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SCPIE MANAGEMENT COMPANY

SCPIE MANAGEMENT COMPANY

Company Details

Entity Name:	SCPIE MANAGEMENT COMPANY
Jurisdiction:	Illinois
Entity Type:	Corporation - Foreign BCA
Status:	Revoked
Date Formed:	13 Feb 1998
Company Number:	CORP_59803352
File Number:	59803352
Type of Business:	Business Corporations
Date Status Change:	01 Jul 1999
Place of Formation:	CALIFORNIA

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

FREEPORT PEDIATRICS, S.C. PROFIT SHARING PLAN

2011

363905486

2013-01-10

FREEPORT PEDIATRICS, S.C.

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	621111
Sponsor’s telephone number	8152359233
Plan sponsor’s address	750 S. KIWANIS DR., SUITE 209, FREEPORT, IL, 61032

Plan administrator’s name and address

Administrator’s EIN	363905486
Plan administrator’s name	FREEPORT PEDIATRICS, S.C.
Plan administrator’s address	750 S. KIWANIS DR., SUITE 209, FREEPORT, IL, 61032
Administrator’s telephone number	8152359233

Signature of

Role	Plan administrator
Date	2013-01-10
Name of individual signing	PRASAD THOMAS
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2013-01-10
Name of individual signing	PRASAD THOMAS
Valid signature	Filed with authorized/valid electronic signature

FREEPORT PEDIATRICS, S.C. PROFIT SHARING PLAN

2010

363905486

2011-12-19

FREEPORT PEDIATRICS, S.C.

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	621111
Sponsor’s telephone number	8152359233
Plan sponsor’s address	750 S. KIWANIS DR., SUITE 209, FREEPORT, IL, 61032

Plan administrator’s name and address

Administrator’s EIN	363905486
Plan administrator’s name	FREEPORT PEDIATRICS, S.C.
Plan administrator’s address	750 S. KIWANIS DR., SUITE 209, FREEPORT, IL, 61032
Administrator’s telephone number	8152359233

Signature of

Role	Plan administrator
Date	2011-12-19
Name of individual signing	PRASAD THOMAS
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2011-12-19
Name of individual signing	PRASAD THOMAS
Valid signature	Filed with authorized/valid electronic signature

FREEPORT PEDIATRICS, S.C. PROFIT SHARING PLAN

2009

363905486

2011-01-13

FREEPORT PEDIATRICS, S.C.

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1990-01-01
Business code	621111
Sponsor’s telephone number	8152359233
Plan sponsor’s address	750 S. KIWANIS DR., SUITE 209, FREEPORT, IL, 61032

Plan administrator’s name and address

Administrator’s EIN	363905486
Plan administrator’s name	FREEPORT PEDIATRICS, S.C.
Plan administrator’s address	750 S. KIWANIS DR., SUITE 209, FREEPORT, IL, 61032
Administrator’s telephone number	8152359233

Signature of

Role	Plan administrator
Date	2011-01-13
Name of individual signing	PRASAD THOMAS
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2011-01-13
Name of individual signing	PRASAD THOMAS
Valid signature	Filed with authorized/valid electronic signature

Agent

Name and Address	Role	Appointment Date
ILLINOIS CORPORATION SERVICE C, 700 S 2ND STREET, SPRINGFIELD, 62703, SANGAMON	Agent	1998-02-13

President

Name and Address	Role
DONALD J ZUK, 1813 POINSETTIA LN, MANHATTAN BEACH CA 90266	President

Shares

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMMON	No data	Voting Rights	75000	10000000	1

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State