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| Plan Name | DORMAN CONSTRUCTION HEALTH & WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | DORMAN CONSTRUCTION, INC. |
| Employer identification number (EIN): | 931037006 |
| NAIC Classification: | 236200 |
Additional information about DORMAN CONSTRUCTION, INC.
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 1990-08-13 |
| Company Identification Number: | 21400189 |
| Legal Registered Office Address: |
303 SO 5TH ST STE 135 SPRINGFIELD United States of America (USA) 97477 |
More information about DORMAN CONSTRUCTION, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-01-01 | MARCIA FORSHEE | 2022-06-13 |
| 2021: DORMAN CONSTRUCTION HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) | |
| Policy contract number | 10041757 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1135204 |
| Policy instance | 2 |
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