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RESOLUTION NO. 46-00
FOR A LEGISLATIVE BODY RELATING TO A DEFERRED COMPENSATION PLAN
Name of Employer: ,JpffpT1Rnn '. ('.:nunt:y
State:
WA
Title of Program Coordinator: ' Human Resou;ixe11aDager
(see definition below for duties of Program Coordinator)
Resolution of the above named Employer ("Employer")
WHEREAS, the Employer has employees rendering valuable services; and
WHEREAS, the establishment of a deferred compensation plan for such employees serves the interests of the Employer by
enabling it to provide reasonable retirement security for its employees, by providing increased flexibility in its personnel
management system, and by assisting in the attraction and retention of competent personnel; and
WHEREAS, the Employer has determined that the establishment of a deferred compensation plan to be administered by the
ICMA Retirement Corporation serves the above objectives; and
WHEREAS, the Employer desires that its deferred compensation plan be administered by the ICMA Retirement Corporation,
and that some or all of the funds held under such plan be invested in the ICMA Retirement Trust, a trust established by public
employers for the collective investment of funds held under their retirement and deferred compensation plans;
NOW THEREFORE BE IT RESOLVED that the Employer hereby adopts the deferred compensation plan (the "Plan") in the form
of: (Select one)
){H The ICMA Retirement Corporation Deferred Compensation Plan and Trust, referred to as Appendix A
0 The plan provided by the Employer (executed copy attached hereto).
BE IT FURTHER RESOLVED that the Employer hereby executes the Declaration of Trust ofthe ICMA Retirement Trust, attached
hereto as Appendix B, intending this execution to be operative with respect to any retirement or deferred compensation plan
subsequently established by the Employer, if the assets of the plan are to be invested in the ICMA Retirement Trust.
BE IT FURTHER RESOLVED that the assets of the Plan shall be held in trust, with the Employer serving as trustee, for
the exclusive benefit of the Plan participants and their beneficiaries, and the assets shall not be diverted to any other
purpose.
0 Will permit loans
BE IT FURTHER RESOLVED that the Plan: (Select one)
.YWili not permit loans
BE IT FURTHER RESOLVED that the Employer hereby agrees to serve as trustee under the Plan.
BE IT FURTHER RESOLVED that the Human Resou:ìxe 11a,Tlager (use title of official, not name) shall be
the coordinator for this program; shall receive necessary reports, notices, etc. from the ICMA Retirement Corporation
or the ICMA Retirement Trust; shall cast, on behalf of the Employer, any required votes under the ICMA Retirement
Trust; Administrative duties to carry out the plan may be assigned to the appropriate departments, and is authorized
t<¡> execute all necessary agreements ~~~Av~ent Corporation incidental to the administration of the Plan.
L~"n b"U¡AJ~" ~øt;" ,
I, ,Clerk of th~ unty. of '"e eI'son , do hereby certify that the foregoing resolution,
proposed ~ In e oun - Member TI i:1Jtð", <:ok.) e; was duly pas!':ed..anrJ adoptecWa the (~I,
Bo , etc.) ~f . '. Co c.) of y t regular meeting thereo~ .Jssembled tnr'OÒ-15tsãy nf '1J/.tJ!,¿,
, fol OWIn v : O'CA.Å. . r-
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Clerk of the (City, CUUI rtv';""'etc:) Bc:;¡arrß
Jefferson County Commission
Deferred Compensation Plan
This booklet contains the following documents:
.... Suggested Resolution
.... Implementation Data Form
..... Two Administrative Services Agreements
ICMA RETIREMENT CORPORATION
The public service Vantagepoint since 1972
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ICMA RETIREMENT CORPORATION
USING THE 457 DEFERRED
COMPENSATION PLAN
RETURN BOOKLET
This is one of two booklets containing information to
establish your 457 deferred compensation plan with the
ICMA Retirement Corporation. For detailed information
about plan adoption, please see Chapter Two of your
457 Employer 1\Ilal1ual.
This booklet includes:
. Suggested Resolution
. Implementation Data Form
. Administrative Services
Agreements
. Postage-Paid Envelope
Please retum the following originals to RC using the
envelope provided:
1. Approved and Executed Suggested Resolution.
Certain state statutes, regulations and local ordi-
nances contain an express statement that 457 assets
belong to the employer. This may conflict with
some provisions of federal 457 legislation enacted
in 1996, in particular, the trust provision of the
Suggested Resolution.
In cases of conflict, these state and/ or local laws or
regulations may have to be changed before some
or all of the federal 457 law may become effective.
Please check with your legal adviser to determine
whether any of these state and/or local law or
regulation issues pertain to your situation.
If you are selecting the ICMA Retirement Corpo-
ration to administer an existing or a newly estab-
lished 457 plan and no changes to state and/or
local law or regulations are required before the
new federal 457 laws can become effective tor your
plan, you should adopt the Suggested Resolu-
tion.
If you are selecting the ICMA Retirement Corpo-
ration to administer a newly established 457 plan
and your are an employer with a staĆ and/or loc<ù
law issue, you should contact your 457 implemen-
tation analyst at 1-800-326-7272- Be sure that the
full legal title of your unit of (>overnnlent or
. b
organization is completed at the top of the Resolu-
tion you adopt. After obtaining goveming body
approval, the appropriate oflìÖal (city or county
clerk, secretary, etc.) must certify that the Resolu-
tion has been duly sealed and approved.
2. Completed Implementation Data Form.
3. Two executed originals of the Administrative
Services Agreement.
Your governing body m_ay require the execution
of this Agreement at the same time as the
Suggested Resolution, Plan Document (Appen-
dix A) and Declaration of Trust for the ICMA
Retirement Trust (Appendix B).
4. If applicable, a plan implementation fee. (See the
Pricing Q!Jer and Acceptance Page)
You may also send to your 457 plan analyst,
along vvith your Return Booklet, yoU): initial
group of Employee Enrollment Forms completed
by your employees. Please keep copies of all
Return materials for your files.
Please note
Upon receipt and processing of your Return Booklet,
RC will send you a wrÎ1:ten Notice of Plan Accep-
tance, an executed copy of the Administrative
Services Agreement, a publications catalog, plus
complete instructions for submitting contributions
that may also be found in Chapter Four of the
457 Employer ManHal.
For assistance
Please contact your 457 implememation analyst at
1-800-326- 7272.
i
¡ 457 Deferred Compensation Plan
, Implementation Data Form
Please ensure that each section of this form is completed before returning it to the Retirement Corpora-
tion along with the other adoption materials. You may contact Employer Services at 1-800-326-7272 if
you have questions.
The following list of designations should help you while completing the Implementation Data Form:
5. Primary Contact
This person is responsible for the day-to-day administration and processing of RC transactions. This is
the person we call if general questions arise concerning your RC account.
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12. Plan year end date
The plan year designated in our plan document is January 1 through December 31.
19. Plan Coordinator
The title of this person is designated in the resolution. If a different person obtains the same title, you
may use this form to update the name change. You must have your legislative body pass a new resolu-
tion to update the title of the person designated as plan coordinator.
20. Disbursement/Loan
This person(s) will be responsible for signing disbursement and loan withdrawal forms, authorizing any
disbursement or loan transactions, and answering questions pertaining to disbursements and loans.
This should be a person(s) of authority. Also, the person's signature should be placed in the appropriate
section of this form for our reference purposes.
21. Contribution
The person responsible for sending contributions to RC. If there are discrepancies in the actual check or
wire amounts and the corresponding backup, this is the person we will contact to resolve the issue. This
person should have access to all payroll/contribution information to ensure efficient processing of
contributions.
22. Tape/Diskette
Same duties as contribution contact except that we will be contacting this person if the tape or diskette
is damaged, the tape/diskette is not in an acceptable format or the information on the tape/diskette is not
usable.
23. Quarterly Statement
This person will receive all quarterly statements.
24. Billing (Fees)
If RC charges any employer paid fees to your account, this person will receive the invoices.
25. Remittance Reconciliation
This should be the same person as the contribution person. Confirmations for each contribution received
are sent to this individual.
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4~7 Deferred Compensation Plan
Implementation Data Form
~
. Instructions to Employer: Provide necessary information to establish your plan properly,
Please contact Employer Services at 1-800-326-7272, if you have any questions.
leMA RETIREMENT CORPORATION
I
I RC Use Only
I 1. Employer Number:
2. (902) (APAY 302) Employer's Full Name: r'.OllTrty of ,JF>ffpX'~nn'
3. (922) (APA Y 420) Street Address: 182'0 .Jefferson Street
(924)(APAY 421) P. O. Box'1220 -
4. (918) (APAY 424) City: Pori Towns.end
(919) (APAY 425) State: WA (920) (APAY426) Zip Code: 98368
5. (633) Primary Contact Name: Thwl'rl (jal Cì~rnìTh
6. (634) Primary Contact Title: DepÜ1:y County Administrator
7. (631) Primary Contact Telephone#: (360) 38'5....9100
8. (632) Fax #:(..l6D.) 38'5-9382
9. (882) Employer's Federal Tax Identification Number: 916001322
10. # of Employees: ;;75 11. # of Employees Eligible for Plan Participation: 375
General
Information
'1/'
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Plan
Implemen-
tation
Information
12. (B03) Plan Year-end Date: 12/31 13. (802) Fiscal Year-end Date: 12/31
14. Plan Level Quarterly Statements: (Note: * "" default)
a. Sort Order: (629) Jll S""SSN* 0 N=Name
b. Output Media: (627) 13 P=Paper* 0 M=Microfiche
-, c. Type: (626) t;.! S=Summary* 0 D=Oetaii
15. (611) Contribution Information
a. Frequency: (check one): 0 (0) ßi-weekly* ~ (4) Monthly 0 (8) Semi-quarterly
0 (1) Weekly 0 (5) Semi~monthly 0 (9) Bi-annually
0 (2) Semi-weekly 0 (6) ßi-quarterly 0 (10) Annually
0 (3) Bi-monthly 0 (7) Quarterly 0 (11) Semi~annually
b. Deposit Medium: (624) ~ Check * 0 Wire
c. Media Transmission: (523) 0 (T) Tape 0 (Q) RC Quickdisk 0 (E) EDT
[:;t (S) Submittal Document* 0 (D) Diskette
d. First Pay Date Following Implementation: 5th of month
e. Contribution Submittal Printing: (523b) 0 (0) Do Not Print 13 (1) Print wi $ Amount*
0 (2) Print wlo $ Amount
0 (N) Name
0 ß""ßound
f. Sort Order:
(512)-E) (5) SSN*
16. Allocation Change Frequency: ~ (0) No Restrictions *
(220) 0 (1) 1 per 12 months
0 (2) 1 per 6 months
0 (3) 1 per 4 months
0 (4) 1 per 3 months
0 (5) 1 per Plan Year
457 Deferred Compensation Plan
Implementation Data Form
I RC Use Only I
Employer Number:
~
ICMA RETIREMENT CORPORATION
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Plan 17. Default Fund for Investment Allocations:
Implemen- Instructions - Use the Vantagepoint Funds Brochure or sheet to complete this section.
tation
Information A. Default investment allocation. List the fund B. Investment restrictions. List the fund code(s) that
(con't) code(s} and percentage for investment alloca- are NOT eligible for contributions or fund
tion if a participant elected allocation is not transfers:
available. (Note: If no fund code is listed, the
default will be Fund 71 - PLUS Fund.)
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PLAN CONTACTS
(If any item #18-26 is left blank, the Primary Contact in Q. #5 will receive mailings)
Disbursement! 18. AD01 Contact Signature:
Loan Contact
Information (401) Contact Name:
Please (401) Contact Title:
indicate
alternate (502) Telephone: (-) Fax:(_)
addresses
in Comments 19. AD08 Contact Signature:
Section on
Page 3 (401) Contact Name:
(401) Contact Tit!e:
(502) Telephone: (-) Fax:(_)
20. AD09 Contact Signature:
(401) Contact Name:
(401) Contact Title:
(502) Telephone: ( ) Fax:(_)
Contribution 21. AD02 (401) Contact Name: Cheri Farara
Contact Payroll Specialist
Information (401) Contact Title:
(502) Telephone: ( 360) 385-9120 Fax:( 360 ) 385-9228
Tape! 22. AD03 (407) Contact Name: Cherl Farara
Diskette Payroll Specialist
Contact (407) Contact Title:
Information (502) Telephone: L.3..6.QJ ~R¡;-ql?n Fax:L3.6.~) ::!85-9728
Quarterly 23. AD04 (401) Contact Name: C1ìp.T'i FFrT'i'JY'i'J
Statement Payroll Specialist
Contact (401) Contact Title:
Information (502) Telephone: L...3..6J1J 385-9120 Fax:! 360 ) 385-9228
Plan 24. AD05 (407) Contact Name:
Coordinator Contact Title:
Contact (401)
Information Note: Changing this title requires an amendment to your resolution.
(502) Telephone: (-) Fax:(_)
I RC Use Only
Employer Number:
457 Deferred Compensation Plan
Implementation Data Form
I
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ICMA RETIREMENT CORPORATION
Billing 25. AD06 (401) Contact Name: Cheri farara
(Fees) (401) Contact Title: Pavroll Specialist
Contact
Information (502) Telephone: (360 ) 385-9120 Fax:(~) 385....9228
Remittance 26. AD07 (401) Contact Name: Cheri .farara
Reconcilia- (401) Contact Title: Payroll Specialist
tion
Contact. (502) Telephone: L..3..6D-) '385-Ql?n Fax:(~) 385-9228
Comments:
(Alternate
Addresses
for #18-28)
Transferred 27. Is there a transfer of assets? 0 Yes )DNa
Plan Asset Will total plan assets be transferred or is co-administration required?
Information 0 In total 0 Co-administration
Administrator Name (if app.)
Company
Address
Telephone (-) Fax(_)
How many participants will be eligible to transfer assets to RC?
What is the estimated cash value of the assets to be transferred to RC7 $
Date and methods (check, wire, etc.) the assets will be transferred to RC:
To ensure your funds are posted timely and accurately, please forward the following information t
RC plan analyst before any assets are transferred.
0 Copies of most recent participant statements.
0 Complete list of participant names, social security numbers, total assets to be transferred.
0 Employer plan conversion form for each participant for allocation of funds or letter from employer if alloc
are the same as contributions.
0 Administrative enrollment for retired or terminated participants with assets.
. Copies of participant disbursement request forms for those currently receiving disbursements.
Copy of existing plan document for individually designed plan.
How many partipant loans are currently outstanding with your current Plan administrator? We must
the informaiton for all outstanding loans to ensure a successful transition of the loan balances to RC.
0 Participant Name 0 Loan payment amount
0 Social Security Number 0 Payment frequency
0 Original loan amount 0 Current loan balance
0 Original loan issue date 0 Highest 12 month balance
0 Loan interest rate 0 Loan number
0 Current balance by source (employer dollars, employee pre-tax dolars, etc.)
a your
ations
receive
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Internal RC Use Only
072 ~ VRU Allowed
641 ~ Plan Setup Date
074~Adv/PTS, MERS
630 ~ Government Code
644 ~ Contract Completion Date
643 ~ PTS Plan #
912 ~ Short City Name
This booklet should be accompanied by the following materials:
Loan Guidelines Packet
Vantage point Funds Sheet
Enrollment Forms
Pre-addressed, Postage-Paid Envelope
If you have not received all of these documents, please notify your
Implementation Analyst at (800) 326-7272 immediately.
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ICMA RETIREMENT CORPORATION
777 North Capitol Street, NE
Washington, DC 20002-4240
1-202-962-4600
T oll-F ree 1-800-669-7400
BRC571-005-9805
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