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?. ACTION AGENDA
Board of Trustses'af the Employees' Pension Fund
?}I -' Monday, April 4, 1984
9:00 A.M.
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1. Cali to order 1, 9:00 a.m.
2. Approval of Minutes. 29 ' Approved as.submitted.
of 2128194 . r .
Request for acceptance' 3. "Approved
,
into membership: .
a)' Deritangian Davis s
b) Daniel J. Rozzi
c) Carolyn L. Brink
d) David A. Desgro ;
e? Pawei W. Dembinski i
' f? David G. Nardin.
Regular Pension to be granted: 4. Granted.'
John Chester
I
5., Regular Pension to be granted:, 5. Granted.
Joan M: Stiers
6. 'Regular Pension to be granted: 6. Granted.
' Robert . C. Craft
i?
7. Non-Job-Connected Disability . 7. Granted.
Pension to' be granted: •I
Reba J.-Parker
.8. Other Business: S. Waived requirement for 3
members to vote on disability
9. Adjournment:
pensions.
9. 9:06 a.m.
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1fF'. 'AGENDA
'
Board of Trustees,
f the Employees' Pension Fund
Monday, April 4,1994
9:00 A-M:.
1,. • Call •to order .
2.. Approval of Minutes
of 2128194
3., Request for acceptance
into membership; ;
' a) Deritangian. Davis
b) • Daniel 'J. Rozzi.
c) Carolyn L. Brink 1
d) David A. Desgro
i
•
e) Pawel W. Dembinski
f) David G. Nardiri i
.4. Regular Pension to be granted:
' John Chester
5. Regular Pension to, be granted:
' Joan M. Suers '
6.. Regular Pension to be granted:
Robert C. Craft
7. Nan-Jots-Connected Disability
Pension to be granted:
Reba J. Parker
' 8 Other Business:
9. Adjournment:
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TRUSTEES OF THE EMPLOYEES' PENSION FUND Item #
Meeting Date: -4/A/94--
Agenda Cover Memorandum
:. Subject:
Membership in Employees' Pension Plan
Recommendation/Motion:
Employce(s) listed below he accepted into the Employees' Pension Plan as recommended by the
Pension Advisory Committee,
? and that the appropriate officials be authorized'to execute same.
BACKGROUND:
Seri iority Pension
Name aad Job Qloss Dent.lli-V1 D-01.Q Effecti-Yr, Date
Dcritangian `Davis, Library Asst. I Library 217188 1131194
Daniel J. Rozzi, Police Officer Police 317194 317194
Carolyn L. Brink, Sr. Staff Asst. City Manager 217194 217194
David A. Desgro, Survey Asst. I Pub. Wks./Eng. 2122194 2/22194
Pawel W. Dembinski, Drafting Tech. I Pub. Wks./Eng. 2122194 2122194
David G. Nardin, Senior Electrician Parks & Rec. 2122194 .2122/94
Page Reviewed by: Originating Dept: sts: Commission Action:
Human Resources Total
Legal NA ? Approved
?
Budget _ NA Approved w/conditions
Purchasing JJA User Dept.: Current FY ? Denied
Risk Mgmt. _NA ? Continued to:
CIS Funding Source:
ACM Advertised: ? Capt. imp.
Other NA Date: ? Operating
Paper: ? Other Attachments:
Not required
Submitted by: Affected parties Appropriation Code: Letter(s)
? Notified
® Not required ? None
Citv Manager
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' CITY OF CLEARWATER
EMPLOYEES' PENSION PLAN
PENSION ADVISORY COMMITTEE
TO:. Pension Trustees
FROM, Pension Advisory Committee
SUBJECT: Recommendation for Acceptance Into Pension P1nn•
' DATE: March 2, 1994
` As Trustees of the City of Clearwater Employees' Pension Fund, you are hereby notified thut the
employee(s) listed below have been duly examined by a local physician' and each has been
designated as a "first class risk".
These employees are eligible. for pension membership as noted in the Pension Eligibility Date
column below, and . it is, the recommendation of the Pension Advisory Committee that they be
accepted, into membership.
Pension Elig.
NaMg. Job. ,15, & DeWDiv. 11jl;Ih.Date Hire Dote I3?te
Pawel'.W. Dembinski, Drafting Technician I;, 6111156 2122/94 2122194
Public Works/Engineering
David G. Nardin, Senior Electrician, 8126163 2122194 2/22194
Parks & Recreation Department
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CITY OF..CLEARWATER {
'EMPLOYEES' PENSION' PLAN
PENSION ADVISORY COMMITTEE
T0. Pension Trustees)
FROM, Pension Advisory Committee
SUBJECT: Recommendation for Acceptance into Pension Ptah
DATE: February 16, 1994
AS Trustees of the City of -Clearwater Employees'. Pension Fund, you are hereby notified that the
employee(s) listed below have been duly examined by a local physician' and each has been
designated' as a "first class . risk".
These employees are eligible for pension membership as noted in the Pension Eligibility Date
column below, and it is the recommendation of the Pension Advisory Committee that they be
accepted into membership.
Pension Elig. I
awe.-Job. ClnSs. & Dept./Div. irk Date Hitg Date Da3c i
r
' Deritangian Davis, Library' Asst.. 1 9/6162 2/7/88 1131194
Library
" *Employee hired from permanent part-time j
to full-time permanent status. Hire date
reflects date 'hired 'as ' permanent part-time.
Daniel J. Rbzzi, Police, Officer, 711 316 S 3/7/94 317/94
Police Department !
Carolyn L. Brink, Senior Staff Assistant 10127/41 2/7/94 217/94 s
City Manager's Office
David A. Desgro, Survey Assistant 1, S/ 1 0/60 2/22/94 2/22/94 ?
Public Works/Engineering !
!
TRUSTEES OF THE EMPLOYEES' PENSION FUND Item #
Meeting Dale: 41.4/94
? Agenda Cover Memorandum
Subject:
Pension to be Granted.
Recommendation/Motion:
John Chester, Fire Prevention Inspector, Fire Department, be granted a regular pension under
Section(s) 2.396 of the Employees' Pension Plan as recommended by the Pension Advisory
Committee.
? and that- the appropriate officials be authorized to execute same.
BACKGROUND:
John Chester, Fire Prevention Inspector, Fire Department, was employed by the City on
August 27, 1973, and began participating in the Pension Plan on February 27, 1974. His retirement
will be effective on February 28, 1994, at the beginning of the day.
Mr. Chester's pension was approved by the Pension Advisory Committee at its meeting of
February 16, 1994. Based on an average salary of approximately $38,640' over the past five years
and the formula for computing; regular pensions, Mr. Chester's pension will approximate $19,320
annually. Charts from Finance which take into consideration mortality rates and age reflect t h e
"present value cost of financing" this pension will be approximately $188,622.
Note: When Mr. Chester was originally employed, pension deductions were riot taken for the first
six months and employees contributed to Social Security. When employees were given an option to
buy back their first six months of service, Mr. Chester chose not to exercise such option.
Page Reviewed by:
Legal _ _ N A
Budget _ NA
Purchasing _h[A
Risk Mgmt. -1-4A
CIS f.._NA
ACM
Other NA
Submitted by:
Originating Dept:
Human Resources,,,
User De
Advertised:
Date:
Paper:
? Not required
Affected parties
? Notified
? Not required
of s : ?
Total
%_ - i I%; pit V t
Funding Source:
? Capt. lanp.
? Operating
? Other Pension
Appropriation Code:
646.07410-51,0100.5R5,
Commission Action:
? Approved
? Approved wlconditions
? Denied
? Continual to:
Attachments:
Letter(s)
? None
Citv Manager
C' I T Y OF C L E A R W A T E R
POST OFFICE BOX 4746
CLEARWATER, FLORIDA 34 618.4748
Human Resourees Department
462.6070
'IY? Honorable Mayor and Members. of the City Commission as Trustees of the
Employees' Pension Plan
FROM: Pension Advisory Committee
COPIES: Debbie Bailey, Payroll Services Manager
Ernployee's File
SUBJECT: Regular Pension-John R. Chester
DATE: February 16, 1994
The Pension Advisory Committee received an application for regular pension from
John R. Chester 'on February 2, 1994.
Mr. Chester was employed by the City on August 27, 1973, and has been a participant in t h e
Pension Plan since February 27, 1974. The amount of Mr. Chester's pension will . be
computed by the Finance Department at such time as his last five years of service and salary
can be calculated.
By motion matte and duly carried at its meeting of February 16, 1994, the Pension Advisory
Committee approved/recommended a regular pension based on years of service for
John R, Chester in accordance with Section 2.396 of the City Code. This pension will be
effective on February 28, 1994, at the beginning of the clay.
I hereby certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension for John R. Chester and the above dates are correct.
Ch it an, NiTsion Advisory Committee
q*- I
'Equal Employment and Affirmative Action Employer''
PENSION REQUEST FORM
I. John R. Chester " do hereby apply for retirement
from the City of Clearwater General Employees' Pension Plan.
My benefits date is February 27, 1974 (Eatr elate into
Y P pension plan)
My date ' of hire is 'August 27, 1973
My birthday is September 13, 1942
my job classification is Fire Prevention inspector and I work
is the Fire Department. Division.
M y resignation date is February 27, 1994
The type of peasioa for which I am applying is (check only one):
x Regular Pension based an years of service
lob-connected Disability Pension
Non-job-connected Disability Pension
My spouse's name is: Laurie
Dependent children under the age of 13 and residing in my household are:
(Print Child's Full. Name) (Ch.(M's Date of Birth)
I hereby certify all of the above to be true and correct:
ignatura)
February 2, 1994
(Date) .
(Notary Public)
;10TARY PUBLIC STATE OF FLORMA
Illy '+• r
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i?rED THRUDGEHEM ins. Ui,Dy4
CITY OF CLEARWATER
GENERAL EMPLOYEES' PENSION PLAN
OPTIONS - FIREFIGHTERS
OPTION ?-1: Employees can receive a lump sum payment for ?
vacation and holiday pay and 1f2 of accrued sick leave
at the time. of separation from the City. There will be no
S`ro deduction for pension from this lump sum payment
nor will this amount count as earnings in' the
calculation of the pension. 'fhe last day of ' work' will be `
the termination date and pension benefits will begin
the following dav.
OPTION. Emolovee can extend termination date by the time due !
(Only available to for vacation, holiday pay, and 1J2 of accrued sick- 'leave.
employees hired 'Termination date will be the final day of extended time. ?
prior to 101113.3) Pension • benefits will begin the follow•inz dav.
3 ' - • M M M +. :{ s A ? M K y }[ xY .1 M ? ]r ff r ? • r ? y
t` Jahn R. Chester an _-mplovice of the City, of
Clearwater. hereby apply for pension benefits under the General Employees'
Pension Plan.
.l hereby certify that I fully understand the two options offered to me. I choose
to retire using Option n 1 and wish my bencius to be calculated under
this option.
I understand that once this form is signed, my decision is irrevocable.
Ei PLOYEE'S SIGNATURE.
4. Y
SOCIAL SECURITY 26 644376
AD SS:_ 29736 69th way North
Clearviater, FL 34521
C?' ,. ltr
r February 2, 19914
i DATE:
• i
TRUSTEES OF THE EMPLOYEES' PENSION FUND Item #?
Agenda Cover Memorandum Meeting Date: 4, _ Z4 24
Subject:
Pension to be Granted.
'Recommendation/Motion:
Joan M. Stiers, Groundskeeper I, Parks & Recreation Department, be granted a regular pension
under Section(s) 2.396 of the Employees' Pension Plan as recommended by the Pension Advisory
Committee,
? and that the appropriate officials be authorized 'to execute same.
BACKGROUND:
Joan M. Stiers, Groundskeeper [, Parks & Recreation Department, was employed by
the City on February 25, 1974, and began participating in the Pension Plan on that date. Her
retirement will be effective on March 2, 1995, at the beginning of the day,
Ms. Stiers' pension was ' approved by the Pension Advisory Committee at its meeting of February 16,
1.994. Based on an average salary of approximately ,$22,035 over the post five years and t h e
formula for computing regular pensions, Ms. Stiers' pension will approximate $11,568 annually.
Charts from Finance which take into consideration mortality rates and age reflect the "present
value cost of financing" this pension will be approximately $103,374.
Page Reviewed by: originating Dept: ' Costs: $103,374
Human Resot rc Total
Legal NA
Budget ?bIA _
Purchasing _NA User Dept.: Current FY
Risk Mgmt. _NA_
N
Cis Funding Source:
ACM Advertised: ? Capt. Imp.
Other NA Date: ? Operating
fY. Paper: ? Other Vendsin._
? Not requires!
Submitted by,. Affected parties Appropriation Code:
? Notified
? Not required 646-07410-5',Q100-585
Citv Manager
Commission Action:
? Approved
? Approved w/conditions
? Denied
? Continued to:
Attachments:
Letter(s)
? None
C I T.' Y. O F. -C L E .AI. R-W A T E R.
POST OFFICE BOX 47,46
CLEARWATER, FLORIDA 34618.4748
Human Resources Department
. .., 482.8870
T(Y Honorable . Mayor and Members of the City Commission as Trustees of the .
Employees' Pension Plan
FROM: Pension Advisory Committee
COPIES: Debbie Bailey; Payroll Services Manager
Employee's File ,
SUBJECT: Regular Pension----Joan M. Stiers
DATE:. February 16, 1994
The Pension Advisory Committee received an application for regular pension 'from
Joan M. Stiers on, February 14, 1994.
Ms. Stiers was employed by the City on February 25, 1974, and has been a participant in the
Pension Plan since that date. The amount of Ms. Stiers' pension will be computed by the
Finance Department at such time as her last five years of service and salary can be
calculated.
By motion made and duly carried at its meeting of February 16, 1994, the Pension Advisory
Committee approved/recommended a regular pension based on years of service for
Joan M. Stiers in accordance with Section 2.396 of the City Code. This pension will be
effective on March 2, 1995, at the beginning of the day.
I hereby certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension for Joan M. Stiers, and the above dates are correct.
C iai man, ension Advisory Committee
too
"Equal Ern ploymeni and_AfIIrmative Action Employer'
r 1,
PEYS10t REQUEST FORM
Joan M. St:iers
i• do hereby, apply for retirement
from the City. oz Clearwater General Empioyees' Pensio'a Plan.
My benefits date is February 25, 1974 (Entry date into pegs#an plan)
My date of. hire is February-25, 1974
My birthday is February 4, 1931
My job classirication is _ Groundskeeper z and F work
in tiro Parks & Recreation Department. Parks Division.
My resignation date is March 1, 1995
The type of pension for which F am applying 'is (check only one):
x Regular . Pension b:iscd on years of service
,Jot?-connected Disabilitl Pension
tyau•job-connected Disability Pension
My spouse's name is: George
Dependent children under the age of 18 and residing in my household are:
(Print C!Liid's Full ?` =e)
(Child's Late of Birth)
F hereby cermy all of the above to be true and correct
N\ (S azure)
krvary 14, 1994
(Dace)
( tart' ' Public)
NOTARY PUBLIC. STATE OF FLCMDA,
MY C014NIISSION EXPIRES. SEPT. 24. 1994.
¦OND90 THHU k%)TARY PUBLIC U140CRWAIYCM '
OPTIOLN =Z:.
(Only avnilatlle- to
employees hired-
prior to 1411190)
at the time of separation from the City. There will be no
S17o deducdc' n for pensioa from this lump sutra payment
nor will this amount count as earnings in the
calculation of the pension. . The last day of work will' be
the termination date and pension benefits 'will begin
the following day.
Employee can extcnd terminadoa date by the time clue
for : acztion. holiday pay, and ii2 of accrued sick. leave.
T ct•miitation date will `e :he final day at .ate^ded time.
Pension benefits will begirt the following day.
. ??? R Y R Y i Y Y R Y Y Y Y Y Y ? 111 R Y R Y R? '
I. Joan M. Suers an =ploycc of the City of
Clearwater, hereby apply for pension benefits under the Generai Employees'
P--psion Plan.
I hereby certify that l fully understand the two ootiaos offered to mc. l choose
a
to retire using Option and %vish :ray benefits to be calcuiated undo.
this option.
I understand. that once this form is signed. my decision is irrevocable.
ELWI,4YE)~'S SIGNATURE:-
SOCIAL SECURITY n: 088-24-0325
ADDRESS:_ 2250C Shelly Drive
Palm Harbor, FL 34684
f .
DATE' _ February 14, 1994 _
r
TRUSTEES OF THE EMPLOYEES' PENSION FUND
Agenda Cover Memorandurn
Item 0
Meeting Date: -Al
.1194
Subject:
Pension to be Granted,
Recommendation/Motion:
Robert C. Craft, Toll Facilities Supervisor, Marine Department, be granted a regular pension under
Section(s) 2.396 of the Employees' Pension Plan as recommended by the Pension Advisory
Committee.
? and that the appropriate officials be authorized to execute same.
BACKGROUND:
Robert C. Craft, Toll Facilities Supervisor, Marine Department, was employed by t h e
City on 'June 27, 1973, and began participating in the Pension Plan on December 27, 1973. His
retirement will be effective on September 9, 1994, at the beginning of the day.
Mr. Craft's pension was approved by the pension Advisory Committee at its meeting of February 16,
1994. Based on an average salary of approximately $29,871 over the past five years and t h e
formula for computing regular pensions, Mr. Craft's pension will approximate $15,458 annually.
Charts from Finance which take into consideration mortality rates and age reflect the "present
value cost of financing" this pension will be approximately $113,411.
Note: When Mr. Craft was originally employed, pension deductions were not taken for the first
six months. and employees contributed to Social Security. When employees were given an option to
buy back their first six months of service, Mr. Craft chose not to exercise such option.
Past Reviewed by:
Legal NA
Budget NA
Purchasing CIA
Risk Mgmt. --NA
AC `
CAS ?
A cz-.-
Other NA
Submitted by:
City M
r
Originating' Dept Costs: $113,41.11
Human Reso1urce / Total
t 1.
User Dept.:
Advertised:
Date:
Paper:
? Not required
Affected parties
? Notified
? Not required
Current FY
Funding Source:
? Capt. Imp.
? Operating
? Other eension _
Approprintion Code:
646-07410-53 IOQ 0-585
Commission Action:
? Approved
? Approved w/condit'ions
? Denied
? Continued to:
Attachments:
Letter(s)
? None
L.
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r"1!S•r .41. `'' ..9 '11 ?. •`•l4', ,.... ,. .s r.k •`F i .?'. .. i ;f, i ... ., '.S..
C I T Y O F, C .L E A R W A T•E R
POST, OFFICE BOX 4748
Ct_EARWATER, FLOR10A 34818.4748
Human Aesources Department
462-6870.
TID Honorable Mayor and Members of the' City Commission as Trustees of the
Employees' Pension Plan .
FROM: Pension - Advisory Committee
COPIES: Debbie Bailey, Payroll Services, Manager-
Employee's File
SUBJECT:' Regular Pension-Robert C. Craft
DATE: February 16, 1994
The Pension Advisory Committee received an application for regular pension from
Robert C. Craft on February 7, 1994.
Mr. Craft was employed by the City an June 27, 1973, and has been a participant in the
Pension Plan since December 27, 1973.. The amount of Mr. Craft's pension will be computed
by the Finance Department at such time as his last five years of service and salary can be
calculated.
By motion made and duly carried at its meeting of February 16,1994, the Pension Advisory
Committee approved/recommended a regular pension based on years of service for
Robert C. Craft in accordance with Section 2,396 of the City Code. This pension will be
effective on September 9, 1994, at the beginning of the day.
I hereby 'certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension for Robert C.' Craft and the, above dates are correct,
Chaff n, " Pen. o Advisory Committee
I "Equal Employment and Affirmative Action Employer''
---r -rr•1 ??• IV?liblALb11L
from the City of Clearwater General Employees' Pension Plan.
?
My benefits date is December 27, 1973 ? .Fairy, date into pension plan)
My date) of lure is dune 27, 1973
My, birthday is November l• 1929
°.• . • qty job classification is Toll FacilitiesSupervisor
_,.aad I work
4 is the marine Department.
. , Division,
M 'Y resignation date is Sept, 8, 1994
The type of pension for which I am applying is (check only one):
x Regular Pension based' on years of service
Job-connected Disability Pension
Non-job-coanected . Disability Pension
qty spouse's name is: Lillian Mary
Dependent children tinder the age of 18 gad residing in my household are:
(P-.:nt Qild's Fui1 Name)
(5( nature)' f
Feruar? 7, 1 4
(Date)
..(Notary Public)
Mp,R7 pMIC STATE OF FLORIDA
(C Wd's (Date of Binh)
I hereby certziy all of the above to be true and carrrm,-- ;
CITY OF CLEARWATER
GENERAL EMPLOYEES' PENSION PLAN
OPTIONS ? GENERAL EMPLOYEES
OPTION ?1: Employees can receive a lump sum payment for
vacation and holiday pay and 1/2 of accrued sick leave
at the time of separation from the City. There will be no
317o deduction for pension from this lump sum payment
nor will this amount count as earnings in the
calculation of the pension. The last day of work will be
the termination date and pension benefits will begin
the following day.
OPTION : Empkoyee can extend termination date by the time due
(Only available to for -facation. hakiday pay, and 112of accrued sick leave.
employees hired ie.nination date will be the final day of ettended time.
prior to 1011190) P-:nsion 'benefits will begin 'the following day.
Robert C. Craft
I. an ezzplovee of .the City of
Clearwater. hereby apply for pension benefits under the General Employees'
P=nsion Elan.
I herebv certifv that I fatly understand the two ootioas offered to me., I t yloost
to retire using Option = 2 and wish my benefits to be calculated under
this option.
r"
I understand that once this form is signed, fay decision is irrevocable.
EMPLOYEE'S SIGNATURE'. ,- SOCIAL SECURITY '?: 577-34-x.709
_Iq ;ADCRESS: 903 South Greenwood Avenue #&3-A2
Clearwater, FL 34616-4063
February 7, 1994
DATE: _
r r
I ` TRUSTEES OF THE EMPLOYEES' PENSION FUND
Agenda, Cover Memorandum . 77
Item #
Meeting Date: 414/94
Subject-
Pension(s) To Be Granted
Recommendation/Motion:
Rebtt J. Parker, Accounting Clerk II, Finance Division, Administrative Services Department, be
granted a non-jab-connected disability pension under Section(s) 2.396 anchor 2.399 of the
Employees' Pension Plan as recommended by the Pension Advisory Committee,
? and that the appropriate officials be authorized to execute same.
BACKGROUND:
Reba J. Parker, Accounting Clerk 11, Finance Division, Administrative Services
Department, was employed by the City on June 15, 1981, and began participating in the
Employees' Pension Plan on that date.
On February 1, 1994, Donald Parker, on behalf of Reba J. Parker, submitted a request to the Pension
Advisory Committee (PAC) for a non-job-connected disability pension. Mrs. Parker suffered a
stroke which is the basis for this request for pension. Letters from Dr. Michael B. Evans, dated.
January 14, 1994, and February 17, 1994, and Dr. James F. Rivenbark, dated January 21, 1994, were
submitted in support of this request.
The letter from Dr. Evans dated January 14th states, "i first saw Mrs. Parker on 11/28/93 when she
was admitted to Largo Medical Center I-Iospital in. a state of coma ...I have read the information sent
to me by Mr. Parker on the Processing Disability Pension Requests form and also the duties of it n
Accounting Clerk 11, sent to me as a separate sheet. I do not believe that Mrs, Parker would be able
to carry out tiny of the duties outlined on that sheet of paper." The letter from Dr. Evans dated
Fcbrutary 17th states, "She was initially comatose and has improved to a state of severe memory and
cognitive disability. Her prognosis for further recovery is poor. I s?ispect in all probability this
will be a fixed deficit and a permanent condition." The letter from Dr. Rivenbark states
"Reba Jean Parker has suffered a disabling stroke. We were highly surprised and actually
considered it miraculous that she survived... However, she is permanently and totally disabled and
will never be able to work any type of position again. Her current cognitive abilities are limited,
and she requires ongoing; supervision and therapy."
Page Reviewt-d by:
13udget - NA-_,_,,,
I'urehasing -NA-
111A CIS . _. _- IYA
ACM ... -. C?.?'
Other
sttbtltitted hy:
City N1
Originating Dept:
Human Resource
Utter Dept.:
Advertised:
Date:
Paper:
? Not required
Affected parties
? Notified
? Not required
Costs: $fi6,1132
Total
Current FY
Funding Source:
? Capt. Imp.
? Operating
? Other Eensi411-
Appropriation Code:
646-07410-530100-585
Commission Action:
? Approved
? Approved w/conditions
? Denied
? Continued to:
Attachments:
Letter(s)
? None
?Se-' J•13l'?-,.; i '?rS?4??•?br'j.j`?}(^"i.''?`.97 i''ydf. ipl :y? ey S. ,, 6°.• .. i. ,.
,? :a-tiE ;?. ?1?. :I ??'!1. :ti„F?4 y!".?, 5.,:.di){{• ? tii??Ja."kt•l.c..' ,c: 4.
ff J){}[ 1y .? J? ,9 f . ?'S
G74 •'rl?f: 7?. :jo.; (•-i•.",'f, { .l,??t ..L ?:•?"„'7F .vr??t;t, '?.'•, t',i.,
"
?
' ,..'. I'. ,''. ?}'
•t•` lit ,alai ?Jt e,' ?. ?.,•,` ,
o,- ?,E; Jt
` . 1:?:?.e ,.F t:':f ENf ?i4'F r?'ti? t ,? %'?y..- a ',l, •°)..
47 , `,.? •s.
,
',i : ,?:.Z ;ra f: r-f
"? a'.ti ttt .Fo
, . , ?. .alil a,. .<.'::?A't, .. , ei, l i:,, ..3?,
. "
i' .. .}ti..
. (?§? .';4t,. :.9. ., , S; iTY.-'.°.??' .. , '4 •. - t ' `•?;
Agenda ;Item--Reba J. Parker
Page .2•
` 1
. March 14, 1994 '.
P ,
ei'.
- Mrs; Parker's pension was 'approved by the PAC- at its meeting on February 16, 1994. 'This pension
will be. effective on March 3, 1,994, -at 1.3 hours into °the- . day. Based on an average salary o f '
approximately . $21;842 over the past five years. and, the formula for computing - non-job-connected
'
disability
pensions, this pension • will approximate $6,896 ' annually. Charts from 'Finance. w h i c h
take into consideration mortality, rates and age reflect ' the ' "present value cost of financing" tisis
pension will' be' approximately $66,032.
C I- T Y. Q F C L E' A R W. A T ER
- t? POST OFFICE BOX 4748
CLEARWATER, FL0R1.0A 34818.4748
??.-.,.emu r+ t
Human pesourcaa Department
482.81174
'IC}. Honorable Mayor and Members of the City Commission as Trustees of the
Employees' Pension Plan
FROM: Pension Advisory Committee
COPIES: Debbie Bailey, Payroll Services Manager
Employee's File
SUBJECT: Pension for Reba J, Parker---Non-job-connected Disability' Pension
DATE. February 16, 1994
The Pension Advisory. Committee (PAC) received an application for disability pension from
Reba J, Parker on February 1, 1994.
Ms. Parker has been determined by the Pension Advisory Committee to meet t h e
requirements of the Pension Plan for a non-job-connected disability pension. Site was
employed by the City on June 15, 1981, and began participating in the pension plan on that
date. Further, she has submitted medical documentation, copies of which . are attached,
relative to her disability which has been reviewed and approved by the PAC.
By motion made and duly carried at its meeting of February 16, 1994, the Pension Advisory
Committee approved/recommended the granting of a non-job-connected disability pension
to Ms. Parker in accordance with provisions of Section 2.396 of the City Code. This pension
will be effective on March 3, 1994, at 1.3 hours into the day.
The amount of Ms. Parker's pension will be calculated by the Finance Department according
to the formula in the Pension Plan for non-job-connnecte:d disability pension at such time
as her last five years of service and salary can be computed.
I hereby certify that the Pension Advisory Committee has approved the granting of a non-
job-connected disability pension for Reba J. Parker and that the above: dates itre correct.
- --_- -- ---
Cha r an4iP?es"
Advisory -Committee
4ft
"Equal Employment and Affirmative Actlon Employer''
I F', .
O
r1 .i
i
PENSION. REQUEST FORM
¦
Reba J: Parker do hereby ' apply for retirement-
from the. City of Clearwater General Employees' Pension Plan,
My benefits 'date is June 15, 1981 (Entry date into pension plan)
My date of hire is June is, 1981
My birthday is June 29, 1936
My job classification is Accounting Clerk 11 and I work
in the Administrative SexviceDepartment. Finance Division.
M y resignation date is to be •determi.ned
The type of pension for which I . am applying is (check only one):
Regtilar Pension , based on years of service
Job-,connected Disability Pension
x Non-job-connected Disability Pension
My -spouse's name is: Donald
Dependent children under the age of IS and residing in my household ' are:
(Print Child's Full Name) (Child's Date of Birth)
I hereby certify. all of the above io be true and correct:
' - ? c?,? ? ?•-"?'?? _nn behalf of .
(Signature) Reba J. Parker
February 1, 1994
?' , (Date)
?(No .Public)
NOTARY'8tlRL1C: STMT OF FLORIDA.
NDIED TKtnutOO Y Yft USUC UNGKFtWK1TXASj
CITY OF CLEARWATER
GENERAL EMPLOYEES` PENSION PLAN
OPTIONS - GENERAL EMPLOYEES
OPTION #1: ' Employees can receive a lump sum payment for
vacation and holiday pay and 112 of accrued sick leave
at the time of 'separation from the City. There will be -no
8% deduction for pension from this lump sum payment
noa• will this. amount count as earnings in the
calculation of the pension. The last day of work will be
the termination date and pension benefits will. begin
the following day,,
OPTION .#2:: Employee can extend termination date by the time due
(Only available to for vacation; holiday pay, and I!Z of accrued sick. leave.
employees • hired Termination date will be the final day of extended time.
prior to 1€}11190) Pension benefits will begin the following day.
I
IReba J. Parker an employee of the City of
Clearwater, hereby apply for pension ' benefits under the General Employees'
' Pension . Plan.
I hereby certify that I fully understand the two options offered to me. 1 choose
to retire using Option # 2 and wish my benefits to be calculated under
this option.
I understand that once this form is signed, my decision is irrevocable.
f
EMPLOYEE'S SIGNATURE:___! on behalf of
Reba J. Park:.
SOCIAL SECURITY K•? 414-52-2500
,WTrNESSU- ADDRESS: _ 2424 Summerlin Drive
Clearwater, FL 34624-2820
t
DATE: February 1, 1994
:r
•?,?r.?'t??f(c.{f,kj,';?it',??"<1?I?1 :P i.K?..?i.'•.4!{1?,}..'s:?:l'' ti; :??'?• ,?
`1..'' ANQSTHESIOI,OGY `
Marv M Urady, MD
'
' . Jerx w J Lear, MD.
f10Uart A. Levenson, MD.
.
'. I . Andrew Peters. M.D.
Aido
ICI CUNic
CAHDIOVAWN.AfL'MD
°.' '
THOR4CIC SURGrtCRY
i' ` H. Char?aa Curobes, M D. •
I s.. DERMATOLOGY
E.'. Frees S. Gurtrnsn, MD, .
:. LMde J. LoW^ M.D.
r`z Wilsm O. Word. M a
1• ENDOCRINOLOGY '
4 r February 17, 1994,
WiWnP.CfacrrMD
1^` FAMILY PRACTICE
f1t Jan W Beauty, M.D,
JemN E. Lert, It, 440 „
Jomrhsn P. Nagy, MID,
Edward F. CrH M M.D.
E Dorothy Plonks, MD.
ChrWoMer J. P RC TO WHOM IT MAY CONCERN
GFl'4EilALIVASCULAn AR S SURGERY
Jarm T. Etten. M.C.
Mkhasl V. Nerrw, Ada.
KVINM. MEDICINE
Jame A. Avary, M.D,
R, Oranow 6snsan, M D.
Yaai Y. CMa. M.D,
Darks E. Kubk M.O. Re : Reba Parker
Pt"* uuuvw, FAD,
119 04 21
1111 on M. Ogee, M 0.
CChrr tiGLOW.MFAD
Eugene S. Afrttdde, MD.
RoWrt N. Shoos. M.D.
Mkhart J. Thorr"an, M EL
nichaelF,TWowns.MD. Mrs.. Parker had a stroke two months ago affecting the
' Mrguer E Treww. Mb.
Jars VA=A*MO. . diencephalon and dorsal median nucleus of the' thalamus.
INTERNAL NIEDICINEXAROIOLOOY
Alan S.Gaiciont M.0, she was initially comatose and has 'improved to a state of
F?'ELna' severe memory,and.cognitive disability. Her prognosis
°'Wj. MQ °'
Jfmy & So for further recovery is poor. I suspect in all
' 3lephan EXT,.twr. MO.
;. INTERNAL VIEC CINE.' probability this' will .be. a fixed def1cit'and a permanent
GASTROENTEROLOGY
BnwsASat'rW,MCL condition.
M1Chaw SUMULI. MD•
Mo
x
'
irr>FrNwa
1=A
?c
olraN?
Cynthia A_ Paganini. M.D.
Jsrrwa H. Stag MIS
IIYTEftNAL i.IEDiCWE
HEMATOLOGY/QNCOLMY
Leas F. FomarWar, M.D.
INTERNAL MEDIC1NE/NEp}[RCLOGY
Cam*k Forulla. M.4
INTERNAL W.DICINEIONCOLOGY
=t=-
It0-
I W
PULMOI•IAAY DISEASES
F>1St:3
Ffwv a J. Avers. MO.
Ronald E. tlar.em M.D.
Wlllsrr?J.p6nim s.Jr..AID. MICHAEL B. EVANS
- M.D. :
INTERRN& WMPCWErWEUMATOLCQY ,
Wiliam M. Wason, MD,
NEL'FKXJDGY
Mchaal B. Evans. M.D.
MBE/JS
Cyretra 11=
>, I.LD
r
Stead E ' SinoR, MD
COSTETRICSIGYNEC OLOGY
James E. Doran. MD.
Robert J. HNkr, MO.
.Y?saPh Q. Ktebal 1t1, M D. '
.
Iveriss? Ruin, M D
Oi+HTHALMOLOGY=RGERY A
DISORDERS CF THE FYE
Edvitd M Dsulseher, MD.
James A. Robwb. Lt 0,
ORTHOPEDIC. SURGERY
Alan J. Grave, M D,
Wi1em Near. MD.
Gordon Lrerrdoder, MD.
OTOLARYNGOLOGY
EAR NOSE dt THROAT
Jamn S. Sarre, M o.
Warren S. Gddslest. M.D.
PATHOLOGY
f
vmmd? PJd, LLD,
PEDIIATWCS
A Frank Ganes, M D,
A Robert Mdrvk AkO.
A VLtZr. bI D.
n
Jah
. VMento, M.D.
PEDIATRICS
PEDIATTIIC RHEUMATOL013Y
Robe" w. Nlcwssa> Jr.. M D.
PLASTIC SURGERY
Aolmd P. McCtmo, MD:
RADIOLOGYrD1AGNO$TIC IMAGING
M. Union Herbark MD.
Y!n T L NlD
Howard B. Rubin. M D.
UROLOGYA)ROLOGICAL SURGERY
Robed I? Hackae, MD. 1351 West Bay Drive, Largo, Hari is 34640 Phone. (313)181-8767
B Sanay, l
ADMIMSTINISTAATGR+CfO Q 3131 McMudan Eboits Acad. Clearwratar. Flanda 34621 Phona: (3131726-silt
,
Robed R. Drpparrg 1463 S. Ft. Haitisan Avenue. Suite 204. Clearwater, Florida 346t6 Phone: (3131443-4502
CENTER FOR OUTPATIENT SURGERY
1401 West Bay Drive, Largo. Florida 3464D Phone. (813) 585-4500
•' 11.
AtIE3THP51OLd0Y '
Mann M. Brady. M D.
JenMer J Lrn. MD CL' ?
' Fk?Uer4 A. Levrnraf, Ma,
Andrew Pare. MO. DIAGNOSTIC
Jonathan S. Radrn, MD.
CARDIOVASCULAR
THORACIC SIJAG AY
H. Charkp Campba; RD,
DCRMATOLOOY
Fred S. t3wMw % MO.
Lkxla J. Lnhys, MO.
wikwn a. Ward, M.D.
EHDWalarnP CCroon.M0 January 21, 1994
FAMILY PRACTICE
Jon W. B"shov, M D.
Jams E. LWL it. M D.
Jondhcn P. Nagy, 040,
Edward F. OfK=. M D.
E. Dorcrrl Plot", M o.
Crrrxop 1, P1A,"I.MD. Re : Reba Jean Parker
GE7? ERIIWA.SCtJ
L R SURGERY
James T. Eloan. MQ 09 04 21
M 4elit Near MD. .
INTERNAL MF?ICINE
James A. Awry. KM
R. Gtwvw Benson. M.D.
Yaal Y. E154, M M
Kara E. KL*k MD,
`y Debbie LaIsm. MD.
s?µ?{o.D To Whom It May Concern:
Douglas E. PAn, MD,
Cheryl S.R° ynol'ds.MD. Reba Jean Parker has suffered a disabling stroke. We
James F• Wv+nba'1t at. ADD.
Robert 0.Shobs,MD. were highly surprised and actually considered it
Mxt" J. 7hompeat, M.Q
RkItamF.romns.MD. miraculous that- she survived. She has made considerable
Mqua E Towm o. MD.
INTERNA ;:va S.Wk NECjLRCjOLOGY progress since the time of her initial insult. However,
Alan a,C4aldsnaT4Mo. she is permanently and totally disabled and will never be
Raker a. Jorrmw% MO.
Federm E. Lear. MD. able to work at any type, of position again. Her current
Dann W. Mason, III, MO.
Jelfrrys.3ager,l.LO. cognitive abilities are 1ialited, and she requires ongoing
INTERNAL , E"`°'" supervision and therapy.
GASSTfiOENTEROLOGY
Bnxr A. 5char. M.M
Me:harl Sunset, TAD.
Joseph K wA=mn• M.D.
IWE3R414XERIATRIC MIXI CIN6 !
James H St?gM O ?' •
INfCA?1AL MEDICINE
HEMATOLOGYAONCOLCOY"
I= F. Famandrz. MO.
INTEI'INAL
CN?MW ' M.D. °I'°GY James QF ivenbark, ill, M. D.
INTERNAL MEDICWc.IONCOLQGY
Davao R LarvFraa, MQ
ll(iERNAL Mt?oICWE
JFR/JS
PULMONARY DMEASE3
Francis J. Avsn! M.D.
Harald E Sawara. M D.
WXIM .Ridrrds.A.MD. cc: Ms. Reba J. Parker
INTERNAL MEDICINErR4EUMATOLOGY
i Wiliam M.Wafon.MD. 2424 Summerlin Drive
N MchhwI8 Evens. MO. Clearwater, FL 34615
Cyyrrs?ttltir HuttmarL M aD.
Stwr! I-5rx>1r. M
i OBSTEM CSt3YNECOLOGY
James I_ Doran, MQ
Robert J. He6w. IA O.
Josepel 0. Kwebel, lu, MD.
Irra,aas Aum. M D
0.nHTHALM0L0GYiSUR3SRY Jt
LMSCROERS OF THE EYE
S Edward M. L)suscher. M.O.
James A. Roberts. MO,
ORTHDPEDIC SURGERY '
1 Atan J, Graves. WD,
wliam Now. MD.
r . Gon4on Lrerrdoder.MM
OTOLARMiCiO QY
EAR NOSE d THROAT
Jams S. same. M.D.
Warren S. Goktsten. M D,'
FATHOLOGY ,
TAD.
R??rrrr??oorrdd P "d-
P£DU1`TRICS
A. Frank Gomm, MD.
A. Robert Marea4 MD.
. Ftk* V %naw, ma
John C. Vrvato, MM
PEDIATRRICS -
PEDIATRIC RHEUUATOLOGY
Robert W. M.eiceeo,,, Jr., lAM
PLASTIC SURGERY
Robs4 P. MoCuns, MD.
RA0XXWYtD1AC7NSgTIC IMAGING -
M. Union Herbert, h[O.
Ying T. Lea, MD.
Flowrrd B. Rubr4 MQ - -
UROL.OOYAJRDIOGlCAL SUFgER1'
R*bad E HacMd. M.D. 1551 W4W Bay Drive. Largo, Florida 34640 Phones (813) 551-8767
Bruce A SarR MD.
ADMi1w5TRATCfbCEO 3131 McMullan Booth Road, Cloarwater, Florida 34621 Phone: (e1:) 726-8871
' -
RONA R. Dppong 1465 S Ft Harrison Avenue, Wta 2(14. Clearwater, Florida 34616 Phone:. (813) 443-4302
CENTER FOR OUTPATIENT SURGERY
' 1401 Wass Bay Drive. Largo. Florida 34640 Phone: (813) 583-9500
0 ! I4.
DIA
CLINIC
GNOSTIC
January 14, 1994
Re: Reba Parker
09 04 21
V,
To Whom'It May Concern:
Eugene S. Srmcfd& MD.
Jarros F. R)vsf9mM III, MO.
nabod N. Shots. MO.
I first saw Mrs. Parker on 11/28/93 when she was admitted
to Largo Medical•Center Hospital in a, state. of coma.
=3 V ME). Over,,the next two weeks she regained consciousness to a
Alan & Qa4wT%U% MD.
somnolent state with limited ability to understand or
WAMW G. Johroxx% WO.
F*Jamo E. Lenz. MD.
speak. She 'was then transferred to HealthSouth
Rehabilitati.on'Hospital, where I believe she is still a
'H'' ''h
HB"TOLOOY
]NOOLMY
Patient.
A
Luis F. Fau=x" MD.
INTERMAL I EMINE
?A?Sc riOr.OMD.
I have read the information sent to me by Mr. Parker, on
J0040 MD, the Processing Disability Pension Requests form and also
ffrEWVUAU"WM 'Me the duties of an Accounting Clerk Level II, sent to me as
a separate sheet. I do not believe that Mrs. Parker
would be able to carry out any of the duties outlined on
F
J
PAD that sheet of paper.
IN302
,
rldd I- =6. am
Yours sincerely,
clrtttra H?f>asu?, MD.
uad E Sk+arl, AKQ
OBSTEfRICSoGYNECOMY
Jarrms I-
%
~ r
Rabat J. Heller.
Jaseptl 0. lCuabeL in. MD.
IvrMieee Rut; MD.
O F°TW? 'a
Michael B. Evans, M.D., F.R.C.P.C.
t?w.,d M. D.utsahar MD.
Jomea A_ Ro6arh[, fvl?7.
CRIHDPEDIC SURGERY
Alan J. C3rwo% MD.
William Now. M.D.
Ootdcn 22ren+dad4r, M D.
MBE/JS
emtwctvrafX% MY
P*)t, AID.
RobaA P. MaQne, MD.
RADIOLOOY101AONOSTSC 1MACiIN0
Evan F. Chanbem M Q
M. Luton HerbwlR MO.
WaneKmtvr, M0.
Ying T. Low M.D.
How-rd B. AubiN Ma
Ur%0C1YA1Fl0LICAL SURGERY
Robert E HscketL MD,
AruoaA.Saruy MD,
AD I115TRATORI?EO
Rouen R_ Oppong
1351 West Bay Diva, LarQo, Florida 34640 Phone: {6131581-8767
313t McMullan Baoih Road, Cloarwaler, Florida 34621 Phan: (813) 7264971
1465 S. Ft. Hajoson Avenue, Suita 204, Clearwater, Florida 34616 Phone: (913)443-4502
CENTER FOR OUTPATIENT SURGERY
1401 Wass Bay Drive, Largo, Florida 34640 Phone; (113) 515-9500
mv. vn