0001700167-20-000001.txt : 20200710 0001700167-20-000001.hdr.sgml : 20200710 20200710132120 ACCESSION NUMBER: 0001700167-20-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200710 DATE AS OF CHANGE: 20200710 EFFECTIVENESS DATE: 20200710 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Covered Insurance Solutions, Inc. CENTRAL INDEX KEY: 0001700167 IRS NUMBER: 814512828 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-370719 FILM NUMBER: 201022686 BUSINESS ADDRESS: STREET 1: 1391 SPEER BLVD, STE 850 CITY: DENVER STATE: CO ZIP: 80204 BUSINESS PHONE: 605-209-1062 MAIL ADDRESS: STREET 1: 1391 SPEER BLVD, STE 850 CITY: DENVER STATE: CO ZIP: 80204 D 1 primary_doc.xml X0708 D LIVE 0001700167 Covered Insurance Solutions, Inc. 1391 SPEER BLVD, STE 850 DENVER CO COLORADO 80204 605-209-1062 DELAWARE None None Corporation true 2016 Ross Diedrich 1391 Speer Blvd, Ste 850 Denver CO COLORADO 80204 Executive Officer Director Promoter Michael Diedrich 1391 Speer Blvd, Ste 850 Denver CO COLORADO 80204 Executive Officer Director Promoter Christopher Diedrich 1391 Speer Blvd, Ste 850 Denver CO COLORADO 80204 Executive Officer Director Promoter David Fitzgerald 1391 Speer Blvd, Ste 850 Denver CO COLORADO 80204 Director Michael Sandler 1391 Speer Blvd, Ste 850 Denver CO COLORADO 80204 Director Other Technology Decline to Disclose 06b false 2020-06-29 false true true false 0 86989 86989 0 Total Offering Amount represents the purchase price of the warrant and amount receivable by the Issuer upon the exercise of the warrant to purchase capital stock of the Issuer. The warrant has not yet been exercised. false 1 0 0 0 false Covered Insurance Solutions, Inc. /s/ Ross P. Diedrich Ross P. Diedrich President 2020-07-10