Detail by Officer/Registered Agent Name

Florida Profit Corporation

HOSPITAL MEDICAL STAFF SELF-INSURANCE TRUST, INC

Filing Information
J19144 65-6002372 06/12/1986 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/16/2005 NONE
Principal Address
C/O AON RISK SERVICES, INC. OF FLORIDA
1001 BRICKELL BAY DR., SUITE 1100
MIAMI, FL 33131

Changed: 10/28/1998
Mailing Address
C/O AON RISK SERVICES, INC. OF FLORIDA
1001 BRICKELL BAY DR., SUITE 1100
MIAMI, FL 33131

Changed: 10/28/1998
Registered Agent Name & Address AON RISK SERVICES, INC. OF FLORIDA
1001 BRICKELL BAY DR.
SUITE 1100
MIAMI, FL 33131

Name Changed: 10/28/1998

Address Changed: 10/28/1998
Officer/Director Detail Name & Address

Title ST

ALDRICH, JOSE J.
2645 SW 37TH AVE.
MIAMI, FL

Title D

BAXTER, ALAN J
10261 SW 128 ST
MIAMI, FL

Title C

SCHEINER, MONROE L.
9000 CORAL REEF DR.
MIAMI, FL

Annual Reports
Report YearFiled Date
2002 04/02/2002
2003 04/21/2003
2004 04/29/2004