|
FORUS 401(K)
|
2023
|
823166754
|
2024-09-15
|
PVD BREAD LLC
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2014-11-01
|
| Business code |
722410
|
| Sponsor’s telephone number |
6174294264
|
| Plan sponsor’s
address |
377 RICHMOND STREET, PROVIDENCE, RI, 02903
|
Plan administrator’s name and address
| Administrator’s EIN |
461803145 |
| Plan administrator’s name |
FORUSALL, INC. |
| Plan administrator’s
address |
809 LAUREL ST., #1328, SAN CARLOS, CA, 94070 |
| Administrator’s telephone number |
8444012253 |
Signature of
| Role |
Plan administrator |
| Date |
2024-09-15 |
| Name of individual signing |
JUSTIN RAMIREZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FORUS 401(K)
|
2022
|
823166754
|
2023-08-15
|
PVD BREAD LLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2014-11-01
|
| Business code |
722410
|
| Sponsor’s telephone number |
6174294264
|
| Plan sponsor’s
address |
377 RICHMOND STREET, PROVIDENCE, RI, 02903
|
Plan administrator’s name and address
| Administrator’s EIN |
461803145 |
| Plan administrator’s name |
FORUSALL, INC. |
| Plan administrator’s
address |
809 LAUREL ST., #1328, SAN CARLOS, CA, 94070 |
| Administrator’s telephone number |
8444012253 |
Signature of
| Role |
Plan administrator |
| Date |
2023-08-15 |
| Name of individual signing |
ALEXANDER JACOBSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FORUS 401(K)
|
2021
|
823166754
|
2022-09-22
|
PVD BREAD LLC
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2014-11-01
|
| Business code |
722410
|
| Sponsor’s telephone number |
6174294264
|
| Plan sponsor’s
address |
377 RICHMOND STREET, PROVIDENCE, RI, 02903
|
Plan administrator’s name and address
| Administrator’s EIN |
461803145 |
| Plan administrator’s name |
FORUSALL, INC. |
| Plan administrator’s
address |
809 LAUREL ST., #1328, SAN CARLOS, CA, 94070 |
| Administrator’s telephone number |
8444012253 |
Signature of
| Role |
Plan administrator |
| Date |
2022-09-22 |
| Name of individual signing |
ALEXANDER JACOBSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
