DOMNICK & SHEVIN PL

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-04-01
Business code	541110
Sponsor’s telephone number	5612290395
Plan sponsor’s address	11701 LAKE VICTORIA GARDENS AVE, SUITE 3201, PALM BEACH GARDENS, FL, 33410

Signature of

Role	Plan administrator
Date	2015-12-28
Name of individual signing	JEANNE KENNEDY
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-04-01
Business code	541110
Sponsor’s telephone number	5612290395
Plan sponsor’s address	11701 LAKE VICTORIA GARDENS AVE, SUITE 3201, PALM BEACH GARDENS, FL, 33410

Signature of

Role	Plan administrator
Date	2015-09-28
Name of individual signing	JEANNE KENNEDY
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-04-01
Business code	541110
Sponsor’s telephone number	5616305363
Plan sponsor’s address	11701 LAKE VICTORIA GARDENS AVE, SUITE 3201, PALM BEACH GARDENS, FL, 33410

Signature of

Role	Plan administrator
Date	2014-07-07
Name of individual signing	JEANNE KENNEDY
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-04-01
Business code	541110
Sponsor’s telephone number	5616305363
Plan sponsor’s address	5100 PGA BLVD. STE 317, PALM BEACH GARDENS, FL, 33418

Signature of

Role	Plan administrator
Date	2013-07-01
Name of individual signing	SEAN DOMNICK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-04-01
Business code	541110
Sponsor’s telephone number	5616305363
Plan sponsor’s address	5100 PGA BLVD STE 317, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address

Administrator’s EIN	320235677
Plan administrator’s name	DOMNICK & SHEVIN PL
Plan administrator’s address	5100 PGA BLVD STE 317, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number	5616305363

Signature of

Role	Plan administrator
Date	2012-07-09
Name of individual signing	SEAN DOMNICK
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-04-01
Business code	541110
Sponsor’s telephone number	5616305363
Plan sponsor’s address	5100 PGA BLVD STE 317, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address

Administrator’s EIN	320235677
Plan administrator’s name	DOMNICK & SHEVIN PL
Plan administrator’s address	5100 PGA BLVD STE 317, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number	5616305363

Signature of

Role	Plan administrator
Date	2011-08-10
Name of individual signing	SEAN DOMNICK
Valid signature	Filed with authorized/valid electronic signature