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| Plan Name | SINGLE SOURCE, INC. BASIC LIFE AND AD&D PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SINGLE SOURCE, INC. |
| Employer identification number (EIN): | 582171480 |
| NAIC Classification: | 424950 |
| NAIC Description: | Paint, Varnish, and Supplies Merchant Wholesalers |
Additional information about SINGLE SOURCE, INC.
| Jurisdiction of Incorporation: | State of Delaware Division of Corporations |
| Incorporation Date: | |
| Company Identification Number: | 2091280 |
More information about SINGLE SOURCE, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2010-10-01 | MIKE DEVRIES | |||
| 503 | 2009-10-01 | TERRI JOHNSTON | ANTHONY RAGUNAS | 2011-04-28 |
| 2010: SINGLE SOURCE, INC. BASIC LIFE AND AD&D PLAN 2010 form 5500 responses | ||
|---|---|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Submission has been amended | Yes |
| 2010-10-01 | This submission is the final filing | Yes |
| 2010-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2010-10-01 | Plan is a collectively bargained plan | No |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SINGLE SOURCE, INC. BASIC LIFE AND AD&D PLAN 2009 form 5500 responses | ||
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | First time form 5500 has been submitted | Yes |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | H59341 |
| Policy instance | 1 |
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