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GENERAL INFORMATION <br /> Name of Plan: City of St. Anthony Premium Conversion Plan <br /> Plan Sponsor: City of St. Anthony <br /> 3301 Silver Lake Road <br /> St. Anthony, MN 55418 <br /> Plan Administrator: City of St. Anthony <br /> 3301 Silver Lake Road <br /> 612-789-8881 <br /> Employer Identification Number: 41-6005512 <br /> Plan Number: 501 <br /> Type of Plan: The Premium Conversion Plan is a cafeteria plan <br /> under Section 125 of the Internal Revenue Code, allowing a choice <br /> between cash and certain qualified benefits. <br /> Plan Year: January 1, 1991 through December 31, 1991 <br /> Funding: The Plan is funded entirely through the general assets <br /> of the employer. Medical, dental and group term life benefits <br /> are provided through insurance contracts. <br /> For questions or service of legal process contact: <br /> Thomas Burt <br /> City of St. Anthony <br /> 3301 Silver Lake Road <br /> St. Anthony, MN 55418 <br /> 612-789-8881 <br /> • <br /> 6 <br />