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BOARD OF TRUSTEES
Village of Tequesta General Employees
Pension and Trust Fund
ADMINISTRATIVE RULES
• August 2005
• TABLE OF CONTENTS
PART 1 -GENERAL PROVISIONS ...................................... .
1.1 Purpose .......................................................
1.2 Definitions .....................................................
Pension Board .............................................
Pension Code .............................................
Pension Fund .............................................
Municipality .............................................. .
Definitions of the Ordinance ................................. .
PART 2 -ADMINISTRATION ........................................... .
2.1 Board Creation ..................................................
2.2 Terms of Office .................................................
2.3 Election Procedure .............................................. .
Setting Date for Election of Employee-Trustees .................. .
Sixty (60) Day Notice of Vacancy ............................. .
Employee-Trustees ...................................
Village Tnastee ...................................... .
Fifth Trustee .........................................
Election of Employee Trustees ............................... .
Notice of Candidacy .................................. .
• Certified List of Eligible Candidates ......................
Election Judges .....................................
Election Procedure ................................... .
Election Results ..................................... .
Run-off Election ......................................
Election Challenges ...... .......................... .
Certification of Election Results ......................... .
Mid-Term Vacanaes ........................................
Declaring Vacancy ....................................
Filling of Vacancies ................................... .
Employee-Trustee .............................. .
Village-Trustees ................................ .
Calendar Days .................................. ...
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5
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PART 3 -COMPENSATION AND EXPENSES .............................. 6
3.1 Compensation and Reimbursement of Expenses ....................... 6
3.2 Reimbursement of Expenses ....................................... 6
3.3 Refund of Employee Contributions .................................. 6
3.4 Payment practices ............................................... 6
• August 2005
• PART 4 -MEETINGS 7
7
4.1 ..................................
Meetings .................
4.2 Emergency Meetings ............................ ................. 7
4.3 Location of Meetings ............................ ................. 7
4.4 Time of Meetings ............................... ................. 7
4
5 Notice of Meetings .............................. ................. 7
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4.6 Open Meetings; Exceptions ....................... ................. 8
4
7 Order of Business .............................. ................. 8
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4
8 Minutes .............:....................... .................. 8
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4.9 Quorum ..................................... .................. 8
PART 5 -PENSION BOARD OFFICERS AND EMPLOYEES . .................. 9
5.1 Officers ..................................... .................. 9
5.2 Employees ................................... .................. 9
5.3 Duties of the Chairperson ....................... .................. 9
5.4 Duties of the Secretary ......................... .................. 9
PART 6 -RECORD KEEPING AND REPORTING REQUIREMENTS ............ 10
6.1 Minutes of Meetings ............................ ................. 10
6.2 Correspondence File ........................... ................. 10
3
6 Investment File ................................ ................. 10
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6.4 Litigation File ................................. ................. 10
6.5 Annual Report by the Pension Board ............... ................. 10
• 6.6 Record keeping as to Employee Participants :::::::: :::::::::::::::.: 10
11
6.7 Record keeping as to Retirees .
6.8 Record keeping as to Separated Members .......... ................. 12
6.9 Confidentiality ................................ ................. 12
6.10 Florida Public Records Law or Freedom of Information Act Requests ...... 12
PART 7 -ADJUDICATION RETIREMENT PENSION CLAIMS ................. 13
7.1 Appeal procedures ............................. ................. 13
7.2 Subpoenas ................................... ................. 14
PART 8 -INVESTMENT POLICIES ..................... ................. 15
8.1 Purpose ..................................... ................. 15
PART 9 -INCOME DEDUCTION ORDERS ............... ................. 16
9.1 Income Deduction Orders ....................... ................. 16
Assignment of Benefits Upon Divorce ........ ................. 16
Filing of Claims .......................... ................. 16
Definitions .............................. ................. 16
Alternate Payee .................... ................. 16
Income Deduction Order ............. ................. 16
Designation of Representative ............. .................. 16
Payment of Benefits Pending Trustees' Decision ................. 16
• Augus t 2005
• ADMINISTRATIVE RULES -SIGNATURE PAGE ........................... 17
APPENDIX "A" EXPENSE POLICY ...................................... 18
APPENDIX "B" EXPENSE REPORT /REIMBURSEMENT VOUCHER .......... 19
APPENDIX "C" Application for Membership ............................... 20
Vested Terminated Empbyee ..................................... 21
APPENDIX "D" APPLICATION FOR BENEFITS ............................ 22
Acknowledgments ................................................... 25
APPENDIX "E" Vested Terminated Employee ............................. 27
•
• August 2005
• PART 1 -GENERAL PROVISIONS
1.1 Purpose. The purpose of these rules is to establish uniform procedures for the
implementation of Ordinance No. 585, Exhibit A of the Village of Tequesta and
applicable provisions of Chapter 112 of the Florida Statutes and the administratan
of the Village of Tequesta General Employees Retirement Plan. These rules are
also promulgated for the benefit of and to provide guidance to retirement plan
members, participants and beneficiaries and are available for inspection at the
office of the Retirement Plan.
1.2 Definitions. As used in these rules, the terms set forth below shall have the
following definitions and meanings, except when the context of the rule specifies
.and requires a different meaning.
1) Pension Board. "Pension Board" shall mean the Board of Trustees of the
Village of Tequesta General Employees Retirement Plan as established
under Village Ordinance No. 585, Exhibit A.
~, „
2) Pension Code. Pension Code means the provisions contained in
Village Ordinance No. 585, Exhibit A.
3) Pension Fund. "Pension Fund" shall mean the pension fund established
pursuant to Village Ordinance No. 585, Exhibit A for the benefit of the
• participants and beneficiaries of the Fund.
4) Municiaality. "Municipality" shall mean the Village of Tequesta,
Florida.
5) Definitions of the Ordinance. The definitions contained in Village
Ordinance No. 585, Exhibit A shall be deemed to be the definitions
incorporated in these Rules.
• August 2005
. PART 2 -ADMINISTRATION
2.1 Board Creation. The Village of Tequesta General Employees Retirement Plan
is created pursuant to Village Ordinance No. 585, Exhibit A. The composition of the
Pension Board is to be governed by the provisions of the ordinance.
2.2 Terms of Office.
a) Each employee trustee of the Village of Tequesta General Empbyees
Retirement Plan shall serve a two year term of office.
b) The resident members appointed by the Village Council shall serve a two
year term at the pleasure of the Council so long as the trustee remains a
resident of the Village.
c) The fifth trustee shall serve a two year term of office.
2.3 Election Procedure.
a) Setting Date for Election of Employee-Trustees. At least sixty (60) days
before the end of the term of each Employee-Trustee, the Board of Trustees
should set the date, for an election to be held, if possible, thirty (30) days
before the term expires. At the same time, the Board of Trustees should set
• the date, for gran-off election to be held, if possible, ten (10) days before the
term expires.
b) Sixty160~Day Notice of Vacancy. At least sixty (60) days before the end of
each T.rustee's term, the administrative manager/pension coordinatorforthe
plan should take the following action:
1) Employee-Trustees. Notice of the election and run-off election should
be given by posting a Notice on all bulletin boarrJs in the department
where notices to employees are posted, and by requesting the
department to publish the notice in any newsletter delivered to
employees. The Notice shall include:
A) The date the Employee-Trustee's term expires;
B) A declaration that the expiring position is for an
employee Trustee;
C) A request for candidates to submit a written
notice of their candidacy to the Board of
Trustees by a date certain (no later than forty-
five (45) days before the Employee-Trustee's
term expires); and
• August 2005 2
• ~ D) The date, of the election and, if necessary, the
run-off election.
2) Village Trustee. Notice shalt be given in writing to the Mayor and
Village Clerk. The Notice shall include:
A) The date the Village Trustee's term expires;
B) A request for the Village to appoint a Trustee
before the Village Trustee's term expires.
3) Fifth Trustee. Notice shall be posted in writing. The Notice shall
include:
A) The date the Fifth Trustee's term expires;
B) A request for the remaining four (4) trustees to select by
majority vote a fifth (5~') Trustee.
c) Election of Employee Trustees
1) Notice of Candidacy. Each prospective candidate must submit his or
her name to the Board of Trustees in writing no later than forty-five
• (45) days before the date of the election, or by such other time as set
by the Board of Trustees.
2) Certified List of Eligible Candidates. Before the election, the Board of
Trustees shall certify those candidates who are full-time employees
who are eligible to be elected as an Employee-Trustee. These are
the only candidates eligible for election, there shall be no write-in
candidates. If only one candidate is certified, the election will not be
held and the certified candidate will be deemed elected.
3) Election Judges. At the same time as the list of eligible candidates
has been certified, the Board of Trustees shall appoint two (2) non-
candidates to be election judges.
4) Election Procedure. Election for Employee-Trustees shall be by
secret mail ballot. Each official ballot shall be embossed with the
stamp of the Board of Trustees and mailed to each currently
employed participant in the Village of Tequesta General Employees
Retirement Plan. As soon as the mail has been received on the
election date, the ballots shall be counted in public. Ballots not clearly
marked and any ballots with more votes than vacant positions shall
not be counted, but shall be kept separately. If more than one trustee
position is vacant, then each employee shall vote for two trustees. All
• 3
August 2005
• ballots shall be turned over to the Board of Trustees by the judges
with a tally of the election results.
5) Election Results -The top vote getter shall fill the vacant Employee-
Trustee position. In the event there are 2 vacant Trustee positions,
the top two vote getters shall fill the vacant positions.
6) Run-off Election. In the event of a tie which will affect the outcome of
the election, then the 2 candidates who are tied shall be in the run-off
election.
7) Election Challenges. Any challenge to an election must be given in
writing to the Board of Trustees within five (5) days of the date of the
election, or run-off election, as applicable. A challenge shall not strop
a run-off election from being held.
8) Certification of Election Results.
A) The Board of Trustees shall certify the election results.
B) The Board of Trustees shall resolve all challenges to an
election and may schedule a new election, if deemed
appropriate, or .take other action to resolve any
• challenges.
d) Mid-Term Vacanaes.
1) Declaring Vacancy. If a Trustees resigns, is removed or becomes
ineligible to serve, the Board of Trustees shall declare, by resolution,
the office of the Trustee vacated.
2) Filling_of Vacancies.
A) Employee-Trustee. If the vacancy occurs less than
ninety (90) days before the Trustee's term was due to
expire, the vacancy shall be filled at' the next regular
election as provided in these Rules and Regulations.
Otherwise, the vacancy shall be filled for the unexpired
portion of the term by a new election as provided in
these Rules and Regulations. The Board of Trustees
may reduce the time required for notice of the election,
notice of candidacy, or any other time limits to expedite
a new election.
• August 2005 4
• B) Village Trustees. The Board of Trustees shall notifythe
Mayor and Village Clerk in writing of the vacancy and
request the appointment of a Successor Trustee.
e) Calendar Davs. All days are calendar days.
C7
• August 2005
• PART 3 -COMPENSATION AND EXPENSES
3.1 Compensation and Reimbursementof Expenses. Pension Board Trustees are
not entitled to receive any compensation for service performed as trustees.
3.2 Reimbursement of Expenses. A Trustee shall be reimbursed only for expenses
properly and actually incun-ed in the performance of his or her duties with the Plan
in accordance with the Village of Tequesta General Employees Retirement Fund
Statement of Policy for Trustee Expenses, attached as Exhibit "A". Reimbursement
shall be requested by completing the report of travel expenses form attached as
Exhibit "B".
3.3 Refund of Employee Contributions. Members who are eligible for a refund of
contributions in lieu of any benefit under the plan shall submit the application for the
refund at least fifteen (15) days before a meeting. Applications which are submitted
less than fifteen (15) days before a meeting will be considered at the following
meeting.
3.4 Payment practices.
a) No payments shall be made without the approval of the Board of Trustees.
• b) Two signatures are required for all disbursements.
• August 2005 6
• PART 6 -RECORD KEEPING AND REPORTING REQUIREMENTS
6.1 Minutes of Meetings. The Secretary shall keep and maintain minutes of all
public meetings and shall keep and maintain separate minutes of matters heard in
closed session.
6.2 Correspondence File. The Pension Board shall maintain a general
correspondence file with copies of all correspondence sent or received by the
Pension Board, including contracts entered into by the Board with legal counsel,
investment managers and other persons empbyed or retained by the Pension
Board.
6.3 Investment File. The Pension Board shall maintain on an annual basis, an
investment file containing all documentation and correspondence relating to
investment activity each year.
6.4 Litigation File. The Pension Board shall maintain a separate file as to all
matters in litigation. If the litigation involves the denial of retirement pension, the
litigation may be maintained as a part of the applicant's file.
6.5 Annual Report by the Pension Board.
a) The Pension Board shall also submit an annual report to the Municipality as
• to the general condition of the Pension Fund.
b) The annual report shall contain the following information:
The assets of the Pension Fund
2. The estimated receipts during the next succeeding calendar yearfrom
the deductions of the salaries of employees and all other sources;
3. The estimated amount required during the next calendar year to pay
all pensions and other obligations of the Pension Fund and to meet
the annual requirements of the Pension Fund for the Village's portion
or the financing of the Pension Fund.
c) The Actuarial Valuation may serve as this annual report.
6.6 Record keening as to Employee Participants.
a) A file shall be maintained on each active employee who is a participant and
member of the Pension Fund. Records shall be maintained in the Finance
Department as a part of his or her personnel file. Each active member's file
should contain, if available, the following documentation:
•
August 2005
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• 1. Application for Membership (attached as Appendix "C");
2. A record of the participant's contributions and service credits on an
annual basis;
3. Yearly creditable service reports received from the Village (if any);
4. Copies of any orders and decisions of the Pension Board denying a
retirement pension filed by the participant;
5. Designation of beneficiary form;
6. All correspondence from the participant and a copy of any
correspondence to the participant.
b) Each participant shall be required to complete a Designation of Beneficiary
Form.
6.7 Record keeping as to Retirees.
a) Retiree. A file shall be maintained on all retired members of the Pension
Fund. Each retired member's file should contain the following
documentation.
1. Application for retirement benefits (attached as Appendix "D");
2. Documentation as to Benefit Computations
a. Date of Birth;
b. Date of Hire;
• c. Date of Retirement;
d. Creditable Service Records;
e. Applicable Pension Rates;
f. Salary attached to the job held by the pension applicant;
g. All documents previously maintained pursuant to 6.6 above.
h. Certificate of marriage, if applicable, and personal information
on spouse.
b) Vested deferred retiree. A file shall be maintained on all vested deferred
retirees of the Pension Fund. Each file should contain the following
documentation.
1. Applicationforvesteddefeaed retirement (attached as Appendix "E°);
2. Documentation as to Benefit Computations
a. Date of Birth;
b. Date of Hire;
c. Date of Retirement;
d. Creditable Service Records;
e. Applicable Pension Rates;
f. Salary attached to the job held by the pension applicant;
g. All documents previously maintained pursuant to 6.6 above.
August 2005
11
• h. Certificate of marriage, if applicable, and personal information
on spouse.
Upon reaching normal or early retirement, the member wilt need to complete an
Application for retirement benefits (attached as Appendix "D") to initiate the payment
of benefits.
6.8 Record keeping as to Separated Members. A file shall be maintained on each
participant and Pension Fund member who withdraws from the Pension Fund.
Each file should contain the following documentation:
a) Written application withdrawing from the Pension Fund and. requesting a
refund of contributions;
b) Service date documentation;
c) Documentation as to how refund was computed;
d) Copy of canceled check or other documentation indicating payment of
refund;
e) All documents previously maintained pursuant to 6.7 above.
6.9 Confidentiality. To the extent permitted bylaw, all records of the Pension Board
shall be considered confidential and not subject to disclosure to the general public.
6.10 Florida Public Records Law or Freedom of Information Act Requests. Any request
• for information or to review documentation made pursuant to the Florida Public
Records Law or the Freedom of Information Act shall be handled by the Pension
Board's legal counsel. A copy of the request for information should be immediately
sent to the Pension Board's legal counsel.
•
August 2005 12
• PART 7 -ADJUDICATION RETIREMENT PENSION CLAIMS
7.1 Appeal procedures.
a) The applicant for benefits under these Rules and Regulations may, within
twenty (20) days after being informed of the denial of his request for pension
benefits, appeal said denial by filing a reply to the proposed order with the
pension's coordinator. If no appeal is filed within the time period, then the
proposed order shall be final.
b) The board of trustees shall hold a hearing within forty-five (45) days of the
receipt of the appeal. Written notice of said hearing shall be sent by certified
mail to the applicant at the address listed on his application ten (10) days
prior to the hearing.
c) The procedures at the hearing shall be as follows:
1) All parties shall have an opportunity to respond, to present physical
and testimonial evidence and argument on all issues involved, to
conduct cross-examination, submit rebuttal evidence, and to be
represented by counsel. Medical reports and depositions may be
accepted in lieu of live testimony, at the board's discretion.
2) All witnesses shall be sworn.
• 3) The applicant and the board shall have an opportunity to question all
witnesses.
4) Formal rules of evidence and formal rules of civil procedure shall not
apply. The proceedings shall comply with the essential requirements
of due process and faw.
5) The record in a case governed by this subsection shall consist only of:
A) A tape recording of the hearing, to be taped and
maintained as part of the official files of the
board of trustees, by the pension's secretary.
B) Evidence received or considered.
C) All notices, pleadings, motions and intermediate
rulings.
D) Any decisions, opinions, proposed or recommended
orders or reports by the board of trustees.
d) Within thirty (30) days after the hearing, the board shall take one of the
following actions:
1) Grant the pension benefits by overturning the proposed order by
majority vote.
• August 2005 13
• 2)' Deny the benefits and approve the proposed order as a final order,
after making any changes in the order that the board feels is
necessary.
A) Findings of fact by the board shall be based on competent,
substantial evidence on the record.
B) Within twenty (20) calendardays after rendering its order, the
board of trustees shall send by certified mail a copy of said
order to the applicant.
C) The applicant may seek review of the order of the board of
trustees by filing a petition for writ of certiorari with the circuit
court within thirty (30) days.
7.2 Subpoenas.
a) The Pension Board has the power to subpoena witnesses or documentation
in all proceedings under these rules and regulations. The Pension Board
shall retain a copy of each subpoena that is issued. The Pension Board will
also issue a check with each subpoena for mileage or witness fees as
provided by law on any subpoena that the Pension Board initiates on its own
behalf.
b) At the request of any applicant in a retirement pension proceeding, the
• Pension Board will execute and issue subpoenas. The subpoena shall be
prepared on a form acceptable to the Pension Board. The Pension Board
will not be responsible for the payment of any mileage or witness fees as
required by law. Such fees that be the responsibility of the person
requesting the subpoena.
• August 2005 14
• PART 8 -INVESTMENT POLICIES
8.1 Purpose. The Board of Trustees ("Trustees") of the Village of Tequesta General
Employees Retirement Plan ("Fund") has the power and authority to invest and
reinvest the moneys of the fund, and to hold, purchase, sell, assign, transfer, and
dispose of any securities and investments held in the fund, including the power and
authority to employ counseling or investment management services. Attached as
Exhibit "F" is a copy of the Investment Policy Statement of the Board.
•
• August 2005 15
• PART 9 -INCOME DEDUCTION ORDERS
9.1 Income Deduction Orders.
a) Assignment of Benefits Upon Divorce The prohibition against attachments,
garnishment, execution or any other legal process shall also apply to a
domestic relations order, unless such order is determined to be an income
deduction income deduction orderas defined by Florida Statutes §§61.1301,
61.046(4) and 61.076, and such benefit is only for purposes of alimony
and/or child support.
b) Filingof Claims All claims for benefits underan income deduction order shall
be filed, in writing, with the Board of Trustees along with a copy of the
income deduction order.
c) Definitions
1) Alternate Payee -The term "alternate payee" means any spouse,
former spouse, child or other dependent of a Participant who is
recognized by a domestic relations orderas having a right to all, or a
portion of, the benefit payable under the Plan with respect to the
Participant.
• 2) Income Deduction Order- The term "income deduction order" means
any judgment, decree or order which relates to child support or
alimony payments to a spouse (or former spouse), child, or other
dependent of a Participant, made pursuant to a state domestic
relations taw.
d) Designation of Representative The Participant and the altemate payee(s)
may designate an attorney or other representative to receive notices and
communications from the Trust Fund instead of the Participant or the
alternate payee. This designation must be in writing and must be signed by
the Participant or by the alternate payee.
e) Payment of Benefits Pending_Trustees' Deasion. Pending a decision by the
Board of Trustees whether an income deduction order should be honored,
any amount which would be payable to the altemate payee(s) if the income
deduction order was honored shall be accounted for separately.
• August 2005 16
• Village of Tequesta General Employees Retirement Plan
ADMINISTRATIVE RULES -SIGNATURE PAGE
Chairman
Trustee
Trustee
BSJ/ka
Administrative Rules Addendum
• September 28, 2005
Secretary
Trustee
WITNESS as to Trustees
• August 2005 ~~
• APPENDIX °A°
EXHIBIT °A"
ATTACH EXPENSE POLICY
• August 2005 18
• VILLAGE OF TEQUESTA
GENERAL EMPLOYEES' PENSION FUND
STATEMENT OF POLICY FOR TRUSTEE EXPENSES
WHEREAS, the Trustees of the Village of Tequesta General Employees' Pension
Fund ("Trustees") attend conferences, seminars, and meetings ("conferences") and
otherwise engage in services necessary to perform their duties for the Village of Tequesta
General Employees' Pension Fund ("Fund"); and
WHEREAS, the Trustees desire to adopt a Statement of Policy regarding Trustee
conference expenses consistent with their fiduaary duties, the provisions of Section
112.061, Florida Statutes, Village of Personnel Policy and all other applicable laws;
• THEREFORE it is hereb resolved that the following Statement of Policy
NOW, Y
Regarding Trustee Expenses is hereby adopted.
I. GENERAL CONSIDERATIONS
A. A Trustee shall be reimbursed only for expenses properly and actually
incurred in the performance of his or her duties with the Fund.
B. A Trustee shall not be reimbursed for any expenses for which he or
she had been paid or is due payment from any other source. A Trustee shall not be
reimbursed for any expenses which would result in double payment.
• Page 1 of 6
•
C. Trustee expenses shall be reasonable in amount and necessarily
incurred, taking into account the area of the country where the expense is incurred and the
standards for business expenses allowable by Fbrida Statutes and the Internal Revenue
Service.
D. The Board of Trustees shall approve all reimbursements for expenses
in accordance with this Statement of Policy.
II. TRAVEL EXPENSES
Trustees are entitled to payment for the actual costs incurred for:
A. Air: Tourist Class (most economical) airfare.
B. Car: Miles traveled times forty and one-half cents ($0.405) per mile,
•
or the tRS standard mileage rate, whichever is greater, subject
to the maximum payable if the Trustee could have traveled by
air. If more than one Trustee travels in the same car,
reimbursement shall be made to the Trustee who incurs the
expense.
C. Other Means of Travel: Actual cost incurred on a common carrier,
subject to the maximum payable if the Trustee could have traveled by
air.
No travel expenses shall be allowed if the Trustee is transported without charge.
• Page 2 of 6
• III. LODGING EXPENSES
Trustees are entitled to reimbursement for actual costs incurred for lodging
based on a single occupancy rate.
IV. FOOD EXPENSE
Trustees are entitled to reimbursement for actual costs incurred subject to
the maximum allowable of $42.00 per day.
V. OTHER EXPENSES
A. Trustees are entitled to reimbursementforsctual costs incurred for taxi, ferry
fares, bridge, road and tunnel tolls, storage or parking fees and communication expense.
• VI. PER DIEM
In lieu of all other payment for subsistence (including Lodging, Food and
Other Expenses), a Trustee traveling overnightshall be entitled to receive $50.00 per diem,
plus Travel and Conference Expenses. If travel is overnight but less than 24 hours, then
$12.50 shall be paid for each six (6) hours, or fraction thereof, of the day, measured from
midnight to midnight.
VII. CONFERENCE EXPENSES
Convention registration fees and other actual and necessary fees for
attending events which are not included in a basic registration fee, such as banquets are
reimbursable. If meals or lodging are included in the registration fee, the Trustee will not
• Page 3 of 6
be entitled to be reimbursed for such expenses separately, and the per diem shall be
•
reduced.
VIII. DAYS FOR WHICH REIMBURSEMENT IS PAYABLE
A. A Trustee shall be entitled to reimbursement while attending any
conference and for direct travel to and from the point of origin and the point of destination,
not to exceed one day of travel each way before and after the conference, unless it is not
practical to complete the travel in one day.
B. A Trustee shall not be entitled to any expense incur-ed as a result of
any trips or personal expenditures outside the scope of his or her direct travel route on
behalf of the Plan.
• IX. ACCOUNTING FOR EXPENSES
A. A Trustee must submit an expense voucher for all expenses incurred,
including per diem, within thirty (30) days after incurring the expense, on a form approved
by the Board of Trustees. The approved Trustee Expense Voucher form is attached
hereto. A copy of the Program or Agenda of the conference must be attached to the
completed Trustee Expenses Voucher.
B. Except for reimbursement for per diem, a Trustee must attach
invoices, receipts or other written documentation to the completed Trustee Expense
Voucher. Receipts are required for each expense in excess of $25.00. If any receipt
includes amounts not subject to reimbursement (e.g., for a Trustee's spouse), the receipt
should so indicate and be reduced accordingly.
• Page 4 of 6
C. For any conference where a certificate of attendance is issued, a
•
Trustee must earn such a certificate in order to be reimbursed for expenses, unless the
Trustee's absence is the result of illness or other good cause.
D. The Certified Public Accountant for the Plan shall audit all Trustees
expenses on an annual basis. The Certified Public Accountant shall notify the Board of
Trustees if any expenses for Trustees do not comply with this Statement of Policy
regarding Trustee Expenses.
X. ADVANCES
A. A Trustee may receive an advance to cover the expenses to be
properly and actually incurred in the immediate future. However, a copy of the Program
or Agenda for the conference must be provided before the advance is paid, itemizing the
• registration fee and any meals or lodging included in the registration fee.
B. A Trustee shall promptly return to the Plan any amount advanced
which exceeds the expenses incurred.
C. A Trustee shall be entitled to reimbursement for expenses incurred in
excess of the advance, but consistent with this Statement of Policy, and subject to approval
by the Trustees.
• Page 5 of 6
. THIS STATEMENT OF POLICY REGARDING TRUSTEE EXPENSES is adopted
effective January 1, 2005 by the Trustees of the Village of Tequesta General Employees'
Pension Fund this day of
TRUSTEES
2005.
By: Chairman By: Secretary
Witnessed by:
BSJ/ka
November 18, 2005
H:\Tequesta GE 1012\POLICIES & Fortns\2005 T EXP.wpd
•
• Page 6 of 6
• APPENDIX "B"
EXHIBIT "B"
ATTACH EXPENSE REPORT /REIMBURSEMENT VOUCHER
•
• August 2005 ~ 9
TEQUESTA GENERAL EMPLOYEES PENSION TRUST FUND
Travel Expense Reimbursement Form
.Department Name• Travel Dates:
Employee Name: Mileage Rate: 50.405
Lodging Sun Mon Tue Wed Thu Fri Sat Totals
Lodging $
Other $
Totals $
Food Sun Mon Tue Wed . Thu Fri Sat Totals
reakfast $
Lunch $
Dinner $
Other $
Totals $
Miscellaneous Sun Mon Tue Wed Thu Fri Sat Totals
Supplies /Equipment $
Phone, Fax $
Other $
Totals $
Conference/Seminar/Meeting
Date Place Name & Location Business Purpose Registration AnlOUftt
Totals
Summa of Ex enses
Total Expenses $ Prepared By: Date:
Less Cash Advance $
Less Company Charges $ Signature
Amount Due to Employee $ Approved By: Date:
mount Due to Village $
Signature
Account #
Account #
Prepared by: Bonni S. Jensen
HANSON PERRY JENSEN, PA
• APPENDIX "C"
Village of Tequesta General Employees Retirement Plan
Employee Application for Membership
System: ()General Employees ()Police & Fire c"~1cOn8 {Social Security No:
Employee:
Lest ~~ Fugt Middle Initial
Date of BiM Sex Empbymenl Dats
Employee's
Beneficiary:
Frst Name
Middle IMtlal Last Name
Relationship to Employee
Date of BiAh
I hereby apply to the Village of Tequesta General Employees Retirement Plan for
membership in the retirement system and accept all terms and conditions of said plan, as
• prescribed by the Board of Trustees.
Date
Signature of Employee
• August 2005 20
• Vested Terminated Employee
Dept.
$.
Employee Name: S.S. #:
$eX: Date of Birth: Date Hired: Termination Date:
LAST 5 YEAR WAGE OF EMPLOYEE Employee
Beneficiary:
•
Date of Birth:
Relationship:
• August 2005 21
•
APPENDIX "D"
APPLICATION FOR BENEFITS
PLEASE PRINT OR TYPE:
1. a. Name of Employee:
b. Social Security Number.
c. Date of Birth:
d. Home Telephone Number:~~
(Area Code)
(Attach birth certificate or other proof,
e. Home Address:
•
•
f. Permanent address to which check and correspondence should be sent:
2. a. Are you currently married? Yes No
If yes, please complete the following:
b. Name of Spouse:
c. Spouse's Social Security Number:
d. Spouse's Date Of Blrth: (Attach birth certificate or other proof)
e. Date of Marriage:
August 2005 22
3. Name(s) and Date(s) of Birth of Child(ren):
• Name Date of Birth
•
4. Names of Your Living Parent:.:
a. Mother:
b. Father:
5. a. Date of hire by the Vill~ige of Tequesta as a Swom Police Officer:
b. Current Position in the Department:
6. I plan to retire on:
7. Type of retirement which you are receiving:
Normal Retirement
Early Retirement
Line-of-D~~ty Disability
Non-Line-•of--Duty Disability
• August 2005 23
8. If you are applying for a disability retirement, please complete the following:
•
a.
b.
Date disability commenced: _
Nature and cause of disability:
c. Did your disability result from any of the following:
(1) Use of drugs, intoxicants or narcotics?
•
(2) Due to a fight, ri~~t, civil insurrection or crime?
(3) From an injury or disease sustained while you
were serving in any armed forces?
(4) After your employment with the Village terminated?
(5) While working for anyone other than the Village and
arising out of such employment?
d. A copy of my doctor's medical opinion is attached:
Yes No
NOTE: If you are applying for a disability benefit, records must be filed to show that
the disability is total and permanent. If application is made for aline-of-duty
disability, copies of workers' compensation records must also be filed to
show that the disability occurred in the line-of-duty. Also, the Board of
Trustees may require yc~u to be examined by a doctor selected by the Board.
• August 2005 24
Ac:knowled~ments
•
I hereby certify that the above; statements are true and correct to the best of my
knowledge. I understand that a falsE: statement may disqualify me for benefits.
I have reviewed the Designatio n of Beneficiary Form filed with the Board of Trustees
and I hereby certify its accuracy. If I desire to change my designated beneficiary(ies), (will
file a new Designation of Beneficiary Form with this Application.
I hereby authorize the releas~a of any and all medical records including but not
limited to the complete history record;> in possession of all doctors listed below concerning
my illness and/or treatment.
•
I hereby waive my right of confidentiality of my medical records and other medical
evidence in order that my application for disability benefits may be property processed. I
understand that in so doing, such records will be discussed during one or more public
meetings and will become public record. I understand that the Board(s) will rely upon this
waiver and that I will not be able to withdraw same at a later date.
I agree to cooperate fully with the Board of Trustees of the Village of Tequesta
General Employees Retirement Plan in making available to the Board, or authorized
agents of the Board, information which reasonably relates to the initial payment of or
continuing eligibility for payment of bE~nefits from the Fund.
• August 2005 25
I hereby agree to indemnify and hold harmless the Village of Tequesta General
• Employees Retirement Plan from and against any and all claims, demands, or causes of
action of any kind or nature resulting from or in connection with Village of Tequesta's
release of the results of the undersigned's annual physical to the Pension Plan and from
and against any resulting losses, costs, expenses, reasonable attorneys' fees, liabilities,
damages, orders, judgments, or decrees in connection therewith.
Dated this day of , 20 , A.D.
Signature of Participant:
Participant, please sign above
WITNESS:
Printed name of Participant
• Signature of Witness Printed name of Witness
Sworn to and subscribed before me this day of . 20_
by
Personally known to me -OR-
Produced identification (Please indicate type of identification produced on space provided below):
NOTARY PUBLIC
Printed, typed or stamped name of Notary:
[ notary seal ]
My Commission Expires:
• August 2005 26
APPENDIX "E°
Village of Tequesta General Empbyees Retirement Plan
Vested Terminated Employee
•
Dept
Employee Name: S.S. #:
Sex: Date of Birth:
Date Hired: Termination Date:
LAST 5 YEAR WAGE OF EMPLOYEE
Employee:
Beneficiary:_
Date of Birth:
Relationship:,
BSJ/ka
November 18, 2005
H:\Tequesta GE 1012\Plan Docs 8 RulesWDMIN RULES~2005~2005 ADMIN RULES GE.wpd
• August 2005 27
.. -----~---- iag~ivli
In~eY•nal Rc~Tcnue Se~~vi~e IRS.~o~c~
• DEFt;!tTiitElr`T GF TfiE TFfASl1P,f
IRS Increases Mileage Rate Until Dec. 31, 2005
IR-2005-99, Sept. 9, 2005
WASHINGTON -The Internal Revenue Service and Treasury Department announced today
an increase to the optional standard mileage rates far the final four months of 2005.
The rate will increase to 48.5 cents a mile for all business miles driven between Sept. 1 and
Dec. 31, 2005. This is an increase of 8 cents from the 40.5 cent rate in effect for the first eight
months of 2005, as set forth in Rev. Proc. 2004-64.
"This is about fairness for taxpayers," said IRS Commissioner Mark W. Everson. "People are
entitled to deduct the real cost of operating a vehicle. We've responded to the recent gas
price increases by making this special adjustment so taxpayers get the tax benefit they
deserve."
In recognition of recent gasoline price increases, the IRS made this special adjustment for the
final months of 2005. The IRS normally updates the mileage rates once a year in the fall for
the next calendar year.
"With many predicting a decline in gas prices over coming months, we will hold off on setting
the 2006 rate until closer to January," Everson said. Next year's rate could be lower than 48.5
cents.
• While gasoline is a major factor in the mileage figure, other items enter into the calculation of
mileage rates, such as the price of new vehicles and insurance.
The optional business standard mileage rate is used to compute the deductible costs of
operating an automobile for business use in lieu of the extra burden of tracking actual costs.
This rate is also used as a benchmark by the federal government and many businesses to
reimburse their employees for mileage.
The new four-month rate for computing deductible medical or moving expenses will be 22
cents a mile, up from 15 cents for the first eight months of 2005. The rate for providing
services for charitable organizations is set by statute, not the IRS, and remains at 14 cents a
mile.
The annual Revenue Procedure includes limitations on who is not eligible to use the standard
mileage rate.
•
http://www.irs.gov/newsroom/article/0„id=147423,00.him1 9/12/2005