| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
541600
|
| Sponsor’s telephone number |
9705909383
|
| Plan sponsor’s mailing address |
5502 W. 1ST STREET, GREELEY, CO, 80634
|
| Plan sponsor’s
address |
3850 N. GRANT STREET, SUITE 100, LOVELAND, CO, 80538
|
Plan administrator’s name and address
| Administrator’s EIN |
262466784 |
| Plan administrator’s name |
MEDPOWER, LLC |
| Plan administrator’s
address |
5502 W. 1ST STREET, GREELEY, CO, 80634 |
| Administrator’s telephone number |
9706695717 |
Number of participants as of the end of the plan year
| Active participants |
0 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
14 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
14 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-04-28 |
| Name of individual signing |
SUSAN BECK |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-04-28 |
| Name of individual signing |
SUSAN BECK |
| Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
