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| Plan Name | BLACKLINE ENERGY SERVICES WRAP PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLACKLINE ENERGY SERVICES LLC |
| Employer identification number (EIN): | 472095027 |
| NAIC Classification: | 213110 |
| NAIC Description: | Support Activities for Mining |
Additional information about BLACKLINE ENERGY SERVICES LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2014-10-07 |
| Company Identification Number: | 0802077478 |
| Legal Registered Office Address: |
PO BOX 3 MIDLAND United States of America (USA) 79702 |
More information about BLACKLINE ENERGY SERVICES LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-11-01 | ||||
| 501 | 2019-11-01 | ||||
| 501 | 2018-11-01 | REED TAYLOR | 2020-05-15 | ||
| 501 | 2017-11-01 | PATRICK SCHNEIDER | 2019-05-15 |
| 2019: BLACKLINE ENERGY SERVICES WRAP PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-11-01 | Type of plan entity | Single employer plan |
| 2019-11-01 | Submission has been amended | No |
| 2019-11-01 | This submission is the final filing | No |
| 2019-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-11-01 | Plan is a collectively bargained plan | No |
| 2019-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: BLACKLINE ENERGY SERVICES WRAP PLAN 2018 form 5500 responses | ||
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: BLACKLINE ENERGY SERVICES WRAP PLAN 2017 form 5500 responses | ||
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | First time form 5500 has been submitted | Yes |
| 2017-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | 276200 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00566321 |
| Policy instance | 2 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5944128 |
| Policy instance | 1 |
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