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12/13/2010 4 PENSION TRUSTEES AGENDA Location: Council Chambers - City Hall Date: 12/13/2010- 8:30 AM 1. Call to Order 2. Approval of Minutes 2.1 Approve the minutes of the November 1, 2010 Pension Trustees meeting as submitted in written summation by the City Clerk. Attachments 3. Pension Trustee Items 3.1 Approve new hires for acceptance into Pension Plan as listed and recommended by the Pension Advisory Committee. Attachments 3.2 Approve the requests of employees Deborah Richter of Police, Mark Goheen of Parks and Recreation, Joseph Young of Police, and Ronald Sudler of Police for regular pensions as provided by Sections 2.397 and 2.398 of the Employees' Pension Plan as recommended by the Pension Advisory Committee. Attachments 4. Other Business 5. Adjourn Meeting Date: 12/13/20 10 Pension Trustees Agenda Council Chambers - City Hall SUBJECT / RECOMMENDATION: Approve the minutes of the November 1, 2010 Pension Trustees meeting as submitted in written summation by the City Clerk. SUMMARY: Review Approval: 1) Clerk Cover Memo Item # 1 TRUSTEES OF THE EMPLOYEES' PENSION FUND MEETING MINUTES CITY OF CLEARWATER November 1, 2010 Present: Chair/Trustee Frank Hibbard, Trustee George N. Cretekos, Trustee John Doran, Trustee Paul Gibson, and Trustee Bill Jonson. Also William B. Horne II - City Manager, Jill S. Silverboard - Assistant City present: Manager, Rod Irwin - Assistant City Manager, Pamela K_ Akin - City Attorney, Rosemarie Call - City Clerk, and Patricia O. Sullivan - Board Reporter. Unapproved To provide continuity for research, items are in agenda order although not necessarily discussed in that order. 1. Call to Order - Chair/TrusI a [-rank 'H- bbard The meeting was called to order at 9:06 a.m. at City Hall. 2. Approval of Minutes 2.1 Approve the rfliu UIR, c,s of the October 18. 2010 Pension Trustees meeting as submitted in written summation bV [he City Clerk. Trustee Bill Jonson moved to approve the minutes of the October 18, 2010 Pension Trustees meeting as submitted in written summation by the City Clerk. The motion was duly seconded and carried unanimously. Pension Trustees 2010-11-01 1 3. Pension Trustee Items 3.1 Approve new hires for membership into Pension Plan as listed. ame, Job. Class, Dept./Div. ric Kelly, Solid Waste Equip. Oper./Solid /aste/Gen.Ser. Tension ire Date Elig. Date '30/10 8/30/10 8/30/10 4/21/03 9/13/10 8/30/10 9/11/10* 9/13/10 9/13/10 nn Marie Hughes, Accounting Clerk/Finance 9/13/10 Dale Marion, WWTP Operator Trainee/Public 9/13/10 9/13/10 Utilities Kari Connor, Accounting Clerk/Solid Waste/General 9/13/10 9/13/10 Ser. Sheri Bowers, Accounting Clerk/information 9/20/10 9/20/10 Technology William Olive, Police Com. 9/27/10 9/27/10 Oper./Police Martin Tobin, Systems ProgJlnformation 9/27/10 9/27/10 Technology Leanne Walker, Library 3/15/10 9/25/10 Assistant/Library *originally hired on 4/21/03 as part-time; voluntarily demoted and pension eligible as of 9/13/10 **originally hired on 3/15/10 as part-time; promoted and pension eligible as of 9/25/10 Trustee John Doran moved to approve new hires for membership into Pension Plan as listed. The motion was duly seconded and carried unanimously. Pension Trustees 2010-11-01 2 3.2 Approve the request of employee Margie Simmons, Finance Department, for a regular pension as provided by Sections 2.397 and 2.398 of the Employees Pension Plan. Margaret Simmons, Finance Director, Finance Department, was employed by the City on September 20, 1982, and her pension service credit is effective on that date. Her pension will be effective March 1, 2011. Based on an average salary of approximately $113,248 per year over the past five years, the formula for computing regular pensions, and Ms. Simmons' selection of the 100% Joint and Survivor Annuity, this pension will approximate $87,475 annually. Section 2.397 provides for normal retirement eligibility when a participant has completed thirty years of credited service, has reached age 55 and completed twenty years of credited service, or has reached age 65 and completed ten years of credited service. Ms. Simmons qualifies under the 20 years of service and at least age 55 criteria. Trustee George N. Cretekos moved to approve the request of employee Margie Simmons, Finance Department, for a regular pension as provided by Sections 2.397 and 2.398 of the Employees Pension Plan. The motion was duly seconded and carried unanimously. 3.3 Approve the administrative ?uizovero??u? the re_un of empl????4 contributions. The City of Clearwater Employees' Pension Plan provides for a return of employee contributions upon an employee's termination should it occur prior to the employee's early retirement date or normal retirement date. The Plan defines an employee as any person employed as a full-time permanent employee. At times employees will transfer from full-time permanent status to part-time permanent status. Upon this change in status, the employee is no longer eligible to participate in the Plan. There is an ambiguity in the Plan, as full-time employees who have become part- time are not allowed to participate in the Plan. Under these circumstances, the employee should be entitled to a return of his/her contributions. Staff is asking that the Trustees adopt an administrative rule governing the refund of employee contributions. In response to questions, Human Resources Director Joe Roseto said the City does not provide tax advice but encourages employees who request the return of their contributions to contact a tax advisor. Discussion ensued regarding the origin of the ordinance requirement that the plan pay 5% simple interest on returned employee contributions. It was Pension Trustees 2010-11-01 3 recommended that this amount be reviewed when other changes to the pension are considered. Trustee Paul Gibson moved to approve the administrative rule governing the return of employee contributions. The motion was duly seconded and carried unanimously. 4. Other Business - None. 5. Adjourn The meeting was adjourned at 9:12 p.m. Chair Employee's Pension Plan Trustees Attest City Clerk Pension Trustees 2010-11-01 4 Meeting Date: 12/13/20 10 Pension Trustees Agenda Council Chambers - City Hall SUBJECT / RECOMMENDATION: Approve new hires for acceptance into Pension Plan as listed and recommended by the Pension Advisory Committee. SUMMARY: Pension Name, Job. Class, & Dept./Div. Hire Date Elig Date Deborah Del Sole, Field Service Rep. I/Customer Service 10/4/10 10/4/10 Kevin Nurnberger, Planner II/Planning and Development 10/18/10 10/18/10 Manuel Diaz, Police Aide/Police 12/22/07 10/11/10 * Sean Kelly, Systems Programmer/Information Technology 10/11/10 10/11/10 Cheri Drigan, Customer Service Representative/Gas 10/11/10 10/11/10 Ekaterini Gerakios, Economic Dev. Coordinator/Econ. Dev. 10/4/10 10/4/10 Williiam Olive, Police Communications Operator/Police 9/27/10 9/27/10 Originally hired as part-time on 12/22/07; transferred to full-time and pension eligible as of 10/11/10 Review Approval: 1) Clerk Cover Memo Item # 2 Meeting Date: 12/13/20 10 Pension Trustees Agenda Council Chambers - City Hall SUBJECT / RECOMMENDATION: Approve the requests of employees Deborah Richter of Police, Mark Goheen of Parks and Recreation, Joseph Young of Police, and Ronald Sudler of Police for regular pensions as provided by Sections 2.397 and 2.398 of the Employees' Pension Plan as recommended by the Pension Advisory Committee. SUMMARY: Deborah Richter, Administrative Support Manager, Police Department, was employed by the City on July 27, 1981, and her pension service credit is effective on that date. Her pension will be effective August 1, 2011. Based on an average salary of approximately $60,963 per year over the past five years, the formula for computing regular pensions, and Ms. Richter's selection of the 100% Joint and Survivor Annuity, this pension will approximate $49,995 annually. Mark Goheen, Administrative Analyst, Parks and Recreation Department, was employed by the City on September 6, 1979, and his pension service credit is effective on February 8, 1981. His pension will be effective March 1, 2011. Based on an average salary of approximately $54,260 per year over the past five years, the formula for computing regular pensions and Mr. Goheen's selection of the Joint and Survivor Annuity, this pension will approximate $44,835 annually. Joseph Young, Police Lieutenant, Police Department, was employed by the City on May 20, 1988, and his pension service credit is effective on that date. His pension will be effective November 1, 2010. Based on an average salary of approximately $107,153 per year over the past five years, the formula for computing regular pensions and Mr. Young's selection of the Life Annuity, this pension will approximate $72,577 annually. Ronald Sudler, Police Lieutenant, Police Department, was employed by the City on April 12, 1982, and his pension service credit is effective on that date. His pension will be effective November 1, 2010. Based on an average salary of approximately $95,696 per year over the past five years, the formula for computing regular pensions, and Mr. Sudler's selection of the 100% Joint and Survivor Annuity, this pension will approximate $74,019 annually. Section 2.397 provides for normal retirement eligibility when a participant has completed thirty years of credited service, has reached age 55 and completed twenty years of credited service, or has reached age 65 and completed ten years of credited service. Section 2.397 also provides for normal retirement eligibility when a participant has completed twenty years of credited service or has reached age 55 and completed ten years of credited service in a type of employment described as hazardous duty and further defines service as a Police Lieutenant as meeting the hazardous duty criteria. Ms. Richter and Mr. Goheen qualify under the 30 years of service criteria. Mr. Young and Mr. Sudler qualify under the hazardous duty criteria. Review Approval: 1) Clerk Cover Memo Item # 3 CITY OF CLEARWATER EMPL O PEES' SEPARA T/ON PA Y PREFERENCES PREFERENCE #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 month. PREFERENCE #2 Employee can extend termination date by part or all of the time due for vacation, floating -holiday pay, sick leave incentive, bonus days Of applicable), and 1 /2 of accrued sick leave. Employee may choose to run out this time in any manner. Balance will be paid in a lump sum on employee's final paycheck. Termination date will be the final day of extended time. Pension benefits will begin the following month. dri??EI? , 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 # 62 and wish my benefits to be calculated under this preference. Please use my leave in the following manner: Run Out Ln Q-1 S3vacation S(P 3'5?4-ick C30 S floaters bonus hours Lump Sum vacation sick floaters ?3' ??- bonus hours I understand that my preference cannot be changed once this form is signed and that my decision is irrevocable. WTNESSES: /(1 ' 4t,/ Revised 1/02 Form #9900-0008 EMPLOYEE'S SIGNATURE: -X- V Y C ` SOCIAL SECURITY #: k ADDRESS: C> Slf°-) 13 Ml Aur' Isci PHONE: 7 ?Q 1 54S ) 5ADATE: ilU j e//Cj File Name: Employee Separation Pay Pref CITY OF CLEARWATER PENSION ENTITLEMENT OPTION REQUEST FORM 1, _Je.?X7eC7.?1 w- T-`t CYT-tizr of Clearwater General Employees' Pension Plan. Job Classification: Department: Benefits Date: _ Spouse's Name: -?J-o h,l ,\ Spouse's Date of Birth: i O iA- do hereby apply for retirement under the City Sex: The type of pension for which I am applying is (check only one): 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. Option 1 - Joint and Survivor Annuity 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 (b) (1)] Option 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) (1)] Option 3 -10 Year Certain & Life Annuity - (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. If payments to the beneficiary commence and he/she dies before the total of 120 payments has been made, the remainder of the payments is paid to the beneficiary's estate. If the first beneficiary predeceases the participant, he/she may designate a new beneficiary. If no beneficiary is alive at the time of the participant's death, the participant's estate will be paid the balance of the 120 payments. [Section 2.398 (b) (2) (a) (2)] Option 4 - 50% Joint & 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 his/her 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) (3)] Option 5 - 75% Joint & 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 75% of the pension for the rest of his/her 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) (3)] Option 6 -100% Joint & 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 100% of the pension for the rest of his/her 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) (3)] 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 my first pension check is received, my decision on this option is irrevocable Option #: 2 Employee's Signature: Dependent children under the age of 18 and residing in my household are: Child's Name Sex If taking Option 2 sign below: Option #: 2 Description: Life Annuity Employee's Signature: Date: Description: Joint and Survivor Annuity Date: Date of Birth Option #: Description: My designated b nefic'ry 's Name: C? h?'? Bch p o° Harp of Birth: i) 3 / 70 Sex fQF Social Security Number: 1 Phone Number: Address: -25G-.), 3? iJ e , SW ®. FL 3 3 770 -V,422 Employee's Signature: JLC??M `L? LC&7,- Date: /0 / STATE OF FLORIDA The fore oing instrument was acknowledged before me this COUNTY OF PINELLAS i O ? ? 1 CV by J?Ld fa k W who is personally known to me or who has provided as il"tification and an y ? ' . ..-`C Notary Public ignature) _ L Name of Notary Printed NOTARY PUBLIC-STATE OF FLQF', '' My Commission expires: ....,,?e?©? i. T'nt`:A J' hnt Commission # DD763' s^ ?,, apses: MAY 15, 2G1? ilawo Tnj: pTyypllC BQA JIPi6r Kti„ f' Rev. 4/08 Form #9900-0009 File Name: Pension Entitlement Option Form Estimated Pension Worksheet Deborah Richter GROSS CALENDAR PENSION YEAR EARNINGS LAST DATE PAID: 7/29/2011 2006 $57,662.98 BENEFITS DATE 7/27/1981 2007 $60,010.60 CREDITED SERVICE 30.0056 2008 $62,381.02 2009 $62,381.02 2010 $62,381.02 $304,816.64 (5 Year Total) 5/ $60,963.33 (Yearly Avg) 12/ $5,080.28 (Monthly Avg) x 0.0275 (Benefit Rate) x 30.0056 (Yrs of Service) $4,192.01 (Est Mtly Pension) Signature: Date: City of Clearwater Employees' Pension Plan Actuarial Equivalence Factors 08-Oct-10 sm ESTIMATE c1ract01 Version: Employee Name: Deborah Richter 1-4-96 Employee Date of Birth: 7 29 1963 Marital Status: m Spouse Date of Birth: 10 31 1948 Beneficiary Date of Birth: 10 31 1948 Benefit Commencement Date : 8 1 2011 Estimated Monthly Normal Reti rement Benefit: $4,192.01 Estimated Monthly Actuarial Equivalent Adjustment Factors: Benefit Option 1 J&S Annuity 1.00000 $4,192.01 Option 2 Life Annuity 1.02536 $4,298.31 Option 3 10 Year Certain 1.01800 $4,267.45 Option 4 50% J&S 1.00936 $4,231.25 Option 5 75% J&S 1.00155 $4,198.50 Option 6 100% J&S 0.99386 $4,166.25 ESTIMATE CITY OF CLEARWATER EMPL O YEES' SERA RA TION PA Y PREFERENCES PREFERENCE #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 month. PREFERENCE #2 Employee can extend termination date by part or all of the time due for vacation, floating holiday pay, sick leave incentive, bonus days (if applicable), and 1 /2 of accrued sick leave. Employee may choose to run out this time in any manner. Balance will be paid in a lump sum on employee's final paycheck. Termination date will be the final day of extended time. Pension benefits will begin the following month. d Se- n 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. Please use my leave in the following manner: Run Out vacation sick floaters bonus hours Lump Sum 1, 56 vacation 3' ` Osick floaters bonus hours I understand that my preference cannot be changed once this form is signed and that my decision is irrevocable. EMPLOYEE'S SIGNATURE: V ",, SOCIAL SECURITY #: ' v WITNESSES: Vdt?; ADDRESS: PHONE: i - i ? - J VV I 1 ? )ATE: 1 a /I S"/I o Revised 1/02 Form #9900-0008 File Name: Employee Separation Pay Pref CITY OF CLEARWATER PENSION ENTITLEMENT OPTION REQUEST FORM SWORN POLICE AND FIRE PERSONNEL I, j V .1 C 1 2 P1 V do hereby apply for retirement under the City of Clearwater Gener E ployees' Pen on Pl n. Job Classification: a `m / / ° 1 L? C'v)' Pv)Gh Sgg??cc:G F 1 ' ? Department: Division: ;i C;7. Jv erv? Benefits Date: .10 jr Date of Hire: S o10 Date of Birth: S Resignation Date: 10 Ler Spouse's Name: l'G1'1? ?l e- &1 Sex: M? Spouse's Date of Birth: S 1 d' ?0 The type of pension for which I am applying is (check only one): ?_ Regular Pension based on years of service Job-connected Disability Pension Non-job-connected Disability Pension Early Retirement 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 - #7) shall be computed to be the Actuarial Equivalent of the normal benefit. Option 1 - Joint and Survivor Annuity 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, except that, if greater for police officers and firefighters, the normal form of benefit shall be an annuity paid monthly for the life of the participant with 120 payments guaranteed. [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 (b) (1)] Option 2 - Life Annuity r 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) (1)] Option 3 - 10 Year Certain & Life Annuity - (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. If payments to the beneficiary commence and he/she dies before the total of 120 payments has been made, the remainder of the payments is paid to the beneficiary's estate. If the first beneficiary predeceases the participant, he/she may designate a new beneficiary. If no beneficiary is alive at the time of the participant's death, the participant's estate will be paid the balance of the 120 payments. [Section 2.398 (b) (2) (a) (2)] Option 4 - 50% Joint & 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 his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time. [Section 2.398 (b) (2) (a) (3)] Option 5 - 75% Joint & 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 75% of the pension for the rest of his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at anytime. [Section 2.398 (b) (2) (a) (3)] [lntinn F _100% Join8r S"niiv r 4nnnitv - (.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 his/her life- If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time. [Section 2.398 (b) (2) (a) (3)] Option 7 - 66 2/'1% Joint & 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 66 213% of the pension for the rest of his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time- [Section 2.398 (b) (2) (a) (3)] 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 7) 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 my first pension check is received, my decision on this option is irrevocable. Option #: I Description: Joint and 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 si n below: Option #: 2 Description: ? ife Annuity Date: A Employee's Signature ?t i??X If taking Option 3 4 5 6 or 7 fill in beneficiary information and sign 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 Thp fnr mina instrument was ack wledged befo e me this COUNTY OF PINELLAS QC. j S 0- by ta/d 61Q -who is personally known to me or who has provided as identifi a ion d who di id rlt ath. Notary Public (Signature) / d / L r Name of Notary Printed My Commission expWo F UBLI - „ . eboraii _: commission #D?j D76,) F, EXpi1 es 426 Rev. 4108 80 4TtvA ? MAY 15 2022 Form #9900-0053 'ri {V YBCcPW. ion Entitlement Option Form Police & Fire City of Clearwater Employees' Pension Plan Actuarial Equivalence Factors Police and Fire Members Only Employee Name: Employee Date of Birth: Marital Status: Spouse Date of Birth: Beneficiary Date of Birth: Benefit Commencement Date : Joseph Young 4 5 1963 M 5 18 1980 5 18 1980 11 1 2010 15-Oct-10 sm clract03 Version: August 9, 2000 Estimated Monthly Normal Retirement Benefit: $5,510.77 Estimated ...................... ................. Monthly Actuarial Equivalent Adjustment Factors: Benefit J&S Annuity 1.00000 $5,510.77 Life Annuity 1.09751 $6,048.10 10 Year Certain 1.08963 $6,004.68 50% J&S 1.03526 $5,705.05 67% J&S 1.01605 $5,599.19 75% J&S 1.00670 $5,547.72 100% J&S 0.97969 $5,398.83 II Estimated Pension Worksheet II Joseph Young LAST DATE PAID: BENEFITS DATE CREDITED SERVICE 10/29/2010 5/20/1988 22.4417 GROSS CALENDAR PENSION YEAR EARNINGS 2004 $13,227.90 estimated 2006 $99,789.75 2007 $110,251.89 2008 $110,819.46 2009 $111,778.54 2010 $89,899.56 estimated $535,767.10 (5 Year Total) 5/ $107,153.42 (Yearly Avg) 12/ $8,929.45 (Monthly Avg) x 0.0275 (Benefit Rate) x 22.4417 (Yrs of Service) $5,510.77 (Est Mtly Pension) Prepared by: Deborah Ford Date: 8/6/2010 CITY OF CLEARWATER EMPLO YEES' SEPARA TION PA Y PREFERENCES PREFERENCE #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 month. PREFERENCE #2 Employee can extend termination date by part or all of the time due for vacation, floating holiday pay, sick leave incentive, bonus days (if applicable), and 1 /2 of accrued sick leave. Employee may choose to run out this time in any manner. Balance will be paid in a lump sum on employee's final paycheck. Termination date will be the final day of extended time. Pension benefits will begin the following month. I, ?I)c _?Q of 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 preferences offered to me. I choose to retire using separation pay preference # and wish my benefits to be calculated under this preference. Please use my leave in the following manner: Run Out vacation sick floaters bonus hours Lump Sum rod c:1 ?9c2_vacation 6?0'0 sick O floaters bonus hours I understand that my preference cannot be changed once this form is signed and that my decision is irrevocable. EMPLOYEE'S SIGNATURE: SOCIAL SECURITY #: WITNESSES: DDRESS PHONE; Revised 1/02 Form #9900-0008 ?. DATE: /0 O File Name: Employee Separation Pay Pref CITY OF CLEARWATER PENSION ENTITLEMENT OPTION REQUEST FORM SWORN POLICE AND FIRE PERSONNEL I, ? Kcmc 1 A SUCH l er of Clearwater General Employees' Pension Plan. do hereby apply for retirement under the City Job Classification: -?C)I lrCr_- t /i-Cv?ek?Gf//4- Department: o Benefits Date: `r Date of Birth: Spouse's Name: Spouse's Date of Birth: Sex:0MM F Division: Date of Hire: q1134-0 °n' Resignation Date: /o oZC/ /U n // det v1?1? Yud /C;/-. Sex: MG) The type of pension for which I am applying is (check only one): Regular Pension based on years of service Job-connected Disability Pension Non-job-connected Disability Pension Early Retirement 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 - #7) shall be computed to be the Actuarial Equivalent of the normal benefit. Option 1 - Joint and Survivor Annuity 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, except that, if greater for police officers and firefighters, the normal form of benefit shall be an annuity paid monthly for the life of the participant with 120 payments guaranteed. [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 (b) (1)] Option 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) (1)] - (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. If payments to the beneficiary commence and he/she dies before the total of 120 payments has been made, the remainder of the payments is paid to the beneficiary's estate. If the first beneficiary predeceases the participant, he/she may designate a new beneficiary. If no beneficiary is alive at the time of the participant's death, the participant's estate will be paid the balance of the 120 payments. [Section 2.398 (b) (2) (a) (2)] Option 4 - 50% Joint & 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 his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time. [Section 2.398 (b) (2) (a) (3)] Option 5 - 75% Joint & 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 75% of the pension for the rest of his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time. [Section 2.398 (b) (2) (a) (3)] (Option 6 - 100% Joint & Siirvivnr 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 his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time. [Section 2.398 (b) (2) (a) (3)] Option 7 - 66 213% Joint & 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 66 213% of the pension for the rest of his/her life. If the beneficiary dies first, the Participant continues to receive 100% of his/her pension and upon his/her death, benefits cease. The beneficiary can be changed at any time. [Section 2.398 (b) (2) (a) (3)] 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 7) 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.) 1 understand that once my first pension check is received, my decision on this option is irrevocable. Option #: 1 Employee's Signature: Description: joint and Survivor Annuity 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: Dption #: -2- Description: Life Annuity Employee's Signature: Date: If taking Option 3 4 5 6 or 7 fill in beneficiary information and sign below: Option #: Description: o aj"14- `' vv r v c3? h My designated beneficiary i Name: tToA h r1 ?e? Date of Birth: `P 1 Y /G0 Sex M0 Social Security Number: Phone Numbe Address: ---- - , - Employee's Signature: r.., Date: STATE OF FLORIDA COUNTY OF PINELLAS Rev. 4/08 Form #9900-0053 The fore P?19 strument wa knowledfor e this )d ?, U by Una l? yC1C? who is personally known to me or who has provided as identifAl ioVnq \who di?)Elid 1 11 Notary Public gym..,.,. ej;pt0. e of Notary Printed vi 1 L.IJluLHm Deborah L. Commission expires- . Y763 --?=1 753 2b Expires: A'fAy 2:12 BONDED THRU An.,. TIC Bop Dl.`iG C(:., i:IC. File Name: Pension Entitlement Option Form Police & Fire Estimated Pension Worksheet Ronald Sudler GROSS CALENDAR PENSION YEAR EARNINGS LAST DATE PAID: 9/30/2010 2005 $26,046.32 8 pay periods of 2005 BENEFITS DATE 4/12/1982 2006 $92,039.92 CREDITED SERVICE 28.4667 2007 $91,795.40 2008 $95,939.59 2009 $103,198.43 2010 $69,460.51 as of 8/27/10 (18 pay periods) $478,480.17 (5 Year Total) 5/ $95,696.03 (Yearly Avg) 12/ $7,974.67 (Monthly Avg) x 0.0275 (Benefit Rate) x 28.4667 (Yrs of Service) $6,242.84 (Est Mtly Pension) Prepared by: Deborah Ford Date: 9/9/2010 City of Clearwater Employees' Pension Plan Actuarial Equivalence Factors Police and Fire Members Only 22-Oct-10 sm ciract03 Version: August 9, 2000 Employee Name: Ronald Sudler Employee Date of Birth: 7 24 1961 Marital Status: m Spouse Date of Birth: 4 14 1960 Beneficiary Date of Birth: 4 14 1960 Benefit Commencement Date : 10 1 2010 Estimated Monthly Normal Retirement Benefit: $6,242.84 Estimated ....................................... Monthly Actuarial Equivalent Adjustment Factors: Benefit J&S Annuity 1.00000 $6,242.84 Life Annuity 1.05920 $6,612.42 10 Year Certain 1.05076 $6,559.72 50% J&S 1.02239 $6,382.62 67% J&S 1.01068 $6,309.53 75% J&S 1.00493 $6,273.60 100% J&S 0.98805 $6,168.25 CITY OF CLEARWATER EMPL OYEES' SEPARA TION PA Y PREFERENCES PREFERENCE #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 month. PREFERENCE #2 Employee can extend termination date by part or all of the time due for vacation, floating holiday pay, sick leave incentive, bonus days (if applicable), and 1 /2 of accrued sick leave. Employee may choose to run out this time in any manner. Balance will be paid in a lump sum on employee's final paycheck. Termination date will be the final day of extended time. Pension benefits will begin the following month. I, i " ' `'? e ?-?? 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 # -t;L and wish my benefits to be calculated under this preference. Please use my leave in the following manner: Run Out 1 3 9.a? vacation 3 a 5:1 g sick floaters Lump Sum vacation l.r`• a? sick floaters bonus hours I t J- -s bonus hours I understand that my preference cannot be changed once this form is signed and that my decision is irrevocable. WITNESSES: 4-4- EMPLOYEE'S SIGNATURE: "" a4l E SOCIAL SECURITY #: ADDRESS: /(o t o I ;S ?-k E+- '" SSA - ?-'?i4evs bvvrv, . f?(- -'3 '7 0V J ` PHONE: -74- r S sQ : &/ADATE: 8 ?3 °L I C? Revised 1/02 Form #9900-0008 File Name: Employee Separation Pay Pref CITY OF CLEARWATER PENSION ENTITLEMENT OPTION REQUEST FORM I, Y lay, k- Go V) e e-o do hereby apply for retirement under the City of Clearwater General Employees' Pension Plan. Job Classifica i m n ?R S 'vim 4 1,4 Sex: M F Department: ar S ec v ?? o s?1 • Division: Benefits Date: r i Date of Hire: -7, Date of Birth: 5 \ S Resignation Date: 02 ll Spouse's Name: A,4 Sex: M F Spouse's Date of Birth: The type of pension for which 1 am applying is (check only one): 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. Option 1 - Joint and Survivor Annuity 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 (b) (1)] Option 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) (1)] Option 3 -10 Year Certain & Lif _ Annuity - (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. If payments to the beneficiary commence and he/she dies before the total of 120 payments has been made, the remainder of the payments is paid to the beneficiary s estate. If the first beneficiary predeceases the participant, he/she may designate a new beneficiary. If no beneficiary is alive at the time of the participant's death, the participant's estate will be paid the balance of the 120 payments. [Section 2.398 (b) (2) (a) (2)] Option 4 - 50% Joint & 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 his/her 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) (3)] Option 5 - 75% Joint & 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 75% of the pension for the rest of his/her 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) (3)] Option 6 - 100% Joint & 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 100% of the pension for the rest of his/her 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) (3)] 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 my first pension check is received, my decision on this option is irrevocable. Option #: 1 Description: Joint and Survivor Annuity A 116 Employee's Signature: Mo Date: 0 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. 5. or 6 fill in beneficiary information and sian 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 The fore oing in trument was acknowledged before me this COUNTY OF PINELLAS 10 &-a ?t O by 00 rL ? h e-who is personally known to me or who has provided Notary Public Notary Printed Rev. 4/08 Form #9900-0009 NOTARY PUBLIC-STATE OF FLORIDA Deborah L. Ford :Commission # DD763426 15 2012 Exires: MAY - Bo.....nMDATLANTICBONDING CO.,"N*fle Name: Pension Entitlement Option Form My Commission expires: II Estimated Pension Worksheet II Mark Goheen LAST DATE PAID: BENEFITS DATE CREDITED SERVICE 2/25/2011 2/8/1981 30.0472 Signature:.. . V" Date: 10 aa I v GROSS CALENDAR PENSION YEAR EARNINGS 2006 $50,915.47 2007 $52,944.15 2008 $55,045.18 2009 $56,891.35 2010 $55,503.76 $271,299.91 (5 Year Total) 5/ $54,259.98 (Yearly Avg) 12/ $4,521.67 (Monthly Avg) x 0.0275 (Benefit Rate) x 30.0472 (Yrs of Service) $3,736.25 (Est Mtly Pension)