Item C10 BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: Wed. Dec. 11, 2013 Division: Employee Services
Bulk Item: Yes No — Department: Human Resources
Staff Contact/Phone#:Teresa Aeuiar
PH: 305 292-4458
AGENDA ITEM WORDING:Approval to execute 457 Custody Agreement with Nationwide Trust
Company, FSB in order to create self-directed option for employees with Nationwide deferred
compensation plans, and authorization for Human Resources staff to execute Self-Directed Option
Participant Releases on an as-needed basis.
ITEM BACKGROUND: Monroe County has established voluntary personal tax deferred retirement savings
plans for employees that automatically pulls monthly contributions to their personal retirement savings
accounts from their pay before taxes are computed on their earnings,thereby reducing their gross taxable
income. The restrictions on withdrawal from these 457 savings accounts will remain the same, allowing only
very limited access to the balance until retirement age is reached or the enrollee terminates their
employment with Monroe County.
Self-directed investment options is a growing trend, most notably the State Florida Retirement System will be
unveiling their SDO program set to roll out in January of 2014. The standard mutual fund menu and
professionally managed options will remain the same. The SDO will supplement the standard options for
those employees who have experience with stock investments and knowledge of the market so they can
execute more control over the earnings of their investment account. Employees who participate in the SDO
will be required to sign a Participant Release and Covenant not to sue over any losses in their investments.
There is no cost to the County for adding this SDO option to the Nationwide Retirement Solutions Deferred
Compensation Plan.
PREVIOUS RELEVANT BOCC ACTION: In 1987, the BOCC approved Resolution #335-1987 setting up the
deferred compensation plan for employees.
CONTRACT/AGREEMENT CHANGES:
STAFF RECOMMENDATIONS:Approve.
TOTAL COST:0 COST:0 BUDGETED: Yes No_
DIFFERENTIAL OF LOCAL PREFERENCE:
COST TO COUNTY:0 SOURCE OF FUNDS:
REVENUE PRODUCING: Yes_ No XX AMOUNT PER MONTH Year
APPROVED BY: County Attyl OMBB/A Purchasing_Risk Managemen
DOCUMENTATION: Included XX Not Required
DISPOSITION: AGENDA ITEM#
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Nationwide Trust, FSB Contract#
Effective Date: January 1, 2014
Expiration Date: N/A
Contract Purpose/Description:
457 Custody Agreement with Nationwide Trust Company, FSB in order to create self-
directed option for employees with Nationwide deferred compensation plans, and
authorization for Human Resources staff to execute Self-Directed Option Participant
Releases on an as-needed basis.
Contract Manager: Teresa Aguiar 4458 -Employee Services
(Name) (Ext.) (Department/Stop#)
for BOCC meeting on Dec. 11, 2013 Agenda Deadline: Nov. 25, 2013
CONTRACT COSTS
Total Dollar Value of Contract: $ 0 Current Year Portion: $ 0
Budgeted? Yes❑ No ❑ Account Codes:
Grant: $ 0
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $0/yr For: 0
(Not included in dollar value above) (eg.maintenance,utilities,janitorial,salaries,etc.)
CONTRACT REVIEW
Changes Date Out
Date In Needed Re wer
Division Director Yes❑No
w,
"v
Risk Management Yes❑ No
❑ 7
O.M.B./Purchasing i� - � Yes No 4
County Attorney f Yes[:]No
Comments:
Nationwide Trust Company, FSB
457 Custody Agreement
(The "Agreement")
This Agreement including the Schedule of Investments attached is made and entered into by and
between Monroe County Board of County Commissioners ("Sponsor") and Nationwide Trust
Company, FSB a division of Nationwide Bank as Custodian ("NTC") pursuant to the Monroe County
Board of County Commissioners Deferred Compensation Program for Public Employees
("Plan")to establish the Monroe County Board of County Commissioners Deferred
Compensation Program for Public Employees Custodial Account("Account").
By signing below, signatories on behalf of the By signing below, NTC has agreed to and accepted
Sponsor and the Plan acknowledge that they have all rights and obligations contained herein.
received the Agreement, Inclusive of all Schedules
listed above, and agree to all terms. Further, they
represent that they have the authority to enter into,
on behalf of the Sponsor and the Plan, a
contractual relationship with NTC with respect to
these documents and will be subject to all rights
and obligations contained therein.
Printed Sponsor Name NTC
Sponsor Signature Date Acceptance Date
Title
Printed Name
MONROE COUNTY ATTORNEY
Signature Date A ROVED,A T F RIVI:
XYNTHIA L. HALL
Title ASSISTANT COUNTY�. 0 IMF�AT ORNEY
Date itPrinted Name
Signature Date
Title
Monroe Cty-NRS-SDO Only(05/2009) - 1 of 8-
ARTICLE I—PURPOSE
The Sponsor adopts this Agreement on behalf of the Plan and represents and warrants that the Plan is
intended to meet the requirements of an eligible deferred compensation plan under Section 457 of the
Internal Revenue Code of 1986, as amended ("Code") and intends to keep such Plan in compliance with
the then applicable requirements of the Code. Further, the Sponsor represents and warrants that the
Employer of all individuals eligible to participate in the Plan is a state, political subdivision of a state, or an
agency or instrumentality of either.
ARTICLE II—DEFINITIONS
Account—The custodial account established herein by which NTC will hold the assets of the Plan or
any portion thereof as agreed upon by Sponsor and NTC.
Business Day—A day on which NTC and New York Stock Exchange are both open for business.
Effective Date — The date on which the Account is created by NTC's acceptance of cash or other
assets on behalf of the Sponsor. Prior to the Effective Date, NTC shall have no responsibility hereunder.
Employer(s)—The employer(s)of the Participants in the Plan.
Funding Vehicles)—As permitted by applicable law, securities held in self-directed brokerage accounts
made available by NTC.
Original Signature—An authentic, hardcopy, non-reproduced signature of the Sponsor or its designee.
Participant—A person for whom benefits are provided under this Agreement, in accordance with the
Plan.
Plan—The Plan identified on the front page of this Agreement, including any written plan document and
trust provisions.
Required Format—Acceptable format for submitting information to NTC as prescribed by NTC and on
transaction forms prescribed by NTC.
Signature — Either the Original Signature or an Original Signature that has been replicated by
photocopy, electronic means, or fax.
Successor—The trustee or custodian appointed by the Sponsor who succeeds NTC.
Written Instruction(s) —Any notices, instructions or other instruments required to be in writing (with
Signature or Original Signature, where so indicated) from NTC, Sponsor, or its designee. Written
Instructions may take the form of a letter, electronic communication through an on-line communication
system mutually agreeable to the parties;or a facsimile transmission.
NRS-SDO Only(05/2009) -2 of 8-
ARTICLE III—THE ACCOUNT
The Sponsor advises NTC that the Account shall be funded as described herein. The Sponsor hereby
authorizes NTC to take any action required to establish and maintain any Funding Vehicle(s) designated
by the Sponsor under this Agreement.
NTC has entered into arrangements with a provider to make available a Funding Vehicle for possible
inclusion in the Account. The assets of the Account shall consist of the Funding Vehicle. The Account
and any funds invested pursuant to this Agreement are not insured by the Federal Deposit Insurance
Corporation ("FDIC"), are not deposits or other obligations of NTC and are not guaranteed by NTC. The
value of the Account is subject to investment risks, including possible loss of principal. NTC agrees to
hold and administer the Account in accordance with this Agreement.
NTC shall not be under any duty to require payment of any contributions to the Account, if any, or to see
that any payment made to it is computed in accordance with the provisions of the Plan. NTC shall
continue to administer the Account in accordance with this Agreement until its obligations are discharged
and satisfied.
ARTICLE IV—GENERAL ADMINISTRATIVE RESPONSIBILITIES OF NTC
NTC is authorized to take any action set forth below with respect to the Account:
Accept instructions in the Required Format from the Sponsor or its designee regarding the allocation,
distribution or other disposition of the assets of the Account and all matters relating thereto;
Cause any portion or all of the Account to be issued, held, or registered in the individual name of NTC, in
the name of its nominee, in an affiliated securities depository, or in such other form as may be required or
permitted under applicable law (however, the records of NTC shall indicate the true ownership of such
property);
Employ such agents and counsel, including legal counsel, as NTC determines to be reasonably
necessary to manage and protect the assets held in the Account, to handle controversies that may arise
under this Agreement, or to defend itself successfully against allegations of a fiduciary breach, and to pay
such agents and counsel their compensation from the Account unless such compensation is otherwise
paid by the Sponsor;
Commence, maintain, or defend any litigation necessary in connection with the administration of the
Account, except that NTC shall not be obligated to do so unless it is to be indemnified to its satisfaction
against all expenses and liabilities sustained or anticipated by reason thereof;
Take all other acts necessary for the proper administration of the Account.
ARTICLE V—INVESTMENT RESPONSIBILITY
NTC shall have no investment management responsibility or liability with respect to the Account or any
other assets held under the Plan. Plan contributions or other assets received by NTC shall be allocated
in accordance with Written Instructions. Neither Sponsor nor NTC warrant or guarantees the
performance of any Funding Vehicle selected by the Sponsor or Participants.
The Sponsor, or other party designated under the Plan, shall have full responsibility for the selection of
the Funding Vehicle and the management, disposition, and investment of assets of the Account. NTC
shall comply with Written Instructions concerning those assets, subject to restrictions, if any, imposed by
the Funding Vehicle and the operation of any securities markets. Except to the extent required by
applicable law or otherwise provided in this Agreement, NTC shall have no duty to review, initiate action,
or make recommendations regarding the Account or its investments.
NRS-SDO Only(05/2009) -3 of 8-
NTC shall not be liable for any loss which results from the exercise of investment control by a Sponsor,
Participant or beneficiary, or designated investment manager. If a Participant who has investment
authority under the terms of the Plan fails to provide investment direction, the Sponsor shall direct the
investment of the Participant's account.
No one providing investment advice to the Plan, Sponsor, Participant or other party is acting as an agent
of NTC.
ARTICLE VI—CONTRIBUTIONS NOT RECOVERABLE
Except as described in the Purpose section of this Agreement and to the extent permitted by the Plan and
applicable law, under no circumstances shall any part of the Account be recoverable by the Sponsor or
be used other than for the exclusive purposes of providing benefits to Participants and their beneficiaries
and paying reasonable expenses of the Plan prior to the satisfaction of all liabilities to Participants and
their beneficiaries; provided, however, a contribution by a Sponsor or a Participant made as a result of a
mistake of fact that is discovered within one(1)year after the contribution is made shall be returned to the
Sponsor or Participant as soon as administratively feasible, if the Sponsor so requests and the Funding
Vehicle(s)permits.
ARTICLE VII ACCOUNT RECORDS AND REPORTS
NTC or its designee shall maintain accurate records and detailed accounts of all investments, receipts,
disbursements, earnings, and other transactions related to the Account, and those records shall be
available at all reasonable times to the Sponsor.
ARTICLE VIII—FIDUCIARY RESPONSIBILITIES AND LIABILITIES
NTC may rely upon any information provided by the Sponsor or its designee. NTC, the Sponsor, and all
other fiduciaries under the Plan and this Agreement intend that each party shall be solely responsible for
those specific duties and powers assigned to it. Each party may rely upon any direction, information, or
action of another party as being proper under the Plan and this Agreement. NTC shall not be required by
the Sponsor or its designee to engage in any action, or make any investment which constitutes a
prohibited transaction or is otherwise contrary to the provisions of applicable law, the Code, or the terms
of the Plan, if any, or this Agreement.
NTC shall be responsible only for those functions which have been assigned to it under this Agreement
and shall have no responsibility to perform any duty of the Sponsor, or other fiduciary, required by the
Plan or applicable law. NTC shall have no duty to determine the rights or benefits of any person having
or claiming an interest under the Plan or this Agreement.
Except as otherwise provided in the Agreement, including any schedules thereto, any action to be taken
by NTC under the Agreement shall be taken upon Written Instruction from the Sponsor or its designee.
NTC shall comply with such instructions and shall incur no liability for any loss which may result from any
action or failure of action on its part due to its compliance with such Written Instructions.
ARTICLE IX—LIMITATION OF LIABILITY
To the extent permitted by applicable law, NTC and Sponsor shall not be liable for any failure or delay in
the performance of their obligations under this Agreement arising out of or caused, directly or indirectly,
by circumstances beyond its reasonable control, including, without limitation, acts of God; earthquakes;
NRS-SDO Only(05/2009) -4 of 8-
fires; floods; wars; civil or military disturbances; sabotage; epidemics; riots; interruptions, loss or
malfunction of utilities, computer (hardware or software) or communications services; accidents; labor
disputes;acts of civil or military authority or government actions.
ARTICLE X—RELIANCE ON COUNSEL AND INDEMNIFICATION
NTC may consult with, and act upon the advice of counsel (who may be counsel for the Sponsor),
regarding its responsibilities under this Agreement. To the extent permitted under applicable law, the
Sponsor shall indemnify and hold harmless NTC, its officers, employees, and agents from and against all
liabilities, losses, expenses, and claims (including reasonable attorneys' fees and costs of defense)
arising as a result of:
Acts or omissions to act with respect to the Plan or Account by persons unrelated to NTC;
NTC's action or inaction with respect to the Plan or Account resulting from reliance on the action or
inaction of unrelated persons;
Any violation by any unrelated person of the provisions of the Code or applicable laws, unless NTC
commits a breach of its duties by reason of its gross negligence or willful misconduct;
Any decision by the Sponsor, any Participant or any other fiduciary to acquire, retain, or dispose of any
security or other property of the Account;
Any violation or breach by a fiduciary or other person associated with the Plan which occurred prior to the
Effective Date; or
NTC's acts, omissions and conduct, and those of its agents, in their official capacity, except to the extent
that such documented loss or expense results from negligence directly and solely attributable to NTC or
its agents, or from an intentional violation by them of any provision of this Agreement.
Such obligation to indemnify shall extend to any liability or expense that arises as a result of the
inaccuracy of any representation made, any action taken or failure to act, or any violation of this
Agreement, the terms of the Plan by the Sponsor, its designee, any fiduciary of the Plan, and their
agents, employees and officers under this Agreement or otherwise related to the administration of the
Account. NTC shall not be required to give any bond or other security for the faithful performance of its
duties under this Agreement except to the extent required by applicable law.
ARTICLE XI—NTC'S USE OF AFFILIATED COMPANIES
NTC and Sponsor may enter into agreements and share information with its affiliates in performing
responsibilities under this Agreement and any other applicable agreement. Investments made in
accordance with the Agreement, may include mutual funds or other investments advised by affiliates of
NTC. The investment advisers of such investments may be affiliates of NTC and may derive investment
management and other fees for services provided.
ARTICLE XII—NTC'S COMPENSATION AND EXPENSES
NTC's compensation for the ordinary services provided under this Agreement shall be included in and
paid from the overall fees and charges assessed by the Plan's third party administrator. NTC will receive
additional reasonable compensation for any extraordinary services or computations required as agreed
upon by the Sponsor and NTC in advance.
The Funding Vehicle provider ("Provider") may assess trading commissions or other fees in accordance
with the procedures established by the Provider. Such fees will be assessed against participant accounts
and are not the responsibility of NTC.
NRS-SDO Only(05/2009) -5 of 8-
ARTICLE XIV—TAXES
Until advised to the contrary by the Sponsor, NTC shall assume that the Account is exempt from federal,
state, local and foreign income taxes. NTC shall not be responsible for filing any federal, state, local or
foreign tax and informational returns relating to the Plan or Account.
ARTICLE XV—AMENDMENT
Notwithstanding any other provision of the Agreement, NTC may amend the Agreement at any time by
providing written notice to the Sponsor not less than thirty (30) days prior to the effective date of such
change, or at any time in the event NTC determines that such amendment is necessary to comply with
any applicable legal or regulatory requirements.
No person except for an authorized officer has the legal capacity to change this Agreement otherwise, or
to bind NTC to other commitments not covered within this Agreement.
ARTICLE XVI—RESIGNATION REMOVAL AND TERMINATION
NTC may resign at any time after providing at least thirty (30) days notice via Written Instructions to the
Sponsor. The Sponsor may remove NTC by delivery of Written Instructions, to take effect at a date
specified therein, which shall not be less than thirty (30) days after the delivery of such Written
Instructions with Original Signature to NTC, unless Funding Vehicle provisions specify otherwise.
Notwithstanding the foregoing, NTC may retain responsibilities per the terms of this Agreement over
assets remaining at NTC beyond the thirty (30) day timeframe, concurrent with Funding Vehicle
provisions.
The Agreement will be terminated at such time as the Account is terminated, the Funding Vehicle are
redeemed in full, upon the resignation or removal of NTC as trustee, as applicable, of the Account, or
upon the termination by Sponsor of any separate agreement with NTC or Nationwide Retirement.
Solutions, Inc.that relates to the services provided by NTC under this Agreement. The discontinuance of
contributions to the Account shall not, by itself,terminate the Account.
NTC is authorized to reserve such sum of money as it may deem advisable for payment of its fees and
expenses in connection with the settlement of the Account, and any balance of such reserve remaining
after the payment of such fees and expenses shall be paid to the Successor by NTC.
ARTICLE XVII—SUCCESSOR
Upon resignation or removal of NTC, the Sponsor shall appoint a Successor and the Sponsor shall notify
NTC of such appointment by Written Instructions with Signature. NTC shall transfer the assets of the
Account, subject to any applicable fees as described in the Agreement to such Successor.
If either party has given notice of termination and upon the expiration of the advance notice period no
party has accepted an appointment as Successor, NTC will have the right to commence an action in the
nature of an interpleader(or other appropriate action) and seek to deposit the assets of the Account in a
court of competent jurisdiction in Franklin County, Ohio, for administration until a Successor may be
appointed and accepts the transfer of the assets. The Sponsor will be responsible for any costs incurred
as a result of such action and/or transfer, as well as any expenses of NTC which are incurred in carrying
out its duties under this Agreement in such a situation.
ARTICLE XVIII—GOVERNING LAW
The Account will be administered in the State of Ohio, and its validity, construction, and all rights
hereunder shall be governed by the Code, Home Owners' Loan Act of 1933 and, to the extent not pre-
empted, by the laws of Ohio. All contributions to the Account shall be deemed to occur in Ohio.
NRS-SDO Only(05/2009) -6 of 8-
ARTICLE XIX—IDENTITY VERIFICATION NOTICE
To help the government fight the funding of terrorism and money laundering activities, Federal law
requires all financial institutions to obtain, verify, and record information that identifies certain persons or
entities that open an account. When an account is opened, NTC may ask for the name, address and
other information that will allow NTC to identify the entity or person that sponsors the Plan. NTC may also
ask for a copy of identifying documents, such as a driver's license, government-issued business license,
or other documents.
ARTICLE XX—RULES OF CONSTRUCTION
The Agreement, together with all attached schedules and any applicable investment contracts shall
constitute the entire Agreement. The Plan and this Agreement shall be read and construed together. By
signing this Agreement, the Sponsor represents to NTC that the Plan conforms to and is consistent with
the provisions of this Agreement. Should the Plan need to be amended to conform to the provisions of
this Agreement, the Sponsor is responsible for such amendments. The terms of this Agreement shall
prevail over terms of the Plan in cases of conflict.
ARTICLE XXI—WAIVER
Failure of either party to insist upon strict compliance with any of the conditions of the Agreement shall
not be construed as a waiver of any of such conditions, but the same shall remain in full force and effect.
No waiver of any provision of the Agreement shall be deemed, or shall constitute, a waiver of any other
provision,whether or not similar, nor shall any waiver constitute a continuing waiver.
ARTICLE XXII—REFERENCES
Unless the context clearly indicates to the contrary, a reference to a statute, regulation, document, or
provision shall be construed as referring to any subsequently enacted, adopted, or re-designated statute
or regulation or executed counterpart.
ARTICLE XXIII—SEVERABILITY
If any provision of the Agreement shall be held by a court of competent jurisdiction to be invalid, illegal,or
unenforceable,the remaining provisions shall continue to be effective.
NRS-SDO Only(05/2009) -7 of 8-
Schedule of Investments
(`Investment Authorization")
WHEREAS, NTC and the Sponsor have entered into an Agreement in which the assets of the Plan are to
be held, Invested and distributed;and
WHEREAS,the authority to select the Funding Vehicles under the Plan resides with the Sponsor; and
WHEREAS, NTC and Sponsor agree that NTC may act upon Written Instructions from the Sponsor;
NOW THEREFORE,the Sponsor authorizes NTC to establish an account for each Funding Vehicle set
forth below
1. On the Effective Date, the Funding Vehicles in the Plan shall be:
Schwab PCRA Self-Directed Brokerage Option
NRS-SDO Only(05/2008) -8 of 8-
MONROE COUNTY DEFERRED COMPENSATION PLAN/
SELF-DIRECTED OPTION
PLAN PARTICIPANT RELEASE AND COVENANT NOT TO SUE AGREEMENT
This Release and Covenant Not To Sue Agreement ("Agreement") is entered into by and
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA
("County") and , an employee of Monroe County and a participant in the County's
457(b) Deferred Compensation Plan ("PCRA Participant"). This Agreement shall at all times
include EMPLOYER and its current and former Commissioners, Administrators, employees,
assigns and successors in interest, representatives, agents, and insurers, both in their representative
and individual capacities. All references to County expressly include all of the aforementioned
individuals and the County as a duly created political subdivision of the State of Florida.
RECITALS
WHEREAS, as a service to its employees, the County provides an opportunity for its
employees to contribute funds to a deferred compensation plan established under Section 457 of the
Internal Revenue Code of 1986,as amended("Plan"); and
WHEREAS, at the request of one or more employees, the COUNTY has arranged for Plan
participants to be able to manage all or a portion of his or her Plan funds via a sub-account opened
with Charles Schwab & Co., Inc., namely, the Schwab Personal Choice Retirement Account
("PCRA"), a self-directed brokerage option, pursuant to the terms and conditions under one or more
Limited Power of Attorney Agreement("LPOA Agreements")between Charles Schwab& Co., Inc.
and the PCRA Participant; and
WHEREAS, PCRA Participant seeks to enter or has entered into one or more such LPOA
Agreements in order to establish a Schwab PCRA;
NOW, THEREFORE, the County and PCRA Participant agree as follows, in consideration
of mutual promises,the receipt and sufficiency of which as consideration are hereby acknowledged.
AGREEMENT
1. Role of PCRA Participant. The PCRA Participant agrees and acknowledges that:
a. PCRA Participant is solely responsible for determining the nature, potential
value, and suitability of any particular security, transaction, or investment
strategy;
b. PCRA Participant is solely aware for collecting and reading any and
prospectuses and other materials necessary in order to make sound investment
decisions, and is also solely responsible for reading, reviewing and maintaining
any and all documents evidencing individual transactions;
c. Participant is solely responsible for being aware of and taking into consideration
any fees or costs involved with transactions;
d. Participating in the Schwab PCRA involves risks of financial loss of some or all
of the PCRA Participant's Plan funds due to the inherent risks of investing as
well as the direction of investment by the PCRA Participant;
PCRA Participant Self Directed Option Participant Release page I
e. PCRA is of sound mind and capacity for making financial and investment
decisions;
f. PCRA Participants is under no force or duress of any kind to compel PCRA
Participant's participation in the PCRA, any investment decision, or the signing
of this document;
g. PCRA Participant understands completely that he or she has the right to review
all aspects of this Agreement with an attorney of his or her choice; has had the
opportunity to consult with an attorney and has done so or has declined to do so;
fully understands the provisions of this Agreement; and is freely, knowingly and
voluntarily entering into this Agreement.
h. The terms and conditions of any PCRA are governed by the agreements between
the PCRA Participant and Charles Schwab & Co., Inc. and/or Nationwide Trust
Company. The PCRA Participant must abide by any such terms and conditions.
2. Role of the County. The PCRA Participant agrees and acknowledges that:
a. The County will not provide legal, tax or investment advice;
b. The County is not acting as a fiduciary; and
c. The County will not be responsible for paying fees, commissions, or transaction
costs with regard to the PCRA.
3. Release and Covenant Not To Sue. In connection with the PCRA described
herein,PCRA Participant agrees and covenants as follows:
a. PCRA Participant releases and discharges the County from any and all liabilities
in connection with the PCRA;
b. PCRA Participant agrees not to sue the County for any liabilities in connection
with the PCRA;
C. PCRA Participant agrees that this Agreement may be used as a defense to any
such suit or action against the County, and that it constitutes a complete bar to
the commencement or maintenance of any such suit or action;
d. As used in this section, the term "liabilities"means any and all causes of action,
suits, claims, demands or rights, whether for damages or equitable relief,
including injunctive or declaratory, and including but not limited to any claims
for costs or attorneys' fees.
e. As used in this section, the term "sue"means to institute any lawsuit or action at
law or in equity, or to aid in any way the institution or prosecution of a lawsuit or
action.
4. General.
a. This Agreement may only be amended in a writing signed by the undersigned
parties. It binds and benefits the heirs and estates of the individual parties, and
may not be assigned without consent of the County.
b. This Agreement is governed by Florida law. It is not subject to arbitration.
PCRA Participant Self Directed Option Participant Release page 2
c. The terms of this Agreement are severable. The rights and responsibilities laid
out in the Agreement are not waived by exercising some but not all of the rights
and responsibilities.
d. This Agreement constitutes the entire agreement between the parties. It
supersedes any and all oral statements or prior written representations or
agreements. It is effective only upon complete execution. It shall be strictly
construed against both parties equally, without regard to which party drafted the
Agreement.
PLEASE READ THIS AGREEMENT CAREFULLY BEFORE SIGNING IT. THIS
AGREEMENT HAS IWORTANT LEGAL CONSEQUENCES.
PCRA Participant, an individual Monroe County Board of County
Commissioners
Signature: Signature:
Printed name: Printed name:
Date: Title:
Date:
PCRA Participant Self Directed Option Participant Release page 3
F
Capt. Thomas W. Brown
County Administrator
RESOLUTION NO. 335-1987
A RESOLUTION OF THE BOARD OF COUNTY COMMIS-
SIONERS OF MONROE COUNTY, FLORIDA, ACCEPTING
THE NATIONAL ASSOCIATION OF COUNTIES DEFERRED
COMPENSATION PROGRAM; ADOPTING AND
ESTABLISHING THE MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS DEFERRED COMPENSATION
PROGRAM FOR PUBLIC EMPLOYEES; AND AUTHORIZING
THE MAYOR/CHAIRMAN OF THE BOARD TO EXECUTE
(1) THE PLAN DOCUMENT, (2) THE MEMBER COUNTY
ADMINISTRATIVE AGREEMENT, (3) THE MASTER
ANNUITY APPLICATION FOR GROUP FLEXIBLE FUND
RETIREMENT CONTRACT AND (4) THE APPLICATION
FOR AND ACCEPTANCE OF GROUP FIXED FUND
RETIREMENT CONTRACT PERTAINING TO SAID
DEFERRED COMPENSATION PROGRAM FOR PUBLIC
EMPLOYEES.
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, as follows:
1. That said Board hereby accepts the National Association
of Counties Deferred Compensation Program.
2. That said Board hereby adopts and establishes the Monroe
County Board of County Commissioners Deferred Compensation
Program for Public Employees; and
3. That said Boad authorizes the Mayor/Chairman of the
Board to execute (1) the Plan Document, (2) the Member County
Administrative Agreement, (3) the Master Annuity Application for
Group Flexible Fund Retirement Contract and (4) the Application
for and Acceptance of Group Fixed Fund Retirement Contract, a
copy of same being attached hereto, pertaining to said Deferred
Compensation Program for Public Employees.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a regular meeting of said Board held
on the 1st day of September, A.D. 1987.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY:
(SEAL)
Attest: DANNY I& KOLHAGE, Clerk
AP ROVED ALFF1C,4C
O FORM
D GAL S
B
Arrorney's O/firs
STATE OF FLORIDA
COUNTY OF MONROE
This Copy is a True Copy of the
Ori,ainal on File in this Office. Witness
my hand and Official Seal.
This k3 - day of
A.D., 20 06.
D NNY L. KOI.HAGE
Clertrcui`
D.C.
. x 't 23 v�
�PYM♦ .~
,... ...
NATIONAL ASSOCIATION OF COUNTIES
r � DEFERRED COMPENSATION PROGRAM
THE DEFERRED COMPENSATION PLAN FOR PUBLIC EMPLOYEES
PLAN DOCUMENT
The _A0&dQa G UAP T J041— 0.9 CAwu t GoMA'i��y J� p N:r �L 4
hereby accepts the National Association of Counties Deferred Compensation Program and adopts and
establishes the d3amao.Ar ea&yV!y go.dda a ;= "ilAITV Comm tc GNL" of r_7".
Deferred Compensation Plan for Public Employees,(hereinafter called the Plan).The Plan consists of the
provisions set forth in this document,and Is applicable to each public employee who elects to participate
In the Plan.The Plan is effective as to each such public employee upon the date he becomes a"PARTICI-
PANT" by signing and filing the Participation Agreement referred to herein with the Administrator.
ARTICLE I
Definitions
1.01. A definition of words and terms used in this plan is attached, entitled Exhibit "A", and by this
reference is made a part of the Plan.
ARTICLE II
Election to Defer Compensation
IN
2.01. Compensation will be deferred for any calendar month only if an agreement providing for such defer-
ral is entered into before the beginning of such month.
2.02. Upon signing the Participation Agreement, the PARTICIPANT elects to participate In this Plan and
consents to the EMPLOYER deferring the amount specified in the Participation Agreement from the PAR-
TICIPANT's gross compensation for each pay period.The dollar amount deferred("deferred amount")must
equal at least $20 per month.
2.03. The PARTICIPANT may revoke his election to participate and may amend the amount of compensa-
tion to be deferred or his investment specification by signing and filing with the Administrator a written
revocation or amendment on a form and in the procedural manner approved by the Administrator.Any such
revocation or amendment of the amount of compensation to be deferred shall be effective prospectively
only.Any amendment of the PARTICIPANT'S investment specification shall be effective prospectively on-
ly.Any change in the PARTICIPANT'S investment specification shall be effective on a date consistent with
the rules and specifications of the investment carrier.Changes in Investment specifications may be made
for both prior and future amounts deferred.
2.04. The original election to participate shall be effective for pay periods commencing during the first
month after the date on which the Participation Agreement is filed with the Administrator.
Notice to ALL PARTICIPANTS to Read These Provisions Providing Deferral Limitations and "Catch-up"
Deferrals Under the Plan
2.05. Except as provided in Section 2.06, the maximum amount that may be deferred under the Plan for
the PARTICIPANT's taxable year shall not exceed the lesser of (a) $7,500 or(b) 331h% of the PARTICI-
PANT'S includible compensation as provided in IRC § 457.
2.06. For one or more of the PARTICIPANT'S last 3 taxable years ending before he attains normal retire-
ment age under the Plan,the maximum deferral shall be the lesser of: (a)$15,000, reduced by any amount
APO-502 (5/86)
t
r
excludable under the F IPANT'S gross income for the taxable year under IR 3(b) on account
of contributions made by the EMPLOYER; or(b) the sum of(I) the limitation established for purposes of
Section 2.05 of the Plan for the taxable year(determined without regard to this section), plus(ii)the limita-
tion established for purposes of Section 2.05 for prior taxable years, beginning after December 31, 1978,
during which the PARTICIPANT was eligible to participate,less the amount of compensation deferred under
the Plan for such prior taxable years, as provided in IRC § 457.
2.07. in applying Section 2.05, an amount excluded on behalf of the PARTICIPANT during a taxable year
under IRC §403(b), including a custodial account described in §403(b) (7), shall be treated as an amount
deferred.
ARTICLE III
Accounts and Reports
3.01. THE EMPLOYER shall remit the deferred amounts to the Administrator or his designated agent.
The Administrator shall have no duty to determine whether the funds paid to him by the EMPLOYER are
correct, nor to collect or enforce such payment.
3.02. For convenience and to facilitate an orderly administration of the Plan,the Administrator shall main-
tain a deferred account with respect to each PARTICIPANT. All assets of the Plan, including all deferred
amounts, property and rights purchased with deferred amounts, and all income attributable to such de•
ferred amounts, property or rights, shall be the exclusive property of the EMPLOYER and shall be subject
to all the claims of creditors of the EMPLOYER, without protection or preference.
3.03. Upon receipt of deferred amounts by the underwriter of the designated Investment option made
pursuant to this Plan, the PARTICIPANT'S deferred account shall be credited with the amount received.
A written report of the status of the PARTICIPANT'S deferred account shall be furnished at least annually
and within ninety (90) days after the end of each calendar year.
3.04. Within ninety(90)days after the end of the calendar year, the Administrator shall file with the EM-
PLOYER a written report of the assets of the Plan, a schedule of all receipts and disbursements, and a
report of all material transactions of the Plan during thq preceding year.
3.05. The Administrator's records shall be open to inspection during normal business hours by the
EMPLOYER or any PARTICIPANT, or their designated representatives.
3.06. The rights of the PARTICIPANT created by this Plan shall be those of a general creditor of the
EMPLOYER, and in an amount equal to fair market value of the deferred account maintained with respect
to the PARTICIPANT.The PARTICIPANT acknowledges that his rights are no greater than those of a general
creditor of the EMPLOYER and that in any suit for an accounting, to impose a constructive trust, or to
recover any sum under this Plan, the PARTICIPANT'S rights are limited to those of a general creditor of
the EMPLOYER. The EMPLOYER acknowledges that the Administrator is the agent of the EMPLOYER.
ARTICLE IV
Investment of Deferred Amount
4.01. The deferred amount shall be delivered by the EMPLOYER to the Administrator or his designated
agent for investment as designated by the EMPLOYER.
4.02. The EMPLOYER may use the PARTICIPANT'S investment specifications so as to determine the value
of the deferred account maintained with respect to the PARTICIPANT as if the deferred amounts had been
invested according to such specifications.The EMPLOYER shall be under no obligation to invest the de-
ferred amount in such investment specification. All contracts and other evidences of the investments of
all assets under this Plan shall be registered in the name of the EMPLOYER which shall be the owner thereof.
4.03. Ail interest, dividends, charges for premiums and administrative expenses, and changes in value
due to market fluctuations applicable to each PARTICIPANT'S deferred account shall be credited or debited
to the account as they occur. All reports to the PARTICIPANT shall be based on fair market value as of
the reporting date.
2
alkTICLE V
Benefits
r 5.01. Benefits shall be paid in accordance with this Article. Benefits payable to the PARTICIPANT will
be the equivalent of the total benefits that would have been created had the deferred amounts been in-
vested as specified by the PARTICIPANT from time to time. Notwithstanding subsections(a)through (h)
below, the payment of amounts deferred will commence not later than the later of:
(1) 60 days after the close of the Plan Year in which the PARTICIPANT or former PARTICIPANT attains
(or would have attained) normal retirement age; or
(ii) 60 days after the close of the Plan Year in which the PARTICIPANT separates from service with
the state.
(a) Normal Retirement. Upon the PARTICIPANT, other than an INDEPENDENT CONTRACTOR, attain-
ing normal retirement age,he may retire and receive the benefits provided under this Plan.Such benefits
shall be paid in accordance with the payment option selected by the PARTICIPANT.
(b) Early Retirement. The PARTICIPANT,other than an INDEPENDENT CONTRACTOR, may select early
retirement in accordance with the Employer's Retirement System and receive the benefits provided
under this Plan. Such benefits shall be paid in accordance with the payment option selected by the
PARTICIPANT.
(c) Late Retirement. If the PARTICIPANT, other than an INDEPENDENT CONTRACTOR, continues his
employment with the EMPLOYER after attaining normal retirement age,all benefits payable under this
Plan will be deferred(whether or not the PARTICIPANT continues to defer additional sums under this
Plan) until the PARTICIPANT retires.At such time, such benefits shall be paid In accordance with the
payment option selected by the PARTICIPANT. No deferral or additional credits under this Plan may
be made by the PARTICIPANT after the month in which he attains age seventy (70).
(d) Separation from Service. If the PARTICIPANT separates from service with the Employer,benefits shall
be paid In accordance with the payment options elected by the PARTICIPANT.An INDEPENDENT CON-
TRACTOR shall not be considered separated from service with the Employer and shall not receive any
w` benefits hereunder unless (1) at least 12 months have expired since the date on which the last con-
tract, pursuant to which the INDEPENDENT CONTRACTOR provided any services to the Employer,
was terminated,and(11)the INDEPENDENT CONTRACTOR has performed no services for the Employer
during the 12-month period referred to herein either as an INDEPENDENT CONTRACTOR or employee.
(e) Death. If the PARTICIPANT dies while employed with the Employer,or the PARTICIPANT dies before
the benefits to which he is entitled under this Plan have been exhausted, the benefits payable under
this Plan shall be paid to his designated Beneficiary.
(f) Designated Beneficiary. The PARTICIPANT shall have the right to file with the Administrator, a writ-
ten Beneficiary or change of Beneficiary form designating the person or persons who shall receive
the benefits payable under this Plan in the event of the PARTICIPANT'S death. The form for this pur-
pose shall be provided by the Administrator and will have no effect until it is signed, filed with the
Administrator by the PARTICIPANT, and accepted by the Administrator. If the PARTICIPANT dies
without having a Beneficiary form on file, the estate of the PARTICIPANT will be the presumed
Beneficiary. The PARTICIPANT accepts and acknowledges that he has the burden for executing and
filing with the Administrator a proper Beneficiary designation form.The Beneficiary shall have the right
to elect the time and mode of payment of such benefits,subject to the limitations set forth in subsec-
tion(h)hereof.Such election as to the time of payment shall be filed by the Beneficiary not later than
thirty (30) days following the end of the Plan Year during which the PARTICIPANT died and shall be
irrevocable. The Beneficiary may elect a distribution commencement date which Is not earlier than
60 days following the PARTICIPANT'S death and not later than 60 days following the end of the Plan
year during which the PARTICIPANT would have attained Normal Retirement Age(or the Plan year in
which the PARTICIPANT died, if later).An election concerning the mode of payment shall be filed by
the Beneficiary at least thirty (30) days prior to the date elected for the commencement of benefits.
Failure to file an election as to the time or manner of payment will result in the Administrator making
a lump sum cash distribution to the Beneficiary within sixty(60) days following the close of the Plan
Year in which the PARTICIPANT died.
(g) Benefit elections. The PARTICIPANT shall,within thirty(30)days following the occurrence of an event
described in subsections(a)to(d), choose the time at which distributions under the Plan are to com-
a
. , 1
mence by designating the month and year during which the first payment is to ua o, ode.The PARTICI-
PANT may elect a date not earlier than 60 days following the occurrence of the event described in
subsections(a)to(d)and not later than 60 days following the end of the Plan year In which he attains
Normal Retirement Age(or separates from service,if later). Such election shall be Irrevocable. Failure
to file an election with the Administrator within the appropriate time period will result in the Ad-
ministrator beginning distributions sixty(60)days after the end of the Plan Year in which the PARTICI-
PANT attains Normal Retirement Age or separates from service, whichever is later.
Not later than thirty (30) days prior to the date selected for commencement of benefits pursuant to
the preceding paragraph, the PARTICIPANT shall elect the mode of payment based upon the options
then available. Such election shall be irrevocable after the thirtieth day preceding the date of com-
mencement of benefits. Failure to file an election with the Administrator will result in the Administrator
electing an annuity payout for the PARTICIPANT providing for equal payments to the PARTICIPANT
on a monthly basis for the remainder of the PARTICIPANT's life.
(h) Payment and Settlement Options. Payment,method of payment,and settlement options are available
as provided by each of the investment index options, provided, however, that benefits payable to a
Beneficiary in the event of the death of a PARTICIPANT prior to the complete distribution of benefits
to him shall, In all events, be completed during a period not in excess of(i)the life of the Beneficiary,
if such Beneficiary is the surviving spouse of the PARTICIPANT, or (il) 15 years, in all other cir-
cumstances. In addition, no settlement option available to the PARTICIPANT shall provide benefits
to Beneficiaries which are equal to or greater than one-half of the maximum benefit that would have
been payable to the Participant if no provision had been made for payment to a Beneficiary(as deter-
mined by the use of the expected return multiples In Treasury Regulation Section 1.72-9, or, in the
case of payments under a contract issued by an insurance company,by the use of the mortality tables
of such company).
5.02. Notwithstanding any other provisions herein, in the event of an Unforeseeable Emergency, a PAR-
TICIPANT may request the Administrator to pay benefits to him prior to retirement, disability or separa-
tion from service.If the application for payment Is approved by the Administrator,payments shall be effected
within 45 days of such approval. Benefits to be paid shall be limited strictly to the amount necessary to
meet the Unforeseeable Emergency constituting financial hardship to the extent such Unforeseeable
Emergency is not relieved:
(a) through reimbursement or compensation by insurance or otherwise;
(b) by liquidation of the PARTICIPANT'S assets, to the extent the liquidation of such assets would not
itself cause financial hardship; or
(c) by cessation of deferrals under the Plan.
Any remaining benefits shall be paid in accordance with Section 5.01 of this Plan. Foreseeable personal
expenditures normally budgetable, such as a down payment on a home, the purchase of an automobile,
college or other education expenses,etc., will not constitute an Unforeseeable Emergency. The decision
of the Administrator concerning the payment of benefits under this section shall be final.
ARTICLE VI
Administration of Plan
6.01. The EMPLOYER may at anytime amend,modify,or terminate this Plan with or without the consent
of the PARTICIPANT(or any Beneficiary thereof) provided:
(a) That all amendments shall become effective on the first day of the month following the giving of not
less than forty-five (45) days prior notice of the amendment. Notice shall be deemed given when the
amendment is posted in the office of the Administrator and the EMPLOYER. To the extent it is possi.
ble to do so, the Administrator shall mail a copy of all amendments that become effective during the
year to the PARTICIPANT with his annual report. No amendments shall deprive the PARTICIPANT of
any of the benefits to which he is entitled under this Plan with respect to deferred amounts credited
to his account prior to the effective date of the amendment; and
(b) If the Plan is curtailed, terminated, or the acceptance of additional deferred amounts suspended per.
manently, the Administrator shall nonetheless be responsible for the supervision of the payment of
benefits resulting from amounts deferred prior to the amendment, modification, or termination in ac-
cordance with Article V hereof.
4
i
6.02. Any companies th issue any policies,contracts, or other Investment mi ed by the EM-
PLOYER or specified by the PARTICIPANT, are not parties to this Plan and such comNdsaes shall have
no responsibility or accountability to the PARTICIPANT or his Beneficiary with regard to the operation
of this Plan.
6.03. Participation in this Plan by a public employee shall not be construed to give a contract of employ-
ment to the PARTICIPANT or to alter or amend an existing employment contract of the PARTICIPANT,
nor shall participation in this Plan be construed as affording to the PARTICIPANT any representation or
guarantee regarding his continued employment.
6.04. The EMPLOYER and the Administrator do not represent or guarantee that any particular Federal
or State income, payroll, personal property, or other tax consequence will occur because of the PARTICI-
PANT'S participation in this Plan. The PARTICIPANT should consult with his own representative regard-
ing all questions of Federal or State income, payroll,personal property,or other tax consequences arising
from participation in this Plan.
6.05. The Administrator shall have the power to appoint agents to act for and in the administration of
this Plan and to select depositories for the assets of this Plan.
6.06. Whenever used herein, the masculine gender shall include the feminine and the singular and shall
include the plural unless the provisions of the contract specifically require a different construction.
6.07. The law of the State of the Employer shall apply in determining the construction and validity of
this Plan.
6.08. The rights of the PARTICIPANT under this Plan shall not be subject to the rights of creditors of
the PARTICIPANT or any Beneficiary,and shall be exempt from execution, attachment, prior assignment,
or any other judicial relief or order for the benefit of creditors or other third persons.
Ut 6.09. It is agreed that neither the PARTICIPANT nor his Beneficiary nor any other designee shall have
any right to commute, sell,assign,transfer,or otherwise convey the right to receive any payments hereunder
which payments and right thereto are expressly declared to be nonassignable and nontransferable.
6.10. This Plan, and any properly adopted amendment, shall constitute the total agreement or contract
between the EMPLOYER and the PARTICIPANT regarding the Plan. No oral statement regarding the Plan
may be relied upon by the PARTICIPANT.
6.11. This Plan and any properly adopted amendment, shall be binding on the parties hereto and their
respective heirs,administrators, trustees,successors,and assignees and on all Beneficiaries of the PAR-
TICIPANT.
ARTICLE VII
Notice to ALL PARTICIPANTS to Read These Provisions Providing Broad Powers and Absolute Safeguards
to the Employer
7.01. The EMPLOYER,or its authorized agent,the Administrator,shall be authorized to resolve any ques-
tions of fact necessary to decide the PARTICIPANT'S right under this Plan and such decision shall be
binding on the PARTICIPANT and any beneficiary thereof.
7.02. The EMPLOYER,or its authorized agent, the Administrator,shall be authorized to construe the Plan
and to resolve any ambiguity in the Plan.
7.03. The PARTICIPANT specifically agrees not to seek recovery against the EMPLOYER,the Administrator
or any other employee, contractee, or agent of the EMPLOYER or Administrator, or any Endorser for any
loss sustained by the PARTICIPANT or his beneficiary,for the non-performance of their duties,negligence,
or any other misconduct of the above named persons except that this paragraph shall not excuse fraud
or wrongful taking by any person.
5
7.04. The EMPLOYER, agents Including the Administrator, if in doubt conce he correctness
of their action In making a payment of a benefit, may suspend the payment until satisfied as to the cor-
rectness of the payment or the person to receive the payment or allow the filing in any state court of com-
patent jurisdiction,a suit in such form as they consider appropriate for a legal determination of the benefits
to be paid and the persons to receive them.The EMPLOYER shall comply with the final orders of the court
in any such suit and the PARTICIPANT, for himself and his Beneficiary, consents to be bound thereby
insofar as it affects the benefits payable under this Plan or the method or manner of payment.
7.05. The EMPLOYER and Its agents,including the Administrator,are hereby held harmless from all court
costs and all claims for the attorneys' fees arising from any action brought by the PARTICIPANT or any
beneficiary thereof under this Plan or to enforce his rights under this Plan, including any amendments
hereof.
7.06. The Administrator shall not be required to participate in any litigation concerning the Plan except
upon written demand from the EMPLOYER. The Administrator may compromise, adjust or effect settle-
ment of litigation when specifically Instructed to do so by the EMPLOYER.
IN WITNESS WHEREOF, the undersigned has executed this Plan this
day of , 19
By
kg
:. ,FD A.S ro FORD
•+: SUFFIVIZ.'CY.
•
►pan^%s Office
EXHIBIT "A"
DEFINITIONS
The following terms shall, for purposes of this Plan and all Exhibits thereto, have the meaning set forth
herein.
1. ADMINISTRATOR means,the person,department,agency,or organization appointed by the Employer
to administer the Plan.
2. BENEFICIARY means, the person properly designated by a Participant to receive the Participant's
benefit.
3. COMPENSATION means, all payments made by the Employer as remuneration for services rendered,
including salaries, fees, etc.
4. EMPLOYER means, the or any of its agencies, departments,
subdivisions or Instrumentalities, for whom services are performed by a Participant.
S. INCLUDIBLE COMPENSATION means, for the purposes of the limitations on deferral, compensation
for services performed for the Employer which(taking Into account amounts deferred under IRC Sec-
tions 457 and 403(b))Is currently includible in gross income.The amount of Includible compensation
shall be determined without regard to any community property laws.
6. INDEPENDENT CONTRACTOR means,any person receiving any type of compensation from the Em-
ployer or any of its agencies, departments, subdivisions or instrumentalities for whom services are
rendered pursuant to one or more written or oral contracts, if such person is not an employee.
7. IRC means, the Internal Revenue Code of 1954, as amended.
8. NORMAL RETIREMENT AGE means, the age at which the Employee is eligible to retire pursuant to
the Employer's Retirement System, by virtue of age, length of service or both, without consent of the
Employer and with the right to receive immediate retirement benefits without actuarial or similar reduc-
tion because of retirement before some later specified age,but in no event later than age 701/2. In the
absence of a formal Employer's Retirement System, normal retirement age shall mean 65.
9. PARTICIPANT means, any individual who is eligible to defer compensation under the Plan and who
participates under this Plan by signing the Participation Agreement.
10. PARTICIPATION AGREEMENT means, the Application to the Administrator to participate in the Plan
which is also entitled "Consent to Compensation Change."
11. PLAN means, the Deferred Compensation Plan for Public Employees as set forth in this document
and as it may be amended from time to time.
12. PLAN YEAR means,the calendar year in which the Plan becomes effective,and each succeeding calen-
dar year during the existence of this Plan.
13. SEPARATION FROM SERVICE means,separation from service within the meaning of IRC§402(e)(4)(A)(iii)
and on account of the Participant's death or retirement.
14. UNFORESEEABLE EMERGENCY means, severe financial hardship to the Participant resulting from
a sudden and unexpected Illness or accident of the Participant or a dependent (as defined in IRC §
152(a))of the Participant,loss of the Participant's property due to casualty,or other similar or extraor-
dinary and unforeseeable circumstances arising as a result of events beyond the control of the Partici-
pant.
' AATIONAL ASSOCIATION OF COUNTIES
DEFERRED COMPENSATION PROGRAM
MEMBER COUNTY ADMINISTRATIVE AGREEMENT
N
This Agreement is executed this day of 19 , by and between the
National Association of Counties (NACo), Washington, D.C., and the County of
(Member County), and Public Employees Benefit Services Corporation (PEBSCO).
WHEREAS,NACo sponsors a prototype deferred compensation program(Program)pursuant to section 457 of the
Internal Revenue Code,as amended,for the benefit of NACo's member counties or other entities approved by NACo's
President; and
WHEREAS,the Member County recognizes that such tax deferred savings'benefits as may be derived from adop-
tion of a Plan under the Program will act as incentives for employees to voluntarily set aside and Invest portions
of their current Income to meet their future financial requirements and supplement their retirement income; and
WHEREAS, the Member County recognizes that through the adoption of a Plan under the Program, all such regu-
latory, operational, administrative, and other Plan management responsibilities are assumed by NACo on behalf of
the Member County, In accordance with the Program document, and said responsibilities may be delegated, in the
sole discretion of NACo, to the Program Administrator; and
WHEREAS,the Member County recognizes the important contribution of NACo's technical expertise in the design.
implementation, and administration of a national Program established and administered In compliance with all ap-
plicable regulatory authorities; and
WHEREAS,the Member County recognizes the advantages and economies of scale secured by the mass purchas-
ing leverage of NACo and its member counties through a comprehensive national bid selection analysis; and
WHEREAS, the Member County recognizes the benefits of NACo's making arrangements on behalf of member
counties for a functional administrative system to administer the Program; and
WHEREAS, the Member County has enacted the necessary resolution/court order to adopt the NACo Program
Agreement and to establish its Plan for its employees.
NOW,THEREFORE, in consideration of the premises set forth hereinabove,and the promises contained hereinafter,
the parties agree as follows.
1. THE PROGRAM:
A. NACo offers a prototype section 457 Program developed in cooperation with a third party administrator,which
permits the Member County and its employees to enjoy the advantages derived from section 457 of the Inter-
nal Revenue Code.
B. The Program Is intended to assist the Member County in providing an increased measure of financial securi-
ty to its employees by providing for additional retirement income through the deferral of before-tax dollars
and the reduction of current income tax liability.
C. Plans adopted pursuant to the Program will be provided at no cost to the Member County other than inciden-
tal expense related to payroll deductions.
II. REGULATORY CONSIDERATIONS:
The third party administrator has represented and warranted to NACo that the Program and the Plans adopted
thereunder meet all necessary criteria for approval by all federal and state regulatory authorities governing such
programs.
III. COMPETITIVE BID PROCESS:
The Program makes available to the Member County a third party administrator and investment media which,
as a result of a careful evaluation of administrative abilities and experience,and the combination of costs,benefits,
and services, provide a quality Deferred Compensation Program. A national bid selection process for these ad-
ministrative and investment services was performed by NACo.
IV. PROGRAM ADMINISTRATOR:
NACo has agreed to sponsor the Program in its present form, and has selected and exclusively contracted
with an independent third party administrator, PEBSCO,qualified to fulfill the responsibility for all administrative
requirements necessary for the successful operation of the Program.
The Member County hereby accepts PEBSCO to act as Program Administrator in fulfilling the administrative
and marketing requirements of its Plan and the Program.
APO-286
V. �ESPONSIBILITIES OF .... .
NACo agrees to
• monitor the administrative,operational,and financial performance of the Program Administrator and selected.
investment media and take such actions as are reasonably necessary to assure the Member County and its
employees the best possible combination of costs, benefits, and services; and
• monitor annually the accounting and audit systems of the Program Administrator and the selected invest-
ment media as is necessary to ensure the fiscal integrity of the Program.
VI. RESPONSIBILITIES OF THE MEMBER COUNTY:
The Member County agrees to
• provide NACo and the Program Administrator its full cooperation and support in administering the necessary
salary deferral system for employee contributions;
• disseminate from time to time such promotional materials as provided to It for employee distribution;
• arrange for representatives of the Program Administrator to conduct enrollment meetings with the Member
County's employees;
• name a county official or committee to act as an administrator on behalf of the Member County on all materi-
al matters relating to activities of the Plan;
• accept the terms and conditions of the Investment media contracts issued to the Member County pursuant
to the Plan adopted by the Member County; and
• use only the NACo Plan Document, promotional materials, and other forms provided to it as a participant
of the Program in connection with its Plan or otherwise approved by NACo or PEBSCO.
VI1. TERMINATION BY MEMBER COUNTY;
A. If NACo or PEBSCO unsatisfactorily performs the responsibilities and services pursuant to this Agreement,
the Member County shall give written notice to both NACo and PEBSCO, specifically stating the nature of
NACo s or PEBSCO s failure to perform. If the specified default is not corrected within 60 days following
the written notice of default by the Member County, the Member County may terminate this Agreement.
B. This Agreement is effective until written notice of termination is provided by either party.
r
NATIONAL ASSOCIATION OF COUNTIES (NACo)
President
Executive Director
MEMBER COUNTY
Title:
PUBLIC EMPLOYEES BENEFIT SERVICES CORPORATION
President
:1r 177C
i -
MASTER ANNUITY APPLICATION FOR
GROUP FLEXIBLE FUND RETIREMENT CONTRACT
TO
NATIONWIDE LIFE INSURANCE COMPANY
COLUMBUS, OHIO 43215
PLEASE TYPE OR PRINT ALL INFORMATION
APPLICATION IS HEREBY MADE FOR A GROUP FLEXIBLE FUND RETIREMENT CONTRACT /t)�F Ayo y
1. Applicant (give exact legal name) MazyR0-xr Cyov ry jO/g,eo Q iC ca TY G'0�1/Fll�f,S�DiL1��CS
tY1� Last mijl� First
t OF �.4. Middle
Address: .53;w / �� ./�li l�jl6.ri do4e
Street C State Zip
2. Mail notices to: Name: BRoey_ TD h'I
�AGl+e' Last �i first Middle
Address: 4 S�/ am l ¢ .410V�-I�.+.
Street Cit -- State Zip
3. The effective date of the contract shall be; 9 I 87
Month Day Year
OPTIONAL CONTRACT PROVISIONS
4. 5% Alternate Assumed Investment Rate: [ ) Yes No
6
5. Fund(s) Of Separate Account
NATIONWIDE FUND NATIONWIDE BOND FUND
NATIONWIDE GROWTH FUND NATIONWIDE MONEY MARKET FUND
SELIGMAN GROWTH FUND PUTNAM INVESTORS FUND, INC.
MASSACHUSETTS INVESTORS GROWTH STOCK FUND MASSACHUSETTS CAPITAL DEVELOPMENT FUND
MASSACHUSETTS FINANCIAL HIGH INCOME TRUST , TWENTIETH CENTURY GROWTH INVESTORS
DREYFUS THIRD CENTURY FUND, INC. THE BOND FUND OF AMERICA, INC.
EVERGREEN TOTAL RETURN FUND
6. Special Request:
It is understood that ownership and control of the contract applied for under this Master Application will be vested in
Y10V90a Cour9t'4_ 43oge.0 OR COuNTf (ry►)JA c. A . The applicant hereby certifies that before the application was
signed he had received a current prospectus of the Group Flexible Fund Retirement Contract that described all sales chargub
and other information relative to the contract(s) being applied for.
[ ) Please send me a copy of the Statement of Additional Information to the prospectus.
(Signature)
1 UNDERSTAND THAT RETIREMENT INCOME PAYMENTS (AND TERMINATION VALUES, IF ANY) PROVIDED BY THE CONTRACTS) ARE VARIABLE WHEN
BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT AND ARE NOT GUARANTEED AS TO DOLLAR ANOUNT.
The Flexible Fund Retirement Contract applied for shalt become effective upon its Contract Date if the purchase payment and
the application are each acceptable to Nationwide Life. In the event the purchase payment or the application is not
acceptable, Nationwide Life's liability shall be Limited to a return of the sum of money paid.
Signed at: City this day of 19
Witness Signature of Applicant
Licensed Agent Supervisor of Fi
If!
^ .11 TQ r-0R
nl'ci lira,I5 H7)
r�
NATIONWIDE LIFE INSURANCE COMPANY
(The RmW)
APPLICATICH FOR AND ACCEPTANCE OF
GROUP FIM FUND RE IREMW CONTRACT
Application is hereby made to the Company by 1 7cI 0J6-
D OP COU4 711 C,0 In 14/ss,1 0-V 4-.,eS aF FL 4-
(The Applicant)
for the attached Group Fixed Fund Retirement Contract No. 'The Applicant
approves and accepts the terms of the Contract.
The Applicant agrees to perform the duties of the Owner under the Contract.
It is further agreed that as of the later of: (1) the date this Application
for and Acceptance of Group Fixed Fund Retirement Contract is signed; or
(2) the date as of which the Contract is executed by the Company; this
Application for and Acceptance of Group Fixed Fled Retirement Contract
shall supersede any preliminary application previously executed.
(Applicant)
Dated: _ By:
Title:
TZM 2182