|
PARK AVENUE SURGERY CENTER RETIREMENT PLAN
|
2022
|
721565454
|
2023-06-11
|
PARK AVENUE SURGERY CENTER, LLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034688844
|
| Plan sponsor’s
address |
1800 EMERSON STREET #220, DENVER, CO, 80218
|
Signature of
| Role |
Plan administrator |
| Date |
2023-06-11 |
| Name of individual signing |
KIMBERLY BLANTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PARK AVENUE SURGERY CENTER RETIREMENT PLAN
|
2021
|
721565454
|
2022-07-13
|
PARK AVENUE SURGERY CENTER, LLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034688844
|
| Plan sponsor’s
address |
1800 EMERSON STREET #220, DENVER, CO, 80218
|
Signature of
| Role |
Plan administrator |
| Date |
2022-07-13 |
| Name of individual signing |
KIMBERLY BLANTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PARK AVENUE SURGERY CENTER RETIREMENT PLAN
|
2020
|
721565454
|
2021-05-02
|
PARK AVENUE SURGERY CENTER, LLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034688844
|
| Plan sponsor’s
address |
1800 EMERSON STREET #220, DENVER, CO, 80218
|
Signature of
| Role |
Plan administrator |
| Date |
2021-05-01 |
| Name of individual signing |
KIMBERLY BLANTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PARK AVENUE SURGERY CENTER RETIREMENT PLAN
|
2019
|
721565454
|
2020-06-22
|
PARK AVENUE SURGERY CENTER, LLC
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3034688844
|
| Plan sponsor’s
address |
1800 EMERSON STREET #220, DENVER, CO, 80218
|
Signature of
| Role |
Plan administrator |
| Date |
2020-06-22 |
| Name of individual signing |
KIMBERLY BLANTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2020-06-22 |
| Name of individual signing |
KIMBERLY BLANTON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PARK AVENUE SURGERY CENTER RETIREMENT PLAN
|
2018
|
721565454
|
2019-06-28
|
PARK AVENUE SURGERY CENTER, LLC
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2018-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
3033397800
|
| Plan sponsor’s
address |
1800 N EMERSON ST STE 220, DENVER, CO, 802181067
|
Signature of
| Role |
Plan administrator |
| Date |
2019-06-28 |
| Name of individual signing |
BONNIE SHIPPY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
