| Entity Name: | BRISTOL INSURANCE AGENCY, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Stock |
| Citizenship: | Domestic |
| Status: | Forfeited |
| Date Formed: | 26 Dec 1968 (Companies founded in December 1968) |
| Business ALEI: | 0006234 |
| Business address: | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410 |
| ZIP code: | 06410 (Companies in New Haven, 06410) |
| County: | New Haven |
| Place of Formation: | CONNECTICUT |
| Total authorized shares: | 100 |
| E-Mail: | Bristol.Insurance@palmerilaw.com |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRISTOL INSURANCE AGENCY INC. PROFIT SHARING PLAN | 2011 | 060854094 | 2012-07-20 | BRISTOL INSURANCE AGENCY | 2 | |||||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 060854094 |
| Plan administrator’s name | BRISTOL INSURANCE AGENCY |
| Plan administrator’s address | 195 SOUTH MAIN STREET, CHESHIRE, CT, 06410 |
| Administrator’s telephone number | 2032723567 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-18 |
| Name of individual signing | WILLIAM SHAY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-07-18 |
| Name of individual signing | WILLIAM SHAY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 1994-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 2032723567 |
| Plan sponsor’s address | 195 SOUTH MAIN STREET, CHESHIRE, CT, 06410 |
Plan administrator’s name and address
| Administrator’s EIN | 060854094 |
| Plan administrator’s name | BRISTOL INSURANCE AGENCY |
| Plan administrator’s address | 195 SOUTH MAIN STREET, CHESHIRE, CT, 06410 |
| Administrator’s telephone number | 2032723567 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-26 |
| Name of individual signing | WILLIAM SHAY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-07-26 |
| Name of individual signing | WILLIAM SHAY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 1994-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 2032723567 |
| Plan sponsor’s address | 195 SOUTH MAIN STREET, CHESHIRE, CT, 06410 |
Plan administrator’s name and address
| Administrator’s EIN | 060854094 |
| Plan administrator’s name | BRISTOL INSURANCE AGENCY |
| Plan administrator’s address | 195 SOUTH MAIN STREET, CHESHIRE, CT, 06410 |
| Administrator’s telephone number | 2032723567 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-26 |
| Name of individual signing | WILLIAM SHAY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-07-26 |
| Name of individual signing | WILLIAM SHAY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Residence address | |
|---|---|---|---|---|
| WILLIAM H SHAY JR | Agent | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States | Bristol.Insurance@palmerilaw.com | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| WILLIAM H. SHAY JR. | Officer | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States |
| HILARY DIMAURO | Officer | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States | 1030 MERIDEN AVE., SOUTHINGTON, CT, 06489, United States |
| WILLIAM H SHAY III | Officer | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States | 77 FAR HORIZON DRIVE, CHESHIRE, CT, 06410, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0011698566 | 2023-02-14 | No data | Administrative Dissolution | Certificate of Dissolution/Revocation | No data |
| BF-0011057620 | 2022-11-10 | No data | Administrative Dissolution | Notice of Intent to Dissolve/Revoke | No data |
| 0005237834 | 2014-12-17 | No data | Change of Agent Address | Agent Address Change | No data |
| 0005237826 | 2014-12-17 | No data | Annual Report | Annual Report | 2014 |
| 0005025090 | 2014-01-23 | No data | Annual Report | Annual Report | 2013 |
| 0005025083 | 2014-01-23 | No data | Annual Report | Annual Report | 2012 |
| 0004653128 | 2011-11-23 | No data | Annual Report | Annual Report | 2011 |
| 0004355884 | 2010-12-17 | No data | Annual Report | Annual Report | 2010 |
| 0004083436 | 2009-12-07 | No data | Annual Report | Annual Report | 2009 |
| 0003834354 | 2008-11-21 | No data | Annual Report | Annual Report | 2008 |
Date of last update: 04 Nov 2024
Sources: Connecticut's Official State Website
