02/13/20121. Call to Order
2. Approval of Minutes
PENSION TRUSTEES AGENDA
Location: Council Chambers - City Hall
Date: 2/13/2012- 1:00 PM
2.1 Approve the minutes of the January 9, 2012 Pension Trustees meeting as submitted in written summation
by the City Clerk.
� Attachments
3. Pension Trustee Items
3.1 Approve the new hires for acceptance into the Pension Plan as listed.
6� Attachments
3.2 Approve the request of employee Robert Maran, Engineering Department; Georgette Summarell, Police
Department; and Vincent Carino, Fire Department, for a regular pension as provided by Sections 2397
and 2398 of the Employees' Pension Plan.
i� Attachments
3.3 Approve the request of employee Diana Atkinson, Solid Waste/General Services Department, to vest her
pension as provided by Section 2.397 of the Employees' Pension Plan.
� Attachments
4. Other Business
5. Adjourn
Pension Trustees Agenda
Council Chambers - City Hall
Meeting Date:2/13/2012
SUBJECT / RECOMMENDATION:
Approve the minutes of the January 9, 2012 Pension Trustees meeting as submitted in written summation by the City Clerk.
SUMMARY:
Review Approval:
Cover Memo
��11�:�)
Attachment number 1 \nPage 1
TRUSTEES OF THE EMPLOYEES' PENSION FUND MEETING MINUTES
CITY OF CLEARWATER
r� r � � �
Present
I_1�:7�iii
Chair/Trustee Frank Hibbard, Trustee George N. C
John Doran, Trustee Paul Gibson, and Trustee Bill
William B. Horne II - City Manager, Jill S. Silve
Manager, Rod Irwin - Assistant City Manager; ;
Attorney, Rosemarie Call - City Clerk, and Nicc
Records and Legislative Services Coordinator.
To provide continuity for research, items are in agenda
necessarily discussed in that order.
Unapproved
The meeting was called to ord
Trustee
minutes of the December 13, 2011 Pension
ummation by the City Clerk. The motion was
Sari Shedd, Library Assistant/Library
Sean Bennett, Tradesworker/Solid Waste-Gen'1 Services
Pension Trustees 2012-01-09
Pension
Eli _ .� Date
10/25/10 11/5/11 *
1 U21/11 1 U21/11
1
Item # 1
Kyle Cresi, Gas Technician I/Gas
Karl Haeussel, Gas Technician UGas
Jose Betancourt, Gas Technician I/Gas
Peter Ellmore, Custodial Worker/Marine & Aviation
Jeremy Harrison, Gas Technician UGas
William MaYwell, Senior Beach Lifeguard/Parks & Rec
Jamie Greene, Gas Technician I/Gas
1 U21/11
11/21/11
11/21/11
10/25/08
11/21/11
11/19/11
11/21/11
*originally hired 10/25/10 as permanent part-time; promoted
eligible as of 11/5/11
**originally hired 10/25/08 as permanent part-time;
eligible as of 11/21/11
Trustee John Doran moved to approve the new hires for acceptance
Plan as listed. The motion was duly seconded and carcied unanimou
3.2
Ruud. Plannina and Deve
Manuel Pandelos, Gas S
February 17, 1981, and, t
p�nsion will be effecfive 1
ap�arQxim�#e�y $58,039 p;
computing regular pensic
Survivor
Alan Ruud, Code� 1
was employed by
effective on Septe
Based on an aver
years, the formula
100°/a Joint & Su�
pen
�
sion service cr�
1, 2012. Basec
� over the past f
d Mr. Pandelas
rill approximate
,�
i�yc.r��
Attachment number 1 \nPage 2
1 U21/11
1 U21/11
11/21/11
11/21/11 **
1ll21/11
11/19/11
� 11/21/11
Pension
#, was employe�# by the City on
is effective on that date. His
an average salary of
year�a th��formula for
lectic�n c�f the 100% Joint &
�,959"annually.
nent �nspector, Planning & Development Department,
on August 26, 1996, and his pension service credit is
, 1996. His pension will be effective February 1, 2012.
ry of approximately $46,780 per year over the past five
puting regular pensions, and Mr. Ruud's selection of the
�uity, this pension will approximate $19,088 annually.
�ection 2.397 prQVides for normal retirement eligibility when a participant has
cc�mpleted thirky years of credited service, has reached age 55 and completed
twen#y years c�f credited service, or has reached age 65 and completed ten years
of credited service. Mr. Pandelos qualifies under the 30 years of service criteria.
Mr. Ruud qualifies under the age 65 and 10 years of service criteria.
Trustee George N. Cretekos moved to approve the request of employee Manuel
Pandelos, Gas Department, and Alan Ruud, Planning and Development Department,
Pension Trustees 2012-01-09 2
Item # 1
Attachment number 1 \nPage 3
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 unanimsously.
4. Other Business — None.
�
.. .
The meeting was adjourned at 10:50 a.m.
Employee's Pensio
Pension Trustees 2012-01-09 3
Item # 1
Pension Trustees Agenda
Council Chambers - City Hall
SUBJECT / RECOMMENDATION:
Approve the new hires for acceptance into the Pension Plan as listed.
SUMMARY:
Pension
Name, Job. Class, & Dept./Div. Hire Date Eli�. Date
Matthew Carter, Parks Service Technician UParks & Rec. 12/5/11 12/5/11
Antwan Williams, Parks Service Technician UParks & Rec. 12/5/11 12/5/11
Lynn Clark, Customer Service Rep./Customer Service 12/19/11 12/19/11
Stuart Miller, Electrician/Solid Waste-General Services 12/19/11 12/19/11
Deborah Humes, Customer Service Rep./Customer Service 12/19/11 12/19/11
Review Approval:
Meeting Date:2/13/2012
Cover Memo
��11�:��
Pension Trustees Agenda
Council Chambers - City Hall
Meeting Date:2/13/2012
SUBJECT / RECOMMENDATION:
Approve the request of employee Robert Maran, Engineering Department; Georgette Summarell, Police Department; and Vincent
Carino, Fire Department, for a regular pension as provided by Sections 2397 and 2398 of the Employees' Pension Plan.
SUMMARY:
Robert Maran, Engineering Specialist III, Engineering Department, was employed by the City on November 19, 1973, and his
pension service credit is effective on October 9, 1984. His pension will be effective March 1, 2012.
Based on an average salary of approximately $73,634 per year over the past five years, the formula for computing regular pensions, and
Mr. Maran's selection of the 75% Joint & Survivor Annuity, this pension will approximate $55,897 annually.
Georgette Summarell, Police Communications Operator, Police Department, was employed by the City on December 1, 1976, and
her pension service credit is effective on March 23, 1992. Her pension will be effective April 1, 2012.
Based on an average salary of approximately $46,398 per year over the past five years, the formula for computing regular pensions, and
Ms. Summarell's selection of the Joint & Survivor Annuity, this pension will approximate $25,519 annually.
Vincent Carino, Firefighter/Driver-Operator, Fire Department, was employed by the City on February 14, 1977, and his pension
service credit is effective on that date. His pension will be effective March 1, 2012.
Based on an average salary of approximately $61,129 per year over the past five years, the formula for computing regular pensions, and
Mr. Carino's selection of the 10-year Certain and Life Annuity, this pension will approximate $63,747 annually.
Section 2397 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
2397 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 dury" and further de�nes service as
a Firefighter/Driver-Operator as meeting the hazardous duty criteria. Mr. Maran and Ms. Summarell qualify under the age 55 and
twenty years of service criteria. Mr. Carino qualifies under the hazardous dury criteria.
Review Approval:
Cover Memo
��11�:��
a � i.. c� � o u v c, � � i i. �. � � v , ...., �.� .....,. r ., , . .. �., �.., ......., . , , ._.. ... . . � ., . ._ _ _ . . _ . _
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 eamings in the
calculation of the pension. The last day of work will be the termination date
and pension benefits will begin the foliowing month.
PREFERENCE #2 Employee can extend termination date by part or all of the time due for
---- ---- vacation, oa ing o i ay pay, sic eave incen ive, onus ays i apptica e,-- ---
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 fl�alAf��S��G�mber 1\nPage 1
Termination date will be the final day of extended time. Pension benefits will
begin the foilowing month.
�� __
� �d �pCV'� ���%a✓�• , an empioyee of the i ity oi �iearwaier, hereby appiy iur
pension benefits under the City's Employees' Pension Pian.
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 fioaters bonus hours
Lump Sum ��0� � vacation i a. O� sick aa'S floaters ��a� -� bonus hours
l understand that my preference cannot be changed once this form is signed and that my decision is
irrevocable. �J \ � . ' ` \ G^-�,.,---.
EMPLOYEE'S SIGNATURE.
SOCIAL SECURITY #:
WITNESSES: DDRESS:
,��.��.� .,�.�,�
PHONE:
Revised 1 i02
Form �9900-0008
S s �� n �'r, � (1�o crv� ( �
�1 �� �wa��d; ��, �3 ��
_ � i1a�% %' �!u; SC� �S DATE: I e� [� � �
File Name: Employee Separation Pay Pref
I, d� r-'�" G V Ci Vl
of Clearwater General Employees' Pension Plan.
Job Classification
Department: _
Benefits Date:
Date of Birth:
do hereby apply for retirement under the City
�� t� l°�.r►�� �'C.��� �is�" �.� Sex:� F
� e r � �1 Division:
� Date of Hire: t} 4 7
� o� � Resignation Date: � � 1�,. ,
Spouse's Name: �
Spouse's Date of Birth:
�f �
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
Sex: �
Attachment n
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) shail be computed to be the Actuarial Equivafent of the normal benefit.
Option 1- Joint and Survivor Annuitv
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 ParticipanYs 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 heJshe 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 participanYs estate will be paid the balance of the 120 payments. [Section 2.398 (b) (2) (a) (2)]
Option 4- 50% Joint 8� Survivor Annuitv -(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°/a Joint 8� 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)J
r 1 \nPage 2
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.
If taking Option 1 sign below:
Option #: 1
Employee's Signature:
Description: Joint and Survivor Annuitv
Dependent children under the age of 18 and residing in my household are:
Child's Name Sex
If taking Option 2
Option #: 2
Employee's Signature:
below:
Description: Life Annuitv
DBte: Attar.hment
Date of Birth
Date:
If takin O tion 3, 4, 5, or 6 fill in beneficia information and si n below:
Option #: S Description: 'i S � c�,"h '� S u v v+ V
My desi nated beneficiary is: j
Name: � r I�eI �r�^ Date of Birth: � I� 3 y� Sex M�
Social Security Number: � Phone Number. �? a� ���`�� � S-
Acidress� � �e S� � i►� pC.��',nC �i 0� v c�t J r•
l �e.�c:� ✓��.�-� r
Employee's Signature: �
��
, �-- Date: � d 1 3 I i
STATE OF FLORIDA The fore oing instrument was cknowledged before me this
COUNTY OF PINELLAS �� � �� py �U 6 e r'f —�Cl V'� who is
personally known to me or who has provided
as ider�f£i�catio� and who �id/di� n�t t,ake�an oa�
Rev. 4/08
Form #9900-0009
�[/�'(T'�� �/1 ' 7 "-
- (�b' natur� � � �
d �� •�
Notary Public
Name of Notary Printed
My Commission expires:
NOTARY PUBLI�-�TATE
Deborah L. Ford
: Commission # DD7 63426
� ` Expires: NIAY 15, 2012
�'�• ,,, .•�''�
BONDED THRU ATLAN'1'IC S0�"DING CO„ L`�C:.
File Name: Pension Entitlement Option Form
r 1 \nPage 3
Robert Maran
LAST DATE PAI D:
BENEFITS DATE
CREDITED SERVICE
Prepared by:
Date:
2/24/2012
10/9/1984
27.3750
Deborah Ford
12/1 /2011
GROSS
CALENDAR PENSION
YEAR EARNINGS
2007 $71,138.71
2008 $73,220.42 Attachment number 1\nPage 4
2009 $75,701.19
2010 $73,854.82
2011 $74,254.82
$368,169.96 (5 Year Total) '
5/ $73,633.99 (Yearly Avg)
12/ $6,136.17 (Monthly Avg)
x 0.0275 (Benefit Rate)
x 27.3750 (Yrs of Service)
$4,619.39 (Est Mtly Pension)
ESTIMATE clract01
Version:
Employee Name: Robert Maran 1-4-96
Employee Date of Birth: 8 24 1946
Marital Status: m
Spouse Date of Birth: 8 13 1948
Beneficiary Date of Birth: 8 13 1948
Benefit Commencement Date : 3 1 2012
Estimated Monthly Normal Retirement Benefit: $4,619.39
Actuarial Equivalent Adjustment Factors:
Option 1 Normal Form 1.00000
Option 2 Life Annuity 1.15326
Option 3 10 Year Certain 1.09277
Option 4 50% J&S 1.05245
Option 5 75% J&S 1.00838
Option 6 100% J&S 0.96785
ESTIMATE
Attachment number 1 \nPage 5
Estimated
Monthly
Benefit
$4,619.39
$5,327.35
$5, 047.93
$4,861.67
$4,658.08
$4,470.86
_------ -- - __ J _ . .
t�e ��me �se�ratr�rrfirom�t�r�£itp� __��iere�vil�-be-�o--d���+�n-f-o�pens�w�-----__
from this lump sum payment nor wili 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 mor�th.
PREFERENCE #2 Employee can extend termination date by part or all of the time d�e for
---- ------ vacation, oating o i ay pay, sFC eave incen ive, onus ays Ci apptica e,--- -
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 fina����ch�ck.
a men number 1\nPage 6
Termination date will be the final day of extended tirne. Pension benefits wifl
begin the folfowing month.
i C�ev� e ���', an empioyee of the Ciiy of Ciearwaier, h�r�by app{y foi
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 ��S�vacation �S�`S sick
Lump Sum vacation sick
floaters �'S� �� bonus hours
floaters °Zy'� `� bonus hours
l understand that my preference cannot be changed once this form is signed and that my decision is
irrevocable.
EMPLOYEE'S SIGNATURE:
_ �...5� .�p
-�
SOCIAL SECURITY #: — -
,���
/ �
� r � j � � � / �,
PHONE
/
0
J
DATE: � � �/� �
Revised 1 i02
Form �9900-0008 File Name: Employee Separation Pay Pref
of Clearwater Ge eral Employees' Pension Plan.
Job Ciassification:
Department:
Benefits Date:
Date of Birth:
�a
�.n�iswi i. _
Date of Hire:
Resignation Date:
� rc��•�
Spouse's Name: /U�}' Sex: M F
SpOUS2'S Date Of Blfth: Attachment nu ber 1\nPage 7
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 manrrer 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 Annuifii
The normal form of retirement benefit shall be an annuity paid monthly for the life of the Participant, with a
100°/a 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 annuiry 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 Annuitv
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)j
Option 4- 50% Joint 8� 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 hisJher life. If the beneficiary dies first, the Participant continues to
receive 100°/o 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)]
� .� .v awvvi ��uu..0 vl l t111.7 1 v1111 q.7 V IIVI l
1� ��d-thre vaROa�aftEmative- optional-beriefrt-payrrterrt r�et�rads�Opfieri��-t�feErgFr�}-E►r�der����an ar�d-k�av€ --
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.
If taking Option 1 sign below:
Option #: 1 Description: Joint and Survivor Annuitv
Employee's Signature: �� .n��- � ,,���,,�,,,� .,,ll Date: % / O % ttachment n
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
Employee's Signature:
Description: Life Annuitv
Date:
If taking Option 3, 4, 5, or 6 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 The fore oing � strument was acknowledged befo e me this
COUNTY OF PINELLAS J J U / a_ by �Caf C' 7Te ,.�V vn �► a�e��who is
personally known to me or who has provided
as id¢n�ifica�,ion and whcl did�di¢-r�o� talsree an oath.
Rev. 4f08
Form #9900-0009
My Commission expires:
NOTARY PUBLIC-STATE OF FLORIDA
"""''• Deborah L, Ford
�i: Commission # DD763426
�•.;, �.�' Expires: MAY 15, 2012
BONDED THRU ATT.ANITC BOA"DING CO3 INC.
J
Notary Public
Name of Notary Printed
File Name: Pension Entitlement Option Form
r 1 \nPage 8
�eorg�tt�-gammaretl --- _ _ ___
LAST DATE PAID:
BENEFITS DATE
CREDITED SERVICE
3/23/2012
3/23/1992
20.0000
Prepared by: Deborah Ford
Date: 1/10/12
GROSS
CALENDAR PENSION
YEAR EARNINGS
2007 $44,776.76
2008 $46,370.97 Attachment number 1\nPage 9
2009 $47,489.80
2010 $46,292.82
2011 $47,059.59
$231,989.94 (5 Year Total)
5/ $46,397.99 (Yeariy Avg)
12/ $3,866.50 (Monthly Avg)
x 0.0275 (Benefit Rate)
x 20.0000 (Yrs of Service)
$2,126.58 (Est Mtly Pension)
the time of separation fram the City. There wi�l be no deduction for pension
from this lump sum payment nor will this amount count as earnings in the
calculation of the pension. The fast 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 ali of the time due for
--- ----- vacation, oating o i ay pay, sic eave mcen ive, onus ays i apprica e,-"
and 1/2 of accrued sick leave. Empioyee may choose to run out this time in
any manner. Balance will be paid in a lump sum on employee's final Da�ch�ck.
Attac men number 1\nPage 1i
Termination date wili be the fina► day of extended time. Pension benefits will
begin the foliowing month.
- �� -_
i V I?/1 �-� /1� � Cc ✓��1 � , an empioyee of tne Ci�y oi �iearwaier, hereby aapiy io�
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 �-��-- �o vac tion ��y' �a-sick ����floaters bonus hours
�/2�01U �nl��
l understand that my preference cannot be changed once this form is signed and that my decision is
irrevocable. !' ��
EMPLOYEE'S SIGNATURE. '�-� �
SOCIAL SECURITY #:
WI NESSES: ADDRESS:
�
PHONE: _
Reviszd 7 i02
1=orm r79900-0008
)ATE: f `�� —/ �
File Name: Employee Separation Pay Pref
Job Classification
Department:
Benefits Date: _
Date of Birth:
Spouse's Name:
Spouse's Date of Birth:
^ �*7
�
�a
�e
f� �✓e�—U�/%� f�'q,�iTJ.� Sex:�M F
_ Division:
Date of Hire: � 5�
Resignation Date: � / S /
U
The ty,pe of pension for which I am applying is (check only one):
9� Regular Pension based on years of service
Job-connected Disability Pension
Non-job-connected Disability Pension
Early Retirement
Sex: M �
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 rep� esents the stardard or normal form of retireme�t benefit. The
other optional forms (#2 -#7) shall be computed to be the Actuarial Equivalent of the normal benefit.
Ontion 1-Joint and S��rvivnr �nn��i ��
The normai 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 shail 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 untii 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 - Lif _ Ann �itT
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)j
Qntion 3-10 Year C_ ain &�fp Annn�, t� _(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 participanYs estate will be paid the balance of the 120 payments. [Section 2.398 (b) (2) (a) (2)]
c]ntion 4- 5o%.ioint & s��►,����r nnn���t� _(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)]
Ontion S- 75% loint & S�rvivor Ann��it;! _(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 pensior� and upon his/her death, benefits cease. The beneficiary can be changed at
any time. [Section 2.398 (b) (2) (a) (3}]
r 1 \nPage 1
�ption 7— 66 2/'�% lnin & S�rvivor Annuit� -(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 2/3% 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.)
Attachment number 1 \nPage 1:
I understand that once my first pension check is received, my decision on this option is irrevocable.
�
Option #: � 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
Option #: 2
Employee's Signature:
Option #:
Description: Life Annuity
in benetici
Description:
Date:
My desi ated beneficia s: /
Name: ��'�"�► ��t rt �a r►;�tt Date of Birth: �/� � S Sex M�
Social Security Number: __
Address: �.
,
Employee's Signature: �
STATE OF FLORIDA
COUNTY OF PINELLAS
Rev. 4/08
Form #9900-0053
1 ���
� ����
Phone Number:
Date: %�{
hh ��
The for oi instrument wasr a� knowled e_�J .b�for e this
i 1I by V d��► e�f'17`•/� �G r� i7 who is
personally known to me or who has provided
as i tific �on and wh id/di _ t n
� (Signatur )
l r�,�� � _ ��'e
Notary Public
Name of Notary Printed
�'�.��-�'�'���L . �,:.:
'"' Deborah L. Ford
�: Commission #DD763426
'�•.,.. . •` Expires; MAY 15, 2012
Boxn�rxRUqTi.AN'��iCgpA-��r6sa:,arc, File Name: Pension Entitlement Option Form Police & Fire
Vincent Carino
LAST DATE PAID:
BENEFITS DATE
CREDITED SERVICE
2/14/2012
2/14/1977
35.0000
Prepared by: Deborah Ford
Date: 1/11/12
GROSS
CALENDAR PENSION
YEAR EARNINGS
2007 $60,413.82
2008 $62,097.36 Attachment number 1\nPage 1;
2009 $61,240.70
2010 $61,124.32
2011 $60,769.19
$305,645.39 (5 Year Total)
5/ $61,129.08 (Yearly Avg)
12/ $5,094.09 (Monthly Avg)
x 0.0275 (Benefit Rate)
x 35.0000 (Yrs of Service)
$4,903.06 (Est Mtly Pension)
clract03
Version:
August 9, 2000
Employee Name: Vincent Carino
Employee Date of Birth: 12 29 1952
Marital Status: m
Spouse Date of Birth: 7 10 1954
Beneficiary Date of Birth: 7 10 1954 Attachment number 1\nPage 1�
Benefit Commencement Date : 3 1 2012
Estimated Monthly Normal Retirement Benefit: $4,903.06 Estimated
....................................... Monthly
Actuarial Equivalent Adjustment Factors: Benefit
J&S Annuity 1.00000 $4,903.06
Life Annuity 1.10811 $5,433.11
10 Year Certain 1.08346 $5,312.27
50% J&S 1.04119 $5,105.03
67% J&S 1.02065 $5,004.31
75% J&S 1.01068 $4,955.42
100% J&S 0.98190 $4,814.32
Pension Trustees Agenda
Council Chambers - City Hall
Meeting Date:2/13/2012
SUBJECT / RECOMMENDATION:
Approve the request of employee Diana Atkinson, Solid Waste/General Services Department, to vest her pension as provided by
Section 2397 of the Employees' Pension Plan.
SUMMARY:
Diana Atkinson, Accounting Clerk, Solid Waste/General Services Department, was employed by the City on November 4,
1992, and began participating in the Pension Plan on that date. Ms. Atkinson terminated from City employment on December 8,
2011.
The Employees' Pension Plan provides that should an employee cease to be an employee of the City of Clearwater or change
status from full-time to part-time after completing ten or more years of creditable service (pension participation), such employee
shall acquire a vested interest in the retirement benefits. Vested pension payments commence on the first of the month following
the month in which the employee normally would have been eligible for retirement.
Section 2.397) provides for normal retirement eligibility when a participant has reached age 55 and completed twenty years of
credited service, has completed 30 years of credited service, or has reached age 65 and completed ten years of credited
service. Ms. Atkinson would have completed at least 20 years of service and reached age 55 on November 4, 2012. Her pension
will be effective December 1, 2012.
Review Approval:
Cover Memo
��11�:��
Lity ot t;�earwater, F-lorida, and having completed ten (10) or more years of credited service,
such service having occurred during the period from (date of entry into Pension Plan)
/'�over,�►.��er y�qq�o (date of resignation or change of status) ►�evn(�j�r�' d0//
hereby makes application to receive the vested rights pension provided for by the ity Code of
Ordinances. As such former employee, I understand the pension requested will be computed
pursuant to the provisions of the City Code of Ordinance in effect on the date of resignation.
I hereby further certify that my date of birth is _ �Q ��f'1 J�/k J-�!' ��
Attachment number 1 \nPage 1
The date I will begin to receive my pension will be � ec-e�rn ��v /� �G /�
Further, I additionally certify that � have made no application seeking to obtain a return of the
contributions that I paid into the Pension Fund during the period of my employment set forth
above, I have not been convicted of a felony during my period of employment, and I have not
received any other type of pension from the City.
� an.�_� r �--
Signature
�c� t i�� � 5� �(�-Cr, e ra,� c��P �rJ► �. eS
DepartmenUDivision
� G o t�� V-�r/1 l.. / e I' K.
� Job CI ification
STATE OF FLORIDA
Social Security Number
Street Address
City, State, Zip Code
The foregoing instrument was acknowledged before
COUNTY OF PINELLAS me this � 3 day of _ �,� ���,,,,. 6�,� , 20 1 �
,
by � � u��ti L d /i -� (< .� n s o,-�
who i personally know to m or who has provided
Rev. 4/09
as identification
and who did/ id not ta an oath.
vl ��.�-�-� --��� .�_../ Notary Public
L • %� . � � s `�i `,� � � Name of Notary Printed
My commission expires: �.°...°°...,p .................................
° i R uec-nNr_a
:
�.�P�v�P' � Comm# DD0745115
'`����^ �X ��.����
�(3 "�. �I2S
°+ �'h�i���ii�'� E�lOfi�3 Pi0f8(y/�5311.. �IfC :
.�onenn�a�e masesane�ouutu�uuuu�u�f
Vested Pension Form