s EIN |
050515239 |
Plan administrator’s name |
WEST BAY DERMATOLOGY, LTD. |
Plan administrator’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818 |
Administrator’s telephone number |
4018854100 |
Signature of
Role |
Plan administrator |
Date |
2014-05-27 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2012
|
050515239
|
2013-10-03
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Plan administrator’s name and address
Administrator’s EIN |
050515239 |
Plan administrator’s name |
WEST BAY DERMATOLOGY, LTD. |
Plan administrator’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818 |
Administrator’s telephone number |
4018854100 |
Signature of
Role |
Plan administrator |
Date |
2013-10-03 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2011
|
050515239
|
2012-09-19
|
WEST BAY DERMATOLOGY, LTD.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Plan administrator’s name and address
Administrator’s EIN |
050515239 |
Plan administrator’s name |
WEST BAY DERMATOLOGY, LTD. |
Plan administrator’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818 |
Administrator’s telephone number |
4018854100 |
Signature of
Role |
Plan administrator |
Date |
2012-09-19 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2010
|
050515239
|
2011-06-20
|
WEST BAY DERMATOLOGY, LTD.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Plan administrator’s name and address
Administrator’s EIN |
050515239 |
Plan administrator’s name |
WEST BAY DERMATOLOGY, LTD. |
Plan administrator’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818 |
Administrator’s telephone number |
4018854100 |
Signature of
Role |
Plan administrator |
Date |
2011-06-20 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-06-20 |
Name of individual signing |
DR. KATHLEEN CARNEY-GODLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST BAY DERMATOLOGY LTD. 401(K) PLAN
|
2009
|
050515239
|
2010-10-08
|
WEST BAY DERMATOLOGY, LTD.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
4018854100
|
Plan sponsor’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818
|
Plan administrator’s name and address
Administrator’s EIN |
050515239 |
Plan administrator’s name |
WEST BAY DERMATOLOGY, LTD. |
Plan administrator’s
address |
1672 SO. COUNTY TRAIL, SUITE 202, EAST GREENWICH, RI, 02818 |
Administrator’s telephone number |
4018854100 |
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
CAROL LIPMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|