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Florida
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59-3359111
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(State
or other jurisdiction of
incorporation
or organization)
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(I.R.S.
Employer
Identification
No.)
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Title
Of Each
Class
Of
Securities
To Be
Registered
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Amount
To Be
Registered(1)
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Proposed
Maximum
Offering
Price
Per
Share(2)
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Proposed
Maximum
Aggregate
Offering
Price(2)
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Amount
Of
Registration
fee(2)
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Common
Stock,
$.10
par value per share
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250,000 shares
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$36.12
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$9,030,000
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$966.21
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| FPIC INSURANCE GROUP, INC. | ||
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(Registrant) |
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/s/ John R. Byers
John R. Byers President and Chief Executive
Officer
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||
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(Signature)
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(Title)
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(Date)
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/s/
John R. Byers
John
R. Byers
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President,
Chief Executive Officer and Director (Principal Executive
Officer)
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December 21,
2005
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/s/
Kim D. Thorpe
Kim
D. Thorpe
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Executive
Vice President and Chief Financial Officer (Principal Financial
Officer
and Principal Accounting Officer)
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December
21, 2005
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(Signature)
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(Title)
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(Date)
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/s/
Robert O. Baratta, M.D.
Robert
O. Baratta, M.D.
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Chairman
of the Board
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December
21, 2005
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/s/
Kenneth M. Kirschner
Kenneth
M. Kirschner
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Vice
Chairman
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December
21, 2005
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/s/
John K. Anderson, Jr.
John
K. Anderson, Jr.
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Director
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December
21, 2005
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/s/
Richard J. Bagby, M.D.
Richard
J. Bagby, M.D.
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Director
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December
21, 2005
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|
|
|
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/s/
M. C. Harden, III
M.
C. Harden, III
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Director
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December
21, 2005
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|
|
|
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/s/
Terence P. McCoy, M.D.
Terence
P. McCoy, M.D.
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Director
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December
21, 2005
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|
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/s/
John G. Rich
John
G. Rich
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Director
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December
21, 2005
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/s/
Joan D. Ruffier
Joan
D. Ruffier
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Director
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December
21, 2005
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|
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/s/
Guy T. Selander, M.D.
Guy
T. Selander, M.D.
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Director
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December
21, 2005
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|
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|
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/s/
David M. Shapiro, M.D.
David
M. Shapiro, M.D.
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Director
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December
21, 2005
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|
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| DEFINED CONTRIBUTION PLAN | ||
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(The
Plan) |
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/s/ John R. Byers
John R. Byers President and Chief Executive
Officer
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||
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Exhibit
Number
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Description
of Exhibit
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4
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Defined
Contribution Plan*
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