Item C16BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: January 16, 2008
Bulk Item: Yes X No
Division:Emegency Services
Department: Fire Rescue
Staff Contact Person/Phone #: Claudia Wilkerson
305-289-6014
AGENDA ITEM WORDING: Approval by the Board, acting as Plan Administrator of the Length of
Service Award Plan (LOSAP) to begin 10 year disbursement of funds to three eligible participants of
the plan, Sharon Prime with a monthly benefit of $210.00 commencing June 1, 2006, Kay Cullen with
a monthly benefit of $150.00 commencing February 1, 2007, and Linda Lee Sawart with a monthly
benefit of $165.00 commencing February 1, 2008.
ITEM BACKGROUND: In June of 1999, the Board approved an Ordinance providing for the
creation of a Length of Service Award Plan. Three participants are now eligible for benefits, one as of
June 1, 2006, one as of February 1, 2007, and one as of February 1, 2008.
PREVIOUS RELEVANT BOCC ACTION: On June 9, 1999, the Board approved Ordinance No.
026-1999 providing for the creation of a Length of Service Award Plan. Subsequently, annually the
Board has approved the current actuarial valuation and credit of an additional year of service. ,
CONTRACT/AGREEMENT CHANGES: Not applicable.
STAFF RECOMMENDATIONS: Approval.
TOTAL COST F/Y 2008: $10,200.00
COST TO COUNTY: $10,200.00
REVENUE PRODUCING: Yes No
APPROVED BY: County Atty N/A
DOCUMENTATION: Included
DISPOSITION:
Revised 8/06
BUDGETED: Yes X No
SOURCE OF FUNDS: LOSAP Trust Fund
Account #14500 530360
X AMOUNT P MONTH Year
OMB/Purchasing Risk Management N/A
Not Required X
AGENDA ITEM #
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Dec 28 2007 11:19RM Fire Rescue 305-289-6336 p.2
Monroe County, Florida 'volunteer Firefighter and
Emergency Medical Services
Length of Service Award Program
Benefit Certification Form
Bate: November 21, 2007
To: Ms. Kay Cullen
From: Monroe County Board of County Commissioners
Fire Rescue Services,
A review of records maintained for the Length of Service Award Program (LOSAP) indicates
that you may be eligible for the following level of certification:
❑ You have completed 10 years of active service. You will be eligible for payment of
benefits upon reaching the age of 60.
You have completed 10 years of active service AND have reached the minimum age of
60. You are eligible for immediate payment of benefits.
In order to complete our certification of your eligibility for benefits, we require that the
following information be provided:
NAME: Kay Cullen
ADDRESS: 614 LaPaloma Rd.
CITY: Key Largo ST: FL ZIP: 33037
SOCIAL SECURITY NUMBER•oft
DATE OF BIRTH: 01/29/1947
(Note. In order to verify date of birth, a copy of your driver license or certificate of
birth must be included math this application.)
Name of Volunteer Department from which this application is submitted:
Key Largo Volunteer Ambulance Corps.
I hereby certify that the information above is true and accurate to the best of our belief and
knowledge. I
Signature of Applicant:
Signature of Department President or Chief:
Dec 28 2007 11:19RM Fire Rescue 305-289-6336 p.1
Monroe County, Florida Volunteer Firefighter and
Emergency Medical Services
Length of Service Award Program
Benefit Certification Form
Date: November 21, 2007
To: Linda Lee Sawart
From: Monroe County Board of County Commissioners
Fire Rescue Services,
A review of records maintained for the Length of Service Award Program (LOSAP) indicates
that you may be eligible for the following level of certification:
❑ You have completed 10 years of active service. You will be eligible for payment of
benefits upon reaching the age of 60.
® You have completed 10 years of active service AND have reached the minimum age of
60. You are eligible for immediate payment of benefits.
In order to complete our certification of your eligibility for benefits, we require that the
following information be provided:
1►/_���I Il�'�T1:7flM— T-71 W
ADDRESS: 778 Canal Street
CITY: Key Largo ST: FL ZIP: 33037
SOCIAL SECURITY NUMBER:
DATE OF BIRTH: 01/07/1948
_. _ :. _ .:- .. (Nate. In order to ..� - _ .. _. _. _._ _. _ _ ._._ . __
(N verify date of birth, a copy of y"r driver license or certificate of
birth must be included with this application.)
Name of Volunteer Department from which this application is submitted:
Key LLxZo Volunteer Ambulance Corps.
I hereby certify that the information above is true and accurate to the best of our belief and
knowledge.
Signature of Applicant:
Signature of Department President or Chief 7-A.0e!, r+-�-�- �f,�r
Dec 28 2007 11:17RM Fire Rescue 305-289-6336 p.2
Monroe County, Florida Volunteer Firefighter and
Emergency Medical Services
Length of Service Award Program
Benefit Certification Form
Date: November 21, 2007
To: Ms. Sharon Prime
From: Monroe County Board of County Commissioners
Fire Rescue Services,
A review of records maintained for the Length of Service Award Program (LOSAP) indicates
that you may be eligible for the following level of certification:
❑ You have completed 10 years of active service. You will be eligible for payment of
benefits upon reaching the age of 60.
[You have completed 10 years of active service AND ha ve reached the minimum age of
60. You are eligible for immediate payment of benefits.
In order to complete our certification of your eligibility for benefits, we require that the
following information be provided:
NAME: Sharon Prime
ADDRESS: 2921 SE 121h Rd. Unit 203
CITY: Homestead ST: FL ZIP: 33035
SOCIAL SECURITY NLTM13ER:
DATE OF BIRTH: 05/02/1946
(Note. In order to verify dame of birth, a copy of your driver license or certificate of
birth must be included with this application.)
Namf of Volunteer Department from which this application is submitted:
Tavernier Volunteer Fire Department
I hereby certify that the information above is true and accurate. to the best of our belief and
knowledge,
41 n`
Signature of Applicant:
Signature of Departmen
:l1 /7;9V VF13