0001700167-18-000005.txt : 20180629 0001700167-18-000005.hdr.sgml : 20180629 20180628203719 ACCESSION NUMBER: 0001700167-18-000005 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180629 DATE AS OF CHANGE: 20180628 EFFECTIVENESS DATE: 20180629 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-307325 FILM NUMBER: 18926877 BUSINESS ADDRESS: STREET 1: 1177 GRANT STREET STREET 2: #302 CITY: DENVER STATE: CO ZIP: 80203 BUSINESS PHONE: 605-209-1062 MAIL ADDRESS: STREET 1: 1177 GRANT STREET STREET 2: #302 CITY: DENVER STATE: CO ZIP: 80203 D/A 1 primary_doc.xml X0708 D/A LIVE 0001700167 Covered Insurance Solutions, Inc. 1177 Grant Street #302 Denver CO COLORADO 80203 605-209-1062 SOUTH DAKOTA None None Corporation true 2016 Ross Diedrich 1177 Grant Street #302 Denver CO COLORADO 80203 Executive Officer Director Promoter Michael Diedrich 1177 Grant Street #302 Denver CO COLORADO 80203 Executive Officer Director Promoter Christopher Diedrich 1177 Grant Street #302 Denver CO COLORADO 80203 Executive Officer Director Promoter David Fitzgerald 1177 Grant Street #302 Denver CO COLORADO 80203 Director Other Technology Decline to Disclose 06b true 0001700167-18-000003 2018-02-23 false true true true true Promissory notes convertible into equity securities of the Issuer. false 0 1450000 1450000 0 false 16 0 0 0 false Covered Insurance Solutions, Inc. /s/ Ross P. Diedrich Ross P. Diedrich President 2018-06-28