| Name: | DALE G. LERVICK, O.D., P.C. |
| Jurisdiction: | Colorado |
| Legal type: | Domestic profit corporation |
| Status: | Good Standing |
| Date of registration: | 02 Jul 1979 (46 years ago) |
| Entity Number: | 19871376800 |
| ZIP code: | 80031 |
| County: | Adams County |
| Place of Formation: | COLORADO |
| Principal Address: | 3686 W 100th Ave Westminster CO 80031 US |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DALE G LERVICK OD PC EMPLOYEES 401K PRF SH PL | 2014 | 840792341 | 2015-10-15 | DALE G. LERVICK O.D., P.C. | 4 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 840792341 |
| Plan administrator’s name | DALE G. LERVICK OD PC |
| Plan administrator’s address | 7586 W JEWELL AVE STE 104, LAKEWOOD, CO, 80232 |
| Administrator’s telephone number | 3032334740 |
Signature of
| Role | Plan administrator |
| Date | 2015-10-15 |
| Name of individual signing | DALE G. LERVICK |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1979-07-02 |
| Business code | 621320 |
| Sponsor’s telephone number | 3032337575 |
| Plan sponsor’s address | 7586 W JEWELL AVE 104, LAKEWOOD, CO, 80232 |
Plan administrator’s name and address
| Administrator’s EIN | 840792341 |
| Plan administrator’s name | DALE G. LERVICK OD PC |
| Plan administrator’s address | 7586 W JEWELL AVE STE 104, LAKEWOOD, CO, 80232 |
| Administrator’s telephone number | 3032334740 |
Signature of
| Role | Plan administrator |
| Date | 2014-08-14 |
| Name of individual signing | DALE G. LERVICK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1979-07-02 |
| Business code | 621320 |
| Sponsor’s telephone number | 3032337575 |
| Plan sponsor’s address | 7586 W JEWELL AVE 104, LAKEWOOD, CO, 80232 |
Plan administrator’s name and address
| Administrator’s EIN | 840792341 |
| Plan administrator’s name | DALE G. LERVICK OD PC |
| Plan administrator’s address | 7586 W JEWELL AVE STE 104, LAKEWOOD, CO, 80232 |
| Administrator’s telephone number | 3032334740 |
Signature of
| Role | Plan administrator |
| Date | 2013-10-11 |
| Name of individual signing | DALE G. LERVICK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1979-07-02 |
| Business code | 621320 |
| Sponsor’s telephone number | 3032337575 |
| Plan sponsor’s address | 7586 W JEWELL AVE STE 104, LAKEWOOD, CO, 80232 |
Plan administrator’s name and address
| Administrator’s EIN | 840792341 |
| Plan administrator’s name | DALE G. LERVICK OD PC |
| Plan administrator’s address | 7586 W JEWELL AVE STE 104, LAKEWOOD, CO, 80232 |
| Administrator’s telephone number | 3032334740 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-11 |
| Name of individual signing | DALE G. LERVICK |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Dale Lervick | Agent | 3686 W 100th Ave Westminster CO 80031 US |
| Transaction ID | Type | Date | Effective date | Name | Comment |
|---|---|---|---|---|---|
| 20248155610 | File Report | 2024-10-28 | 2024-10-28 | No data | Change in registered agent information |
| 20241009163 | File Report | 2024-01-02 | 2024-01-02 | No data | Principal address changed, Change in registered agent information |
| 20231021101 | File Report | 2023-01-05 | 2023-01-05 | No data | Principal address changed, Change in registered agent information |
| 20218238940 | File Report | 2021-12-30 | 2021-12-30 | No data | Change of Registered Agent / Change of Registered Agent Address / Change of Entity Address |
| 20201860925 | Statement Curing Delinquency | 2020-10-02 | 2020-10-02 | DALE G. LERVICK, O.D., P.C. | No data |
| 20171721164 | File Report | 2017-09-25 | 2017-09-25 | No data | No data |
| 20161461144 | File Report | 2016-07-06 | 2016-07-06 | No data | Removed entity mailing address;Removed agent mailing address; / Change of Registered Agent Address / Change of Entity Address |
| 20151506222 | File Report | 2015-08-03 | 2015-08-03 | No data | No data |
| 20141537759 | File Report | 2014-09-02 | 2014-09-02 | No data | No data |
| 20131406517 | File Report | 2013-07-15 | 2013-07-15 | No data | No data |
Date of last update: 13 Jan 2025
Sources: Colorado's Secretary of State
