401k Plan data: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN plan

KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 401k Plan overview

Plan Name	KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN
Plan identification number	501

KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental

401k Sponsoring company profile

KOORSEN FIRE & SECURITY, INC. has sponsored the creation of one or more 401k plans.

Company Name: KOORSEN FIRE & SECURITY, INC.

Employer identification number (EIN): 351153549

NAIC Classification: 811310
NAIC Description: Commercial and Industrial Machinery and Equipment (except Automotive and Electronic) Repair and Maintenance

Additional information about KOORSEN FIRE & SECURITY, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2021-10-27

Company Identification Number: 0804288823

Legal Registered Office Address: 2719 N ARLINGTON AVE

INDIANAPOLIS
United States of America (USA)
46218

More information about KOORSEN FIRE & SECURITY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-05-01 TAMMIE TRUE TAMMIE TRUE 2015-10-01
501 2013-05-01 TAMMIE TRUE TAMMIE TRUE 2014-11-24
501 2012-05-01 TAMMIE TRUE
501 2011-05-01 TAMMIE TRUE
501 2010-05-01 TAMMIE TRUE
501 2009-05-01 TAMMIE TRUE

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2014-05-01	TAMMIE TRUE	TAMMIE TRUE	2015-10-01
501	2013-05-01	TAMMIE TRUE	TAMMIE TRUE	2014-11-24
501	2012-05-01	TAMMIE TRUE
501	2011-05-01	TAMMIE TRUE
501	2010-05-01	TAMMIE TRUE
501	2009-05-01	TAMMIE TRUE

Plan Statistics for KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN

401k plan membership statisitcs for KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN

Measure Date Value
2014: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-05-01 687
Total number of active participants reported on line 7a of the Form 5500 2014-05-01 0
Number of retired or separated participants receiving benefits 2014-05-01 0
Number of other retired or separated participants entitled to future benefits 2014-05-01 0
Total of all active and inactive participants 2014-05-01 0
2013: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-05-01 476
Total number of active participants reported on line 7a of the Form 5500 2013-05-01 684
Number of retired or separated participants receiving benefits 2013-05-01 3
Number of other retired or separated participants entitled to future benefits 2013-05-01 0
Total of all active and inactive participants 2013-05-01 687
2012: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-05-01 442
Total number of active participants reported on line 7a of the Form 5500 2012-05-01 474
Number of retired or separated participants receiving benefits 2012-05-01 0
Number of other retired or separated participants entitled to future benefits 2012-05-01 0
Total of all active and inactive participants 2012-05-01 474
2011: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-05-01 442
Total number of active participants reported on line 7a of the Form 5500 2011-05-01 442
Number of retired or separated participants receiving benefits 2011-05-01 0
Number of other retired or separated participants entitled to future benefits 2011-05-01 0
Total of all active and inactive participants 2011-05-01 442
2010: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year 2010-05-01 442
Total number of active participants reported on line 7a of the Form 5500 2010-05-01 442
Number of retired or separated participants receiving benefits 2010-05-01 0
Number of other retired or separated participants entitled to future benefits 2010-05-01 0
Total of all active and inactive participants 2010-05-01 442
2009: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-05-01 442
Total number of active participants reported on line 7a of the Form 5500 2009-05-01 442
Number of retired or separated participants receiving benefits 2009-05-01 0
Number of other retired or separated participants entitled to future benefits 2009-05-01 0
Total of all active and inactive participants 2009-05-01 442

Measure	Date	Value
2014: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-05-01	687
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	0
Number of retired or separated participants receiving benefits	2014-05-01	0
Number of other retired or separated participants entitled to future benefits	2014-05-01	0
Total of all active and inactive participants	2014-05-01	0
2013: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-05-01	476
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	684
Number of retired or separated participants receiving benefits	2013-05-01	3
Number of other retired or separated participants entitled to future benefits	2013-05-01	0
Total of all active and inactive participants	2013-05-01	687
2012: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-05-01	442
Total number of active participants reported on line 7a of the Form 5500	2012-05-01	474
Number of retired or separated participants receiving benefits	2012-05-01	0
Number of other retired or separated participants entitled to future benefits	2012-05-01	0
Total of all active and inactive participants	2012-05-01	474
2011: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-05-01	442
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	442
Number of retired or separated participants receiving benefits	2011-05-01	0
Number of other retired or separated participants entitled to future benefits	2011-05-01	0
Total of all active and inactive participants	2011-05-01	442
2010: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-05-01	442
Total number of active participants reported on line 7a of the Form 5500	2010-05-01	442
Number of retired or separated participants receiving benefits	2010-05-01	0
Number of other retired or separated participants entitled to future benefits	2010-05-01	0
Total of all active and inactive participants	2010-05-01	442
2009: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-05-01	442
Total number of active participants reported on line 7a of the Form 5500	2009-05-01	442
Number of retired or separated participants receiving benefits	2009-05-01	0
Number of other retired or separated participants entitled to future benefits	2009-05-01	0
Total of all active and inactive participants	2009-05-01	442

Form 5500 Responses for KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN

2014: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2014 form 5500 responses
2014-05-01	Type of plan entity	Single employer plan
2014-05-01	Submission has been amended	No
2014-05-01	This submission is the final filing	Yes
2014-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-05-01	Plan is a collectively bargained plan	No
2014-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2013 form 5500 responses
2013-05-01	Type of plan entity	Single employer plan
2013-05-01	Submission has been amended	No
2013-05-01	This submission is the final filing	No
2013-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-05-01	Plan is a collectively bargained plan	No
2013-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2012 form 5500 responses
2012-05-01	Type of plan entity	Single employer plan
2012-05-01	Submission has been amended	No
2012-05-01	This submission is the final filing	No
2012-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-05-01	Plan is a collectively bargained plan	No
2012-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2011 form 5500 responses
2011-05-01	Type of plan entity	Single employer plan
2011-05-01	Submission has been amended	No
2011-05-01	This submission is the final filing	No
2011-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-05-01	Plan is a collectively bargained plan	No
2011-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2010 form 5500 responses
2010-05-01	Type of plan entity	Single employer plan
2010-05-01	Submission has been amended	No
2010-05-01	This submission is the final filing	No
2010-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-05-01	Plan is a collectively bargained plan	No
2010-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: KOORSEN FIRE AND SECURITY, INC. MEDICAL PLAN 2009 form 5500 responses
2009-05-01	Type of plan entity	Single employer plan
2009-05-01	Submission has been amended	No
2009-05-01	This submission is the final filing	No
2009-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-05-01	Plan is a collectively bargained plan	No
2009-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	KOORSEN FIRE & SECURITY, INC.
Employer identification number (EIN):	351153549
NAIC Classification:	811310
NAIC Description:	Commercial and Industrial Machinery and Equipment (except Automotive and Electronic) Repair and Maintenance

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2021-10-27
Company Identification Number:	0804288823
Legal Registered Office Address:	2719 N ARLINGTON AVE INDIANAPOLIS United States of America (USA) 46218