MEDICAL
|
2017
|
840633105
|
2018-05-10
|
DAVIS PARTNERSHIP P.C.
|
125
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2013-11-01
|
Business code |
541310
|
Sponsor’s telephone number |
3038618555
|
Plan sponsor’s mailing address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Plan sponsor’s
address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Number of participants as of the end of the plan year
Active participants |
107 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-05-10 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-10 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LIFE INSURANCE
|
2016
|
840633105
|
2018-05-17
|
DAVIS PARTNERSHIP P.C.
|
143
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2016-12-01
|
Business code |
541310
|
Sponsor’s telephone number |
3038618555
|
Plan sponsor’s mailing address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Plan sponsor’s
address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Number of participants as of the end of the plan year
Active participants |
158 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-05-17 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-17 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL
|
2016
|
840633105
|
2018-05-17
|
DAVIS PARTNERSHIP P.C.
|
125
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2016-11-01
|
Business code |
541310
|
Sponsor’s telephone number |
3038618555
|
Plan sponsor’s mailing address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Plan sponsor’s
address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Number of participants as of the end of the plan year
Active participants |
152 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-05-17 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-17 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEDICAL
|
2016
|
840633105
|
2018-05-17
|
DAVIS PARTNERSHIP P.C.
|
127
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-11-01
|
Business code |
541310
|
Sponsor’s telephone number |
3038618555
|
Plan sponsor’s mailing address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Plan sponsor’s
address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Number of participants as of the end of the plan year
Active participants |
141 |
Retired or separated participants receiving
benefits |
1 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-05-17 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-17 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEDICAL
|
2015
|
840633105
|
2018-05-10
|
DAVIS PARTNERSHIP P.C.
|
124
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-11-01
|
Business code |
541310
|
Sponsor’s telephone number |
3038618555
|
Plan sponsor’s mailing address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Plan sponsor’s
address |
2901 BLAKE ST STE 100, DENVER, CO, 802052849
|
Number of participants as of the end of the plan year
Active participants |
117 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-05-10 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-10 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEDICAL
|
2014
|
840633105
|
2018-05-10
|
DAVIS PARTNERSHIP P.C.
|
107
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2014-11-01
|
Business code |
541310
|
Sponsor’s telephone number |
3038618555
|
Plan sponsor’s mailing address |
2901 BLAKE STREET, SUITE 100, DENVER, CO, 80205
|
Plan sponsor’s
address |
2901 BLAKE STREET, SUITE 100, DENVER, CO, 80205
|
Number of participants as of the end of the plan year
Active participants |
124 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-05-10 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-10 |
Name of individual signing |
LIZ LOSASSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|