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ACTION AGENDA'.
Board of Trustees of the Employees' Pension Fund
April 1, 1996
1. Call to order 1. 9:00 a.m.
2.. Approval of Minutes: 314196 2. Approved as ,submitted;
1 '3. Request
for acceptance' 3. Approved.
,
..into membership:
' a) Michael'Aleska
b) Elizabeth'Boone
C) Kevin Bowler,
:. d). Dewayne Broad' ater
e) Timothy Chaplinsky
f) Stephen Coward
g) Paul Cronin
h) Oscar ?elBono
i) Louis Georgantas
` j) Ronald Horne
?; . k) Donald Gulley
' it Kenneth Smith
4. Regular' Pension to be granted: 4. Approved.
Jack D. Bryant '
.5. Regular Pension to be granted: 5. Approved-
Terrance L. Clements
' 6. Regular,Pension to be granted:, 6. Approved.
Ellen G. Darrington
7. Regular Pension to be granted: 7. Approved.
,Wayne Vanden Berg
8. Regular Pension to be granted: 8. Approved,
` Albert Myrick
' 9. , Confirm engagement of Godwins 9. Confirmed.
. Booke & Dickenson to provide
' consulting services regarding
administration of a qualified
' . pension plan for an amount not to
exceed $5,000
10. Other Business 10. • None.
?, ' . 11, 'Adjournment 11. 9:05 a. m.
M ,
TRUSTEES OF THE EMPLOYEES' PENSION FUND
Agenda Cover Memorandum
Ilem ft
Meeting Date: 4LJ/9.6
wruum?r+r, wnrirnu? i it^?mrr?wrwumn w,w ww??rrrrwwur?i -
5ubJect: wrr•
Membership in Employees' Pe nsion Plan
Recommendation/Motion:
Employee(s) listed below be accepted into the Employees' Pension Plan as recommended by the
Pension Advisory Committee,
] and that the appro rJp ate officials be authorized to execute same.
ninr
rrrr?n
rr
w rw?r-r?nuinw i i
BACKGROt1Na. wrrrrw
Seniority Pension
Name and Job-Class 1)r tp /Div. 12aiQ Effective Date
Michael Aleska, Firefighter Fire 314/96 314196
Elizabeth Boone, Firefighter Dire 3/4/96 314/96
Kevin Bowler, Firefighter Fire 314/96. 3/4196
Dewayne Broadwater, Custodial Worker Parks & Rec. 2/21 /95 10/ 16/95
Timothy Chaplinsky, Custodial Worker Parks & Rec. 2120196 2120196
Stephen Coward, Firefighter Fire 3/4196 3/4/96
Paul Cronin, Pub. Wks. Ser. Worker I Public Works 1/22/96 1122/96
Oscar DelBono, WWTP Oper. Trainee , Eng./WPC 2/20/96 2120196
Louis Georgantas, Firefighter Fire 3/4/96 314/96
Ronald Horne, Pub. Wks. Ser. Worker 1 Public Works 1/22/96 1122196
Donald Gulley, Custodial Worker Parks & Rec. 2/20/96 2120196
Kenneth Smith, Pub. Wks. Ser. Worker I Public Works 2/20/96 2120/96
Revlewed by: Originating Dept:
Human Resources
Legal NA ?
Budget NA..?
Purchasing _..bjA? User Dept.:
Risk Mgmt. _.NA
Cis NA
ACM Advertised:
Other A Date:
Paper:
Submitted by:
C
? Not required
Affected parties
Notified
? Not required
Costs:
Total
Current FY
Funding Source:
? Capt. imp.
? Operating
? Other
Appropriation Code:
Commission Action:
? Approved
? Approved w/conditions
? Denied
? Continued to:
Attachments:
Letter(s)
? None
r ? 4'ii.i r s, d?'.vtx e.:;'•.i ? r;., r ''da .f. ?[?<:E?.• 't'. '. ? . •'i ??! "? ; ,
.e?" ..y,="r til?`:? f, i "ri? ))I ?i? O()f'.,•. Sri" ?+? , ? '. :,.
l.,ry. .r," :, .\? ..14?.. Et?.'i!! k.l.•J? x,t' .15.x'. fA•<l.? •:t r .,• .f ..'I' ..1 .1.. . . ? ? '.S. ,. '+•
CITY OF CLEARWATER
EMPLOYEES' PENSION PLAN
PENSION ADVISORY COMMITTEE'''
TO: Pension Trustees
FROM: Pension Advisory Committee
SUBJECT. Recommendation for Acceptance into Pension Plan
' DATE: March 14; 1996
As Trustees of the City of Clearwater Employees' Pens ion Fund, you are hereby notified ' that tile
employee(s)' .fisted below have been duly examined by u 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. .
NnM,e. Job. Clnss. & De tp /Div. Him Dalf. D_=
Michael Aleska 03/04/96 03/04/96
Firefighter,, Fire Dept.
Elizabeth Boone 03/04/96 03/04/96
Firefighter, Fire Dept, %
Kevin Bowler 03/04196 03/04/96
Firefighter, Fire Dept.
Dewayne Broadwater 02/21 /95 l 0/ 16/95
Custodial Worker, Parks & Rec. Dept.
Employee hired from part-time
to full-time permanent status.
Hire date reflects date hired part-time.
Timothy Chaplinsky 02/20/96 02/20/96
Custodial Worker,' Parks & Rec. Dept.
Stephen Coward 03/04/96 03/04/96,
Firefighter, Fire Dept.
Paul Cronin 01/22/96 01/22/96
Public Works Svc. Wkr. 1, Public Works Dept.
Oscar DeiBono 02/20/96 02/20/96
WWTP Operator Trainee, Engineering/WPC
Louis Georgantas 03/04/96 03/04/96
Firefighter, Fire Dept.
Ronald Horne 01/22/96 01/22/96
Public Works Svc. Wkr. 1, Public Works Dept.
Donald Gulley 02/20196 02/20/96
Custodial Worker, Parks & Rec. Dept.
Kenneth Smith 02/20/96 02/20/96
+
.s Public Works Svc. Wkr. 1, Public Works Dept,
' TRUSTEES OF THE EMPLOYEES' PENSION FUND Item It
Agenda Cover Memorandum Meeting Date: 4/ 196
Subject:
Pension to be Granted.
Recommendatlon/Motion:
Jack D. Bryant, • Police Department, be granted a regular pension under Section(s) 2.393 and 2.397
of the Employees' Pension Plan as approved by the Pension Advisory Committee.
? and that the a ropriate officials be authorized to execute same.
E ¦????. - -_ r?i - ?r?rrr.r???rrr,?r??r?i?wwrr
BACKGROUND:
Jack D. Bryant, Police Officer, , Police Department, was employed by the City on December
8, 1969, and began participating in the Pension Plan on that date. His retirement will be effective
on April ' 1 6, 1996.
Mr. Bryant's pension was approved by the Pension Advisory Committee (PAC) on March 14, 1996.
Section 2.393 (p) provides for normal retirement eligibility when a participant has completed
twenty years of credited service in a type of employment described as "hazardous duty" a n d
further specifically defines service as a Police. Officer as meeting the hazardous duty criteria.
Based on an average salary of approximately $45,904 per year over the past five years, the formula
for computing regular pensions, and Mr. Bryant's selection of the Joint & Survivor Annuity, this
pension will approximate $33,274 annually. Charts from Finance which take into consideration
mortality rates and age reflect the "present value cost of financing" this pension will be
approximately $4.28,892. The estimated pension cost (cash payout over the life of the pensioner
and his beneficiary) is $1,028,713.
Reviewed by:
Legal
Budget _
Purchasing NA
Risk Mgmt. fS
CIS -
Other _ NA
Submitted by:
City Manager
Originating Dept:
Human Resource;
User Dept.:
Advertised:
Date:
Paper:
? Not required
Affected parties
? Notified
? Not required
Costs: S X8,-92 Commission Action:
Total
? Approved
? Approved w/conditions
Current FY ? Denied
? Continued to:
Funding Source:
? Capt. imp.
? Operating
? Other E9n2 gi},,,--
Appropriation Code:
646-gZd 10-514100-5850
D4.4
Attachments:
Letter(s)
? None
Hurt an Rasources Deportment
(913)462.6870
C I.T Y U Y C E E-A P. W A ,T.E R
POST OFFICE BOX 4746
CLEARWATER, FLORIDA 3461 8-4748
'll} Honorable Mayor and Members ''of the City Commission as Trustees of the
Employees' Pension Plan
FROM: Pension Advisory Committee
COME S: Debbie Bailey, Payroll Services Manager
Employee's File
SUBJECT: Regular Pension---Jack D. Bryant
DATE: March 14, 1996
The, Pension Advisory Committee received an application for regular pension from
Jack D. Bryant on March 5, 1996..
Mr, Bryant was. employed by the City an December 8, 1969, and has been a participant in the
Pension Plan since that date. The amount of Mr. Bryant's pension will be computed by the
Finance Department at such time as his last five years of ser vice and salary can be
calculated.
By motion made and duly carried at its nieeting of March 14, 1996, the Pension Advisory
Committee approved/recommended a regular pension based on years o[' service for
lack D. Bryant in accordance with Section 2,396 of the City Code. This pension will be
effective on May 1, 1996.
I hereby certify ' that the Pension. Advisory Committee has approved the granting of a
regular retirement pension for Jack D. Bryant and the. above dates are correct.
1t..
hairman, Pension A sory Committee
"Equal Ernploymont and Altirrnative Action Employer"
I .
CITY OF CLEARWATER
PENSION ENTITLEMENT OPTION REQUEST FORM
I, Jack D. Bryant do hereby apply to retirement from
the City of Clearwater General Employees' Pension Plan.
Job Classification: Police Officer
Department: Police
Benefits Date:
Date of Birth:' '078748
Sex: M >Ft
Division; Patrol
Date of Hire: 12%8%69
Resignation Date: 4/16/96
Spouse's Name: Lucy Bryant Sex: *t F
Spouse's Date of Birth: 4/10/42
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
Nan-job-connected Disability Pension
The City of Clearwater Employees' Pension Plan provides multiple options to Plan
Participants as to the manner of the pension benefit payment. Option I below represents
the standard or normal form of retirement benefit. 'The other optional forms (#2 - #6)
shall be computed to be the Actuarial Equivalent of the normal benefit.
ty
The normal form of retirement benefit shall be an annuity paid monthly for the life
of the Participant, with a 100% survivor annuity paid monthly for a period of five
years following the death of the Participant to the beneficiary, provided that
following such five year period the survivor annuity shall be reduced to 50% of the
original survivor annuity amount. [See section 2.397 (a) (3) (A)] The Participant's
surviving spouse receives the designated amount for the rest of his/her life or until
he/she remarries. If no surviving spouse, dependent children under the age of 18,
shall be deemed to be the beneficiary and receive the designated amount until the age
of 18. [Section 2.397 (a) (3) and Section 2.398 (e) (3)]
Qp1lon 2 - Llfe Annuity
The Participant receives his/her pension as long as he/she lives. Upon the death of
the Participant, benefits cease. [Section 2.398 (b) (2) (A) (i)]
ration 3 - 10 Year Certain _& Llfe _ Atiniiity - (must designate a beneficlary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies hrjoE; 120 monthly payments have been made, the remaining payments up to the
120 payments are made to his/her beneficiary, or the estate if his/her beneficiary is
not alive. [Section 2.397 (b) (2) (A) (ii)]
= ty - (must designate a beneficlary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 50% of the pension for the rest of their life. If the
beneficiary' dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
jjRtjQ0 S - ty - (must designate a beneficiary)
The. Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 75% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
¦' .
00flon-6--_?009(n spillt & Survlvnr Annuity . (must designate it beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 100% of the pension for the rest of their life. If
the beneficiary dies first, the Participant continues to receive 100% of his/her
pension and upon his/her death, benefits cease. [Section 2,398 (b) (2) (A) (iii)]
I have . considered the normal form of benefit payment under such Plan (which is
designated on this Form as ' Option 1) and the various alternative optional benefit payment
methods (Options 2 through 6) under such Plan and have elected to receive my retirement
benefits as indicated below. (Note: Option selection to be indicated both by Number and
Description.)
I understand that once this Form is signed, my decision is Irrevocable.
takine Ontion I sign below
Option #: Description: Ioi a0d SUrviygL
AS1IIStlSY....?....
Employee's Signature: Date: - .? 6,
Dependent children under he age of 18 an residing in my household are:
Child's Name Sex Date of Birth
Ilr_ takinj__ . Option 2 sign below: .,
Option #: 2 Description: Lj&,-nuity
Employee's Signature: Date:
_ if _ taking .Option 3, 4 5 ,--or 6 fill in beneficiary information and sin below:
Option #: Description:
My designated beneficiary is:
Name: Date of Birth: Sex M F
Social Security Number: Phone Number:
Address: ---
Employee's Signature: Date:
STATE OF FLORIDA Thu, oinstrument was ackn .?vledge before me this
COUNTY OF PINELI.AS j byf who is
personally known to me or who has provided rV. ,
?'s idegification, and wh did/did not take an 92th.
? ?? `? ; ?-? ?--? Notary Public
y t(?ign?tur
of Notary Printed
My C mmission expires:
r k- U %r U A.1 ?.
Form # CEN, -1I IL% M A?3T'.Gtt vN
'AY New 2/96 tiCn Y ruBM.ic Si'A11 OF FfAP,iDA
cOV!SS KO. C0rr,:-9
?iY C?»I`+{1551fti.s c? ^ >t.:r?•I.i4?y
I
CITY OF CLEARWATER
EMPLOYEES' SEPARATION PAY PREFERENCES
PREFERENCE #1 Employees can receive a lump sum payment for vacation, floating
holiday pay, sick leave incentive, bonus days (if applicable), and 112 of
accrued sick leave at the time of separation from the City. There will be .
no 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 month.
PREFERENCE #2 Employee can extend termination date by the time due for vacation,
floating holiday pay, sick leave incentive, bonus days (if applicable), and
112 of accrued sick leave. Termination date will be the final day of
extended time. Pension benefits will begin the following month.
Only available to employees hired prior to 1011190 or Fire bargaining
employees hired prior to 1011188.
PREFERENCE #3 Police bargaining employees can split their accumulated sick time at
one-quarter pay and one quarter early retirement time. That portion
received as one-quarter pay will have no deduction for pension nor will
it count as earnings in the calculation of the pension. The portion
applied toward early retirement time will be subject to the pension
deduction and will count as earnings for pension calc ulations.
Termination date will be the final day of extended time: pension benefits
will begin the following month.
Only available to Police employees hired prior to 10/1/90 covered by the
FOP 10 or the Sergeants and Lieutenants labor contracts.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 0 * * * * * * * * * * * 0 * * * * * * * * * 6 * * * * * * 0 * * *
I, Jack D. Bryant , 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 preferences offered to me. I choose to retire using
separation pay preference # and wish my benefits to be calculated under this
preference.
I understand that my preference cannot be changed once this
is irrevocable.
EMPLOYEE'S SIGNATURE:
SOCIAL SECURITY #:
is signed and that my decision
Q
259-82-•9359
WITNESSES: ADDRESS: 854 Trailwood Court
Palm Harbor, FL 34684
PHONE: 785-1687 DATE: 3-5-96
evi d 2196 '
Form #
TRUSTEES OF THE EMPLOYEES' PENSION FUND Item #
- Agenda Cover Memorandum . Meeting Date, 4/1/96
Subject:
Pension to be Granted.
Recommendation/Motion:
Terrance L.. Clements, Fire Department, be granted a regular pension under Section(s) 2.393 and
2.397 of the Employees' Pension Plan as approved by the Pension Advisory Committee.
and that the appropriate officials be authorized to execute same.
MArgee% mem mom.
Terrance L. Clements; Fire District Chief,, Fire Department, was employed by tile City on
January 8, 1971, and began participating in the Pension Plan on that date. His retirement will be
effective on April 13, 1996.
Mr. Clements' pension was approved by the Pension Advisory Committee (PAC) on March 14, 1995.
Section 2.393 (p) provides for normal retirement eligibility when a participant has completed
twenty years of credited service in a type of employment described as "hazardous duty" and
further specifically defines service as a Fire District Chief as meeting the hazardous duty criteria.
Based on an average salary of approximately $54;808 per year over the past five years, the formula
for computing regular pensions, and Mr. Clements' selection of the 100% Joint &. Survivor
Annuity, ' this pension will approximate $37,312 annually. Charts from Finance which take into
consideration mortality 'rates and age reflect that"'the "present value cost of financing" this
pension will be approximately $497,380. The estimated pension cost (cash payout over the life of
the pensioner and his beneficiary) is $1,337,021.
Reviewed by: Originating Dept
Human Resource:
Legal
NA
Budg
Budget _NA
Purchasing NA User Dept.:
Risk Mgm1. _ _NA __-
CIS NA
ACM Advertised:
Other NA Date:
Paper:
Not required
Submitted by: Affected parties
Notified
Not required
Citv Manager
Costs: $49?7.360 Commission Action:
Total
Approved
_ Approved wfconditions
Current FY Denied
Continued to:
Funding Source:
Capt. Imp.
Operating
Other 2onnsign -_ Attachments.,
Appropriation Code: Letter(s)
646.07410.5141011.585- None
go
31 I. T Y
TEA;`` '
Human Resources Depoitmant
(819) 462.6870
O F C I. " E A' R. -W A T E R.
POST OFFICE BOX 4748
CLEARWATER, FLORIDA 34818-4748
TQ Honorable Mayor and Members . of the City Commission as Trustees of the
Employees' Pension Plan
FROM: Pension Advisory Committee
COPITS: Debbie Bailey, Payroll Services Manager
Employee's File
SUBJECT: Regular ,Pension---Terrance L. Clements
DATE: March 14, 1996
The Pension Advisory Committee received an application' for regular pension from
Terrance L. Clements on February 16, 1996.
Mr. Clements was employed by the City on January S, 1971, and has been a participant in the
Pension Plan since that date. The amount of Mr. Clements' 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 March 14, 1996, the Pension Advisory .
Committee approved/recommended a regular, pension based on years of service for
Terrance L. Clements in accordance with Section 2.396 of the City Code. This pension will be
effective on May 1, 1996.
I hereby certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension for Terrance L. Clements and the above dates are correct.
Chairman, Pension Advis y Committee
i
"Equal Employmont and Affirmative Action Employer"
CITY OF CLEARWATER
PENSION REQUEST FORM
I, Terrance L. Clements do hereby apply to retirement from the City
of Clearwater General Employees' Pension Plan.
Job Classification: F8r; Di5lrict Chief - Sex: M R
Department: Fire Division: jam
Benefits Date: b 1 /I.I Date of Hire:
Date of Birth: _ _06128/43 _ Resignation Date: 44113/96
Spouse's Name: /'?'? r AEU.,F s Sex: #4 F
Spouse's Date of Binh: 11/11/47
The type of pension for which I am applying is (check only one):
-XX-- Regular 'Pension based on years of service
Job-connected Disability Pension .
Non-job-connected Disability Pension
The City of Clearwater Employees' Pension Plan provides multiple options to Plan
Participants as to the manner of the pension benefit payment. Option 1 below represents
the standard or normal form of retirement benefit. The other optional forms (42 - #6)
shall be computed to be the Actuarial Equivalent of the normal benefit.
ty
The normal form of retirement benefit shall be an annuity paid monthly for the life
of the Participant, with a 100% survivor annuity paid monthly for a period of five
years following the death of the Participant to the beneficiary, provided that
following such five year period the survivor annuity shall be reduced to 50% of the
original survivor annuity amount. [See section 2.397 (a) (3) (A)] The Participant's
surviving spouse receives the designated amount for the rest of his/her life or until
he/she ' remarries. If no surviving spouse, dependent children under the age of 18,
shall be deemed to be the beneficiary and receive the designated amount until the age
of 18. [Section 2.397 (a) (3) and Section 2.398 (e) (3)]
Qptign 2 - Life Annuity
The Participant ,
receives his/her pension as long as he/she lives. Upon the death of
the Participant, benefits cease. [Section 2.398 (b) (2) (A) (i)]
' Annuity - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies More 120 monthly payments have been made, the remaining payments up to the
120 payments are made to his/her beneficiary, or the his estate if his/her beneficiary
is not alive. [Section 2.397 (b) (2) (A) (ii)]
S Annuity - - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 50% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
Annuity - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 75% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii))
i
ty - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
'dies first, the beneficiary receives 100% of the pension for the rest of their life. If
the beneficiary dies first, the Participant continues to receive 100% of his/her
pension and upon -his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
I have considered the normal form of benefit payment under such Plan (which is
designated on this Form as Option 1) and the various alternative optional benefit payment
methods (Options 2 through 6) under such Plan and have elected to receive my retirement
benefits as indicated below. (Note: Option selection to be . indicated both by Number and
Description.)
I understated that once this Form is signed, my decision is irrevocable.
skint! Option I slen below:
Option #: _J_ Description: joint and Sryivor Annuity
Employee's Signature: Date:
Dependent children under the age of 18 and residing in my household are:
Child's Name Sex Date of Birth
If takin Option 2 sign below: _ .. ??
Option ,2„_ Description: LA Annuity
Employee's Signature: Date:
Option #: (a Description: _l00 '?)o VV r"7- s %5ye?/00,'e Xi AAJ 1:.I)r?
if t2King_-_.__Option3 , ,_ 4, 5, or 6 fill in beneficiary information and sign
ow:
My designated Uen ??? ry?:e
Name: __.rSd?`d<sG Date of Birth: // /r tf ? Sex <F
op I
Social Security Number: /00 -- 3J _A 8 7 7 Phone Number: 68.422!Yz -8 psZ
v?
Address,
l? ?l
Employee's Signature: Date:
STATE OF FLORIDA The foregoing instrument was acknowledged before me this
COUNTY OF PINELLAS 1 _ : & - T by T -o r , a r, [ e L - C 4 vt es,4 K who is
ersonally known to me or who has provided
as identification and ho did/did not take an oath.
CLA,_.L'\Cj^ Notary Public
(Sisnai e)
3)-., bu ?c_ k k. <,' t r.4 + Name of Notary Printed
My Commission expires:
FF1 1A 1'OTARY SEAL
Form DEBORA" K STRU TT
New 1/96 Form # #
SC7rARY PUBLIC STA'L'E OF FLORIDA
CO`~SMISSIO?S No. CC2g3329
Mt C't??+timl , inn Exp. MAY 22.1997
I&l
i
CITY OF CLEAR WATER
GENERAL EMPLOYEES' PENSION PLAN OPTIONS
OPTION, #1 Employees can receive a lump sum payment for vacation, floating
holiday pay, sick leave incentive, bonus days (if applicable), and 1/2 of
accrued sick ]cave at the time of separation from the City. There will be
no deduction for pension from this lump sum payment nor will thiti
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,
floating holiday pay, sick leave incentive. bonus days (if applicable), and
1/2 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 10/1/90 or Fire bargaining
employees hired prior to 10/1/$$.
OPTION. #3 Police bargaining employees can split their accumulated sick time at
one-quarter pay and one-quarter early retirement time. That portion
received as one-quarter pay will have no deduction for pension nor will
it count as earnings in the calculation of the pension. The portion
applied toward early retirement time will be subject to the pension
deduction and will count as earnings for pension calculations.
Termination date will be the final day of extended time; pension benefits
will begin the following day.
Only available to Police employees hired prior to 10/1/90 covered by the
FOP 10 or the Sergeants and Lieutenants labor contracts.
1, Terrance L, QCMenta 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 options offered to me. I choose to retire using Option
# . 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 #: .,267-62. 059(1
WITNESSES: ADDRESS: 1408 Carlos Ave ue
1„y Cicarwaler. 34615
! 1, -IA.24.AL PHONE: 442-8150 DATE:. x??
Revised 1/96
Form #
E
r
• TRUSTEES OF THE EMPLOYEES' PENSION FUND . Item tf
Meeting Date: 411 / g g ?
Mir_ Agenda Cover Memorandum
t
Subject:
r
Pension to be Granted.
Recommendation/Motion:
t
Ellen G. Darrington, Parks & Recreation Department, be granted a regular pension under
Section(s) 2.393 .and 2.397 of the Employees' Pension Plan as approved by the Pension Advisory
Committee.
? and that the appropriate officials be authorized to execute same.
BACKGROUND:
Ellen G. Darrington, Senior Supervisor, Parks & Recreation
Department, was employed by the City on September 8, 1960, in a part-time status. She changed
to full-time on April 7, 1969, and began participating in the Pension Plan on that date. Her
retirement will be effective on February 14, 1997.
Ms. Darrington's pension was . approved by tine Pension Advisory Committee (PAC) on
March 14, 1996, Section 2.393 (p) defines normal retirement date as when a participant reaches
age 55 and has completed twenty years of credited service or when the participant has completed
thirty years of credited service regardless of age. Ms. Darrington is eligible under the age 55 and
twenty years of service criteria.
Based on an average salary of approximately $35,530 per year over the past five years, the formula
for computing regular pensions, and Ms. Darrington's selection of the 50% Joint & Survivor
Annuity, this pension will approximate $25,444 annually. Charts from Finance which take into
consideration mortality rates and age reflect the "present value cost of financing" this pension
will be approximately $305,307. The estimated pension cost (cash payout over the life of tile
pensioner and her beneficiary) is $763,333.
Reviewed . by:
Legal _ NA
Budget NA
Purchasing NAA
Risk Mgmt. NA
CIS NA
ACM
Other NA
Submitted by:
Originating Dept:
Human Resource;
User Dept.:
Advertised:
Date:
Paper:
? Not required
Affected parties
? Notified
? Not required
Costs: $205.307
Total
Current FY
Funding Source:
? Capt, imp.
? Operating
? Other Pension
Appropriation Code:
Commission Action:
? Approved
? Approved w/conditions
? Denied
? Continued to:
Attachments:
Letter(s)
? None
City Manager 90
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" C I. T Y Q' F C L E A R W A T E R
l; POST OFFICE BOX 4748
TE A,
CLEARWATER, FLORIDA 34618-4748
W:
N ,
I,.
Humcn Rosowces Deportment '
(813) 462.6870
'It7 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---Ellen G. Darrington
DATE; March 14, 1996
The . Pension Advisory Committee ' received an , application for regular pension from
Ellen G. Darrington on February 22, 1996. .
Ms. Darrington was employed by the City on September 8, 1960, and has been a participant
in , the Pension Plan since April 7, 1969. The amount of Ms. Darrington's 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 March 14, 1996, the Pension Advisory
Committee approved/recommended a regular pension based on years of service for
Ellen G. Darrington in accordance with Section 2.396 of the City Code, This pension will be
effective on March 1, 1997.
I hereby certify. that the Pension Advisory Committee has approved the granting of a
regular retirement pension for Ellen G. Darrington and the above' dates are correct.
Chairman, Pension A ory Committee
"Equal Employment and Affirmativo Action Employer'
4
is ? ? .. ., •. 'i Ji• ?. ?, .... ? ? ?
CITY OF CLEAR'WATER
PENSION REQUEST FORM
1, lca G. nsarringlon _ do hereby apply to retirement
from the City, of Clearwater General Employees' Pension Plan.
Job Classification: -•?Senior___RecreatiQ2 Supervisor _ Sex: M F
Department: Pijrk,5 & Recregtion__ _ .,?. Division, _2Qgram Admin.
Benefits Date: 04/07169 Date of Hire: -A2108/60
Date of Birth: 02108/42 Resignation Date: 02114/97
Spouse's Name: NIA Sex: M F
Spouse's Date of Birth:
The type of pension for which I am applying is (check only one):
XX_ Regular Pension based on years of service
Job-connected Disability Pension
Non-job-connected Disability Pension
The City of Clearwater Employees' Pension Plan provides multiple . options to Plan
Participants as to the manner of the pension benefit payment. Option 1 below represents
the standard or normal form of retirement benefit.. The other optional forms (#2 - #6)
shall be computed to be the Actuarial Equivalent of the normal benefit.
a u v•v A ty
The normal form of retirement benefit shall be an annuity paid monthly for the life
of the Participant, with a 100% survivor annuity paid monthly for a period of five
years following the death of the Participant to the beneficiary, provided that
following such five year period the survivor annuity shall be reduced to 50% of the
original survivor annuity amount. [See section 2.397 (a) (3) (A)] The Participant's
surviving spouse receives the designated amount for the rest of his/her life . or until
he/she remarries, If no surviving spouse, dependent children under the age of 18,
shall be deemed to be the beneficiary and receive the designated amount until the age
of 18. [Section 2.397 (a) (3) and Section 2.398 (e) (3)]
Opion 2 - Lifc Annu.]ity
The Participant receives his/her pension as long as he/she lives. Upon the death of
the Participant, benefits cease. [Section 2,398 (b) (2) (A) (i)]
!Qpfign - Annuity -
-3- 10 Year C.crialn .-.& Life- (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies before 120 monthly payments have been made, the remaining payments up to the
120 payments are made to his/her beneficiary, or the his estate if his/her beneficiary
is n ot alive. [Section 2,397 (b) (2) (A) (ii)]
Qption 4 - 50% ,joint . Scj'jurvivor Annuity - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 50% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
QVIion 5 - Me join-L& Survivor Annuity - (rnust designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 75% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
L.,`
Q.ptjan 6 - 100% Joint & Stlrv?X (must designate 'a beneficiary)
The Participant receives his/her pension as long as lie/she lives. If the Participant
dies first, the beneficiary receives 100% of the pension for the rest of their life. If
the beneficiary dies first. the Participant' continues to receive 100% of his/her
pension and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
I have considered the normal form of benefit payment under such Plan (which is
designated on this Form as Option 1) and the various alternative optional benefit payment
methods (Options 2 through 6) under such Plan and have elected to receive my retirement
benefits as indicated below. (Note: Option selection to be indicated both by Number and
Description.)
I understand that once this Form is signed, my decision is irrevocable.
it takine option 1 sten below:
Option #:.J Description: Joint god Survivor Annuity-
Employee's Signature: Date:
Dependent children under the age of 18 and residing in my household are:
Child's Name Sex Date of Birth
If taking Option, 2 sin below:
Option #: _2_ Description: Lif Annuity
Employee's Signature: Date:
If taking Option 3, 4, S. or Cr fill in beneficiary inrormation and sign below:
Option ##:._ Description: 5°r,?-c 3o a rtOk t)o i2
My deli hated, beneficiary is: ,
Name: (L ? A ??-k 0 ? Date of Birth: I 9 Sex M CF
Social Security Number: I. - Ct C? Z Phone Number: L o -14 4
Address: SUS r4 N! fit'
11 t W 55 E E C PC . 3c, 5 y b --
a. aa.l
Employee's Signature: -•-? Date:
STATE OF FLORIDA The foregoing instrument was acknowledged before me this
COUNTY OF PINELLAS Flag un Lz ?1 z 2 q9? by 1 1-e h N v -;,, 54,c+r-i ------who is
a y kno n to me or who has provided
as i enti ication and i id not take an oath.
Notary Public
(inns )
?4 ru Name of Notary Printed
My Commission expires:
Form # RY SEAL
Si'RUCP
New 1/96
TE Of FLORIDA
V. CC263329
P. MAY 221497
EM
CITY OF CLEARWATER
GENERAL EMPLOYEES' PENSION PLAN OPTIONS
;i
I`
I, OPTION #1 Employees can receive a lump sum payment for vacation, floating
?i. holiday pay, sick leave incentive, bonus days (if applicable), and 112 of
`. accrued sick leave at the time of separation from the City.' There will be
I' no 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,
floating holiday pay, sick leave incentive, bonus days (if applicable), 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 or Fire bargaining
employees hired prior to 1011188.
OPTION #3 Police bargaining employees can split their accumulated sick time at
one-quarter • pay and one-quarter early retirement time. That portion
received as one-quarter pay will have no deduction for pension nor will
it count as earnings in the calculation of the pension. The portion
applied toward early retirement time will be subject to the pension
deduction and will count as earnings for pension calculations.
Termination date will be the final day of extended time; pension benefits
will begin the following day.
Only available to Police employees hired prior to 10/1/90 covered by the
FOP 10 or the Sergeants and Lieutenants labor contracts.
I, _E,1letl G. _Darringlon 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 options offered to me. I choose to retire using Option
# and wish my benefits to be calculated under this option.
1 understand that once this form is signed, my decision is irrevocable.
EMPLOYEE'S SIGNATURE: w
SOCIAL SECURITY #: 257-b2.035,_,.)(
I
WITNESSES: ADDRESS: 1825 Willow Oak-Drive
Palin Harbor. 3
,-?? y'. C,,_ ? PHONE: DATE: _ ??a •? ?I ',
Revised 1196
Form #
t
t .
TRUSTEES OF THE EMPLOYEES' PENSION FUND
Agenda Cover Memorandum r7
Item #
Meeting Date: AI I. / 9 s
Subject:
Pension to be Granted.
Recommendation/Motion:
Wayne Vanden Berg, Fire Department, be granted a regular 'pension under Section(s) 2.393 a n d
2.397 of the Employees' Pension Plan as approved by the Pension Advisory Committee.
0 and that the appropriate officials be authorized to execute same.
BACKGROUND:
Wayne Vanden Berg, Firefighter, Fire Department, was employed by the City on
March 31, 1966, and began participating in the Pension Plan on September 30, 1966. His
retirement will be effective on March 31, 1996.
Mr. Vanden Berg's pension . was approved by the Pension Advisory Committee (PAC) on March 14,
1996. Section 2.393 (p) provides for normal retirement eligibility when a participant has
completed twenty years of credited service in a type of employment described as "hazardous duty"
and further specifically defines service as a Firefighter as meeting the hazardous duty criteria.
Based on an average salary of approximately $43,047 per year over (lie past five years, the formula
for computing regular pensions, and Mr. Vanden Berg's selection of the 100% Joint & Survivor
Annuity, this pension will approximate $34,026 annually. Charts from Finance which take into
consideration mortality rates and age reflect that the "present value cost of financing" this
pension will be approximately $456,319. The estimated pension cost (cash payout over the life of
the pensioner and his beneficiary) is $1,222,105.
At the time of Mr. Vanden Berg's employment, pension deductions for employees were n o t
immediately commenced. Subsequently, when employees were provided an opportunity to make
up pension contributions, he did not elect to do so. He began contributing to the plan on
September 30, 1966.
Reviewed by:
Legal NA
Budget NA
Purchasing N6
Risk Mgmt. NA
C(S.-- NA -
ACM
Other NA
Submitted by:
City Manager
Originating Dept:
Human Resource;
User Dept.:
Advertised:
Date,
Paper:
? Not required
Affected parties
? Notified
? Not required
Costs: x_5.319
Total
Current FY
Funding Source:
? Capt. Imp.
? Operating
? Other Ponsign
Appropriation Code:
046-07410-51 A 100-505-
ND
Commission Action:
? Approved
? Approved w/conditions
? Denied
? Continued to:_
Attachments:
Letter(s)
? None
human Resources Deportment
(813) 462-6870
C I T Y
O F -C L L A R-W ,A T E R
POST OFFICt3 BOX 47411
CLEARWATER, FLORIDA 04016-4740
T(). 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--Wayne Vanden Berg
DATE: March 14, 1996
The . Pension Advisory Committee received ' an application for regular pension from
Wayne Vanden Berg on February 15, 1996,
Mr. Vanden Berg was employed by the City on March 31, 1966, and has been a participant in
the Pension Plan since September 30, 1966. The amount of Mr, Vanden Berg'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 March 14, 1996, the Pension Advisory
Committee approvedlrecotnmended a regular. pension based on years ' of service for
Wayne Vanden Berg in accordance with Section, 2.396 of the City Code. This pension will be
effective on April 1, 1996.
1 hereby - certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension. for Wayne Vanden Berg and the above dates are correct.
Chairman, Pension Advis y Committee
"Equal Employment rind Affirmative Action Employer"
CI TY OF CLEARWATER
PENSION REQUEST FORM
L,
Wayne Vanden !ler do hereby apply to retirement from
the City of Clearwater General Employees' Pension Plan.
Job Classification: Sex: M Y X
Department: Fire Division: "P4 S
Benefits Date: 0930 6ti Date of Hire; (7 3 j /U-
Date of Hirsh: 03/10Z40_ ,., Resignation Date: __U /
31 /96
Spouse's Name: Candace L. Vanden Berg Sex: a F
Spouse's Date of Birth: 06/21/48
The type of pension for which 1 am applying is (check only one):
XX Regular Pension based on years of service
Job-connected Disability Pension
Non-job-connected Disability Pension
The City of Clearwater Employees' Pension Plan provides multiple options to Plan
Participants as to the manner of the pension benefit payment. Option 1 below represents
the standard or normal form of retirement benefit. The other optional forms (##2 - #16)
shall be computed to be the Actuarial Equivalent of the normal benefit,
ty
The normal form . of retirement benefit shall be an annuity paid monthly for the life
of the Participant, with a 100% survivor annuity paid monthly for a period of five
years following the death of the Participant to the beneficiary, provided that
following such five year period the survivor annuity shall be reduced to 50% of the
original survivor annuity amount. [See section 2.397 (a) (3) (A)) The Participant's
surviving spouse receives the designated amount for the rest of his/her life or until
he/she remarries. If no surviving spouse, dependent children under the age of 18,
shall be deemed to be the beneficiary and receive the designated amount until the age
of 18. [Section 2.397 (a) (3) and Section 2.398 (e) (3))
The Participant receives his/her pension as long as he/she lives. Upon the death of
the Participant, benefits cease. [Section 2.398 (b) (2) (A) (i)]
(ption _3? -_ 10 Ygar Cgrtain & 1.1fe Annuity - (must designate a beneficiary)
The Participant receives his/her pension as long as be/she lives. If the Participant
dies 'kefore 120 monthly payments have been made, the remaining payments up to the
120 payments are made to his/her beneficiary, or the his estate if his/her beneficiary
is not alive. [Section 2.397 (b) (2) (A) (ii)]
011tion -4 .- 5Q°iJgll3t_&_Survivor nng t,y - (must designate a benericlttry)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 50% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii))
Qntion 5 75% -joint & Survivar nnuity - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 75% of the pension for the rest of their life, if the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death. benefits cease. [Section 2.398 (b) (2) (A) (iii)]
ra
Option _6.__ . 1601-10181 _?C..SUEZJ,Y,U ,g0?ty - (must designate a benenclary)
The Participant receives his/her pension its tong ss he/she lives. If the Participant
dies ? first, the beneficiary receives 100% of the pension for the rest of their life. if
the beneficlary dies first, the Participant continues to receive 100% of his/her
pension and upon his/her death, benefits cease. [Section 2.398 (b). (2) (A) (iii))
I have considered the normal form of benefit payment under such Plan (which is
designated on this Form as Option 1) and the various alternative optional benefit payment
methods (Options 2-through 6) under such Plan and have elected to receive my retirement
benefits as indicated below. (Note: Option selection to be. indicated both by Number and
Description.)
I understand that once this Form is signed, my decision is irrevocable.
it taking Uption
option. #: ?,.
Employee's Signature:
Date:
Dependent children under the age of 18 and residing in my household arc:
Child's Name Sex Date of Birth
If taking Option 2 sign below:
? 5 i•n w. w.wn A.??? rr?r ??i ? i .i r ??i? I? wr
Option #:'-2_ Description: Lift Annuity
Employee's Signature: Date:
IT taking option 3 4 S or 6 fill in beneficiary inrormation and sin below:
Option Description: j?eoh .1 o N %- So v Jail uv ry
My designated beneficiary is:
Name: 15e q Date of Birth: 1?. N fl Sex M C
Social Security Number: ?„?? -_ t.• t ?' _ Phone Number: J-3 9 g
Address: _ 7 7 a Q?/s s1` ?I, G/at ?.,>.?-iL fG,s? , 3
Employee's Signature:
ow:
,,,, •_
Description: _ Joint Ad-Survivor Annuity
Date: 0 i -*r
STATE OF FLORIDA
COUNTY OF PD ELLAS
Form #
New 1/96
The foregoing instrument was acknowledged before me this
a-.I 16.1 S co by L420yn F Ede Y4nde+Z who is
personally known to me or who has provided lfb G VS35.8$S
as identification and who did/did not take an oath. C746 `(?R O-0
-a-%L t) 31101 Cj
' Notary Public
(Signatur?)42-40*0 IUArue.ca ?}n.1Name of Notary Printed
My Commission expires: 17-11L4
CITY OF CLEARWATER
GENERAL EMPLOYEES' PENSION PLAN OPTIONS
i
,f
1!
OPTION #1., Employees can receive a lump sum payment for vacation, floating
holiday pay, sick leave incentive. bonus days (if applicable), and 1/2 of
accrued sick leave at the time of separation from the City. There will be
no, 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,
floating holiday pay, sick leave incentive, bonus days. (if applicable), and
1/2 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 10/1/90 or Fire bargaining
employees hired prior to 10/1/88.
OPTION #3 Police bargaining employees can split their accumulated sick time at
one-quarter pay and one-quarter early retirement time. That portion
received as one-quarter pay will have no deduction for pension nor will
it count as earnings in the calculation of the pension. The. portion
applied toward early retirement time will be subject to the pension
deduction and will count as earnings for pension calculations.
Termination date will be the final day of extended time, pension benefits
will begin the following day.
Only available to pie employees hired prior to 10/1/90 covered by the
FOP 10 or the Sergeants and Lieutenants labor contracts.
titttittttttittdtt ttttif?b#tiiGtittttiiiitttiiitiiiiitiitttttitttttiii*tttttii
1, Wayne Vanden )3 e r , 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 options offered to me. I choose to retire using Option
# / 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 #: 2 5 5- 5 6- 4 9 8 5
WITNESSES: ADDRESS: 1975 Oak S t r e e t
`1 vi ,}., to Clearwater, FT, 34620
c..? PRONE, 531-2958 DATE: 2-11S I B
Revised 1/96
Form #
' TRUSTEES OF THE EMPLOYEES' PENSION FUND item
Agenda Cover Memorandum Meeting Date:
.: Ell
Stabject: ,
Pension to be Granted.
, bra ?wwww?r?rurrru?rr,mn?nnnnnniruoi?rrrrr?rrrri y???
Recommendation/Motion:
Albert Myrick, Public Works Department, be granted a regular pension under Section(s) 2.393 and
2.397 of the Employees' Pension Plan as approved by the Pension Advisory Committee.
C].and that the appropriate,. officials be authorized to execute same.
BACKGRCXJND:
Albert Myrick, Equipment OperatorIll, Public Works Department,was employed by
the City on October 26. 1955, and began participating in the Pension Plan on that date. His
retirement will be effective on March 29, 1996.
Mr. Myrick's pension was approved by the Pension Advisory Committee (PAC) on March 14, 1996.
Section 2,393 (p) defines normal retirement date as when a participant reaches age 55 and has
completed twenty years of credited service or when the participant has completed thirty years of
credited service regardless of age. Mr. Myrick is eligible under either criteria..
Based on an average salary of approximately $30,524 per year over the past five years, the formula
for computing regular pensions, and Mr. Myrick's selection of the 100% Joint & Survivor Annuity,
this pension will approximate $24,589 annually. Charts from Finance which take into
consideration mortality rates and age reflect the "present value cost of financing" this pension
will be approximately $322,824. The estimated pension cost (cash payout over the lift: of t h e
pensioner and his beneficiary) is $771,565.
Reviewed by: Originating Dept: - Costs: $122.824 Commission Action:
Human Resources Total
Legal N6 , ? Approved
Budget . NA _
Purchasing _ NA
User Dept.:
Current FY ? Approved w/conditions
? Denied
Risk Mgmt. _ NA ? Continued to:
CIS.__NA Funding Source:
ACM Advertised: ? Capt. Imp.
Other NA__ Date:
Paper: ? Operating
? Other P_e_ns_io_n _
Attachments:
? Not required
Submitted by: Affected parties
? Notified Appropriation Code: Letter(s)
? Not required 646-07410-514100-585- ? None
City Manager Q44
POST OFFICE HOX 47'46
CLEARWATER, FLORIDA 344318-4748
tatnran Rasotxcas Department
(813) 462-6870
Tl? 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-Albert Myrick
DATE: March 14, 1996
The Pension Advisory Committee received an application for regular, pension from
Albert Myrick on February 22, 1996.
Mr. Myrick was employed by the City on October 26, 1965, and has been a participant in the
Pension Plan since that date. The amount of Mr. Myrick's pension will be computed by t h e
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 March 14, 1996, the Pension Advisory
Committee approved/recommended a regular pension based on years of service for
Albert Myrick in accordance with Section 2.396 of the City Code. This pension will be
effective on April 1, 1996.
I hereby certify that the Pension Advisory Committee has approved the granting of a
regular retirement pension for Albert Myrick and the above dates are correct.
Chairman, Pension Adv' ry Committee
'Equal Ernplaymont and Affirmative Action Employcar"
CITY OF CLEARWATER
PENSION ENTITLEMENT OPTION REQUEST FORM
1, ,, RL_,bsg ' 4 Rtcv do hereby apply to retirement from
the City of Clearwater General Employees' Pension Plan.
Job Classification: _.t9wi mPkilt DPEO-hrom _ Sex:( F
Department: tia-¢„?? < t,?]cs?,xs Division: Vu bum SG K&Ii ,?,
Benefits Date: a . I cb5 Date of Hire: 1d 1 A(, Ito! _
Date of Birth: 9 I-ay1 5% Resignation Date: 4 !R
Spouse's Name: ? ?h [tiR? H A fts* Rlt K Sex: Me
Spouse's Date of Birth: ?, 1r1y3 -
The type of pension for which I am applying is (check only one):
Regular Pension based on years of- service
Job-connccted Disability Pension
Non-job-connected Disability Pension
The City of Clearwater Employees' Pension Plan provides multiple options to Plan
Participants as to the manner of the pension benefit payment. 'Option 1 below represents
the standard or normal form of retirement benefit. The other optional forms (#2 - #6)
shall be computed , to be the Actuarial Equivalent of the normal benefit.
ty
The normal form of retirement benefit shall be an annuity paid monthly for the life
of the Participant, with a 100% survivor annuity paid monthly for a period of five
years following the death of the Participant to the beneficiary, provided that
following such five year period the survivor annuity shall be reduced to 50% of the
original survivor annuity amount. [See section 2.397 (a) (3) (A)] The Participant's
surviving spouse receives the designated amount for the rest of his/her life or until
he/she remarries. If no surviving spouse, dependent children under the age of 18,
shall be deemed to be the beneficiary and receive the designated amount until the age
of 18. [Section 2.397 (a) (3) and Section 2.398 (e) (3))
The Participant receives his/her pension as long as he/she lives. Upon the death of
the Participant, benefits cease. (Section 2,398 (b) (2) (A) (i)]
QAtinn 33 x10 Year. C4rtjin_ LifeAnnuity - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies brfore 120 monthly payments have been made, the remaining payments up to the
120 payments are made to his/her beneficiary, or the estate if his/her beneficiary is
not alive. May designate the estate as beneficiary. [Section 2.397 (b) (2) (A) (ii)]
.091io L4 ?- 50% .Ioiqt- &_ Survivor_ Annuity - (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 50% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
Qom..,; 7;._yg IS1ent Slitylylir Auj)11[ty - (must designate a beneficiary)
The Participant receives hislher pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 75% of the pension for the rest of their life. If the
beneficiary dies first, the Participant continues to receive 100% of his/her pension
and upon his/her death, benefits cease. [Section 2,398 (b) (2) (A) (iii)]
..c . '4•.. yr .. ... .. ..
Qptinr, 6 Joint- & Sue r Annuity - ' (must designate a beneficiary)
The Participant receives his/her pension as long as he/she lives. If the Participant
dies first, the beneficiary receives 100% of the pension for the rest of their life. If
the beneficiary dies first, the Participant continues to receive 100% of his/her
pension and upon his/her death, benefits cease. [Section 2.398 (b) (2) (A) (iii)]
I have considered the normal form of benefit • payment under such Plan (which is
designated on this Form as Option 1) and the various alternative optional benefit payment
methods (Options 2 through 6) under such Plan and have elected to receive my retirement
benefits as indicated below. (Note: Option selection to be indicated both by Number and
Description.)
I understand that once this Form. Is signed, my decision is Irrevocable.
If taking Uation I sign below:
Option #: I Description: Point and Survivor AnnuitX
Employee's Signature: Date:
Dependent children under the age of 18 and residing in my household are:
Child's Name Sex Date of Birth
If taking Option 2 sign below:
Option #: 2-_ Description: Life Annuity
Employee's Signature: Date:
If taking Option. 3 4 S or 6 fill in beneficiary_ information and _sign below:
Option #: t Description: Y3U?ln _dow * SUt,vtvaR NuaU ITS
My designated beneficiary is:
Name: it?t3RZNQ m_ Ry Date of Birth: a I-) 'S Sex M
Social Security Number: ?tnte - [?? • 4565 S _ __ Phone Number: 6 pia _y ],1?
Address: IS?o QK\t- V {L1-Nc c -De-we
Employee's Signature: Date:`
STATE OF FLORIDA The foregoing instrument was acknowledged before me this
COUNTY OFPINELLAS y IL by who is
`.
personally known to me or who has provided i"?- M% `?? 4 t r,
ld?entiticantipn> d +io did/did not take an oath.
signatu
Name of Notary Printed
My Commission expires:
OFFICIAL NOTARY SEAL
Form # DEBORAH K STRUTT
Ncw 2/96 NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC283329
tif? %t) :'1S5? 1\ FXP. MAY 220997
t
CITY OF CLEARWATER
GENERAL EMPLOYEES' PENSION PLAN OPTIONS
OPTION #1 Employees can receive a lump. sum payment for vacation, floating
holiday pay, sick leave incentive, bonus days (if applicable), and 1/2 of
accrued sick leave at the time' of separation from the City. There will be
no 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,
floating holiday pay, sick leave incentive, bonus days (if applicable), and
1/2 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 10/1/90 or Fire bargaining
employees hired prior to 10/1/88.
OPTION #3 Police bargaining employees can split their' accumulated sick time at
one-quarter pay and one-quarter early retirement, time. That portion
received as one-quarter pay will have no deduction for pension nor will
it count as earnings in the calculation of the pension. The portion
applied toward early retirement time . will be subject to the pension
deduction and ' will count as earnings for pension calculations.
Termination date; will be the final day of extended time; pension benefits
will begin the following day.
Only available to Police employees hired prior to 10/1/90 covered by the
FOP 10 or the Sergeants and Lieutenants labor contracts.
****w***wwwwwww**wwww*************w+*w*****w*r#***r***w*ww**ww***w*******#*ww
I, -aT C 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 options offered Jo me. I choose to retire using Option
# , I and wish my benefits to be calculated under this option.
I understand that once this form is signed, my decision is
EMPLOYEE'S SIGNATURE:
SOCIAL SECURITY
WITNESSES: ADDRESS:. S5S
C?at*?-?? A!!/?`a--? - PHONE; lam' ?.? -
Revised 1/96
Form #
irrevocable.
F L 3A Ia y!&
DATE: __cl-1 as ) q /d
hW-:
s
TRUSTEES OF THE EMPLOYEES' PENSION FUND
Agenda Cover Memorandum
item p
Meeting Data:
I. q
SUBJECT:
QUALIFIED.PENSION PLAN CONSULTING SERVICES
RECOMMENDATION/MOTION:
Confirm the engagement of Godwins Booke & Dickenson to provide consulting
services regarding administration of a qualified pension plan for an amount not
to exceed $5,000
IM and that the appropriate officials be authorized to execute same.
BACKGROUND:
* Effective January 1, 1596, the Employees' Pension Plan became a qualified
plan.
* The City intended to have a third-party pension administrator on board
immediately to handle the pension plan due to the complicated legal and
tax implications of a qualified plan.
* The City prepared and issued an RFP for services for a third-party
administrator. Unfortunately, only two proposals were received and both
were unacceptable to the City.
* It became imperative that the City obtain immediate, competent help to
assist the City with the in-house implementation until a third-party
administrator could be hired.
* Godwins Booke & Dickenson (formerly Ogle & Waters) is a firm with an
excellent reputation for employee benefits consulting services. They are
located in Clearwater, and previously contracted with and assisted the
City with the implementation of the Section 125 Program.
* Godwins Booke & Dickenson were contacted and were available to provide
immediate assistance.
* Funds are available in the Employees' Pension Fund.
Reviewed by: Originating Dept: Costs: S 5.000 Comission Action:
Legal NIA Finance Total 13 Approved
Budget "`? `1Y17(? ? Approved k/conditions
Purchasing S 5.040
Risk Mgmt. N/A
?. User Dept: CurrentFtscaYr. ? Denied
N/A
Cis ? Continued to:
ACM Funding source:
?
other Capital Imp.
Advertised: ? Operating Attachments-
Date: 0 Other Emn.
Pension
Plnn Proposal Letter
+ Paper: _
_
t ? Not Re
uired
?
Subai t Iby q
Affected Parties
Appropriation Code: E3 Hone
,
r
? ? Notified 646-07410-530100.585.000
,
Required
13 Not
Cit Manager
Gomm :BooKL ? DicJcENsoN
13535 Festher Sound Drive, Suite 600
Clearwater, FL 34622.5545
(813) 573-2884 FAx (813) 573.1073
(813) 571-1440
Match 1, 1996
Ms. Debbie Bailey
City.af Clearwater
Post Office Box 4748
Clearwater, Florida 34518
Re: City of Clearwater General Employees' Pension Plan
Dear Debbie:
Dave Shanks and I enjoyed our telephone conversation with you today and we-look
forward to assisting you and the City of Clearwater with various actuarial and
administrative issues which have arisen recently.
Specifically, we intend to assist you by
• Providiag you with guidance on the issues of immediate concern,
Reviewing your plan document for the qualifications of a §414(h) plan, and
o Reviewing your administrative procedures for compliance.
We expect to be able to provide you with these initiul consulting services for a fec not to .
exceed $5,000.
Should you have any questions, please call me or Dave at any time. Meanwhile, I look
forward to meeting you on Tuesday.
Sincerely yours,
Fred Wiliia.tna
Cousul&g Actuary
FW:alw
.F. AnACWcompmy
r