|
KIDS AND FAMILIES MEDICAL CLINIC 401(K) PLAN
|
2023
|
205715865
|
2024-01-25
|
KIDS AND FAMILIES MEDICAL CLINIC, LLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9047473800
|
| Plan sponsor’s
address |
12086 FORT CAROLINE ROAD, SUITE 404, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2024-01-25 |
| Name of individual signing |
CHRISTINE RIMER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
KIDS AND FAMILIES MEDICAL CLINIC 401(K) PLAN
|
2022
|
205715865
|
2023-05-27
|
KIDS AND FAMILIES MEDICAL CLINIC, LLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9047473800
|
| Plan sponsor’s
address |
12086 FORT CAROLINE ROAD, SUITE 404, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2023-05-27 |
| Name of individual signing |
CHRISTINE RIMER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
KIDS AND FAMILIES MEDICAL CLINIC 401(K) PLAN
|
2021
|
205715865
|
2022-08-19
|
KIDS AND FAMILIES MEDICAL CLINIC, LLC
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9047473800
|
| Plan sponsor’s
address |
12086 FORT CAROLINE ROAD, SUITE 404, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2022-08-19 |
| Name of individual signing |
CHRISTINE RIMER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
KIDS AND FAMILIES MEDICAL CLINIC 401(K) PLAN
|
2020
|
205715865
|
2021-05-13
|
KIDS AND FAMILIES MEDICAL CLINIC, LLC
|
13
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2012-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
9047473800
|
| Plan sponsor’s
address |
12086 FORT CAROLINE ROAD, SUITE 404, JACKSONVILLE, FL, 32225
|
Plan administrator’s name and address
| Administrator’s EIN |
474474775 |
| Plan administrator’s name |
GUIDELINE, INC. |
| Plan administrator’s
address |
3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403 |
| Administrator’s telephone number |
8882283491 |
Signature of
| Role |
Plan administrator |
| Date |
2021-05-13 |
| Name of individual signing |
CAROL HO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
