BLACK ROOFING, INC. 401(K) PLAN
|
2020
|
841096626
|
2022-03-15
|
BLACK ROOFING, INC.
|
81
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
236200
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE SUITE A, BOULDER, CO, 80301
|
Signature of
Role |
Plan administrator |
Date |
2022-03-15 |
Name of individual signing |
JENNIFER KERRIG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401(K) PLAN
|
2019
|
841096626
|
2021-03-03
|
BLACK ROOFING, INC.
|
76
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
236200
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE SUITE A, BOULDER, CO, 80301
|
Signature of
Role |
Plan administrator |
Date |
2021-03-03 |
Name of individual signing |
JENNIFER KERRIGAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401(K) PLAN
|
2018
|
841096626
|
2020-06-24
|
BLACK ROOFING, INC.
|
71
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
236200
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE SUITE A, BOULDER, CO, 80301
|
Signature of
Role |
Plan administrator |
Date |
2020-06-24 |
Name of individual signing |
TARA SENTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401(K) PLAN
|
2017
|
841096626
|
2019-07-09
|
BLACK ROOFING, INC.
|
61
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
236200
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE SUITE A, BOULDER, CO, 80301
|
Signature of
Role |
Plan administrator |
Date |
2019-07-09 |
Name of individual signing |
GENA BEAGLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401K PLAN
|
2016
|
841096626
|
2019-01-22
|
BLACK ROOFING, INC.
|
62
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
238900
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988
|
Signature of
Role |
Plan administrator |
Date |
2019-01-22 |
Name of individual signing |
DANIEL ZAHTILA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401K PLAN
|
2015
|
841096626
|
2017-06-02
|
BLACK ROOFING, INC.
|
90
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
238900
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988
|
Signature of
Role |
Plan administrator |
Date |
2017-06-02 |
Name of individual signing |
DANIEL ZAHTILA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401K PLAN
|
2014
|
841096626
|
2016-01-18
|
BLACK ROOFING, INC.
|
74
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
238900
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988
|
Signature of
Role |
Plan administrator |
Date |
2016-01-18 |
Name of individual signing |
DANIEL ZAHTILA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401K PLAN
|
2013
|
841096626
|
2015-04-01
|
BLACK ROOFING, INC.
|
71
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
238900
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988
|
Signature of
Role |
Plan administrator |
Date |
2015-04-01 |
Name of individual signing |
DANIEL ZAHTILA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401K PLAN
|
2012
|
841096626
|
2014-04-14
|
BLACK ROOFING, INC.
|
71
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
238900
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988
|
Signature of
Role |
Plan administrator |
Date |
2014-04-14 |
Name of individual signing |
DANIEL ZAHTILA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK ROOFING, INC. 401K PLAN
|
2011
|
841096626
|
2012-12-03
|
BLACK ROOFING, INC.
|
76
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1990-10-01
|
Business code |
238900
|
Sponsor’s telephone number |
3034495176
|
Plan sponsor’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988
|
Plan administrator’s name and address
Administrator’s EIN |
841096626 |
Plan administrator’s name |
BLACK ROOFING, INC. |
Plan administrator’s
address |
6115 BEN PLACE, SUITE A, BOULDER, CO, 803012988 |
Administrator’s telephone number |
3034495176 |
Signature of
Role |
Plan administrator |
Date |
2012-12-03 |
Name of individual signing |
DANIEL ZAHTILA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|