2024-11-07T19:27:08-06:00 2023-12-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS RD STE 1500 RALEIGH NC 27609 990 2023-01-01 270057453 CRUDEN BAY RISK RETENTION GROUP INC CRUD 8023712212 126 COLLEGE STREET 300 BURLINGTON VT 05401 WILLIAM W HIGGINBOTHAM II ASSISTANT TREASURER 9046975880 2024-11-07 1 0 J CALVIN MARKS P01226973 9197196400 2023 2024-10-15 13:58:12Z X RODNEY MCKENDREE 126 COLLEGE STREET 300 BURLINGTON VT 05401 10432401 0 X N/A X 2003 VT PROVISION OF INSURANCE COVERAGE 4 1 0 0 0 0 0 0 3310000 3690000 2839537 2488150 0 0 6149537 6178150 0 0 4642300 5974466 0 0 0 0 0 343907 389210 4986207 6363676 1163330 -185526 16643132 18330052 13226066 16387285 3417066 1942767 CRUDEN BAY PROVIDES MEDICAL PROFESSIONAL LIABILITY COVERAGE AND DIRECTORS AND OFFICERS LIABILITY COVERAGE. 0 0 6183357 3690000 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. 6183357 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 (TO AUG '23) 0.00 0.00 X X 0 1617233 65893 RODNEY MCKENDREE PRESIDENT AND TREASURER 1.00 42.00 X X 0 1248488 180251 DR MICHAEL ERHARD DIRECTOR (FROM AUG '23) 2.00 43.00 X 0 1005928 159561 LAURA KOWAL DIRECTOR (FROM AUG '23) 2.00 42.00 X 0 603012 88826 JOHN LORD PRESIDENT AND DIRECTOR (TO AUG '23) 2.00 15.00 X X 0 153931 0 RYAN GADAPEE SECRETARY AND DIRECTOR (FROM AUG '23) 2.00 X X 0 0 0 JEFFREY P JOHNSON SECRETARY AND DIRECTOR (TO (AUG '23) 2.00 X X 0 0 0 WILLIAM W HIGGINBOTHAM II ASSISTANT TREASURER 3.00 45.00 X 0 520224 96529 0 5148816 591060 0 0 1 0 0 PREMIUMS EARNED 524292 3690000 3690000 3690000 488006 488006 6254395 4254251 2000144 2000144 2000144 6178150 3690000 0 2488150 5974466 5974466 74250 74250 10500 10500 32710 32710 45647 45647 6491 6491 1022 1022 15464 15464 PREMIUM TAX EXPENSE 182030 182030 REGULATORY AND LICENSE 20370 20370 726 726 6363676 6183357 180319 0 20850 553957 833236 1310397 3087 15705771 16385076 80188 80622 16643132 18330052 1381636 1688615 11844430 14698670 13226066 16387285 X 3417066 1942767 3417066 1942767 16643132 18330052 -185526 -1288773 0 X 0 1 X 1 0 X X 1 THE NEMOURS FOUNDATION 590634433 3 1 0 6363676 1 0 6363676 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 LOSSES & LOSS EXPENSE RESERVES 14698670 14698670 X 4843730 -1288773 -1288773 6132503 45647 45647 6178150 6318029 0 6318029 45647 45647 6363676 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. 1 1 0 0 0 0 0 0 0 ROBERT D BRIDGES TREASURER AND DIRECTOR (TO AUG '23) 0 34961 0 285493 0 1296779 0 34743 0 31150 0 1683126 0 406009 RODNEY MCKENDREE PRESIDENT AND TREASURER 0 822072 0 289940 0 136476 0 130220 0 50031 0 1428739 0 134169 DR MICHAEL ERHARD DIRECTOR (FROM AUG '23) 0 676645 0 236833 0 92450 0 104426 0 55135 0 1165489 0 62595 LAURA KOWAL DIRECTOR (FROM AUG '23) 0 462316 0 121463 0 19233 0 46142 0 42684 0 691838 0 0 WILLIAM W HIGGINBOTHAM II ASSISTANT TREASURER 0 362922 0 108939 0 48363 0 42700 0 53829 0 616753 0 39425 JOHN LORD PRESIDENT AND DIRECTOR (TO AUG '23) 0 0 0 0 0 153931 0 0 0 0 0 153931 0 0 PART I, LINES 4A-B IN 2023, THE FOLLOWING WE PAID SEVERANCE FROM THE NEMOURS FOUNDATION: ROBERT D. BRIDGES $772,332 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 2023, THE FOLLOWING WERE PAID FROM THE SERP: RODNEY MCKENDREE $134,169 MICHAEL ERHARD MD $62,595 WILLIAM W. HIGGINBOTHAM II $39,425 ROBERT D. BRIDGES $406,009 FORM 990, PART VI, SECTION A, LINE 3 CRUDEN BAY'S MANAGEMENT DUTIES ARE DELEGATED TO AMETHYST CAPTIVE INSURANCE SOLUTIONS. 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) N/A 0 ALFRED I DUPONT TRUST UA 510 ALFRED I DUPONT PLACE JACKSONVILLE FL 32202 596122734 FOUNDATION FL 501(C)(3) PF ALFRED I DUPONT CHARITABLE TRUST 0 SDP SPECIAL SITUATIONS LLC - SERIES M 1350 BAYSHORE HWY STE 905 BURLINGAME CA 94010 874437426 INVESTMENTS CA ALFRED I DUPONT CHARITABLE TRUST INVES-EXCLUDED 0 0 JMK MK SIDE CAR LP 261 MADISON AVE 9TH FLOOR NEW YORK NY 10016 832986453 INVESTMENTS NY ALFRED I DUPONT CHARITABLE TRUST INVES-EXCLUDED 0 0 SEACREST NCS FUND LP VICTORIA PLACE 31 VICTORIA ST HAMILTON BD HM 10 981372477 INVESTMENTS BD ALFRED I DUPONT CHARITABLE TRUST INVES-EXCLUDED 0 0 ATALAYA AIF COINVESTMENT FUND LP ONE ROCKEFELLER PLAZA 32ND FLOOR NEW YORK NY 10020 932752137 INVESTMENTS NY ALFRED I DUPONT CHARITABLE TRUST INVES-EXCLUDED 0 0 MEREWETHER CYCLICALS OPPORTUNITIES FUND LP 1900 N PEARL ST STE 2175 DALLAS TX 75201 884077024 INVESTMENTS TX ALFRED I DUPONT CHARITABLE TRUST INVES-EXCLUDED 0 0 NEUBERGER BERMAN SHORT DURATION EMERGING MARKET DEBT FUND LLC 190 SOUTH LASALLE ST STE 2400 CHICAGO IL 60603 472100194 INVESTMENTS IL THE NEMOURS FOUNDATION INVES-EXCLUDED 0 0 SPRINTS CAPITAL FLINT LP EAST WING TRAFALGAR COURT LES BANQUES ST. PETER PORT GK GYI 3PP INVESTMENTS GK ALFRED I DUPONT CHARITABLE TRUST INVES-EXCLUDED 0 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