2023-11-01T11:02:33-05:00 2022-12-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS RD STE 1500 RALEIGH NC 27609 990 2022-01-01 270057453 CRUDEN BAY RISK RETENTION GROUP INC CRUD 8023712212 135 ALLEN BROOKE LANE SE 101 WILLISTON VT 05495 WILLIAM W HIGGINBOTHAM II ASSISTANT TREASURER 9046975880 2023-10-31 1 WILLIAM HIGGINBOTHAM II 999009999 0 J CALVIN MARKS P01226973 9197196400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOHN LORD 10140 CENTURION PKWY NORTH JACKSONVILLE FL 32256 10018132 0 X N/A X 2003 VT PROVISION OF INSURANCE COVERAGE 4 1 0 0 0 0 0 0 3220000 3310000 2828862 2839537 0 0 6048862 6149537 0 0 3070127 4642300 0 0 0 0 0 374391 343907 3444518 4986207 2604344 1163330 20126037 16643132 13201857 13226066 6924180 3417066 CRUDEN BAY PROVIDES MEDICAL PROFESSIONAL LIABILITY COVERAGE AND DIRECTORS AND OFFICERS LIABILITY COVERAGE. 0 0 4828211 3310000 CRUDEN BAY WAS FORMED TO SUPPORT THE NEMOURS FOUNDATION BY PROVIDING MEDICAL PROFESSIONAL LIABILITY INSURANCE TO NEMOURS PHYSICIANS AND SURGEONS IN FLORIDA, PENNSYLVANIA, AND NEW JERSEY. CRUDEN BAY ALSO PROVIDES MEDICAL PROFESSIONAL LIABILITY INSURANCE FOR CERTIFIED REGISTERED NURSE PRACTITIONERS IN PENNSYLVANIA AND DIRECTORS AND OFFICERS LIABILITY COVERAGE TO MEMBERS OF THE ASSOCIATION EXECUTIVE COUNCIL. 4828211 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 1 0 0 1 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X WILLIAM W HIGGINBOTHAM II 9046975880 10140 CENTURIAN PKWY NORTH JACKSONVILLE FL 32256 ROBERT D BRIDGES TREASURER AND DIRECTOR 1.00 46.00 X X 0 1304834 209863 RODNEY MCKENDREE DIRECTOR 2.00 42.00 X 0 1167653 179616 JOHN LORD PRESIDENT AND DIRECTOR 2.00 15.00 X X 0 153510 0 JEFFREY P JOHNSON SECRETARY AND DIRECTOR 2.00 X X 0 0 0 WILLIAM W HIGGINBOTHAM II ASSISTANT TREASURER 2.00 46.00 X 0 467255 99054 0 3093252 488533 0 0 1 0 0 PREMIUMS EARNED 524292 3310000 3310000 3310000 324171 324171 6383961 3868595 2515366 2515366 2515366 6149537 3310000 0 2839537 4642300 4642300 50000 50000 10600 10600 33300 33300 49608 49608 15000 15000 748 748 PREMIUM TAX EXPENSE 163296 163296 REGULATORY AND LICENSE 7615 7615 13740 13740 4986207 4828211 157996 0 87803 20850 1986991 833236 3087 17992888 15705771 58355 80188 20126037 16643132 1446085 1381636 11755772 11844430 13201857 13226066 X 6924180 3417066 6924180 3417066 20126037 16643132 1163330 -4670444 0 X 0 1 X 1 0 X X 1 THE NEMOURS FOUNDATION 590634433 3 1 0 4986207 1 0 4986207 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 LOSSES & LOSS EXPENSE RESERVES 11844430 11844430 X 1429485 -4670444 -4670444 6099929 49608 49608 6149537 4936599 0 4936599 49608 49608 4986207 PART X, LINE 2: CRUDEN BAY RECEIVED EXEMPTION FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. CRUDEN BAY HAS NOT TAKEN ANY UNCERTAIN TAX POSITIONS THAT WOULD JEOPARDIZE ITS FEDERAL INCOME TAX EXEMPTION STATUS. 0 1 0 0 0 0 0 0 0 ROBERT D BRIDGES TREASURER AND DIRECTOR 0 761337 0 241520 0 301977 0 155161 0 54702 0 1514697 0 298413 RODNEY MCKENDREE DIRECTOR 0 775922 0 198572 0 193159 0 128069 0 51547 0 1347269 0 190837 WILLIAM W HIGGINBOTHAM II ASSISTANT TREASURER 0 349255 0 74191 0 43809 0 43235 0 55819 0 566309 0 35279 JOHN LORD PRESIDENT AND DIRECTOR 0 153510 0 0 0 0 0 0 0 0 0 153510 0 0 PART I, LINE 4B THE NEMOURS FOUNDATION MAINTAINED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") FOR MOST OF THE MEMBERS OF THE NEMOURS EXECUTIVE TEAM AS DETERMINED BY THE BOARD OF DIRECTORS. THE SERP PROVIDES EACH PARTICIPANT AN EMPLOYER PROVIDED ANNUAL "FLEXIBLE" BENEFIT ALLOWANCE IN THE FORM OF DOLLAR CREDITS WHICH THE PARTICIPANT MAY APPLY TO ANY OF THE BENEFITS OFFERED UNDER THE PLAN WHICH INCLUDE INDIVIDUAL LONG-TERM DISABILITY INSURANCE, AND UNFUNDED NONQUALIFIED DEFERRED COMPENSATION BENEFITS SUBJECT TO IRC SECTION 457(F). UNDER THE PLAN, EACH OF THE PARTICIPANTS MAKES AN ANNUAL ELECTION ALLOCATING HIS OR HER FLEXIBLE BENEFIT ALLOWANCE FOR THE UPCOMING YEAR AMONG THE COMPONENT BENEFITS. THE AMOUNT OF THE FLEXIBLE BENEFIT ALLOWANCE MAY VARY AMOUNG THE PARTICIPANTS AS DETERMINED BY NEMOURS AND NEMOURS MAY DISCONTINUE THE FLEXIBLE BENEFIT ALLOWANCES AT ANY TIME. IN 2022, THE FOLLOWING WERE PAID FROM THE SERP: ROBERT D. BRIDGES $298,413 RODNEY MCKENDREE $190,837 WILLIAM W. HIGGINBOTHAM II $35,279 FORM 990, PART VI, SECTION A, LINE 3 CRUDEN BAY'S MANAGEMENT DUTIES ARE DELEGATED TO QUEST. HOWEVER, CRUDEN BAY IS UNDER CONTROL OF ITS SUPPORTED ORGANIZATION, THE NEMOURS FOUNDATION, THROUGH GOVERNANCE. FORM 990, PART VI, SECTION A, LINE 6 CRUDEN BAY HAS TWO MEMBERS, THE NEMOURS FOUNDATION AND ASSOCIATION OF NEMOURS' EXECUTIVE COUNCIL MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE NEMOURS FOUNDATION, AS THE SOLE CLASS A MEMBER OF CRUDEN BAY, HAS THE RIGHT TO ELECT AT LEAST 3 CLASS A DIRECTORS. THE ASSOCIATION OF NEMOURS' EXECUTIVE COUNCIL MEMBERS, AS THE SOLE CLASS B MEMBER OF CRUDEN BAY, HAS THE RIGHT TO ELECT 1 CLASS B DIRECTOR. FORM 990, PART VI, SECTION A, LINE 8B CRUDEN BAY DOES NOT HAVE ANY COMMITTEES OF ITS BOARD OF DIRECTORS. HOWEVER, THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR A THOROUGH REVIEW. IN ADDITION TO THE REVIEW PERFORMED BY THE BOARD OF DIRECTORS, THE 990 WAS REVIEWED BY USA RISK GROUP OF VERMONT. FORM 990, PART VI, SECTION B, LINE 12C CRUDEN BAY MONITORS AND ENFORCES COMPLIANCE BY REVIEWING THE CONFLICT OF INTEREST STATEMENTS AT THE ANNUAL BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 19 CRUDEN BAY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE NEMOURS FOUNDATION 10140 CENTURION PARKWAY NORTH JACKSONVILLE FL 32256 590634433 PEDIATRIC HEALTH CARE AND HEALTH EDUCATION FL 501(C)(3) LINE 3 HOSPITAL N/A 0 PEDIATRIC MEDICAL SERVICES OF FLORIDA 9145 NARCOOSSEE ROAD ORLANDO FL 32827 453584225 PEDIATRIC HEALTH CARE FL 501(C)(3) 509(A)(2) THE NEMOURS FOUNDATION 0 NEMOURS NEW JERSEY PHYSICIAN PRACTICE PC 1801 ROCKLAND ROAD WILMINGTON DE 19803 463160718 PEDIATRIC HEALTH CARE FL 501(C)(3) 509(A)(2) THE NEMOURS FOUNDATION 0 ALFRED I DUPONT CHARITABLE TRUST 510 ALFRED I DUPONT PLACE JACKSONVILLE FL 32202 590226560 INVESTING FOR CHARITABLE PURPOSES FL 501(C)(3) 509(A)(3) THE NEMOURS FOUNDATION 0 DORNOCH SUTHERLAND ASSURANCE LTD PO BOX 1085 GRAND CAYMAN CJ KY1-1102 980404800 CAPTIVE INSURANCE CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0