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'. t ... ACTION'AGENDA
Board of Trustees of the Em' ployee s` •Pen?lon Fund
f " March 13, 1995 ,
1. Call to order . 1. 1:18 P.M.
Approval of Minutes' 2.' Approved as submitted.
of 2127195
3, Request for acceptance 3, Approved.
into membership: `
a) Ruby Jackson
b) Linda Byars
' c) Carol A. Richard . F
. ' d) Joseph Fazio
e) Waiter Kelier II
f) Derrick Griggley
' g) Freddie Hinson i '
h) Shirley Dawkins
4. Regular Pension to be grant ed: ' 4. Granted.' .
Ruben Green
5. :. Regular Pension to be grant ed: 5. Granted,
' Robert Van Reveren
6.. Other Business: 6. None.
' 7. Adjournment: 7. 1:20 p.m.
TRUSTEES OF THE EMPLOYEES' PENSION FUND item #
Agenda Cover Memorandum Meet ing Date: 3/13/95
?r?r?r•r-?III?II.IIPllrlrrrrr?.¦ ?? ^?III Ilrrl.r
Subject: IlrpPllllr9l?i I?IIIIIggqi111iPr?.?Yrtlr
` Membership in Employees'' Pension Plan
Recommendation/Motion-
Employee(s) listed below be accepted into the Employees' Pension Plan as recommended by the
Pension Advisory Committee.
. ? and that the appropriate officials be authorized to execute same.,
BACKGROUND:
Seniority Pension
?. Natne--and,Job Class Dept./Div. Ds= Effective Date
Ruby Jackson, Maintenance Worker II Parks & Rec. 613185 1/27/95
Linda Byars, Loan Officer Economic Dev. 1123195 1123195
Carol A. Richard, Maintenance Wkr, I Parks & Rec. 216/95 216195
Joseph Fazio, Maintenance Worker I Parks & Rec. 2/6195 216/95
Walter Keller II, Gas Technician II. Gas 1123195 1/23/95
Derrick Griggley, Custodial Worker Parks & Rec. 318193 2/6/95
Freddie Hinson, Code Enforcement Tec h. Com. Response Team 2/6/95 216195
Shirley Dawkins, Code Enf. Tech. Cam. Response Team 216/95 2/6/95
Reviewed by: Originating Dept:' ? Costs: Commission Action:
Human Resources Total
Legal N6 ? Approved
Budget -- - NA, _ ? Approved w/conditions
Purchasing __NA _ User Dept.: Current FY ? Denied
Risk Mgmt. - NA•,,,•_ ? Continued to:
CIS
10 Funding Source:
'ACM Advertised: ? Capt. Imp.
Other NA _ Date: ? Operaling
Paper: ? Other Attachments:
? Not required
Submitted by: Affected parties Appropriation Code: Letter(s)
? Notified
? Not required ? None
City Manager- -
EMPLOYEES' PENSION PLAN
PENSION ADVISORY COMMITTEE
TO, Pension Trustees
FROM: Pension Advisory Committee
' ., SUBJECT: Recommendation for Acceptan a into Pension Plan
`.. , DATE: February 15, 1995
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 Committ ee that they be
'accepted into membership,
Pension Elig.
Name. job, Cinss. & Dept./Div. Minh ate Hire Date DAM
Ruby Jackson, SS#251-88-6413,' 9/ 1 7147 6/3/85 1 /27195 *
. Maint. Wkr. 41, Parks & Recreation Dept.
*Etriployee denied acceptance to the Pension Plan at time of hire. Employee paid for physical examination
on 1/27195 to re-apply for acceptance.
Linda Byars, SS#261-98-5235,
.Loan Officer, Economic Development Dept. 6119149 1/23/95 1/23/95
Carol A. Richard, SS#294-68-1381
Maint. Wkr. 1, Parks & Recreation Dept. 9129/60 2/6/95 2/6/95
Joseph Fazio, SS#093-62-0001
Maint. Wkr, I, Parks & Recreation Dept. 8/19/66 2/6/95 2/6/95
Walter Keller 11, SS#261-77-1394
Gas Technician 11, Gas System 2/20/62 1123195 1/23/95
Derrick Griggley, SS#262-25-4006
Custodial Wkr., Parks & Recreation Dept. 8/13168 318193 216195*
*Employee hired from permanent part-time
to full-time permanent status.
Hire date reflects date hired as permanent part-time.
Freddie: Hinson, SS#261-69-7553
Code Enforcement Tech., Community Response
Team 816164 216/95 2/6/95
Shirley Dawkins, SS#2261-73-2294
Code Enforcement Tech., Community Response
Team 10/23/64 216/95 2/6/95
1
-1- A
' TRUSTEES OF THE EMPLOYEES' PENSION FUND Item #
` Meeting Date: 3 / 1 319 6
a Agenda Cover Memorandum
Subject:
Pension to be Granted.
Recommendation/Motion:
'Ruben Green, Solid Waste Department, be granted a regular pension under Section(s) 2.396 of t h e
Employees' Pension Plan as recommended by the Pension Advisory Committee.
? and that the appropriate officials be authorized to execute same.
BACKGROUND:
Ruben' Green, Solid Waste Worker, Solid Waste Department, was employed by the City on
February 23, 1970, and began participating in the Pension Plan on that date. His retirement will
be effective. on February 11, 1995, at the beginning of the day.
Mr. Green's pension was approved by the Pension Advisory Committee at its meeting of
February 15, 1995. Based on an average salary of approximately $24,031 over the past five years
and the formula for computing regular pensions, this pension will approximate $15,019 annually.
Charts from Finance which take into consideration mortality rates and age reflect the "present
value cost of financing" this pension will be approximately $160,666. The estimated pension cost
(cash payout over the life of the pensioner and his spouse) is $285,366,
Reviewed by: Originating Dept: Costs: S16U.666 Commission Action:
Legal NA Human Resources
?-? Total
? Approved
?
Budget _ NA _
Purchasing NA
Risk Mgmt. NA
User Dept.:
Current FY Approved w/conditions
? Denied
? Continued to:
CIS NA Funding Source:
ACM Advertised: ? Capt. Imp.
other _ Date:
Paper.
Ef Not required ? Operating
Other Pension
Attachments:
Submitted by: Affected parties Appropriation Code: Letter(s)
? Notified
Not required
546-07410-514109;585-.
? None
City Manager OD
al
C I T 'Y CA F' C, L EA R W A T E R
POST OFF ICE BOX 4748
CLEARWATER, FLORIDA 34 818.4748
Human Resourcas 0epartment
' 81314824870
i.
TD., 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-Ruben Green
DATE: February 15, 1995
The Pension Advisory Committee received an application for regular pension From
Ruben Green on February 2, 1995.
Mr. Green was employed by the City on February 23, 1970, and has been a participant in the
Pension Plan since that date. The amount of Mr. Green's pension will be computed by t11e
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 15, 1995, the Pension Advisory
Committee approved/recommended u regular pension based , on years of service for
Ruben . Green in accordance with Section 2.396 of the City Code. This pension will be
effective on February 11, 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 Ruben Green and the above dates are correct.
-I- *id
C • i an, Pension Advisory Committee
--T. M. HC"4- ._
''Equal Employment and Affirmative Action Employer''
1` . .
PENSION REQUEST FORM
4 ` Ruben Green do hereby. apply for retirement from the City of Clearwater
! General Employees' Pension 'Plan.
My benefits date is February 23, 1970 (Entry date into pension- plan)
M y
, date of hire is February 23, 1970 ,
-
My f
birthday is February 22, 19341
My job classification is ' Solid Waste Worker and I work in the
'Solid Waste _ Department, Division.
My resignation date is February 10, 1995
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-connected Disability Pension
My spouse's name is:
Dependent children under the age of 13 and residing in my -household are:
(Print Child's Full Name) (Child's Date of Birth)
I hereby certify all of the above to be true and correct:
STATE of FLORIDA BeIrfGing trv ment aclctiowled;ed before me this
h
prime )
t
CYNrN1A M ANVE! N
- - - NOTARY tS5EON NQ Ca97649 i?A PUBLIC -MY CO JON P.
Mir S Pr 29,1598
-
'February 2_,_1995
(Date)
COUNTY OF PINELLa5 ?? by N?q ? ? o is personally
no n Co me or who has produce `
- s identification and who did/did not taA an oath.
' Notary Public
? (i ature) '
• Commission No.
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 6% 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 #2: Employee can extend - termination date by the time due for
vacation, holiday pay, and 112' of accrued sick leave. . Termination
date will be the final day of extended time. Pension benefits will
begin the following day,
(Only available to employees hired prior to 1011190.)
??***??*?****?**?***?*?**»?********wow*?****?x*******************?**
I Ruben Green .
an employee of the City of Clearwater, hereby apply for
pension benefits under the City's Employees" Pension Plan.
I hereby certify that I fully understand the two options .offered to me. I choose to retire using
Option # _--L _and wish my benefits to be calculated under this option.
I understand that once this form is signed, my decision is irrevocable.
EMPLOYEE'S SIGNATURE; ?__,
SOCIAL SECURITY 420-40-8258
ADDRESS: 1108 Woodlawn Street
Clearwater, FL 34615
DATE: February 2, 1995
?tnl 01%
.?-.
,• r
f
TRUSTEES OF THE EMPLOYEES' PENSION FUND Item #
Agenda Cover Memorandum Meeting Dale: 0 /13/95
Subject:
' Pension to be Granted.
Recommendation/Motion-
Robert Van Beveren, Parks & Recreation Department, be granted a regular pens ion 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 Van Beveren, Tradesworker II, Parks & Recreation Department, was employed
by the City on February. 24, 1971, and began participating in the Pension Plan on that date. His
retirement will be effective on February 11, 1995, at the beginning of the day.
Mr. Van Beveren's pension was approved by the Pension Advisory Committee at its meeting of
Februrry 15, 1995, Based on an average salary of approximately $28,431 over the past five years
and the formula for computing regular pensions, this pension will approximate $17,059 annually,
Charts from Finance which take into consideration mortality rates and age reflect the "present
value cost of financing" this pension will be approximately $202,386. The estimated pension cost
(cash payout over the life of the pensioner and his spouse) is $409,409.
Reviewed by:
Legal N
Budget NA
Purchasing _-NA,
Risk Mgmt. NA
CIS
ACM
Other NA
Submitted by:
City Manager
Originating Dept:
Human Resources
User Dept.:
Advertised:
Date:
Pa er:
2 Not required
Affected parties
? Notified
Not required
Costs: Q 2.M Commission Action:
Total
? Approved
? Approved w/conditions
Current FY ? Denied
? Continued to:
Funding Source;
? Capt. Imp.
? Operating
EZ Other Pension Attachments:
Appropriation Code: Letter(s)
$;Q7410-514100-585• ? None
Human Resources Department
8131462$870
C I T Y O E C L E A R W A T E R
POST OFFICE BOX 4748
CLEAR WA TER. FLORIDA 34 616.47413
TO. 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
SOJECT:' Regular Pension-Robert Van Beveren
DATE: February" 15, 1995
The Pension Advisory Committee received an application for regular pension from
Robert Van Beveren on February G, 1995.
Mr. Van Beveren was employed by the City on February 24, 1971, and has been a participant
in the Pension Plan since that date. The amount of Mr. Van Beveren'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 15, 1995, the Pension Advisory
Committee approved/recommended a regular pension based nn years of service for
Robert Van Beveren in accordance with Section 2.396 of the City Code. This pension will be
effective on February 11, 1995, at the beginning of the clay.
I hereby certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension for Robert Van Beveren and (lie above dates are correct.
h an, Pension Advisory Committee
"Equal Employment and. Alllrmallve Actlon Employer"
PENSION REQUEST FORM
I* Robert: van severer do hereby apply for retirement from the City of Clearwater
General Employees' Pension Plan.
My benefits date is February 24, 1971 (Entry date into pension' plan)
M y date of hire is February 24, 1971
My birthday is august 15, 1932
My job classification is Tiadesworker It and i work in the
Parks & Recreation Recreation Facilities
Department, Division.
My resignation date' is February 10,-1995.
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-,jab-connected Disability Pension
My spouse's name is: Marjarie 5/31/35
Dependent children under the abe of 13 and residing in my..-household are:
(Print Child's Full Name) (Child's Date of Birth)
I hereby certify all of the above to be true and correct:
(Signature)
- February 6, 1995
(Date)
STATE OF FLORIDA h ore going i tr :r,:cn a ns ac, owledaed before me this
COUNTY OF PINELLAS by ILt)Z ' .? ?%o Ai?pers nail - (
r known to me or who has produced 1
as identification and ho did/did not take an oath.
n ! Notary Public
(Signature)
Commission No.
(Nam of
OF 1 to O . Y 5
CYNTHIA M ANDERSON
OF FLORIDA
NOTARY P1UBi.IC MAP
COM41Lc,?JON NO. CC3 r
*,IY COV II ION EXP. 5EI'T 24.1993
r:? • r::??j`-1v°?;n•`s;;y"i£!:i.h,.',F•v;:e iir, .• .. _ < •i, i apt, r.• 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 6%n deduction' for
• pension from this lump sum payment nor will this amount . c o u n t
as earnings in the calculation of the pension.' The last day of.
' '• work will be the termination date and pension benefits will berrin
the 'following day.
OPTION 42: Employee can extend termination date. by the time due for
-vacation, holiday pay, and 112 of accrued sick leave. Termination
date will be the final day of extended time, pension benefits, will
beiin the following day.
(Only available to, employees hired prior to 1011190.)
* k k # * k M !N ?M ?k * * * * ? * ? * # * * # ? * 4 N k #.* ? * * * * ? k >M * * * N oM ?e k ? * !k k +K W ? M? 4 * * * :k rk ?: * :k k * M # # k
Robert Van Beveren an employee of the City of Clearwater, hereby apply for
pension, benefits under the City's Employees" Pension Plan.
I hereby certify that I fully understand the two options offered to me., I choose. to retire using
Option .n _LL -and wish my benefits to be calculated under this option.
I understand that once this form is signed, my decision is irrevocable,
WI?1`IESSES: ? i
4
E1IPLOYEE'S SIGNATURE: `_-? ?' /4: r j?/, r. /.•
? y
S06AL SECURITY 135-24--9734_
ADDRESS: _ 145 Douglas avenue
Dunedin , FL 34698
DATE: February 6, 1995
mss..