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DerivActiv, LLC

Company Details

Name: DerivActiv, LLC
Jurisdiction: Minnesota
Legal type: Limited Liability Company (Domestic)
Status: Active / In Good Standing
Date formed: 31 Jan 2005 (20 years ago)
Company Number: 15afedf6-8ad4-e011-a886-001ec94ffe7f
File Number: 1214866-2
Registered Office Address: 6400 Flying Cloud Drv, Eden Prairie, MN 55344, USA
Principal Executive Office Address: 6400 FLYING CLOUD DR STE 200, EDEN PRAIRIE, MN 55344–3331, USA
ZIP code: 55344
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
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

Manager

Name Role Address
Johan Rosenberg Manager 6400 FLYING CLOUD DR STE 200, EDEN PRAIRIE, MN 55344–3331, USA

Agent

Name Role
John W Trefethen Agent

Filing

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) 2009-11-19
Annual Reinstatement - Limited Liability Company (Domestic) 2008-02-25
Administrative Termination - Limited Liability Company (Domestic) 2008-01-07
Limited Liability Company (Domestic) Business Name (Business Name: DerivActiv, LLC) 2005-02-01
Original Filing - Limited Liability Company (Domestic) 2005-01-31
Limited Liability Company (Domestic) Business Name (Business Name: DerivActive, LLC) 2005-01-31

Date of last update: 27 Dec 2024

Sources: Minnesota's Official State Website