GERALD H. PHIPPS, INC. LONG-TERM DISABILITY
|
2009
|
840423359
|
2010-10-08
|
GERALD H. PHIPPS, INC.
|
128
|
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1995-11-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan administrator’s name and address
Plan administrator’s name |
SAME |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GERALD H. PHIPPS, INC. LONG-TERM DISABILITY
|
2009
|
840423359
|
2010-10-28
|
GERALD H. PHIPPS, INC.
|
128
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1995-11-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan administrator’s name and address
Administrator’s EIN |
840423359 |
Plan administrator’s name |
GERALD H. PHIPPS, INC. |
Plan administrator’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710 |
Administrator’s telephone number |
3035715377 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-10-28 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GERALD H. PHIPPS, INC. DELTA DENTAL
|
2009
|
840423359
|
2010-10-28
|
GERALD H. PHIPPS, INC.
|
118
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-03-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan administrator’s name and address
Administrator’s EIN |
840423359 |
Plan administrator’s name |
GERALD H. PHIPPS, INC. |
Plan administrator’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111 |
Administrator’s telephone number |
3035715377 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-10-28 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GERALD H. PHIPPS, INC. PPO MEDICAL PLAN
|
2009
|
840423359
|
2010-10-28
|
GERALD H. PHIPPS, INC.
|
162
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-03-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan administrator’s name and address
Administrator’s EIN |
840423359 |
Plan administrator’s name |
GERALD H. PHIPPS, INC. |
Plan administrator’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710 |
Administrator’s telephone number |
3035715377 |
Number of participants as of the end of the plan year
Active participants |
115 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2010-10-28 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MINES AND ASSOCIATES, P.C.
|
2009
|
840423359
|
2010-11-11
|
GERALD H. PHIPPS, INC.
|
122
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2006-03-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan administrator’s name and address
Administrator’s EIN |
840423359 |
Plan administrator’s name |
GERALD H. PHIPPS, INC. |
Plan administrator’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111 |
Administrator’s telephone number |
3035715377 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-11-11 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GERALD H. PHIPPS, INC. PPO MEDICAL PLAN
|
2009
|
840423359
|
2010-10-08
|
GERALD H. PHIPPS, INC.
|
162
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-03-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 801114710
|
Plan administrator’s name and address
Plan administrator’s name |
SAME |
Number of participants as of the end of the plan year
Active participants |
115 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MINES AND ASSOCIATES, P.C.
|
2009
|
840423359
|
2010-10-08
|
GERALD H. PHIPPS, INC.
|
122
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2006-03-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan administrator’s name and address
Plan administrator’s name |
SAME |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GERALD H. PHIPPS, INC. DELTA DENTAL
|
2009
|
840423359
|
2010-10-08
|
GERALD H. PHIPPS, INC.
|
118
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2006-03-01
|
Business code |
236200
|
Sponsor’s telephone number |
3035715377
|
Plan sponsor’s mailing address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan sponsor’s
address |
5995 GREENWOOD PLAZA BLVD., #100, GREENWOOD VILLAGE, CO, 80111
|
Plan administrator’s name and address
Plan administrator’s name |
SAME |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
SHELLY JOHNSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|