0001700167-17-000001.txt : 20170313 0001700167-17-000001.hdr.sgml : 20170313 20170313154314 ACCESSION NUMBER: 0001700167-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170313 DATE AS OF CHANGE: 20170313 EFFECTIVENESS DATE: 20170313 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Covered Insurance Solutions, Inc. CENTRAL INDEX KEY: 0001700167 IRS NUMBER: 814512828 STATE OF INCORPORATION: SD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-282416 FILM NUMBER: 17685102 BUSINESS ADDRESS: STREET 1: 4884 CLIFF DRIVE CITY: RAPID CITY STATE: SD ZIP: 57702 BUSINESS PHONE: 605-209-1062 MAIL ADDRESS: STREET 1: 4884 CLIFF DRIVE CITY: RAPID CITY STATE: SD ZIP: 57702 D 1 primary_doc.xml X0707 D LIVE 0001700167 Covered Insurance Solutions, Inc. 4884 CLIFF DRIVE RAPID CITY SD SOUTH DAKOTA 57702 605-209-1062 SOUTH DAKOTA None None Corporation true 2016 Ross Diedrich 4884 Cliff Drive Rapid City SD SOUTH DAKOTA 57702 Executive Officer Director Promoter Michael Diedrich 4884 Cliff Drive Rapid City SD SOUTH DAKOTA 57702 Executive Officer Director Promoter Christopher Diedrich 2946 S. Bannock Street Englewood CO COLORADO 80110 Executive Officer Director Promoter Other Technology Decline to Disclose 06b false 2017-03-01 false true false 0 750007 140003 610004 false 3 0 0 0 false Covered Insurance Solutions, Inc. /s/ Ross P. Diedrich Ross P. Diedrich President 2017-03-13