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  5. COLORADO MOUNTAIN MEDICAL, P.C.

COLORADO MOUNTAIN MEDICAL, P.C.

Company Details

Name: COLORADO MOUNTAIN MEDICAL, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Delinquent
Date of registration: 14 Dec 1979 (45 years ago)
Date dissolved: 01 Mar 2023
Entity Number: 19871387622
ZIP code: 81620
County: Eagle County
Place of Formation: COLORADO
Principal Address: 50 Buck Creek Road - Suite 200 Avon CO 81620 US
Mailing Address: P.O. Box 4330 Avon CO 81620 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COLORADO MOUNTAIN MEDICAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2013 840808023 2014-06-06 COLORADO MOUNTAIN MEDICAL, P.C. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-12-14
Business code 621111
Sponsor’s telephone number 9703281650
Plan sponsor’s address PO BOX 5850, EAGLE, CO, 81631

Signature of
Role Plan administrator
Date 2014-06-06
Name of individual signing ERIC HAUSEMAN
Valid signature Filed with authorized/valid electronic signature
COLORADO MOUNTAIN MEDICAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2012 840808023 2013-06-21 COLORADO MOUNTAIN MEDICAL, P.C. 98
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-12-14
Business code 621111
Sponsor’s telephone number 9703281650
Plan sponsor’s address PO BOX 5850, EAGLE, CO, 81631

Signature of
Role Plan administrator
Date 2013-06-21
Name of individual signing ERIC HAUSEMAN
Valid signature Filed with authorized/valid electronic signature
COLORADO MOUNTAIN MEDICAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2011 840808023 2012-08-28 COLORADO MOUNTAIN MEDICAL, P.C. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-12-14
Business code 621111
Sponsor’s telephone number 9703281650
Plan sponsor’s address 318 BROADWAY, PB 5850, EAGLE, CO, 81631

Plan administrator’s name and address
Administrator’s EIN 840808023
Plan administrator’s name COLORADO MOUNTAIN MEDICAL, P.C.
Plan administrator’s address 318 BROADWAY, PB 5850, EAGLE, CO, 81631
Administrator’s telephone number 9703281650

Signature of
Role Plan administrator
Date 2012-08-28
Name of individual signing ERIC HAUSEMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-28
Name of individual signing ERIC HAUSEMAN
Valid signature Filed with authorized/valid electronic signature
COLORADO MOUNTAIN MEDICAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2010 840808023 2011-07-19 COLORADO MOUNTAIN MEDICAL, P.C. 110
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-12-14
Business code 621111
Sponsor’s telephone number 9709266350
Plan sponsor’s address PO BOX 5850, EAGLE, CO, 81631

Plan administrator’s name and address
Administrator’s EIN 840808023
Plan administrator’s name COLORADO MOUNTAIN MEDICAL, P.C.
Plan administrator’s address PO BOX 5850, EAGLE, CO, 81631
Administrator’s telephone number 9709266350

Signature of
Role Plan administrator
Date 2011-07-19
Name of individual signing SUSAN ONEILL
Valid signature Filed with authorized/valid electronic signature
COLORADO MOUNTAIN MEDICAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2009 840808023 2010-07-27 COLORADO MOUNTAIN MEDICAL, P.C. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1979-12-14
Business code 621111
Sponsor’s telephone number 9709266350
Plan sponsor’s address PO BOX 5850, EAGLE, CO, 81631

Plan administrator’s name and address
Administrator’s EIN 840808023
Plan administrator’s name COLORADO MOUNTAIN MEDICAL, P.C.
Plan administrator’s address PO BOX 5850, EAGLE, CO, 81631
Administrator’s telephone number 9709266350

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing SUSAN ONEILL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Brooks Bock Agent 50 Buck Creek Road - Suite 200 Avon CO 81620 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20218044083 File Report 2021-11-01 2021-11-01 No data No data
20201919741 Statement Curing Delinquency 2020-10-26 2020-10-26 No data No data
20181916081 File Report 2018-11-26 2018-11-26 No data No data
20171868197 File Report 2017-11-24 2017-11-24 No data No data
20161801203 File Report 2016-11-28 2016-11-28 No data No data
20161541612 Statement of Change Changing the Registered Agent Information 2016-08-10 2016-08-10 No data Registered agent information changed;
20161541592 Statement of Change Changing the Principal Office Address 2016-08-10 2016-08-10 No data Principal address changed;
20151744798 File Report 2015-11-23 2015-11-23 No data No data
20141732807 File Report 2014-12-01 2014-12-01 No data No data
20131673742 File Report 2013-11-26 2013-11-26 No data Change of Registered Agent Address / Change of Entity Address

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State

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