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CAPTIVA RESOURCES, INC.

Company Details

Name: CAPTIVA RESOURCES, INC.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 18 Dec 1990 (34 years ago)
Entity Number: 19901108425
ZIP code: 80112
County: Arapahoe County
Place of Formation: COLORADO
Principal Address: 8001 Interport Blvd Ste 360 Englewood CO 80112 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
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

Agent

Name Role Address
Dane Embury Agent 8001 Interport Blvd Ste 360 Englewood CO 80112 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20248282358 File Report 2024-12-02 2024-12-02 No data Principal address changed, Change in registered agent information
20238292348 File Report 2023-12-13 2023-12-13 No data No data
20231214267 File Report 2023-02-24 2023-02-24 No data Change in registered agent information
20221199692 File Report 2022-02-24 2022-02-24 No data Change of Registered Agent
20211112597 File Report 2021-02-01 2021-02-01 No data No data
20201169393 File Report 2020-02-24 2020-02-24 No data No data
20191165703 File Report 2019-02-25 2019-02-25 No data No data
20181178205 File Report 2018-02-28 2018-02-28 No data No data
20171151830 File Report 2017-02-24 2017-02-24 No data No data
20161145655 File Report 2016-02-26 2016-02-26 No data No data

Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State