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  5. Colorado Spine Institute, Professional LLC

Colorado Spine Institute, Professional LLC

Company Details

Name: Colorado Spine Institute, Professional LLC
Jurisdiction: Colorado
Legal type: Domestic limited liability company
Status: Good Standing
Date of registration: 04 Feb 2014 (11 years ago)
Entity Number: 20141081708
ZIP code: 80534
County: Weld County
Place of Formation: COLORADO
Principal Address: 4795 Larimer Pkwy Johnstown CO 80534 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2022 464900186 2023-01-20 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-12-23
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2023-01-20
Name of individual signing LUCANUS KOLDEWYN
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2021 464900186 2023-01-12 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-12-23
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2023-01-12
Name of individual signing LUCANUS KOLDEWYN
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2020 464900186 2021-10-07 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2021-10-07
Name of individual signing LUC KOLVEWIN
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2019 464900186 2020-10-08 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing LUC KOLVEWIN
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2018 464900186 2019-11-05 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2019-11-05
Name of individual signing EDWARD JEFFREY DONNER
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2018 464900186 2019-10-08 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 8
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2019-10-08
Name of individual signing EDWARD JEFFREY DONNER
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2017 464900186 2018-10-01 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2018-10-01
Name of individual signing EDWARD JEFFREY DONNER
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2016 464900186 2017-09-21 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 4795 LARIMER PARKWAY, JOHNSTOWN, CO, 80534

Signature of
Role Plan administrator
Date 2017-09-21
Name of individual signing EDWARD JEFFREY DONNER
Valid signature Filed with authorized/valid electronic signature
COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 401(K) PLAN 2015 464900186 2016-10-14 COLORADO SPINE INSTITUTE PROFESSIONAL, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9703422220
Plan sponsor’s address 5285 MCWHINNEY BOULEVARD, SUITE 145, LOVELAND, CO, 80538

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing EDWARD JEFFREY DONNER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Lucanus steven koldewyn Agent 4795 Larimer Pkwy Johnstown CO 80534 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20241089126 File Report 2024-01-23 2024-01-23 No data Principal address changed, Change in registered agent information
20231076142 File Report 2023-01-23 2023-01-23 No data Principal address changed, Change in registered agent information
20221263296 File Report 2022-03-11 2022-03-11 No data Change of Registered Agent
20211076911 File Report 2021-01-25 2021-01-25 No data No data
20201386567 File Report 2020-04-28 2020-04-28 No data No data
20191376139 File Report 2019-05-01 2019-05-01 No data No data
20171909514 File Report 2017-12-05 2017-12-05 No data No data
20171281542 Statement of Change Changing the Principal Office Address 2017-04-10 2017-04-10 No data Principal address changed;
20171281553 Statement of Change Changing the Registered Agent Information 2017-04-10 2017-04-10 No data Registered agent information changed;
20171281561 File Report 2017-04-10 2017-04-10 No data No data

Related by officers

No related officers

Related by address

4795 Larimer Pkwy Johnstown CO 80534 US

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Date of last update: 27 Jan 2025

Sources: Colorado's Secretary of State

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