|
EVERGREEN HEALTH CARE CENTER/HOME & COMMUNITY HEALTH SERVICES, INC. EMPLOYEE RETIREMENT SAVINGS PLAN
|
2020
|
223012385
|
2021-06-07
|
JOHNSON EVERGREEN CORPORATION
|
18
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2005-07-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
8606848713
|
| Plan sponsor’s
address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076
|
Signature of
| Role |
Plan administrator |
| Date |
2021-06-07 |
| Name of individual signing |
STUART ROSENBERG |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EVERGREEN HEALTH CARE CENTER/HOME & COMMUNITY HEALTH SERVICES, INC. EMPLOYEE RETIREMENT SAVINGS PLAN
|
2019
|
223012385
|
2020-04-18
|
JOHNSON EVERGREEN CORPORATION
|
69
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2005-07-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
8606848713
|
| Plan sponsor’s
address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076
|
Signature of
| Role |
Plan administrator |
| Date |
2020-04-18 |
| Name of individual signing |
STUART ROSENBERG |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EVERGREEN HEALTH CARE CENTER/HOME & COMMUNITY HEALTH SERVICES, INC. EMPLOYEE RETIREMENT SAVINGS PLAN
|
2018
|
223012385
|
2019-04-28
|
JOHNSON EVERGREEN CORPORATION
|
79
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2005-07-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
8606846341
|
| Plan sponsor’s
address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076
|
Signature of
| Role |
Plan administrator |
| Date |
2019-04-28 |
| Name of individual signing |
STUART ROSENBERG |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EVERGREEN HEALTH CARE CENTER/HOME & COMMUNITY HEALTH SERVICES, INC. EMPLOYEE RETIREMENT SAVINGS PLAN
|
2017
|
223012385
|
2018-05-18
|
JOHNSON EVERGREEN CORPORATION
|
85
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2005-07-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
8606846341
|
| Plan sponsor’s
address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076
|
Signature of
| Role |
Plan administrator |
| Date |
2018-05-18 |
| Name of individual signing |
STUART ROSENBERG |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EVERGREEN HEALTH CARE CENTER/ HOME & COMMUNITY HEALTH SERVICES, INC. EMPLOYEE RETIREMENT SAVINGS PLAN
|
2010
|
223012385
|
2011-05-20
|
JOHNSON EVERGREEN CORPORATION
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
2005-07-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
8606846341
|
| Plan sponsor’s mailing address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076
|
| Plan sponsor’s
address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076
|
Plan administrator’s name and address
| Administrator’s EIN |
223012385 |
| Plan administrator’s name |
JOHNSON EVERGREEN CORPORATION |
| Plan administrator’s
address |
205 CHESTNUT HILL ROAD, STAFFORD SPRINGS, CT, 06076 |
| Administrator’s telephone number |
8606846341 |
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2011-05-20 |
| Name of individual signing |
DIANA ROSE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
