|
BOLT COFFEE COMPANY 401(K) PLAN
|
2023
|
453982268
|
2024-10-10
|
BOLT COFFEE COMPANY LLC
|
49
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2017-01-01
|
| Business code |
722513
|
| Sponsor’s telephone number |
4013315200
|
| Plan sponsor’s
address |
96 CALVERLY STREET, PROVIDENCE, RI, 02908
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2024-10-10 |
| Name of individual signing |
QIAN LIU |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BOLT COFFEE COMPANY LLC 401K PROFIT SHARING PLAN AND TRUST
|
2022
|
453982268
|
2023-06-05
|
BOLT COFFEE COMPANY LLC
|
35
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2017-01-01
|
| Business code |
445299
|
| Sponsor’s telephone number |
5154217752
|
| Plan sponsor’s
address |
96 CALVERLY STREET, PROVIDENCE, RI, 02908
|
Signature of
| Role |
Plan administrator |
| Date |
2023-06-05 |
| Name of individual signing |
ANA ALEJANDRE-LARA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BOLT COFFEE COMPANY LLC 401K PROFIT SHARING PLAN AND TRUST
|
2021
|
453982268
|
2022-06-02
|
BOLT COFFEE COMPANY LLC
|
26
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2017-01-01
|
| Business code |
445299
|
| Sponsor’s telephone number |
5154217752
|
| Plan sponsor’s
address |
96 CALVERLY STREET, PROVIDENCE, RI, 02908
|
Signature of
| Role |
Plan administrator |
| Date |
2022-06-02 |
| Name of individual signing |
ANA ALEJANDRE-LARA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BOLT COFFEE COMPANY LLC 401K PROFIT SHARING PLAN AND TRUST
|
2020
|
453982268
|
2021-06-28
|
BOLT COFFEE COMPANY LLC
|
23
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2017-01-01
|
| Business code |
445299
|
| Sponsor’s telephone number |
5154217752
|
| Plan sponsor’s
address |
96 CALVERLY STREET, PROVIDENCE, RI, 02908
|
Signature of
| Role |
Plan administrator |
| Date |
2021-06-28 |
| Name of individual signing |
ANA ALEJANDRE-LARA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BOLT COFFEE COMPANY LLC 401K PROFIT SHARING PLAN AND TRUST
|
2019
|
453982268
|
2020-07-29
|
BOLT COFFEE COMPANY LLC
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2017-01-01
|
| Business code |
445299
|
| Sponsor’s telephone number |
5154217752
|
| Plan sponsor’s
address |
96 CALVERLY STREET, PROVIDENCE, RI, 02908
|
Signature of
| Role |
Plan administrator |
| Date |
2020-07-29 |
| Name of individual signing |
ANA ALEJANDRE-LARA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
BOLT COFFEE COMPANY LLC 401K PROFIT SHARING PLAN AND TRUST
|
2018
|
453982268
|
2019-07-15
|
BOLT COFFEE COMPANY LLC
|
14
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2017-01-01
|
| Business code |
445299
|
| Sponsor’s telephone number |
4017440211
|
| Plan sponsor’s
address |
96 CALVERLY STREET, PROVIDENCE, RI, 02908
|
Signature of
| Role |
Plan administrator |
| Date |
2019-07-15 |
| Name of individual signing |
MARK HUDLEY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
