| Name: | Coventry Senior Living of Mahtomedi, LLC |
| Jurisdiction: | Minnesota |
| Legal type: | Limited Liability Company (Domestic) |
| Status: | Active / In Good Standing |
| Date formed: | 26 Aug 2010 (14 years ago) |
| Company Number: | 0b0e166c-96d4-e011-a886-001ec94ffe7f |
| File Number: | 3962343-2 |
| Registered Office Address: | 720 Mahtomedi Ave, Mahtomedi, MN 55115, USA |
| Principal Executive Office Address: | 3300 RICE ST STE 100, SAINT PAUL, MN 55126–6455, United States |
| ZIP code: | 55115 |
| County: | Washington County |
| Place of Formation: | Minnesota |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COVENTRY SENIOR LIVING 401K PLAN | 2015 | 273333777 | 2016-12-12 | COVENTRY SENIOR LIVING OF MAHTOMEDI LLC | 32 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2016-12-12 |
| Name of individual signing | NATALIE BENGTSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-12-12 |
| Name of individual signing | NATALIE BENGTSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-08-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 6515288442 |
| Plan sponsor’s address | 720 MAHTOMEDI AVENUE, MAHTOMEDI, MN, 55115 |
Signature of
| Role | Plan administrator |
| Date | 2016-09-26 |
| Name of individual signing | NATALIE BENGTSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-09-26 |
| Name of individual signing | NATALIE BENGTSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GREG JOHNSON | Manager | 3300 RICE ST STE 100, SAINT PAUL, MN 55126–6455, United States |
| Name | Role |
|---|---|
| Robert Skeie | Agent |
| Filing Name | Filing date |
|---|---|
| Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) | 2018-01-01 |
| Registered Office and/or Agent - Limited Liability Company (Domestic) | 2013-06-24 |
| Original Filing - Limited Liability Company (Domestic) (Business Name: Coventry Senior Living of Mahtomedi, LLC) | 2010-08-26 |
Date of last update: 24 Sep 2024
Sources: Minnesota's Official State Website
