CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2023
|
841160876
|
2024-10-15
|
CAPTIVA RESOURCES, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2024-10-15 |
Name of individual signing |
TARA EVANS, FOR TAG RESOURCES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2022
|
841160876
|
2023-09-22
|
CAPTIVA RESOURCES, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2023-09-22 |
Name of individual signing |
TARA EVANS, FOR TAG RESOURCES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2021
|
841160876
|
2022-09-23
|
CAPTIVA RESOURCES, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2022-09-23 |
Name of individual signing |
TARA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2020
|
841160876
|
2021-09-17
|
CAPTIVA RESOURCES, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2021-09-17 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2019
|
841160876
|
2020-06-03
|
CAPTIVA RESOURCES, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2020-06-03 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2018
|
841160876
|
2019-10-02
|
CAPTIVA RESOURCES, INC.
|
9
|
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2019-10-02 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2018
|
841160876
|
2020-06-03
|
CAPTIVA RESOURCES, INC.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2020-06-03 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2017
|
841160876
|
2018-10-05
|
CAPTIVA RESOURCES, INC.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2018-10-05 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2016
|
841160876
|
2017-07-13
|
CAPTIVA RESOURCES, INC.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2017-07-13 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
CAPTIVA RESOURCES, INC. 401(K) PLAN
|
2015
|
841160876
|
2016-07-15
|
CAPTIVA RESOURCES, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
101
|
Effective date of plan |
2012-01-01
|
Business code |
324190
|
Sponsor’s telephone number |
3038323131
|
Plan sponsor’s
address |
8001 S. INTERPORT BLVD., #360, ENGLEWOOD, CO, 80112
|
Plan administrator’s name and address
Administrator’s EIN |
621874769 |
Plan administrator’s name |
TAG RESOURCES, LLC |
Plan administrator’s
address |
6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919 |
Administrator’s telephone number |
8656701844 |
Signature of
Role |
Plan administrator |
Date |
2016-07-15 |
Name of individual signing |
PHIL TISUE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|