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  5. BAY PINES FOUNDATION, INC,

BAY PINES FOUNDATION, INC,

Company Details

Entity Name: BAY PINES FOUNDATION, INC,
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 22 Dec 1989 (35 years ago)
Document Number: N35919
FEI/EIN Number 593018477
Address: Dept. of Veterans Affairs Healthcare Syste, 10,000 BAY PINES BLVD, BAY PINES, FL, 33744, US
Mail Address: P.O. BOX 416, BAY PINES, FL, 33744, US
ZIP code: 33744
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BAY PINES FOUNDATION INC. 401(K) PLAN 2023 593018477 2024-09-01 BAY PINES FOUNDATION INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-04-01
Business code 621112
Sponsor’s telephone number 7273178176
Plan sponsor’s address 10000 BAY PINES BLVD, BLDNG 22, ROOM 115, BAY PINES, FL, 33744

Signature of
Role Plan administrator
Date 2024-09-01
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature
BAY PINES FOUNDATION INC. 401(K) PLAN 2022 593018477 2023-07-06 BAY PINES FOUNDATION INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-04-01
Business code 621112
Sponsor’s telephone number 7273178176
Plan sponsor’s address 10000 BAY PINES BLVD, BLDNG 22, ROOM 115, BAY PINES, FL, 33744

Signature of
Role Plan administrator
Date 2023-07-06
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature
BAY PINES FOUNDATION INC 401(K) PROFIT SHARING PLAN & TRUST 2011 593018477 2012-06-19 BAY PINES FOUNDATION, INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 541700
Sponsor’s telephone number 7273986661
Plan sponsor’s address P.O. BOX 416, BAY PINES, FL, 337440416

Plan administrator’s name and address
Administrator’s EIN 593018477
Plan administrator’s name BAY PINES FOUNDATION, INC
Plan administrator’s address P.O. BOX 416, BAY PINES, FL, 337440416
Administrator’s telephone number 7273986661

Signature of
Role Plan administrator
Date 2012-06-19
Name of individual signing DALE LOOYENGOED
Valid signature Filed with authorized/valid electronic signature
BAY PINES FOUNDATION INC 401 K PROFIT SHARING PLAN TRUST 2010 593018477 2011-06-28 BAY PINES FOUNDATION, INC 15
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 541700
Sponsor’s telephone number 7273986661
Plan sponsor’s address BLDG 22 ROOM 114, 10000 BAY PINES BLVD., ST PETERSBURG, FL, 33708

Plan administrator’s name and address
Administrator’s EIN 593018477
Plan administrator’s name BAY PINES FOUNDATION, INC
Plan administrator’s address BLDG 22 ROOM 114, 10000 BAY PINES BLVD., ST PETERSBURG, FL, 33708
Administrator’s telephone number 7273986661

Signature of
Role Plan administrator
Date 2011-06-28
Name of individual signing BAY PINES FOUNDATION, INC
Valid signature Filed with authorized/valid electronic signature
BAY PINES FOUNDATION INC 401 K PROFIT SHARING PLAN TRUST 2010 593018477 2011-07-25 BAY PINES FOUNDATION, INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 541700
Sponsor’s telephone number 7273986661
Plan sponsor’s address BLDG 22 ROOM 114, 10000 BAY PINES BLVD., ST PETERSBURG, FL, 33708

Plan administrator’s name and address
Administrator’s EIN 593018477
Plan administrator’s name BAY PINES FOUNDATION, INC
Plan administrator’s address BLDG 22 ROOM 114, 10000 BAY PINES BLVD., ST PETERSBURG, FL, 33708
Administrator’s telephone number 7273986661

Signature of
Role Plan administrator
Date 2011-07-25
Name of individual signing BAY PINES FOUNDATION, INC
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Mahaney Caitlin A Agent Dept. of Veterans Affairs Healthcare Syste, BAY PINES, FL, 33744

Director

Name Role Address
Elamin Elamin MMD Director 10000 Bay Pines Blvd., Bay Pines, FL, 33744
Cao Kimberly Director 10000 Bay Pines Blvd., Bay Pines, FL, 33744
Spayde Richard J Director 10000 Bay Pines Blvd., Bay Pines, FL, 33744
Webb Jennifer Director 10000 Bay Pines Blvd., Bay Pines, FL, 33744
Russo Paul Director 10000 Bay Pines Blvd., Bay Pines, FL, 33744

Exec

Name Role Address
Mahaney Caitlin Exec 10000 Bay Pines Blvd., Bay Pines, FL, 33744

Events

Event Type Filed Date Value Description
AMENDMENT 2012-11-13 No data No data
AMENDMENT AND NAME CHANGE 2004-04-19 BAY PINES FOUNDATION, INC, No data

Related by officers

Webb Jennifer

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Russo Paul

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Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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