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  5. CONEJOS COUNTY HOSPITAL CORPORATION

CONEJOS COUNTY HOSPITAL CORPORATION

Company Details

Name: CONEJOS COUNTY HOSPITAL CORPORATION
Jurisdiction: Colorado
Legal type: Domestic nonprofit corporation
Status: Merged
Date of registration: 21 May 2003 (22 years ago)
Entity Number: 20031165768
ZIP code: 81140
County: Conejos County
Place of Formation: COLORADO
Principal Address: 19021 State Highway 285 La Jara CO 81140 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CONEJOS COUNTY HOSPITAL CORPORATION 403(B) PLAN 2012 710947623 2013-11-25 CONEJOS COUNTY HOSPITAL CORPORATION 89
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 7192745121
Plan sponsor’s address 19021 U.S. HWY 285, LA JARA, CO, 811409410

Signature of
Role Plan administrator
Date 2013-11-25
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-11-25
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
CONEJOS COUNTY HOSPITAL CORPORATION 403(B) PLAN 2012 710947623 2013-07-02 CONEJOS COUNTY HOSPITAL CORPORATION 81
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 7192745121
Plan sponsor’s address 19021 U.S. HWY 285, LA JARA, CO, 81140

Signature of
Role Plan administrator
Date 2013-07-02
Name of individual signing DAVID AYALA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-02
Name of individual signing DAVID AYALA
Valid signature Filed with authorized/valid electronic signature
CONEJOS COUNTY HOSPITAL CORPORATION 403(B) PLAN 2011 710947623 2012-07-05 CONEJOS COUNTY HOSPITAL CORPORATION 74
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 7192745121
Plan sponsor’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140

Plan administrator’s name and address
Administrator’s EIN 710947623
Plan administrator’s name CONEJOS COUNTY HOSPITAL CORPORATION
Plan administrator’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140
Administrator’s telephone number 7192745121

Signature of
Role Plan administrator
Date 2012-07-05
Name of individual signing CLORINDA CHAVEZ
Valid signature Filed with authorized/valid electronic signature
CONEJOS COUNTY HOSPITAL CORPORATION 403(B) PLAN 2010 710947623 2011-05-19 CONEJOS COUNTY HOSPITAL CORPORATION 75
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 7192745121
Plan sponsor’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140

Plan administrator’s name and address
Administrator’s EIN 710947623
Plan administrator’s name CONEJOS COUNTY HOSPITAL CORPORATION
Plan administrator’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140
Administrator’s telephone number 7192745121

Signature of
Role Plan administrator
Date 2011-05-19
Name of individual signing CLORINDA CHAVEZ
Valid signature Filed with authorized/valid electronic signature
CONEJOS COUNTY HOSPITAL CORPORATION 403(B) PLAN 2009 710947623 2010-10-05 CONEJOS COUNTY HOSPITAL CORPORATION 78
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 7192745121
Plan sponsor’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140

Plan administrator’s name and address
Administrator’s EIN 710947623
Plan administrator’s name CONEJOS COUNTY HOSPITAL CORPORATION
Plan administrator’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140
Administrator’s telephone number 7192745121

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing TOM HENTON
Valid signature Filed with authorized/valid electronic signature
CONEJOS COUNTY HOSPITAL CORPORATION 403(B) PLAN 2009 710947623 2010-10-04 CONEJOS COUNTY HOSPITAL CORPORATION 78
Three-digit plan number (PN) 003
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 7192745121
Plan sponsor’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140

Plan administrator’s name and address
Administrator’s EIN 710947623
Plan administrator’s name CONEJOS COUNTY HOSPITAL CORPORATION
Plan administrator’s address 19021 U.S. HIGHWAY 285, LA JARA, CO, 81140
Administrator’s telephone number 7192745121

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing TOM HENTON
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-04
Name of individual signing TOM HENTON
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
Robert C Roth, Jr. Agent Kutak Rock LLP 1801 California Street, Suite 3000 Denver CO 80202 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20131387645 Statement of Merger 2013-07-01 2013-07-01 No data Merged to LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
20131327150 File Report 2013-05-31 2013-05-31 No data Change of Registered Agent Address
20121291502 File Report 2012-05-25 2012-05-25 No data No data
20111424239 File Report 2011-07-26 2011-07-26 No data No data
20101308305 File Report 2010-05-29 2010-05-29 No data No data
20091248991 File Report 2009-05-04 2009-05-04 No data Change of Registered Agent
20081294837 File Report 2008-05-30 2008-05-30 No data No data
20071250818 File Report 2007-05-25 2007-05-25 No data No data
20061228400 File Report 2006-06-05 2006-06-05 No data No data
20051292221 File Report 2005-08-01 2005-08-01 No data Change of Registered Agent / Change of Registered Agent Address

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Colorado's Secretary of State

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