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Documentation_Pension Public Safety_Tab 12_11/02/2009
~~L~~GE ~ TEU~sTA CEC ~ES~° Vendor # Date: _. ° ..~ Mail Return to Depte Vendor Marne: Address: ~, } ,, Reason for Request: (Please attach appropriate documentation) ._~ '~ - _ h r .,a ..., z. ` _, - .. .... .., a •, .. ..a .- _' ... -~}' _ charge to Account Pao. ~~ ' ~~ ~ `-` _~ 'Aynount: r ._ J 'Total r ~ ~<..x Requested By = ~ Approved By: ~ ~ '6 (Department Head) Special Instructions: REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5:00 PM WILL BY AVAILABLE. FOR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON. PLEASE PLAN YOUR REQUESTS ACCORDINGLY! WP80Vv1yFiles\Check Requesi ®6~~IS~1~~~ ~~Rl.7I~~~ ~®NI~E~`TIA~6' ~~~o 260 Riverside Drive, Palm Beach Gardens, FL_33410 561-694-7963 Fax: 561-694-1591 July 17, 2009 Invoice No. 9-90 TO: Public Safety Officers' Pension i~vOiC~ Office work for week ended July 10, 2009 .........................3.75 hrs Office work for week ended July 17, 2009 ...........................3.75 hrs 7-1/2 hours @ $33.98 Total Due .......................:............................................ $254.85 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S PUBLlC SAFETY OFFICERS PENSION TRUST FUND 345 TEQUESTA DRIVE TEQUESTA, FL 33469 ..~,~...,-,..-~,.,~m„.-~,~.~..~,~ ~~, SUNAMERICAN BANK ~ 250 Tequeste Dc, 3ui[e 101, Tequaste, FL 33469 ~r ~ ,~ l ~ ~~ i~~'0 L04 3i~' x:06 70°~ 3 L 24~: 1043 63-1312/670 ~ - B ~u~a ~ ~~~~a~f 0 6 70 2 9 7 540 L~~' ~~ Address: ~ ~ Q' Vender # Date: `~ ~ l ~ Mail l~etum ~ Dept. Vendor I~1ame: ~~w` ~--~-~c,~~„~3 r ~- BUSINESS SERVICES CONNECTION, INC. 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 July 31, 2009 Invoice No. 9-98 TO: Public Safety Officers' Pension INVOICE Office work for week ended July 24, 2009 .........................3.75 hrs Office work for week ended July 31, 2009 ...........................3.75 hrs 12.50 hours @ $33.98 Total Due .................................................................... $254.85 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 VILLAGE OF TEQUESTA 80ARD OF TRUSTEE'S PUBLIC SAFETY OFFICERS PENSII;IN TRUST FUND 345 TE~UESTA DRIVE TEQUESTA, FL 33469 I-~ Hess •:~+2r~v _.---~ ~SUNAMERICAN BANK. aao ~w a_ ai vo}. Aq,,.,r~ a ao~e~ 1049 a°a9 n e ~n G $ o`?5f~ • ~ ~S' ~ 1 t9-~ 8 a :. ~ 7~3~ I~ _n~00104911• ~:OE,70 L L 24~: 670 29? 40 LII' r ~~~~~Q~~ ~~ ~~~~~~~~ ~~~~~ ~~' `~~~ ~endcr # date: ~`~ ~ a ~~~' I~aifl ~ Ret~a~a t® ~e~t. fiend®~- l~aane: .~~- ,.., -~ M ~ ~S ~`~. Reason for Request: (Pease attcacda app~°®pa~iate ~Y®~sl~aentcati®~) ~.:~ati gc t® ~ccc~t Nom. ' `' -- _ ~~' ~` ~oa~t: ~~' ~s ~ ~ ~ ~ota~ x:~ ~ r Requested Hy ~.~ -~ ~ ~ ju~,...~ ~ ` Approved ~y: ~~L. ~~~ ~~'~-~ ~ ~°~-. (Department Head) Special Iristructi oxas QiJES~'S I~ECEIYEI- IlY I~'INANCE ~Y Z'iJESI)AY AT' Se00 P1VI VVII.I. EY AVAIL.~I,E F®lt I)IST'RI~VTI®N ~Y 'THE F'®IJI.OWING IYIONi)AY AT' NO®N. PLEASE PLAl~ 3~®IJIt ItE~LTES'I'S AC'CORDINGLY9 WPSOWIyFiles\Check Request ~JSINES SERi/ICES C®IVNECTI®N, iNCo 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 August 14, 2009 Invoice No. 9-102 TO: Public Safety Officers' Pension i1V~~iCE Office work for week ended August , 2009 ......................3.75 hrs Office work for week ended August 14, 2009 ......................3.75 hrs '7 - 0 hours @ $33.98 Total Due .................................................................... $254.85 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S PUBLIC SAFETY OFFICERS PENSION TRUST FUND 345 TEQUESTA DRIVE TEQUESTA, FL 33469 ~~..~ ~ ord~ro(~ _ _i_r-reS ~ ~ Jt c~-~ ~. SUNAMERICAN BANK zso rev~e~e o.., sorts iai, Teyue~e, ~ x+a~ ~~~ ''~ ~'` r~n0 ~105~11' ~:0670~3L24~: ia5i _ _ ~ ~ ~{sa-~a~2/era I ~- ~_. , -; ~. n r.-" --~ dam'-'-'~ -- --- ---- "-" 6 70 29 7 540L11' \y I~~~~~tCe ~~ ~~~l4J~a~~{ ~ Q.~S]l~Q. ~~~1.1~~~ °i~ ~ '.- t ~ °~.~ .~-;°~ r /~ _ ~, address. "°~~,s er+-~-< tl`."' y L:,;~ ~'„~"L.~.~,' vi~ ~~Y..A L~~e~s .~~ Real®~n I°®~ l~egaaesg: (P~ecase attacd~ app~°opa~8sate do~~mentati®ae~ ~` -.~w...,.,i.,w" ~~.`,.,e~;,;"~a~....' ~, __'~.~' ~/G".'~-~' P"~.~ ..~~.~`L~'~'~,-~~L.- ~S `°.~ .~, i' ~`i'.l'e._i~";. ~ " ~ ~ ~ . ,. ~'a.~ ~1 / L' LI Y. _~ ~har~e g® A.cc~ra~~ 1_~`®. ~~" % ~ ~ <,' ~ `~ .~ P '~ ~~ ~ 'A~®aara~: ~ / L` '' s 'T®ta~ ~ ~ ~, ;~ Requested By: ~~~_~,...C~~,<,~ ~_~'~~~_..~~~P<a~-~ Approved By: ~ ~i~ ~Yl ' (Department Mead) Special Instnacti®ns: QUESTS I2ECEIYED IlV i{'INANCE BY TiJESI)Al' AT 5°00 Pl®'I WILL BY AYAIL.ABLE F'®It I)ISTItIBUTI®N BY TIDE F®LLOWING IVIONI3AY AT N®®N. PLEASE PLAN Y®Ult ~tEQUES'TS ACCOIt~INGI~Y! WP80\MyFiles\Check Request BUSINESS SERVICES C®NNECTI®N, INC. 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 August 28, 2009 Invoice No. 9-108 TO: Public Safety Officers' Pension INV®ICE Office work for week ended August 21, 2009 ......................3.75 hrs Office work for week ended August 28, 2009 ......................3.75 hrs 12.50 hours @ $33.98 Total Due .................................................................... $254.85 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 ~N o ~~ ~ ~ a ~~ O ~ ~J' ,-i ~ v0 ~. 4fl ~ ~I G~ .~ i i i ;, ' U D NZ W. N' ~ ~ F- 1- O p,, , EC Z ?~ ~~ Q,W o~_. 4.o.a~ m~~~.. Q~~~ w N t)wW ~~ ~O"~'W H ~ u. W OQ wN J U J "1 ~f~~ ._ O ~~ 1 U'1 [~- n.i O o- c~i ~m - i .~ ~ J ru a rY1 ~ O, o- ~ - O ..11 ~N ~ ~q . `~ ~ O ... O ~ ~~ ~Q c '~ of ~~ Return to Dept. endor# Date: bail -- F kV�I I 9 -11 -ell Vendor Name: Address: Reason for Request: (Please attach appropriate documentation) Charge to Account No. Amount: Total Oj Requested By: Approved By:, (Department Head) Special Instructions: "8O'\MYFi1es\Check Request BUSINESS SERVICES CONNECTION, INC. 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 September 11, 2009 TO: Public Safety Officers' Pension INVOICE Invoice No. 9-116 Office work for week ended September 4, 2009 .............:..3.75 hrs Office work for week ended September 11, 2009 ................3.75 hrs 7.50 hours @ $33.98 Total Due .................................................................... $254.85 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S PUBLIC SAFETY OFFICERS PENSION-TRUST FUND 345 TEQUESTA DRfVE TEQUESTA, FL 33469 ~~ ~~-~ ~ fir, ~~ c~ ord~ro{~ ~ SUNAMERICAN $ANK 250 Teq~esle Oc, SulEe 101, Tequeala, R 33489 pq '~ ! ~f' 0 ~fO ~5 6 ff' ~: 0 6 7 0 °L 3 L 2 4 ~: 6 7 sons 63-1312/670 _ ~ ~~~ WP80V~tyFilu\Chcek Request BUSINESS SERVICES CONNECTION, INC. 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 September 25, 2009 Invoice No. 9-121 TO: Public Safety Officers' Pension INVOICE Office work for week ended September 18, 2009 ................3.75 hrs Office work for week ended September 25, 2009 .................3.75 hrs 7.50 hours @ $33.98 Total Due .................................................................... $254.85 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S PUBLIC SAFETY OFFICERS PENSION TRUST FUND 345 TEQUESTA DRIVE TEQUESTA, FL 33469 SUNAMERICAN BANK 250 Tequeale Dr., Suite 101, Tequesie, R 33498 - ~ ~ ~-~ ~ r ~ ~ ~. °~,, a^OOL05711' ~:0670'L3L24~: _= 1057 - ~ ~ ~ 63-1317J670 ~~ -= r I $,~~ ~, , ~~r~~ - .. o.e,.o~~. 6 70 29 7 540LII' ~ ..__ t ~~ V 13~LLe~~J~ ~~ ~~~~1Jl~ia'~~~ ~~~~~ ~tV~~~ ~Iendcr # Y Date: ~ ~(~ - C7 ~IiRail ~ return to dept. e ~/endor I~larne: R _~.LCm t~ .~ sf j ~.~. ;°~-ft'--~iJ l ' ~~7 /~c~a~-'t c Address: Z ~ D ~~~.:. ~ ~ ~~~ ~ ~~ L~~~~. Reason for Igequest: (Please attach crpp~oprfate doca~»aent~ay~taon/)// . Charge tc Accotatxt 1~To. ~ !~ f . ®G~ ~ ~; ;~/, ~D~ 'Arriourat: 'Totafl ~' ~ ~ ~ ~ .~ Requested ~y: ~ ~, ~~1~ Special Instructions Approved ~y: (Department I~iead) I~QiJES'T$1tECEIVEI) IN B~'INAI~TCE BY Z'IJESI)A~ AT 5:~0 Pll~ WILL ~'~ AVAII..~LE F'®R DISZ'ItI~gJ1'I~iV ~Y THE F'®LI,OWING ~!IONYD~-~f AT N001~1e PLEASE PLC YOITIt REQ~JE~'I'S ACC~R~ING~Y! WP80U~iyFileslCheck Request BUSINESS SERVICES CONNECTION, INC. 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 September 30, 2009 Invoice No. 9-124 TO: Public Safety Officers' Pension INVOICE Office work for week ended September 30, 2009 ................3.75 hrs Office work for week ended October 2, 2009 .....:..................0.00 hrs 3.75 hours @ $33.98 Total Due .................................................................... $127.43 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 VENDOR # ~l ~~ P.O. #_ s INV. DATE '~ INV. 3~ O . # , oD . ~. ~'30. ,3 DEPAR ENT HEAD ~0 DA E RECD. FINANCE APP. VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S PUBLIC SAFETY OFFICERS PENSION TRUST FUND 345 TEQUESTA DRIVE TEQUESTA, FL 33469 of ~~-~tnes~ ~^ J ~ c~ ~- ~~~,. ..r SUNAMERICAN BANK A° 250 7equesle Dr., Sui[e 101, Tequeste, R 334 + pC` ~ ~ lD +~ 0 i0 58ii' x:06 70 L 3 L 240: __ 1058 ~ ~ry ~p 63-1312/670 _ _- ~ ` ~lJ ~~ IM 6 7 0 2 9 7 5 4 0 lpu' ~ __--__.f~~.-~-~ ___ ~~~~~~~ ~~ ~~~~~~~~ Q.~~eQ•~ ~ CV ~~ ~Ie~do~ # r~ s, r~, ;..:- mate: ;~~ -~ ~,~ ~~ ~~ ~e ~ I~aafl ~ lie do Y~ep~e ~ ~, ~l ea~d®~ Dame. ~ ~~ ~ ~' ;f / ~ ~y -.~..r. [~ a~T. ~~,~ ~, ~ V y %3 ~j r 0 i ~ ~~~t~ R~.,~`- .~..~~„ ff :,,t ~~ ~£~ - .t~ ~ ~, ~; ~..~v, ~dd~trss, ~-' ~~ ~'~ ~. [ 1 9 F+.~ - f~ l J ~,~~ y ~ ~ 7 it e.~'",~`1 " ~ ~_f %"~~, ~ ~ C.,L...=i'~,.,it,_.. ~ ~" ~ ~; ~"-~.' ~ ~.r Leas®~ f®~ Requesg: (Please attach app~°o~~-~a~t~ do~~-ae~tatio~~ o ,. ~{ ~ u *.~ l ~ r ~' .. Pp, ~; . _ ;~ S`..~.r~ - ..~~ ,;~;.:2.,~e~.-' ~~ ~:.~ ter, ~4•~~.-~~~, a -~. .~. ~q; ~ r~r ~, + b~,! ~~ ~ ~ ~ ~ of ~4 e ~~~~ ~' ~ ~''~~" ~~~ Requested ~y: ; ~ ' Approved ~y: department I-lead) Special Instructions: ~EQ[TESTS DECEIVED IIV ~N~CE ~Y ~'iJESD.~Y AT' 5:00 Ply ALL ~Y AV.~II,~I,E F®It DISZ'ItI~gJT'I®N ~1' 1'~IE F'®I,I,OWING lv1®1lTIDt1Y .d11' 1,1®®Nv PI~EA~E PI,~ I'®LJlt I~~UES~'S ACCO1~DIllTGLY! WPSOWIyFiles\Check Request THE ~~T ®ICES ®F ~E~~~ J~NSEN~ LLB ANN H. PERRY aperry@perryjensenlaw.com August 25, 2009 1/ia Email Village of Tequesta Public Safety Pension Fund Lori McWilliams, Pension Coordinator 345 Tequesta Drive Tequesta, FL 33469 BONNI SPATARA JENSEN bsjensen@perryjensenlaw.com Re: Le al Services Provided Invoice #63276 Dear Lori: Enciosed please find the Firm's invoice for services rendered for the period that ended 811512009. Thank you for your payment of $2,231.25. Your current balance due is $1,224.53. If you have any questions, please do not hesitate to contact me. Si erely, t Bonni S. Jensen BSJ/adt Enclosure Copy to: Ed Sabin, Chairman Via Email Only 400 EXECUTIVE CENTER DRIVE, SUITE 207• WEST PALM BEACH, Ft_oRIOA 33401-2922 PH: 561.686.6550 ~ Fx: 561.686.2802 13 4oF~1bI~fN+lm THE LAW OFFICES OF PERRY & JEIVSEN, LLC 400 Executive Center Drive Suite 207 West Palm Beach, FL 33401-2922 (nvoice submitted to: Tequesta Public Safety Officers Pension Fund Lori McWilliams, Pension Coordinator -Via Email Village of Tequesta 345 Tequesta Drive Tequesta FL 33469 Betty Laur / Ed Sabin, Chairman -Via Email August 24, 2009 In Reference To: For professional services rendered as follows: Client /File No.: 1011 Invoice #63276 Professional Services Hrs/Rate Amount Attendance at Trustee Meetin4 7/30/2009 KA Research 0.25 18.75 Research minutes in preparation for meeting 75.00lhr Attendance at Trustee Meeting 8/3/2009 BSJ Attend 2.75 550.00 Attend meeting 200.00/hr Attendance at Trustee Meeting SUBTOTAL: [ 3.00 568.75] IRS Determination Letter 7/17/2009 ADT Review and Revise 0.10 7.50 Review and revise Appendix F Schedule 2 per attorney markup 75.00/hr IRS Determination Letter KA Review and Revise 0.50 37.50 Review and revise cover letter in response to Intemal Revenue Service 75.00/hr letters dated 6/15/09 per attomey markup IRS Determination Letter KA Prepare 2.00 150.00 Prepare Documents for submission with response to Internal Revenue 75.00/hr Service letter of 6/15/09 Tequesta Public Safety Officers Pension Fund Page 2 Hrs/Rate Amount Draft list of requested exhibit(s) IRS Determination Letter 7/17/2009 BSJ Review and Revise 0.50 100.00 Review and revise letter to Margaret Saito 200.00/hr Prepare exhibit(s) IRS Determination Letter 8/11!2009 BSJ Correspondence with 0.25 50.00 Correspondence with Internal Revenue Service -Request for 200.00/hr Extension of Time to respond to 2nd request IRS Determination Letter SUBTOTAL: [ 3.35 345.00] IRS Matters -General 7!24/2009 BSJ Correspondence with 0.25 50.00 Correspondence Memorandum to Administrator re: Notice 1036-P - 200.00/hr new withholding tables IRS Matters -General SUBTOTAL: [ 0.25 50.00] Inv Mgr -Rockwood 8/5/2009 ADT E-Mail 0.10 NO CHARGE E-Mail to Board of Trustees sample shareholder proxy voting policy 75.00/hr (ISS) Inv Mgr -Rockwood SUBTOTAL: [ 0.10 0.00] Investment Policy Guidelines 7/28/2009 BSJ Review 0.25 50.00 Review Investment Policy Guidelines 200.00/hr Review Fla. Stat. §112.661 and SB538 E-mail to Dave West at Bogdahn Consulting re: changes and suggestions for Investment Policy Guidelines Investment Policy Guidelines 8/6/2009 BSJ Telephone Call 0.15 30.00 Telephone call with Tony @ Rockwood 200.00/hr E-mail link to SBA: Scrutinized Company List Investmen# Policy Guidelines Tequesta Public Safety Officers Pension Fund SUBTOTAL: Meeting Notices and Aaendas 7/29/200914A E-Mail E-Mail to Betty Laur & Lori McWilliams the disability language to be printed on the meeting notice and agenda Meeting Notices and Agendas Page 3 Hrs/Rate Amount [ 0.40 80.00] 0.20 15.00 75.00/hr 0.20 15.00] SUBTOTAL: [ Misc Matters 7/21/2009 BSJ Telephone Call Telephone call with Keith Davis re: rehire after retirement Misc Matters 7/22/2009 KA E-mails E-mails with Lori McWilliams re: benefit payout form Telephone calls with Betty and message (detailed for Lori McWilliams Misc Matters SUBTOTAL: For professional services rendered Additional Charges Bill File 7/17/2009 PJ UPS Delivery United Parcel Service Invoice No.: OOOF49280309 Tracking #1ZF492801393004044 to /from Internal Revenue Service Bill File 8/15/2009 PJ Photocopies$ Copy Charges Bill File 0.10 20.00 200.00/hr 0.30 22.50 75.00/hr [ 0.40 42.50] 7.70 $1,101.25 Qtv/Price 1 19.53 19.53 415 103.75 0.25 SUBTOTAL: [ 123.28] Total additional charges $123.28 Tequesta Public Safety Officers Pension Fund Page 4 Amount Total amount of this bill $1,224.53 Previous balance $2,231.25 Total payments ($2,231.25) Balance due $1,224.53 a~ o ~ fr ~~ o ~ ~ ~ ~ ~I -~- ~ ;~ ~ ~' I .:. i ~. ~;` ° s ~, f ~ I ~ -,., 0 ~~ ~ ~ 0 N Z _^ u, ~ N N ~ (~ a ~~ ~ ~ ~ ~ - -~, F f- p O p ~~p ~ "W c~ ~w~ ~ ,o © ~~ m N ~ LL L pq • QQw¢ ~ ~ ~O"'~ ~ ~ O ~ ~ ~ O ~ _ O ,LL cn a y e '~ Q C9 0 F.. ~, . _ ~ o (i a m ~~iL~~~ ilQ7~t~ ~~ YL l~~l~J~a~~~ ~~iC~Q,~ ~~~ QIJES'~'S CEI~I) dl~d ~+'I1~CE ~Y ~'iJESI~AY A1' So00 Ply WILL. ~Y ~VAILLE F'®l~ I)IST'ItII3i11'I®lY I3Y ~'I~ ~®LLO~~IG ~I~I~1)E11' A~' N®®l~e PLEASE PI~AI~ Y®LJl2 QL1ES'I'S ACC®~I1~GI~~'~ WP80\MyFiles\Check Request BUSINESS SERVICES C®NNECTI®N9 INCo 260 Riverside Drive, Palm Beach Gardens, FL 33410 561-694-7963 Fax: 561-694-1591 August 18, 2009 Invoice No. 9-105 T®: Public Safety ®fficers' Pension INVOICE Attend Regular Quarterly Meeting on 8/3/09 and prepare minutes, synopsis, and semi-verbatim transcription of agenda item to be communicated to Village Manager. Attendance at meeting 3-1/2 hours; preparation of minutes & synopsis 8 hours 11-1/2 hours @ $33.98 Total Due .................................................................... $390.77 Please make check payable to: Business Services Connection, Inc. 260 Riverside Drive Palm Beach Gardens, FL 33410 c~ 0 o ~~ 9 a ~` ~~ ~: ~ ~ O` ~~ c/~ ~ ~I D cn z ~~ L~. N N F- F- Op Q~~ QW~ '~ ~ ~~~LL. ~~~ W NVww W ~ ~- O ~'~ W F- o°u w~ a~ J '~ >~ a c~ J LJl [~ ru O o- c.0 ti ~ '~ ... ~ m O ~. O ~~ ui ~ O ~~ ~~ ~~ ~ ~ g O ~Iendor # ~ Date: ~ I~ .~ I ~ ~' ~ Mail ~ Return to Dept. \Iendor Name: Address: ~ /1 /~i3-Nr, ~ ~(~ j~ Reason-for Request: (Please attach appropriate documentation] ~.l M 0 A la 0 l.~'YI~ffL~'.l.Yii~P a ~ ~ n ~n ,~~i .~ .~G9-.1i ~1 _~~ - ~„ hli i ~ lt~f.~ Charge to Account No. ~ 4 /, D ®Q . ,~5 ~ ~ D ~ Amount: Total ~ ~ ~ ~ ~ © Q Requested By: ~~''~ A roved B `~ `~- ' I , e~~'Z`~ PP y (Department Head) Special Instructions: PLEASE PLAN. YOUR REQtJE~TS ACC4I~DINGL WP8UUvIyF~les\Cheek Request The Stuaz~t News ~ St. Lucie News Tribune 0 8 / 01 / 0 9 - 0 8 / 31 / 0 9 VOT Indian River Press Journal ~ The Jupiter Courier 3 TOTALAMOUNT DUE `UNAPPUED AMOUN ebastian Sun ~ TC Palm a Treasure Coast Business 3ournal 3 3 6 . 0 0 21 CURRENT NEiAMOUNT DUE 22 30 DAYS 336.00 2 INVOICE NUMBER 4 PAGE# 5 BILLING DATE 6 BILLED ACCOUNT NUMBER 7 1704209 1 08 31 09 15614928 SIGN BOARDS TERMS Of PAYMENT NET DUE END OF MONTH 60.DAY$ -.OVE ~8 BILLED ACCOUNT NAME AND ADDRESS g -- - REMITfANCEADDRE55- SCRIPPS-TREASURE COAST PO BOX 630807 LORI MCWILLIAMS CINCINNATI, OH 45263-0807 VOT PENSION BOARDS 345 TEQUESTA DR TEQUESTA FL 33469 D1D17D42D9DDDDD336DD1 PLEASE ®ETAGIi AND RETURN UPPER PCIRTI®N WITH Y®UR REMITTANCE 10 DATE 11 NEN/SFAPERREFERENCE 13 14 - DESCRIPFION-OTHER COMMEMS/ClIARGES - 15 16 SAU 513E - B1LlED UNITS - V iB TIMES RUN -- - - RATE -.: 14 GROSSAMOUNT ? - NET AMOUNT 07/31 BALANCE FORWARD .00 ---- 08/09 --------------- 2291055 ----------------------------- 82 members wanted ---------- 2x72 --------- 1 ----------- 168.00 ----------- 168.00 COUR 141 12.00 ---- 08/16 --------------- 2294504 ------------------------------ 82/MEMBERS WANTED ---------- 2x7I --------- 1 ----------- 168.00 ----------- .00 COUR 14I 12.00 100% CHAR DISC - - -100.00% -168.00 ----- .08/23 --------------- 2294504 ------------ ----------------- 82/MEMBERS WANTED ------ ---- 2x72 --------- 1 ----------- 168.00 ----------- 168.00 LOUR 14I 12.00 ~~ ~~ ~~ o !~~ PILLAGE CL F3K s OFF6CE ~~~~4~L~~ ~?C.~ STATEIlAENT OP ~-CCOdJNT AGING OF PAST DUE AMOUNTS. A SERVICE CHARGE OF 1'Is% PER MONTH WILL BE ADDED TO PAST DUE BALANCES. ~'~ 21 CURRENT NETAMOUNT DUE 2? - - 30 DAY$-' --- -~ - D._ ~' OYfx 9QbJ+:r'S- ~ -'UNAPPLffD AMOUhl1 _ - ~ 23~ TOTALAMOUNT DUE _ __~ _..__ ._ -------._-._v~_~ _ ~~~~ 772-223-9191 FAX 772-600-1474 REMITTANCE ADDRESS: ,~ Scripps Treasure Coast Scripps-Treasure Coast Toll Free 1-877-560-9191 PO Box 630807 Newspapers TC_Naccc~untin~Ca?scrinnc_cci'm Cincinnati. OH 45263-0807 iNVOIGENUMBER 25 - ~ `: ADVER45ER BJFORMATRDN 1 -- BIWNG PERIOD 6 - --B1lLEDACCCiUNT NUMBER 7- ---. ADVERTISER CLIENT NUMBER 2 ADVERTISER/CLIENT NAME 1704209 08/01/09 - 08/31/09 15614928 VOT PENSION BOARDS 'Unapplied amounts are included in total amount due FED ID# 59-1093327 Billing Code Legend on reverse side FORM 102 VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S PUBLIC SAFETY OFFICERS PENSION TRUST FUND 345 TEQUESTA DRIVE TEQUESTA, FL 33469 1055 - ^ i ~I -1312/670 ~ ~~g~ -----~"T ~ eOOi05511' ~:06.70=i3i24~: 670297540111' . . 4 ~ -%9eNiy M1nwo ~ OM~epa~an Baer IYP ~ .~UNAMERICAN SANK ~' 250 Tequasl9 Dc, SWb 107. Tequest9, R 33960 ~_ Division of Retirement Municipal Police Officers' & Firefighters Retirement trust Funds' Office PO Box 3010 Tallahassee, Fbrida 32315-30 f0 DEPAR'fMEf~T •F MANACsEMENT To1fi Free:877.738.6737 (~ ~\/ Tet: $5©.422.0667 Fax: 850.921.2 16 fi vawvvdm~MyFltxida.com Governor Charlie Crist Secretary Linda H, South IMPORTANT MEETING NOTICE -October 21-23.2009 You are cordially invited to attend the 41" Anneal Police Officers' & Firefighters' Pension Conference seheduial !or October 21-23, 2009, sponsored by the Department of Maasgement Service's Division of Retirement. The Conference will be held at the Radisson Resort Orlando-Celebration, 2900 Parkway Blvd,, Kissimmee, Florida. This conference is offered ~ of charge as a public service by the Department and is uniquely designed far pension plans established under Chapters 175 & 185,1Klorida Statutes. A copy of the program is available on the Web site. Wednesday's Program, on October 21", is being offered specifically far new tnrstess and those interested in understanding the basics of the administration and operation of the Chapter 175 & 185 pension plans. It will include lectures on the trustees' responsibilities, including legal, actuarial, and investment issues. Participants will be encouraged to ask questions and participate in group discussions focusing an the fundamea~ls of pension fend management. If you are interested in finding nut more about the Chapters 175 & 185 retirement plans or are a new trustee on the pension board, we eaeoarage you to participate in this day's special program. Thursday sad Friday's program, on October 22 and 23, is designed far both the new and seasoned trustee and wil! feature presentations on legal, investment, actusr~sl, and ethics issues. There will be sn opportrraity for questions after each speaker's presentation to provide you with a chance to address concerns specifie to your plan. We are adjourning early on Friday to give you plenty of time to return home, so make plans to stay far the entire program ro as not to miss any of the presentations. You do not have to be a pension trustee to attend. AH police officer and firefighter plan participantq, board of trustee members, city officials, administrators, accountant, actuaries, investment advisers, legal counselors, and other advisors, should take advantage of this unique, insightfel and informative conference. Participants may register on the morning of the Conference at the Radissoa's Coaventioa Center. There is no pre- registration ar fee for participating. The program is offered absolutely frce of char~¢e. However, we encoaroge you to make your betel reservat~as right away by calling the Radisson Resort at (407) 39(r70t10, or toll fire at 1-800-333- 3333, as the hotel is holding a limited number of rooms at a special Conference rate of 5139 siagle/doeble until September 30, our program code is MAO. Visit our Web site at htfn:;`Iw~tH~.m~~flnrida.cornlfrs~tmnf for a link to the Hotel reservations site, maps to the ho#el, and other information abaat the Conference. As an added bonus, the Hotel is basting a "Welcome Reception" for all participants on Wedaesdav. October 21, from 5:00 p.m. to b:00 p.m. You are encouraged to take advantage of this opportunity to meet the speakers and your fellow participants! We will keep our fingers crossed that there will be oo hurricanes threatening, but just in case, please check oar Web site for updates on the status of the program. If a warning is issued, we will tepee! sad reschedule for a later date, so make sure to check the Web site before traveling to Orlando. We look forward to seeing you at the Conference in October! S~in]cerely, Patricia F. Shoemaker Benefits Administrator Municipal Police Officers' and firefighters' Retirement Fends We serve those who serve Florida. 41sT ANNUAL POLICE OFFICERS' AND FIREFIGHTERS' PENSION C©NFERENCE October 21, 22 & 23, 2009 Radisson Resort Orlando-Ceiebration -Orlando, Florida WEDNESDAY. OCTOBER 21.2009 -SPECIAL KEW TRUSTEE PROGRAM 8:30 a.m. - 9:00 a.m. REGISTRATIQN-NO REGISTRATK)N FEE Coffee & Tea Availahie 9:00 a.m. - 4:00 p.m. PANEL DISCUSSION -OPEN FORUM MEETING BETWEEN SPEAKERS & PARTICIPANTS 9:00 &m. - 10:00 a.m. WORKSHOP SESSION -PATRI(:IA F. SHOEMAKER-• DIVISION OVERVIEW 10:00 am. - 10:15 a.m. REFRESHMENT BREAK 10:15 am. - I l: l5 a.m. WORKSHOP SESSION - H. LEE DEHNER-LEGAL ISSUES 17:15 a.m. - 12:15 p.m. WORKSHOP SESSHNV-$RADLE1r` I-IEiNRICHS-ACTUARIAL ISSUES 12:15 p.m. - 1:15 p.m. LUNCH ON YOUR OWN L15p.m. - 2:1Sp.m. WoRKSHOPSEasION-MncEWF~,IPaz&JOEBoGD:aHN-1NVEST[~NTIssuEs 2:15 p.m. - 3:00 p.m. WORKSHOP SESSION -PANEL DISCUSSION Wftlt QUESTIONS FROM PARTICIPANTS 3:00 p.m. - 3:15 p.m. REFRESHMENT BREAK 3:15 p.m. - 4:00 p.m. WORKSHOP SESSION -PANEL DISCUSSION WITH QUESTIONS PROM PARTICIPANTS 4:00 p,m. ADJOURN UNTIL THURSDAt' PANEL MEMBERS' Patricia F, Shoemaker, Division Overview Florida Division of Retirement Municipal Police Officers' 8c Firefighters' Retirement Trust Fund Office Tallahassee, Florida H. Les Definer, Legal Issues Christiansen & Definer, P.A. Sarasota, Florida $radley't~Isinrichs, Actuarial Issues Foster & Foster Consulting Actuaries, Inc. Fort Myers, Florida Mika Welker & Joe Bogdaho, Investment Issues Bogdahn Consulting Orlando, Florida WEDNESDAY. OCTOBER 21.2009 *s:oo p.m. - 6:00 p.m.* THE RADISSON CDRDIALLYINYITES YOU TO A "WELCOME RECEPTION" FOR ALL PARTICIPANTS & SPEAKERS 41ST ANNUAL POLICE OFFICERS' AND FIREFIGHTERS' PENSION CONFERENCE October ZI, 22 & 23, 201)9 Radisson Resort Orlando-Celebration -Orlando, Florida THCFR5Dt1Yt OCTOBER 22, 2009-FIRST DAY OF REGULAR PROGRAM 7:30 a.m. - 8:00 a.m. RECrsTRAT}ox-No REC}sTItAT}orr FEE Coffee & Tea Available 8:00 am, - 8:30 a.m. INVOCATION Chaplain, Ortattdo Police Department PLEDGE OF ALLEGIANCE Orland Fi»efghters' & Police Officers' HOr-or Guard WELCOME Sarabetll Snuggs Drreetory DtVi3lOn Of Retirement Tallahassee. Florida 8:30 am. - ~:30 am. EcoNOMtc OUTLOOK -How IT AFFECrs YOURPLAN Bob OhanesiaA Chief Executive Officer, Portfolio Manager 1CC Capital Management Orlando, Florida 9:30 a.m. - 10:30 a.m. PENSION SAFETY FOR PUBLrC SAFETY ROl/ert A. SUS&rAlaA Attotney at Law Sugarman & Susskind, P. A. Coral Gables. Florida 10:30 am. - 10;45 a.m. REFRESHMENT BREAK 10:45 &m. - 11:45 a.m. Du'rtES & RESPONSTBILTrIES OF THE BOARD OF T'RUSTEE5 H. Lee De6Aer Attorney at Law Christiansen & Dehr>er, P. A. Sarasota, Florida 11:45 am. - 1:00 p.m. LtnvcH ON YOUR OwN 1.00 p. m. - 2:00 p.m, F+ THICS LAWS Cdris Anderson, HI Chief Assistant General Counsel Florida Commission on Ethics Tallahassee, Florida 2:00 p.m. - 3:00 p.m. UPDATE FROM THE OFFICE OF FTNANCIAL REGULATION TBA Office of Financial Regulation Depemnent of Financial Services Tallahassee, Floriaa 3:00 p.m. - 3:15 p.m. REFRESHMENT BREAK 3:15 p.m. - 4:15 p.m. ACTUARIAL REPORTING ISSUES Larry Wilson Senior Consultant & Actuary GabrieE, Roeder, Smith & Company Ft. Lauderdale, Florida 4:l 5 p.m. - 4:45 p,m. UPDATE FROM THE DIVISION OF RETIREMENT Patricia F. Shoemaker Benefits Administrator MTmicipal Police Officers' & Firefighters' Retirement Trust Funds 4:45 p.m. ADJOURN UNTIL FRIDAY 41sT ANNUAL POLICE OFFICERS' AND FIREFIGHTERS' PENSION CONFERENCE October 21, 22 & 23, 2009 Radisson Resort Orlando-Celebration -Orlando, Florida FRIDAY, OCTOBER 23, 2009-SECOND DAY OF REGULAR PROGRAM 7:30 am, - B:OU am. REGISTR4TION-NO REGISTRATION FEE CofTee & Tea Available 8:00 am. - 9:00 am. UPD,~TE oN 11~IIwTARx ENTITLEMENTS (USERRA) & coMPLwNCiy wrrH GENERAL LAR' PROVISIONS-CHAPTER 112, F. S. Kenneth R. Harrison, Sr. Attorney At Law Sugarman & Susskind, P. A. Cor$1 Gables, Florida 9:00 am. - 10:00 am. "SHOOT THE PATIENT OR FIND ACURE"-FINANCIAL URGENCY ~[ FUNDING OF PENSION BENEFITS Richard A. Sieking Attorney at Law Coral Gables, Florida IO:~ am. - 10:15 am. REFRESHMENT BREAK 10:15 am. - t l: l5 am. CHAPTERS 17S ~ 18S LEGISLATION AND OTHER UPDATES Bonni S. Jensen Attorney at Law Perry & 3ensen, LLC West Palm Beach, Florida 11:15 am. - 12:15 p.m. NEGOTLITING PENSION BENEFITS IN TODAY'S CLIMATE Paul Donnelly Attorney at Law I?omlelly & Grass, P. A. Gainesville, Florida 12:15 p.m. - 12:30 p.m. CLOSING COMMENTS FROM THE Dlvtsicxv Patrieia F. Shoemaker Benefits Administrator Municipal Police Officers' & Firef ghters' Retirement Trust Fund 12:30 p.m. CONFERENCE AD.K?URNs Radisson Hotels & Resorts, Radisson Resort Orlando-Celebration :Area Map - Powered by 1... ~ Page I of 1 2900 PARKWAY BOULEYARd KISSIMMEE, Florida 34747 Phone:{407)396-7000 FAX: (407) 396-4577 ~Zoomirtg: Dot~Ie-ctiGc rrs~p }mouse stxnll wheel ~ zoom har bebw Penning: Ckdc-and-drag the map ~ penrHng arrows below RolFover Icons Tor more options and Ynks. a T f <~ ~~ ToN 4 ~ ~ ~ ~'~44t'4 j ~ ~~ ~y~ I ~11~Id- i-" i "s i~~_ - ~. GaiebsrNa+ -~ . ~~-Cr-2009~MIaoeote~i~ „~. ;~. ':_.~ ~,.~ _ __ ~~ ~~ °' $~ I in a ~~ o ~ 1 ~ I 1~- . ~ J ~~ ~j ~ µ~ y~ ~~ t ~, ~; :~ ~ ~~ '~ 1 ~_~ ~ o ~~ ~~ a ~ti 0 ~Y o ~ z _• LLJ ~ r ,~.., 1 pJ LL ~ ~ rt.i N U ~ '~ H H ~ ~ .a O 0 0 `~ 'Ci.J ~ ~ ~cnwrn O pC Z>~ _. Oa°~ E~ ~~ Q~~~ ~ ~ ~ ~ ~~ NUwW ® 4 V' l'O OLLM~ ~ ~ ~ DSO w o ~ E -o ~, ~ • z~ - oLL ~' ~ ~~ ~N - ~ ~~~~ J J ~ o~ ~_ -~ ~l _ P ~~~~ J m ' ~ , ~ ~~ V 1~11~eJ3a~~LD~ ~~ ~~~U~ea~~~ ~~~~~ e~E'4J~et~ ~Ienda~ # Date: ~ G ~ ~ ~ l~ai~ Return t® Dept. Mend®~- Nagne: ~z,C Leas®n I'®~ Igequest: (Please attach appropriate docu»aentation) o D .._ ~hagge to ~ccatant l~Ta. S~,1~.~-° ~~'~~ . ~-^~ /~ /]~~ 'At~xaunt: `YV ~/ ~~~6'~~.~l~le'. GO ~'®tafl Requested Dy: -~ Approved ~y: ?~ ~,e Special Instructi®ns: (Department Idea C~ l~u (a~.~ ~ ~'Ylon; ~ ItEQiJES~'S ItECEIVEI) I1V FI1~1.~iCE BY 1'UESIDAY A7[' 5.00 PIdI ALL ~Y AVAILABLE F®lt IDIS~'ItI~iJT®IV BY'I'HE F®LI.,OWIIWG 1VI®1VIDAI~ AZ' I®1®Dlvo PLEASE PLC Y®UR ~tEQUESTS .~-CCORDII~GI~Y! WP80\MyFiles\Check Request Betty, The Fiduciary Liability Policy Premium of $4,137.97 is broken down as follows: (1) Public Safety Officers Pension Trust - $3,261.90 (2) General Employees Pension Trust - $876.07 Thank you. 9-~lonica Rahim Senior Accountant Finance Department The Village of Tequesta 345 Tequesta Drive Tequesta, FL 33469 Tel. No. 561.575.6209 Fax No. 561.575.6232 mrahimC~teguesta. orQ .~ . 11505 Fairchild Gardens Ave., Ste. Palm Beach Gardens, FL 33410 Tel: (561) 626-6797 Fax: (561)626-6970 ._ 202 INVOICE To: Village of Tequesta ATTN: Merlene Reid 345 Tequesta Drive Jupiter, FL 33469 Customer Date Terms Inv. No. T0052-069 08/10/09 Due Upon Receipt 19290 Description Charges PRM34 Premium Due: Fiduciary Liability Village of Tequesta General Employees Pension Fund Policy Period: 10/01/09 - 10/01/10 Policy #: 103505325 PRM34 FHCF Surcharge: $4,097.00 $40.97 Invoice Total: $4,137.97 TRA1/ELERS September 17, 2008 This is an Agent Bill Policy. ATTN: Ellen Jones GEHRING GROUP 1NC {OCJZ86} 11505 FAIRCHILD GARDENS AVE SUITE 202 -PALM BEACH GARDENS, FL 33410 Donna M Corana 4631 Woodland Corporate Blvd. PO Box 31987 (33631-3961} TAMPA, FL 33614 Phone: (813} 890-4069 Fax: (800) 265-1498 Email: DCORONA@trwelers.com This is the Renewal for: VILLAGE OF TEQUESTA GENERAL EMPLOYEES PEiVSION FUND 345 Tequesta Drive TEQUESTA, FLORIDA 33469-0273 Product Type: FRIP NEW Policy Number: 103505325 Total Policy Premium: $8,275.94 Policy Period: October 01, 2008 to October 01, 2010 Billing Period: October 01, 2008 to October 01, 2010 Trans Effective Date: October d1, 2008 Liability; 52,000,000.00 Deductible: $5,000.00 Commission-Percentage: 15A0°J° Special Commission: 5.00 Countersignature Branch: Countersigns#ure Agent: Countersignature Commission: $0.00 Countersignature Rate: 0% Premium Years Agreement Year 1 Year 2 Year 3 Basic $3,808.00 $3,808.00 $.00 Recourse $289.00 $289.00 5.00 Surcharge: $40.97 $40.97 5.00 Tax: $.00 $.00 5.00 Combined Premium: $4,137.97 $4,137.97 $.00 Comments: Thank you for placing your business with us. P~-G~~D2 06-98 POLICY llISCLOS[~ItE NO'I"ICE - TERRORISM RISK INSURANCE ACT OF 2002 On ~ccen~ber 2G, 200?, the President of the United States signed into la«~ amcndtnents to the T'crrorism Risk Insurance Act of 20(}2 (the "Act"), which, among other things, extend the Act art4l expand its scope. ~~ he Act estabfishcs a program under which the Federal Government may partiall}~ reimburse "Insured Losses" (as defined in the Act) caused b~~ "acts of terrorism". An "act of terrorism"' is cicfined in Section. 102(1) of the Act to mean any act that is certified by the Secretan~ of the "I'reasun - in concurrence «=ith the Sccretarv of State and the Attorney General of the United States - to be an act of te~rarisrn; to be a violent act or an act that is dangerous to human fife, property, or infrastructure; to hay°Y resulted in damage ~}7lhrn Else United States, or outside the United States in the case of certain air carriers or vcsseis or the premises of a United States Mission: and to have been committed b}~ an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the poficy or affect the conduct of the 'Jutted States Government by coercion. "nc~ Federal trsovernrnent's share of compensation for Insured Losses is 85°!~ of the amount of Insured Losses in excess of each Insurer's statutorily established deductible, subject to the'°I'roram Trigger", (as defined ir; the A;;t). In no event, however, will the Fcdcral Government or any Insurer be rcquircd to pay' any portion of the amount of aggregate Insured Losses occurring in any one year that exceeds $100,00L',00O.000, provided that such Insurer has met its deductible. If aggregate Instrrcd Losses exceed $10().00(~_00U.(;OC~ in any ane year, ~~our coverage may therefore be reduced. 1'icasc natc iha no separate additional premium charge has been made far the terrorism coverage rcquircd by the :'pct. `t'he premium charge that is allocable to such coverage is inseparable from and imbedded in }our overall premium, and does not include any charge f or the l~or[iott of losses covt;red by Cite l:edcral Government under the Act. The charge is no more €Itan cue percent of your prcmtum. Issuing Company: Travelers Casualty and Suretti~ Company of America Po3ic~~ Number: IOS~{fS32a II,T-I(!18 Rcv. O1-flS Printed in U.S.A. Page I of 1 °21108 T'he Travelers Companies, Inc. All Rights Reserved ~~~>~~~ ~ PENSION AN[3 {NELFARE FUND FIDUCIARY RESPONSIBILITY INSURANCE POLICY o~c1.aR~~~onls _. Travelers Casualty and Surety Company of Amenca D Travelers Casualty artd Surety Company of tlFinois Travelers Casualty and Surety Cohipany Naperville, Iflinois 50553-8+158 . Hartford, Connecticut G6183 (A stock insurance company, herein called the Company) ~. u~~3vwra a e~ t KUS t UK k~LAN -- POt_ICY VILLAGE OF 7EQUESTA GENERAL EMPLOYEES PENSION FUND (See Narne of Designated Trust ar Plan Endorsement} (See Governments! Plan Endorsement} 2,. Mailing Address 345 Tequesta Drive TEQUESTA, FLORIDA 33469-0273 {Number, Street, Ta~~:n, Ccunty, State, Zip Code) 3_ Policy Period 1035053:25 -rorn OCTOBER 01, 2008 To OGTOBER 01, 2010 12:Q1 a.n . Standard Time at the (,nailing Address Stated in Item 2. ~. Hnnuai Aggregate ~imiF of amiability $2,000,OOO.JG Premium for the Policy Period $8,275.94 Premium Payable ~ Current ~ Each Anniversary _ ~ $4,091.00 $4,097.00 6. !nsurance Representatrve ___.__ Michael R. Couzzo..;r. 7. Designated F=duciaries --""- Capacity c. rnaorsements maoe a part of this policy (Designated by Endorsement Number) iLT-1018 01-08, F-2817 09-98, F-1280 02-95, F-1449 09-00, F-2100 07-90, ILT-1067 01-08, ILT-0018 07-04 g_ The premium for this policy has been paid by the Trust or Plan. The Company has the right of recourse pursuant to Condition (14). Endorsement (F-128Q) is attached to eliminate recourse. Premium for elimination of recourse: $289.00 (included in Item 5) ~ In advan.e ~ Each installment OTtCE: ~ state surcharge may apply. Please refer to your billing statement. Countersigned by (if required) Authorized Company Representative F-1191-8 (GS-98j Page 1 of 4 PENSION AND WELFARE FUND FI©UC[ARY ~1 ~~~~,,,,~~~ ,~ RESPONSIBILITY INSURANCE POLICY Travelers Casualty and Surety Company Travelers Casualty and Surety Company of Amenca Travelers Casualty and Surorv r_..R,~~~., Af u~~.,.,~ na, «vru, ~unnecucu[ uo~ u~ Hartford, Connecticut 06183 Naperville, Illinois 60563-8458 THIS IS A CLAIMS MADE Pf~LICY IN CONSIDERATION of the payment of the premium stated in the Declarations and subject to all of the terms, conditions, and limitations at this Polic the Company agrees as follows: t. INSURING AGREEMENT. The Company wilt pay on behalf of the Insured all sums which the Insured shall become legally obligated to pay as Damages on account ofi arty claim made against the Insured for any Wrongful Act and the Company shal9 have the right and duty to defend such claim against the Insured seeking such Damages, even if any of the allegations of the claim are groundless, false or fraudulent, and may make such investigation and settlement of any claim as it deems expedient, but the Company shall not be obligated to pay any claim or judgment or to defend any suit after the applicable limit of the Company's liability has been exhausted by payment of judgments or settlements. ?I. EXCLUSIONS. This insurance does not apply to any claim: (1 }Arising out of any dishonest, fraudulent or criminal act, or willful or reckless violation of any statute, bu# this exclusion does not apply to a claim upon which suit may be brought by reason of any alleged dishonesty on the part of the Insured, unless: (,a) A judgment or ether final adjudication thereof adverse to the Ensured shalt establish '.hat acts of active deliberate dishonesty committed by the Insured was material to the cause of action so adjudicated or (b} The claim ss a claim byr cr on behalf of a fidelity insurer against a natural person whose dishonesty has resulted in a loss which has been paid under a fidelity bond. (2}Arising out of libeE ar slander; (3 Arising out of bodily injury. sickness; disease or death, or loss of, injury to, destruction of, or foss of use of, any tangible property, including loss of currency; coins; bank notes, bullion, travelers checks, register checks, money orders, and all negotiable and non- negotiable instruments or contracts representing money; {4} Arising out of the lnsured's failure to comply with any law concerning Workers` Compensation, Unemployment Insurance, Social Security or Disability Benefits. or any similar law; (5} Arising out of the failure to procure or maintain adequate insurance or bonds on assets or property of ±he Trust or Employee Benefit Plan designated in the Declarations; (6} Arising out cf liability of others assumed by the Insured under any contract or agreement, either oral or written, except in accordance with the Agreement and Declaration of Trust; (7) Arising out of the Insured gaining in fact any personal profit or advantage to which such Insured was not legally entitled or for the return by the Insured of any remuneration paid in fack to such Insured if payment of such remuneration shall be held by the courts to have been in violation of taw. (8} For the failure to cofect contributions owed to the Trust or Employee Benefit Plan described in the Declarations from employers unless such failure is due to the negligence of the Insured or for the return of any contributions to an employer if such amounts are or could be chargeable to the Trust or Employee Benefd Plan, but this exclusion shall not apply to the Company's obligation to defend such claim nor pay the costs and expenses thereof. Ili. DEFINITION OF INSURED. Each of the following is an Insured to the extent set forth below: (1) The Trust or Employee Benefit Pfart designated in the Declarations and any additions Trust or Employee Benefit Plan created during the policy period by the sole sponsor referred to in Item (2) below, or by any interest aovned or controlled by said sole sponsor. provided written notice of such is given tc the Company within 90 days. (2} An employer who is the sole =sponsor of such Trust or Employee Benefd Plan. (3) Any natural person who at any time holds or shall have held the position of: (a) Trustee of such Trust or Employee Benefit Plan. (b) Director, officer or em?loyee of such Trust or Employee Benefit Plan or of such sa a sponsor employer. (4} Any other person or organization designated in the Declarations as a Fiduciary. (5} Any other Trust or Employee Benefit Ptan of any firm hereafter acquired through consolidation, merger or Takeover by the sole sponsor or by any interest awned or controlled by said sole sponsor, provided: (a) Written Halite of such acquisition is given to the Company within 9D days of the effective date of such acquisition, and (b} The Insured pays the Company an additional premium computed pro-rata from the date of such acquisition to the end of the Policy Period, and (c) That specific Application on the Company's form in use at the time of acquisition is made to the Company as soon as practicable after the aforesaid notice is given. The insurance apples separately tc each Insured against whom claim is made or suit is brought except with respect to the application of the limits of liability, and ti shall also apply to the estates, heirs and personal representatives of persons insured hereunder. IV. OTHER DEFINITIONS. (7 } "Wrongful Act" means a breach of fiduciary duty by the Insured in the discharge of duties as respects the Trust ar Empiayee Beneft Plan designated in the Declarations; the term includes any negligent act, error or omission of the Insured in the "Administration" of "Employee Benefits". "Administration" as used herein shall mean: (a) Giving counsel to emp oyees with respect to Employee Benefits; (b) Interpreting Employee Benefits; (c) Handling records in connECtion with Employee Benefits; (d) Effecting enrollment, terrrunation or cancellation of employees under an Employee Benefits program. "Employee Beneftts" as used herein shall mean the Tryst or Employee Benefit Plan designated in the Declarations, Workers' Compensation Insurance. Unemployment insurance, Social Security or Disability Benefds. (2) "Insurance Representative" means the person designated in the Declarations as the exclusive agent to act on behalf of the Insureds, individually or collectively, in a!I matters relating to insurance under this policy, (3) "Damages" shall mean sums of money payable as compensation for loss or in discharge of an obligation of an Insured to make goad a shortage in the Insured Trust o- Employee Benefit Plan_ The word "Damages" shall not include; (a) Fines, penalties, taxes or punitive or exemplary damage. (b} Benefds due or to became due under the terms of the Trust or Plait, unless and to the extent that recovery for such benefits is based upon a Wrongful Act and is payable as a personal obligation of an Insured. V. POLICY PERIOD: TERRITORY. This insurance applies only to claims first made during the policy period described in the Declarations within the United States of America, its territories or possessions or Canada; provided the Insured at the effective date of this insurance had no knowledge of or could not have reasonably foresen any circumstances tivhich might result in such claim. -~ 13?-B (OS-9$i Page 2 of 4 f,:.':; Gov ~t ~ r ~~,5 cs :".nnu ,,,ggr~:gate Lim_e~of r the policy pentad dascr'o~ ~ '.r t'rs l;ecaratans is far a tern: of rr;cre than one year, said "Annual a,gg-agate Limit Liability" shall apply separately to each cansecutir:e annual period. iii. Ci.AiMS fVIAJE EX T ENSIDN Ct.At1SE. if, during the policy period ; areal, the Insured shalF first become aurora of any 1Nronglul Act vvtSici': may subsequently give rise to a claim against any Insured and shall during the policy period hereof give vrrittan notice to the Company of such Wrongful Act, then any such claim which is subsequently made against the Insured arising out cf such Wrongful Act shall for the purposes of this policy be deemed to have been first made against the tnsured during the policy period. tffll. SUPPLEA9ENTAFtt° PA~!Pr1ENTS. The Company vain pay in addition to the limits of liability shavvn In the Declarations all costs, cha-ges and expenses incurred by the Company in the investigation, settlement, defense and negotiation of any claim ccmirg vrithin the terms of this insurance, but, in the event of arty judgment in excess of the amount o€ the aggregate limit available under this policy, the Company's liability for the costs and expenses incurred by it ar ,~s~ith its consent shall be such proportion (hereof as the amount of the aggregate limit available under this policy bears to the amount paid to dispose of the claim- In no event shall the Company be obligated tc pay any claim or judgment or to defend or continue the defense of any suit after the aggregate limit of the Company's liabilir7 has been exhausted by payment of judgments or settlements The Company will pats in addition io the Limits of Liability shown in the t?eclarations reasonabir expenses incurred by ttae Insured at the Companys request. :X. CONSENT TO SETTlE. The Company may, with the vJr;nen consent of the tnsured, make such settlement or such ca.r^premise o` any claim or suit as the Company deems expedia*.t, and if the Insured shalt refuse to consen# to the settlement of any claim or suit recommended by the Company, based upon a judgment or a bonaftde offer cf settlement, the Ensured snail thereafter negotiate ar defend such claim or suit independently of the Company and cn said lnsured's own behalf, and in such event the Darraages and expenses accruing or determined through iit3gatio,^, ar otherwise in excess ofi the amount for which settlement could have been made as so recommended by the Company shall not be recoverable under this policy. X. EXTENSION CLAUSE It is agreed that at any lima prior to Termination or cancellation of this policy as an entirety, whether bs the Insured or try the Company, the Insured may give to the Company notice that it desires to be insured for an additional period of twelve (12} months after the effective date of termination or cancellation, at an additional premium of 2596 of the premium hereunder, far claims made against the insured during the said twelve (12} month period by reason of a Wrongful Act •~ committed or alleged to have keen committed prior to the effective date of termination or cancellation and which vroupd be otherwise insured by this policy, subject to the fallowing provisions. (a} Such additional period shall be deemed part of the policy period and not an addition thereto- (b) Such additional period of lime shall terminate farthwfth on the effective date of any other insurance obtained by the Insured or its successors in business; replacing in whale ar in part the insurance afforded by this policy. Where such other policy Provides no coverage for toss sustained prior to its effective date, ii shall not be deemed to be a replacement of this policy. if the policy period described in the Declarations is for a term of more than one year, the maximum premium for this extension shall be 25% of the equivalent annual premium. ~i6ft?r-'1- -.-.ital. 1.! ItiiF'~ '.~ T);'1 E.,`GS. -I -:: ~ -- -... 1GC", f-,~ ._'; a Icyatc,, o a o~'rcr.o u: c: c ;, rer e t 1 _) m: "., reasonably g.~e 'ISr= .o SllC;i f,e m~ ~' a1,,,gctt~..^ c c U•rrc.r~yfu[ Ac: vrrittan notice oontaining particulars sufficient to identi`y the I`ZSUred and any claimant and also rasonabiy obtainable infarrnatian +nrith respect fa the time, place and circumstances tt;ereaf, and the names and addresses of the injured castles and of available witnesses, snail be given by or €ar the Insured to the Company or any of its authorized agents as soon as practicable, (b} 1€ claim is made or suit is brought against an insured, the Insured or Insurance ftepresentatlve shall immediately fonraard ko the Company every demand, notice, summons or other process received; (c} The insured shall cooperate vaith the Company and, upon the Company's request, assist in snaking settlements, in the conduct cf suits and in enforcing any right a` contribution ar indemnity against any person or organization. .vha may be liable to the Insured because of an act with respec to uvhich insurance is afforded under this policy; and the Insured shat[ attend hearings and trials and assist in securing and giving Evidence and obtaining the attendance of witnesses. The Insured sh•a11 not voluntarily assume ar admit arty liability, nor, except at said Ins,sred's oven cost, voluntarily make any payment, assume any ob;igations c° incur any expense witha~? the Company's prior written consent. (Z) Action Against The Company. No action shall lie against the Company unless, as a condition precedent thereto, there shall have been full compiance vaifh all of the terms of this policy, nor until the 'mount of the Insured's obligation tc pay shall have been finally deterrined either by judgment against the insured after actual trial ar by ~:ritten agreement of the Ensured, the claimant and the Company. Any person or organization a the legal representative thereof who has secured such judgment or tivritten agreement shall thereafter be ertitlec to recover under this policy to the extent of the insurance afforded by this policy. No person or organization, shall have any right under this policy to join the Company as a party tc any action against the tnsured to determine the Insured's liabilit} nor shall the Company be impieaded by the tnsured or said insured's legal representative. Bankruptcy or insolvency of the Ensured or of the Insuted's estate shall rot relieve the Company of any of its cbligaticns hereunder, (3) Other Insurance. This insurance shall apply only rrs excess insurance over any other valid and collectible insurance avaaable to the Insured. (4j Subrogation. In the event of any payment under this policy, the Company shat: be subrogated to all the Insured's rghts of recovery therefor against any person or organization and the Ensured shaft execute and deliver instruments and papers and do v.~hatever else is necessary to secure such rights. The tnsured shall do nothing after lass to prejudice such tights. (b~ Changes. Notice to any agent ar knowledge possessed by any agent or try any other person shall not effect a vniver ar a change in any part of this policy or estop the Company From asserting any right under the terms of this policy, nor shall the terms of this policy be waived or changed, except by endorsement issued to forr^ a par# of this policy. (6) Assignment. Assignment of interest under this poAcy shalt not bind the Company until its consent is endorsed hereon; if, however, the tnsured shall become incompetent or die, such insurance as is afforded by this policy shalt apply to the insured's legs' representative as an Insured, but only while acting within the scope cf said Insured's duties as such_ (7) Cancellation. Page 3 of 4 This policy may be cancelled on behalf of the Insureds at any time by written notice to the Company. This policy may also t~ cancelled on behalf of the Company by rraiiing to the insurance Representative at the address of the Trust or Plan shown in the Qeclarations, written entice stating when, not less than thirty (30} days thereafter, the cancellaticn steal{ become effective. The mailing of such notice shall be sufficient proof of notice, and this policy shalt terminate at the date and hour specified in such no#ice. If this policy shall be cancelled by the Insureds the Company shalt retain the customary short rate proportion of the premium hereon. [f this policy shall be cancelled by nr on behalf of the Company, the Company shall retain the pro-rata proportion of the premium hereon, Payment or tender of ary unearned premium by the Company shall not be a condition precedent to the effectiveness of cancellation, but such payment shall be made as soon as practicable. (8) Declarations. By acceptance of this policy, each Insured agrees that the statements in the Appiicatior, attached to this policy are said fnsured's agreements and representations, that this policy is issued i^t reliance upon the truth of such representations and that this policy embodies all agreements existing between said insured and the Company or any of its agents relating to this €nsurance. (9) Authorization. (3y acceptance of this pniicy, the Insurance Representative agrees to act on behalf of all Insureds with respect to the payment of premium and the receiving of any return premiums that may become due under this policy, and the renewing of all notices of cancellation, non-renevral or change of coverages and the Insureds agree that they have, individually and collectively, deiegatesl this authority exclusively to the insurance Representative. Nothing herein steal! relieve each insured from giving any notice to the Company that is required under Condition {1 } of the policy. (10) Recourse. In the event that an Insured breaches any fiduniary obligation imposed by the Employee Retirement Income Security Act of 1974, as it may be amended from time to time, it is agreed That the Company has the right of recourse against any such Insured for any amount paid by the Gornpany or account of such a breach of fiduciary obligation, but the Company steal' have no such right of recourse if this policy has been purchased by an Employer or by an Employee organization. {11} Liberalization Clause. if during the period that insurance i_ in force under this policy; or within 45 days prior to the inception date thereof, on behalf of the Company there be adopted, or filed with and approved or accepted by the insurance supervisory authorities, ail in conformity with law, any changes in the form attached to this policy by which this form or insurance could be extended or 3roadened without increased premium charge by endorsement of substitution of form, then such extended or broadened insurance shall inure to ttte benefit of the insured hereunder as though such endorsement or substitution of form had been made. IN WETNESS WHEREOF, the Company has caused this policy to be signed by its authorized Company ofcicers at Hartford, Connecticut, and signed on the Declarations page by a duty authorized person on befiaif of the Company, L~~iC~ Executive Vice President _.__..._ _.a.-_ ~ -- -~. _ e --- Corporate Secretary F-7191-3 (OS-98) Page 4 of 4 FIDUCIARY RESPONSIBILITY ~~~~~~~ INSURANCE POLICY RENEWAL CERTIFICATE: - ; PQLI .,Y ;{tiJ4. 10350S32a ` '; i raveiers casualty and Surety Company of America ;~ Travelers Casualty and Surety Company of lilinois ~,``_, Travelers Casualty and Surety Company Naperville, lAinois 60563-E458 Har`ford, Connecticut 06183-9062 (Stock Insurance Companies, t:erein called tie Company-) The foiio-~in;; Items from the lDeciara#ions are changed as indicated. Aii other Items remain tt-e same. I]ESIGNATED TRUST OR PLAN POLICY NUMBER 103505325 VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUND (See Name of Designated Trust or Pian Endorsement) (See Governmental Plan Endorsement) POLICY PERIOC From To October 01, 2008 October 01, 2010 RENEWAL PREMIUM $8,275.94 PREMIUM PAYABLE CURRENT T EACH ANNIVERSARY $4,097.00 ~ $4.097.00 in consideration of the stated renewal premium, the policy is renewed for the Policy Period indicated. The premium for This policy has been paid by the Designated Trust or Plan. The Company has the right of recourse pursuant to Condition (10). Endorsement (F-1280) is attached to eliminate recourse. Premium for elimination of recourse: $289.00 (Included in stated rene~n•ai premium) Payable ^ n Advance ® Each Installment Endorsements attached o ibis poilcy at renewal (Designated by Endorsement Number): ILT-1018 01-08, F-2817 09-98, F-1280 02-95, F-1449 09-00, F-2100 07-90, 1LT-1067 01-08, ILT-5018 07-04 Countersigned 6y (if requited] !~-120`1 -3 (09-98) TRAVELERS) IIVtPORT:~'~N`I' NOTICE REGARDING INDEPEIVllEN1"~' 1~GENT AND BROKER COMPENSATIOIVT >,or ~I1fUrn7at~oT3 about hQw St. Paul Travelers campensat~;s independent agents and brokers, please visit www.StPaulTravelers.com, or you maw request a written copy from Marketing at One Tower Square, 2GS1~, Fart#'ord, C'ennecticut 06183 ILT-IO_,7 ((l4-il5) PENSION AND WELFARE FUND FIDUCIARY RESPONSIBILITY INSURANCE POLltk:Y FLORIDA AMENDATORY ENDORSEMENT To be attached to and form part of: Policy No: 103505325 Issued to: VILLAGE OF TEG2UESTA GENERAL EMPLOYEES PENSION FUND (See (Jame of Designated Trust or Plan Endorsement} (See Governmental Plan Endorsement) A. Section XI. CONDITIONS, (7} Cancellation is repkaced by the following: Cancellation of Folicy: This Policy terminates in its entirety upon occurrence of any of he following: 1. Cancellation For Policies In Effect 9d Days Or Less If this Policy has been in effect for 90 days or tress, the Company may cancel this Policy by mailing ar delivering to the Insurance Representative written notice of cancellation, accompanied by the reasons for cancellation, at least: (1) 10 days before the effective date of cancellation if the Company cancels for nonpayment of premium, (2) 30 days before the effective date of cancellation if the Company cancels for any other reason. except the Company may canoe! immediately if there has been: {a) A material misstatement or misrepresentation; or {la) A failure to comply with underwriting requirements established by the ins~;rer. 2. Cancellation For Policies In Effect For More Than 90 Days If this Policy has been in effect for more than 90 days, the Company may cancpi this Policy only for one or more of the following reasons: (1) Nonpayment of premium; {2) The Policy was obtained by a material misstatement; {3) There has been a failure to comply with underwriting requirements within GO days of the effective date of coverage; (4) There has aeen a substantial change in the risk covered by the Policy; or (5) The cancellation is for all Insureds under such policies for a given class of Insureds. kf the Company cancels this Policy for any of these reasons, the Company will mail or deliver to the insurance Representative written notice of cancellation, accompanied by the reasons for cancellation, at least: (a) 10 days before the effective date of cancellation if cancellation is for the reason stated in (1) above; or (b) 45 days before the effective date of cancellation if cancellation is for the reasons stated in (2}, (3}, (4} or (5) above. 8. The following Condition is added: NONRENEVVAL A. if the Company decides not to renew this Policy the Company wilt mail or deliver to the Insurance Representative written notice of nonrenewal, accompanied by the reason for non°enewal, at least 60 days prior to the expiration of this Policy. B. Any notice of nonrenewal will be mailed or delivered to the Insurance Representative's last mailing address known to the Company. If notice is mailed, proof of mailing wilt be sufficient proof of notice, FLORIDA AMENDATORY ENDORSEMENT ~°2817 (Qg-98) Includes copyrighted material of The Insurance Services ~~ice, Inc POLfCY NQ. 103505325 ELIMINATION OF RECOURSE ENCORSEMENT To ae attached to and form part of Pension and Welfare Fund Fiduciary Fcesponsibility Insurance Policy) It is agreed that: 1. The premium for this policy has been paid by the Designated Trust or Plan_ TFe Company has the right of recourse pursuant to Condition (10} of the policy. 2. In consideration of a separate premium paid to the Company from funds other than from assets of the Designated Trust or Plan, the Company waives such right of recourse. This endorsement forms a part of the policy to which attached, effective on the inception date of the policy unless otherwise stated herein. (The information below is required only when this endorsement is issued subsequent to the preparation of the policy) Endorsement effective: OCTOBER 01, 2008 Policy No.: 049 FF 103505325 BGM Name of Designated Trust or Plan: VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUND (See Name of Designated Trust ar Plan Endorsement) (See Governmental Plan Endarsement) Countersigned by (Authorizes Representative) F-128o (02-95) ISSUED BY: Travelers Casualty and Surety Company of America POLICY NO: 103505325 ISSUED TO. VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUND THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ELIMINATION OF RECOURSE ENDOSORSEMENT (GOVERNMENT FLANS} in consideration of the payment of a separate premium, notwithstanding Section Xl. GONDTiQNS. (~ 0) Recoucse. the Company shall have no right cf recourse against any Insured. Nothing herein contained shah be held to vary, alter, waive or extend any of the terms, conditions, exclusions or ?imitations of the above-mentioned policy, except as expressly stated herein. This endorsement is part of such policy and incorporated therein. This endorsement is effective at the Inception Date stated in ITEM 2 of the Declarations or effective at 12:01 A.M. on October 01, 2008, if indicated herein. Complete the following only when this endorsement is not prepared with the policy or is to be effective en a date other than the Inception Date of the policy. Accepted by. On behalf of the entity named in TEM 1 of the Declarations. Authorized Ccmpany Representative I"-1449 (09-00) ENDORSEMENT To be attached to and form part of: Policy No.: 103505325 issued t©: VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUND (See Name of Designated Trust or Ptan Endorsement) (See Governmental Plan Endorserr~ent) It is agreed that: 1. The Policy is amended as follows: (a} ill. DEFINITION OF INSURED is deleted in its entirety and the following substituted.: lll. DEFINITION OF INSURED Each of the following is ar, insured to the extent set forth below: (~ } The Trust or Employee Benefit Plan Designated in the Declaration and designated herein: Village of Tequesta General Employees' Trust Fund Village of Tequesta Public Safety Officers' Pension Trust Fund (2} Any natural person who at any time holds or shall have held the position of: (a} Trustee of such Trust or Employee Benefit Plan (b} Director, officer or Employee of such Trust or Employee Benefit Plan. The insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the application of the limits of liability and it shall also apply to the estates heirs, and personal representatives of persons insured hereunder." (b} It, The following is added to Section II Exclusions: based on, arising out of; directly or indirectly resulting from, in consequence cf, or in any way involving, investments in debt obligations of the State shown in ITEM 2 of the Declarations or of any political or governmental agency in such State: based on, arising out of, directly or indirectly resulting from, in consequence of, or in any way involving, inadequate funding of the Designated Trust or Plan. based on, arising out of, directly or indirectly resulting from, in consequence of; or in any way involving, actual or alleged seepage, pollution or contamination of any kind. GgVERNMENTAL PLAN EiV13QRSEMENT F-2043 (11-t39} Page 1 of 2 ~`._ ... ~_ R ..~ t=i~'e Th%usaf=~ a-~: t~01~Ei0Dotiars ($5;005.00 (hereinafter referred to as Deductible ~=,rr~our:t; s`tait i~v deducted from the a,~tount of each claim covered hereunder, including ail expense incurred, and the Company sttali be ;fable ony in excess of such Deductible Amount. Claims based on or arising out of the Sarre Wrangf~€i pct or interrelated t;"~rorigfut Acts ofi one or more of the Insureds shall be ccnsidened a single claim and only one Deductible Art~teunt shall be applied to each single claim. Subject to Section lx, CCIVSENT Tt~ SETTLE, of the attached policy, the Company rray pay arty pa, ~ cr ail of tte Deductible Amount to effect settlement of any claim or suit and upon notification of the action taken, the insured shall promptly reimburse the Gomparty for such part of the Deductible Amount as has been paid by the Company. i he Deductible amount steel: be uninsured. Z. 'i"his Endarsement forms part of the policy to which attached, effective on the incetion date ofi the policy unless o~herwise stated herein. Fndorsemeni effective: CCTCBER Q~t, 2[30 By {Authorized Representative ,insurance Representative) GOVEF2Ni~ENTAL PLAN EN€7~RSEMENT -2G43 (17-89) Page 2 of 2 PENSION AND WELFARE FUND FIDUCIARY RESPONSIBiLiTY INSURANCE POLICY DEFENSE WITHIN AGGREGATE ENDORSEMENT To be attached to and part of: Policy No.: 103805325 Issued to: VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUt~JD {See Name of Designated Trust or Plan Endorsement) {See Governmentat Plan Endorsement) It is agreed that: 1. Section 11119, SUPPLEMENTARY PAYMENTS is eliminated in its entirety and replaced with: "The Company will pay as part of the Limit of Liability shown in the Qeclarations al! costs, charges, and expenses incurred by the Company in the investigation, settlement, defense, and negotiation of any claim coming within the terms of this insurance. The Gampany will pay as part of the Limit of Liability shown in the Declarations reasonable expenses incurred by the Insured at the Company's request." This endorsement farms a part of the policy to which attached, effective on the inception date of the policy unless otherwise stated herein. Endorsement effective: OCTOBER 01, 2008 Countersigned by Authorized Representative Accepted By: insurance Representative F-210© (07-90} PENSION AND WELFARE FUND FIDUCIARY RESPONS18iLITY INSURANCE POLICY AMEND EXTENSION CLAUSE ENDORSEMENT '"o be attached to and form pars of Policy No: 103x05325 Issued to: VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUND (See Name of Designated Trust or Ptan Endorsement) (See Governmental Plan Endorsement} It is agreed that: 1. Section X. EXTENSION CLAUSE is deleted in its entirety and replaced by the follF~wing: X. EXTENSION CLAUSE It is agreed that at any time prior to termination or cancellation of this policy as an entirety, whether by the Insured or by fhe Company, the Insured may give to the Company notice that it cesires to be insured for an additional period of (12} months after the effective date of termination or cancellation, at an additional premium of 100°{° of fhe premium hereunder, for claims made against the Insured during the said } month period by reason of a Wrongful Act committed or alleged to have been committed prior to the effective date of termination or cancellation and which would be otherwise insured by this policy; subject io the following previsions: (a) Such additional period shall be deemed part of the policy period and not an addition thereto; {b) Such additiona( period of time shall terminate forthwith on the effective date of any other insurance obtained by the insured or its successors in business, replacing in whole or in park the insurance afforded by the policy. Where such other policy provides no coverage for foss: sustained prior to its effective date, it shall not be deemed io be a replacement of this policy. If the policy perioc described in the Declarations is for a term of more than one year, the percentage of premium chalk be caicufated from the equivalent annual premium. 2. Nothing contained herein shalt vary, after, or extend any of the terms, conditions, and Rmitations of the Pokicy except as stated above. This endorsement forms part of the policy to which it is attached, effective on the inception date of coverage unless otherwise stated herein. Complete ©nly When This Endorsement Is Not Prepared With The Policy Or Is Not Tc Be Effective With The Pokicy. Effective Date of this endorsement: October 01, 2008 Accepted by: {knsurance Representative) By: F-2549 (C?~)-98j ISSEr H;D BY: 7Yavelcrs Casualty and Surety Company of AmCrica POLICY NU: 11!35(15325 ISSUED TO: YILI,A{;E OF TEQI;ESTA UENERAI: EMPLOYEES PENSION FEJND 'I'IIiS l~:NDt;)R,SIMI~NT CHANGES THE POLICY. PLEASE READ I'I' CAItEFILLY. CAP ON LOSSES FROM CERTIFIED ACTS OF'I'ERRORiSM E1'DOR,SEMENT it is agreed thal: 1. The following section is added to this Policy: CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM If aggregate insured {asses attributable to Certified Acts of Terrorism exceed $1 u0 billion in a program year (January 1 through December 31) and the insurer issuing this Rolicy has met the deductible under the Terrorism Risk insurance Act: a. the insurer will not be responsible for the payment of any portion of the amount of such losses that exceeds 5100 billion; and L•. insured losses up to 5100 billion will be subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. "I'he terms and liutiiatiorts of an}~ terrorism exclusion, or the inapplicability or omission of ~~ terrorism exclusion. do not sen~c to create covcrige for any loss which would otherwise be excluded under this Policy. 2. 'fhc following is added to the l~efirtitions section of this Policy: "tertified Act of Terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence wish the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terroram Risk insurance Act for a Certified Act of Terrorism include the following: a. the aci resulted in irrsttred losses in excess of ~5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act: and b. the act is a violent act or an act that is dangerous to human life, propcrt or infrastructure and is cortunitied by zn indi~~iduaI or individuals as part of an effort io coerce the civilian population of the United Slates or to inllucnce the policy or affect the conduct of the tJnitcd States Governrneni by coercion. Nothing herein contained sh~~Il be held to ~~ary, alter, ~w~aivc or extend and= of the terms, conditions, exclusior4s or limitations of the above-mentioned polic~•. except as expressly staled hcrcin, This endorsement is parr of such polio- :rnd incorporated therein. This cudorsentent is eilective at tltc Inception Date stated in ITEM 2 of the Declarations or effective at I2:01 A.M. on October Ol, ?078, if indirrted hcrcin. Complete the following only ~wlien this cndorscmcnt is not prepared n~itL tltc policy or is to be effective on a Gate other than tic Inception date of the policy. Accepted t}~ : -.u_ _. Un bcl~alf a-tlrc entity nanred in l`I'E:-VI 1 of the Declarations. Autl3ori~ed Cortrpany Rcpresentative t'. 20[18 `i he Travcfcrs Companies, Inc. X111 Rights Resen~ed IL.`I'-106? Ed.OIli?8 ISSUED BY: Travelers Casualty and Suret~° Company of America POLICY NO: Ifi350S325 ISSUED TO. VILLAGE OF TEQUESTA GENERAL EMPLOYEES PENSION FUND TI-IIS I+;N€IORSh,MEN'i' CHANGES 'fNE POLICY. PLEASE READ IT C,AREk E,`LLY. CANCELLATIO\/\ONRENEVGAL -FLORIDA FELL CANCELLATION -INSURER lE s agreed that 1. "I"Ile polio?~ pro\~isions regarding canccl[atlon by the Conlpan}~ arc deleted and repiaccd \vittl the follo\ Ong; A_ CA'.~ICI:l,LA"I'ION C)F POLICIES 11\ EFFECT' FOI2 90 DAYS OR LESS (a) 1f this Policy has been in effect for fit) days or Icss and is not a renewal of a policy \vc issued. \~~e tnay cartccl this Policy for an}~ reason by rnaiiillg or delivering to the entiq named in Item I of illc Declarations written notice of cancc[latior including the reason for cancellation at icast 1(I days before the effective dale of cancellation if we cancel for Ilonpaymcnt of premium or at least 2U dad s before the effective cGltc of cancellation if \\~c cancel for am_ other reason. 13. C'ANCEt,L,ATIO'_~1 O~ hOLICIF?S I1 EFF`EC'T FOR MORE THAN 90 DAYS If this Folic} Ilas been in effect for more than IO days, or is a rcne\val of a Polio \ve i4sucd, \ve may cancel only for ollc or more of the following reasons: (a) Vonpaytncnt of premium:. (b) Materia1211isstatcmcnt; (c) I'aihire to CoIllply \\-ith undcrn•rhing rcgllirements established \\~thin 9t) days of tt_c effectuation of coverage:. (d} Substantial chanc in risk: or (e) 1~V'lletl cancellation applies to all insureds \\~thin a given class. i'4'e \\ill mail or deliver n ritten notice of cancellation including the reason for cancellation. under this item B., to the etuit_\ tlziini;d tit Itc~nt 1 of the Declarations at (cast: (I} 10 days bcforc the effective date of cancellation if we cancel for nonpayment of protltiunr; or (2) =I5 di=.ys before the effective date of cancellation if \\c cancel fora .reason dcscribec in Ii.(b) through (e) above. ?. The folly\ving is aadcd and snpcrscdcs qtly other provisiotl to tltc contrar~~: NQNRENEWAL r~. If \\e decide IIDt to renew this Policy, \\°e will mail or deliver \\~ritten nOtiCC o{' nOnranC\\'aI including the reason far nonrcnc\\°aL to the Ci1t1iV IlaIlled In lteln ! of the Declarations ai (cast =I5 days bcforc its expiration date, or its anniversary date if it is a I'o1ic~~ varittc2l for a tcrn2 of more than Otte year or v~~~th no fined expiration date. 3. Proof ol" nlaili~lg is suflic;cnt proof of tloticc. ?~otlliug Herein contained shall be held to vary; alter. \vaive or extend any of the terllls, conditions, exclusions or limitations of the above nletltiancd policy. except as expressly stated herein. 'fhis~endorsenletli is clTecti\~e at the inception date stated in the Declarations and lllis endorsctnetit is part of such policy and incorporated therein. IL"l'-x()18 ((I7-0~#) `F~A~'lwlv~R September 18, 2t1U$ VILLAGE OI~ 'I'k:(~I;ESTA GENE';RAL EVIPL,OYEES PENSION Et;ND 3~5 Tcqucsta llrivc "CEQ[IES'I'A FLORIDA 33~G9-0273 Re: Palic}~ ;~lunab~.r: 1U350532~ Police Tvpc: TRIP NEW Expiration Dalc: October UI, 2UUti Undcn~riting Conapan}~: Travelers Casualty and Surety Companw of America Our records indicate tita~ tl~c above referenced policy (the "Folic}~') will expire on the expiration date shown above ~Vc hawe not ~°ct recei~ cd important undcnvriting information needed to determine what rcnetval terms, if any, to offer. erl<tin state laws require an insurer to adz-ise the insured prior to the policy expiration date ~~•ien it proposes a change in Tenet;°al premium, a change in polio}~ provisions, or nonrcnetwal of the polio}'. Because we arc presenil}~ unable to propose renctwal teens, applicable state laws and rcguialior:s require us to provide this .notice to state that the above referenced Palic}• is not being renctwcd. 7kis does not mean that we no Longer -vant to insure you; rather, tive r~ri not have the information needed to evaluate your account, FVe hope that you twill contact your agent or broker at }our earliest convenience to ensure that we receive al! rclcvamt undcnt:~iting information. tide arc obligated to lei `.au, however, that ncitlaer the continued evaluation of an} infornaatian received to date-nor am• request for ar receipt of an} additional information trill obligate us io rcnety the Folic'} ota any teens. and tltat the Polio}~ tt•ill expire as set forts, abo~~e unless we expressly state otlaenvise in tt~riting after the date of this letter. 'hank }~ou for }~ot:r time and consideration. We look forward to receipt of your renewal application and s,~pparting materials. if yot:astre apty questions, please contact your insurance agent or broker. Sincerely, Donna M Corona cc_ Ellen Jones GEHR1(NG C~ROUI' LNG (UCJ7.86) l1SUS FAIRCHILIB GARD>H;NS Ati'E SEITE 2t12 PALM BEACH GARDENS, FL 33~1f! it<T-~ lf)3 (2-U2; F-1191-f3 (6-8Q) ~~~~~~. ~~~~~~~~ September 18, 2(H18 Ellen Jones GEHRl'_1G GROIP INC (OCJ7.SG) 1I50S FAIRCHILD GA1tDE\S AVF. S[IITE 2O2 PALiv] BEAS:H GARIIE'~S, FL 33~I0 I)oruaa M Comma 4631 Woodland Corporate 131vd. PO 13ox 3I 96 ~~ (33631-3 )Cr7 j '1'Alvli'/~, l~ 1. 3361 ~ ]'hone: (813) $9O-~O6y lax: (8U()) 26S-i~i9$ i :mail: l)CQI20I`l~'ii?travclcrs.ca:a. COPY OF NOTICE SE1TT TO INSL'ItED Re: ~Vanacd Insured: VILLAGE OF TEOUESTA GENERAL EMPLOYEES PENSIOi~ F GND Policti~ Autnbcr: I035(iS325 l'oiicy'I'rpc: FRiP NEV4' Expiration 1)atc: October l)l, 20(18 l ndel7~~ritilag C aanpany: '1"rati~elers Casualty and SurCty Comgan~~ of America Our records indicate that the above referenced policy (the "Polic)•") ~•ill expire on the cxpiraticm date shown above, We have not ~~et reccivcc! important underwriting information n~ded to determine what renewal terms; if any, to offer. Certain state lawws rcgairc an insurer io advise the ilasurcd prior to the policy- expiration dale ~wiicn it proposes a change in rcnc~~al prcnaiuara. sa ciaarag;,x in policy provisions, or [aonrcnc~wal of the police. I3ccausc we arc preseaaily unable to pmposc rcncwal tcnns, applicable state laws and regulations rcgairc as to provide this YaotICC i0 sta1C that the above rel'crenced Polic}' is not bcin~, renewed. This dyes nvt mean that titi•e no lancer want tv insure t'~~u; ratleer, we° f1a trat have the injormutivn needed to evaluate,yvur account. We hope th~9t you wilt contact ~•our agent or broker at your earliest convenicncc to ensure that we receive all relevant underwriting information. 'tVe are obligated to tell ~~ou, ho«-cvcr. chat neither the continued evaluation of clay iaafonnation rcceircd to date nor any request for or receipt ofaany additional information swill obligate us to renew the Policy o1a an}- terms, and that the Polic}• will expire gas set `ortla €ioovc unless lie expressly state olhcnkisc in writing after the date of this letter. Thank woaa for your iiane and consideration. 1~'e look forn=ard to receipt of your rene«'al application and supposing materials. if you have afar questions, please contact your insurance agent or broker. 511acercl}'. Donna M Corona P©t_iCY NO. 103505325 PENSION AND WELFARE FUND FIDUCIAF.Y RESPONSIBILITY INSURANCE POLICY NAME OF DESIGNATED TRUST OR PLAN ENDORSEMENT it is agreed that as of the effective dale hereof the complete name of the Designated Trust or P{an under the a#tached policy is: Village of Tequesta General Employees` Trust Fund Village of Tequesta Public Safety Officers' Pension Trust Fund This endorsement forms part of the policy to which attached, effective on the inception date of the policy unless otherwise stated herein. Endorsement effective: OCTOBBR 01, 2008 Policy No.: 049 FF 103505325 BCM By (Authorized Representative) Accepted by: insurance F~epresentative Name of Designated Trust or Plan Endorsement F-R 658 t03-6fi)