GENERAL THORACIC SURGEONS OF CONNECTICUT, P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621399
Sponsor’s telephone number	2037873488
Plan sponsor’s address	330 ORCHARD STREET, SUITE 300, NEW HAVEN, CT, 06511

Plan administrator’s name and address

Administrator’s EIN	061579180
Plan administrator’s name	GENERAL THORACIC SURGEONS OF CONNECTICUT, P.C.
Plan administrator’s address	330 ORCHARD STREET, SUITE 300, NEW HAVEN, CT, 06511
Administrator’s telephone number	2037873488

Signature of

Role	Plan administrator
Date	2010-09-30
Name of individual signing	MICHAEL FEDERICO
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2010-09-30
Name of individual signing	MICHAEL FEDERICO
Valid signature	Filed with authorized/valid electronic signature