6400 RETIREMENT PLAN
|
2023
|
202250989
|
2024-08-30
|
DERIVACTIV, LLC
|
32
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
3498 MARKET STREET, 24827, MINNEAPOLIS, MN, 55424
|
Signature of
Role |
Plan administrator |
Date |
2024-08-29 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-08-29 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2022
|
202250989
|
2023-09-12
|
DERIVACTIV, LLC
|
32
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2023-09-12 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-12 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2021
|
202250989
|
2022-09-14
|
DERIVACTIV, LLC
|
31
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2022-09-14 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-09-14 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2020
|
202250989
|
2021-10-13
|
DERIVACTIV, LLC
|
36
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2021-10-13 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-10-13 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2019
|
202250989
|
2020-10-05
|
DERIVACTIV, LLC
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2020-10-02 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-02 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2018
|
202250989
|
2019-10-11
|
DERIVACTIV, LLC
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2019-10-11 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-10-11 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2017
|
202250989
|
2018-12-04
|
DERIVACTIV, LLC
|
41
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2018-12-04 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-12-04 |
Name of individual signing |
ANN BOLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2016
|
202250989
|
2017-09-12
|
DERIVACTIV, LLC
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2017-09-12 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-09-12 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2015
|
202250989
|
2016-10-17
|
DERIVACTIV, LLC
|
34
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-17 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
6400 RETIREMENT PLAN
|
2014
|
202250989
|
2015-09-01
|
DERIVACTIV, LLC
|
30
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2000-01-01
|
Business code |
523120
|
Sponsor’s telephone number |
9527466034
|
Plan sponsor’s
address |
6400 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344
|
Signature of
Role |
Plan administrator |
Date |
2015-09-01 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-09-01 |
Name of individual signing |
JOHAN ROSENBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|