| Plan Name | OKLAHOMA OCCUPATIONAL INJURY PLAN - TRISTAR GLASS, INC. |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | TRISTAR GLASS, INC. |
| Employer identification number (EIN): | 731494269 |
| NAIC Classification: | 327210 |
Additional information about TRISTAR GLASS, INC.
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2011-08-05 |
| Company Identification Number: | 0801462355 |
| Legal Registered Office Address: |
1120 W MAIN PKWY CATOOSA United States of America (USA) 74015 |
More information about TRISTAR GLASS, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2015-08-01 | KAREN KELLEY | KAREN KELLEY | 2017-01-31 | |
| 501 | 2014-08-01 | KAREN KELLEY | KAREN KELLEY | 2016-02-02 |
| 2015: OKLAHOMA OCCUPATIONAL INJURY PLAN - TRISTAR GLASS, INC. 2015 form 5500 responses | ||
|---|---|---|
| 2015-08-01 | Type of plan entity | Single employer plan |
| 2015-08-01 | Submission has been amended | No |
| 2015-08-01 | This submission is the final filing | Yes |
| 2015-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-08-01 | Plan is a collectively bargained plan | No |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: OKLAHOMA OCCUPATIONAL INJURY PLAN - TRISTAR GLASS, INC. 2014 form 5500 responses | ||
| 2014-08-01 | Type of plan entity | Single employer plan |
| 2014-08-01 | First time form 5500 has been submitted | Yes |
| 2014-08-01 | Submission has been amended | No |
| 2014-08-01 | This submission is the final filing | No |
| 2014-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-08-01 | Plan is a collectively bargained plan | No |
| 2014-08-01 | Plan funding arrangement – Insurance | Yes |
| 2014-08-01 | Plan benefit arrangement – Insurance | Yes |
| ATLANTIC SPECIALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 27154 ) | |
| Policy contract number | 405-000-001 |
| Policy instance | 1 |
| ATLANTIC SPECIALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 27154 ) | |
| Policy contract number | 405-000-001 |
| Policy instance | 1 |