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  5. CHELSEA INSURANCE AGENCY LLC

CHELSEA INSURANCE AGENCY LLC

Company Details

Entity Name: CHELSEA INSURANCE AGENCY LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 23 Dec 1998
Date of dissolution: 09 Apr 2022
Business ALEI: 0608969
NAICS code: 524210 - Insurance Agencies and Brokerages
Business address: 124 WEST TOWN ST., NORWICH, CT, 06360, United States
Mailing address: 124 WEST TOWN ST., NORWICH, CT, United States, 06360
ZIP code: 06360
County: New London
Place of Formation: CONNECTICUT
E-Mail: steve.dumont344@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHELSEA INSURANCE AGENCY LLC MEDOVA LIFESTYLE HEALTH PLAN 2021 300179274 2023-12-04 CHELSEA INSURANCE AGENCY LLC 0
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-12-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 W TOWN ST, NORWICH, CT, 063602125

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT, INC.
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2023-12-04
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY LLC MEDOVA LIFESTYLE HEALTH PLAN 2020 300179274 2022-09-02 CHELSEA INSURANCE AGENCY LLC 5
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-12-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 W TOWN ST, NORWICH, CT, 063602125

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2022-08-31
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2020 300179274 2021-02-21 CHELSEA INSURANCE AGENCY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 063602125

Signature of
Role Plan administrator
Date 2021-02-21
Name of individual signing STEVEN C. DUMONT
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2019 300179274 2020-09-18 CHELSEA INSURANCE AGENCY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 063602125

Signature of
Role Plan administrator
Date 2020-09-18
Name of individual signing STEVEN C. DUMONT
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2018 300179274 2019-07-09 CHELSEA INSURANCE AGENCY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 063602125

Signature of
Role Plan administrator
Date 2019-07-09
Name of individual signing STEVEN C. DUMONT
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2017 300179274 2018-09-17 CHELSEA INSURANCE AGENCY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 063602125

Signature of
Role Plan administrator
Date 2018-09-17
Name of individual signing STEVEN C. DUMONT
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2016 300179274 2017-06-28 CHELSEA INSURANCE AGENCY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 063602125

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing STEVEN C. DUMONT
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2015 300179274 2016-10-17 CHELSEA INSURANCE AGENCY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing STEVE DUMONT
Valid signature Filed with authorized/valid electronic signature
CHELSEA INSURANCE AGENCY, LLC RETIREMENT PLAN 2014 300179274 2015-09-15 CHELSEA INSURANCE AGENCY, LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 8608861400
Plan sponsor’s address 124 WEST TOWN STREET, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2015-09-15
Name of individual signing STEVE DUMONT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address E-Mail Residence address
STEVE DUMONT Agent 124 W. TOWN ST., NORWICH, CT, 06360, United States 124 W. TOWN ST., NORWICH, CT, 06360, United States steve@chelseainsurance.com CONNECTICUT, 344 LEBANON RD, FRANKLIN, CT, 06254, United States

Officer

Name Role Business address Residence address
STEVEN C DUMONT Officer 124 WEST TOWN ST, NORWICH, CT, 06360, United States 344 LEBANON RD, FRANKLIN, CT, 06254, United States
BONNIE J. DUMONT Officer 124 WEST TOWN ST, NORWICH, CT, 06360, United States 344 LEBANON RD, N. FRANKLIN, CT, 06254, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0010547203 2022-04-08 2022-04-09 Dissolution Certificate of Dissolution No data
0007151106 2021-02-15 No data Annual Report Annual Report 2021
0006761852 2020-02-19 No data Annual Report Annual Report 2020
0006372923 2019-02-08 No data Annual Report Annual Report 2019
0006001230 2018-01-11 No data Annual Report Annual Report 2018
0005969837 2017-11-21 No data Annual Report Annual Report 2017
0005703813 2016-11-28 No data Annual Report Annual Report 2016
0005470862 2016-01-25 No data Annual Report Annual Report 2014
0005470878 2016-01-25 No data Annual Report Annual Report 2015
0005004810 2013-12-20 No data Annual Report Annual Report 2013

Related by officers

STEVE DUMONT

"124 WEST TOWN STREET LLC"

Related by address

No related companies by address

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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