PEDIATRIC HEALTH ASSOCIATES PC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	597 FARMINGTON AVENUE, STE 1, HARTFORD, CT, 061053030

Signature of

Role	Plan administrator
Date	2024-08-18
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	597 FARMINGTON AVENUE, STE 1, HARTFORD, CT, 061053030

Signature of

Role	Plan administrator
Date	2023-11-03
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	576 FARMINGTON AVENUE, HARTFORD, CT, 06105

Signature of

Role	Plan administrator
Date	2022-05-25
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	597 FARMINGTON AVENUE, HARTFORD, CT, 06105

Signature of

Role	Plan administrator
Date	2021-10-19
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	576 FARMINGTON AVENUE, HARTFORD, CT, 06105

Signature of

Role	Plan administrator
Date	2020-10-15
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	576 FARMINGTON AVENUE, HARTFORD, CT, 06105

Signature of

Role	Plan administrator
Date	2019-10-18
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	576 FARMINGTON AVENUE, HARTFORD, CT, 06105

Signature of

Role	Plan administrator
Date	2018-07-05
Name of individual signing	DHINGRA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2016-01-01
Business code	621111
Sponsor’s telephone number	8602664477
Plan sponsor’s address	576 FARMINGTON AVENUE, HARTFORD, CT, 06105

Signature of

Role	Plan administrator
Date	2017-07-14
Name of individual signing	SACHIN DHINGRA
Valid signature	Filed with authorized/valid electronic signature