HomeMy WebLinkAboutResolution #3404RESOLUTION N0. 3404
OMITTED SERVICE CREDITS - I.M.R.F. FOR MILTON RICE OF THE CITY OF
CANTON.
WHEREAS, the member named herein, Milton Rice, for the period
from December 2~4, 1975 to May 14, 1976 totaling (5) months should
have been but was not reported to the Illinois Municipal Retirement
Fund for membership.
RESOLVED, that it is the finding of the Canton City Council
that:
1. The member worked in a position which qualified him for
membership in IMRF during the years and months shown above.
2. None of the service of the member during these years and
months was in a probationary position of six months or less;
3- The member is currently employed in a qualifying position;
FURTHER RESOLVED, that the governing body agrees to accept
the obligation due IMRF for the omitted service employer contributions
payable through future employer contribution rates.
FURTHER RESOLVED, that the authorized agent, the City Clerk,
is hereby authorized and directed to file a certified copy of this
resolution and all other pertinent forms and documents with the
Illinois Municipal Retirement Fund.
That this Resolution shall be in full force and effect
immediately upon its passage by the City Council of the City of
Canton, Illinois and approval by the Mayor thereof.
PASSED by the City Council of the City of Canton, Fulton County,
Illinois at a regular meeting this 16th day of December , 1997,
upon a roll call vote as follows:
AYES: Aldermen May, Nidiffer, Meade, Sarff, Phillips, Molleck,
Hartford .
NAYS: None.
ABSENT: Alderman Shores.
APPR¢~:
FI f ~~~~~
ld E. Edwards, Mayor
ATTEST:
cy tes, City Clerk
APPLICATION FOR RETROACTIVE SERVICE CREDIT
IMRF Form 6.04 (Rev. 3/93)
SEE INSTRUCTIONS ON BACK
PLEASE PRINT OR TYPE
MEMBER'S FIRST NAME MIDDLE INRIAL LAST JR., SR., II, ETC. SOCIAL SECURRY NUMBER
°Zilton E. P3.ce ~ 360-~~$-2019
STREET (MAILING) ADDRESS TELEPHONE NUMBER + AREA CODE
600 ?~1eadow Avenue East Peoria, Illinois 61617_-2921
EMPLOYER FOR WHOM SERVICE WAS RENDERED
City of Canton EMPLOYER IMRF I.D. NUMBER
3332
STREET (MAILING) ADDRESS CrrY, STATE AND ZIP + 4
210 Fast Chestnut Canton, Il 61520
NAME OF CURRENT RETIREMENT SYSTEM
IMt~F DATE PARTICIPATION BEGAN IN CURRENT SYSTEM CURRENT POSRKNd
12/24/ 75 ?
RETROACTIVE POSRION OPTIONAL: ANTICIPATED RETIREMENT DATE
T,?ater. Plant ?
CERTIFlCATION BY AUTHORIZED AGENT
I certify that the following statement of earnings for the above applicant is in agreement with the governmental unit's payroll
records and represents the entire qualifying empbyment period determined by the governing body. I further cert'Ify that:
• The applicant worked in a position which qualified him or her for membership in IMRF.
• The service which the applicant rendered is eligible under one of the following designations:
^ Elected official option "' ^ Annuitant who returned to work prior to
^ City Hospital employee' January 1, 1970.
^ Township road district employee ^ Applicant employed between January 1,
^ ROTC instructor 1956, and July 1, 1957.
Months of Service Credit Months of Service Credit
Calendar With Without Calendar With Without
Year Earnings Earnings Earnings' Year Earnings Earnings Earnings'
75 210.66 1 ~~c
76 4361.32 5 *_~ths
Total
'SE - (Seasonal leave explained on reverse side)
Decerber 29, 1997
Signa ure of A orized Agent Date
' Limited to 50 months.
" A resolution finding that the elected position qualifies for membership must be on file with IMRF.
CERTIFICATION BY MEMBER
I certify that I am currently a member in the Illinois Municipal Retirement Fund or reciprocal system and that I received the above
earnings from the governmental unk indicated above for the months and years indicated.
Signature of Member Date
Applicants who have established an Individual Retirement Account (IRA) for income tax purposes should read the instructions on
the reverse side.
Illinois Municipal Retirement Fund
Suite 500, 2211 York Road, Oak Brook Illinois 60521-2374 708/368-1010
IMRF Form 6.04 (Rev. 3/93) Service Representatives 800/ASK-IMRF
~ -.,:
• ~ 100 S. WALKER DRIVE CHKACO, IWNOIS 60606 PAGE OF PAGES
~i •
` ;~~ ' , ~ • QUARTERLY NON-PARTICIPATING EMPLOYEE REPORT
CONTINUATION FORM 3.13A
~. ~
¢ t Qc EMPLO~(~iYER~~!/~N~pAME~1j pU~ARTER~EN"~D61NG EMPLOYER NO.
~~~" rPL SAOW'E`ACFT~LOYEE'S NAME AND NUMBER EXACTLY A§ THEY APPEAR ON HIS SOCIAL SECURITY CARD. ~~~
°" "" "^'
EMPLOYEES SOCIAL SECURITY NUMBER
.
-~ ~' ~~- .1.a'1:1'y4:6~ 'iGs LJ
""=a'"`'~'''TiAi ""~~ " _ • ~ SEE REVER
e `+ ` , , - -y~tL ~yF #(~RS•, YEE
` ~~ ~a~.i..~ ~ ^ '~',.. f E;V~.: 1,: aL~' ~.:~'
~ `~I$t ~~~ FIRST NAME MIDDLE INITIAL E SIDE FOR THER N TR CTION
COVERED WAGESPAID TO EMPLOYEE
DURRVG QUARTER (FORE DEDUCTKNrS)
DOLLARS CENTS
R~y R:W
i ,,((
2 _
of 68 AUT'1'ON JA1~8
9 ~ 6781 P~AReo~t ~ ' 'Jrx ~ ~ ~
4 ~t~x
1 26 3b8 JR HARRY a o
54 ttt~89 807~R ~ ANA 20
35l 18 3973 ~azrnvc~cco~t ~A~tT 450 00
346
46
6150 ,..
,_
8TEwaRT BO»ExT a.
1686
00
'.M1-
TOTAL WAGES REPORTED ON THIS PAGE ---• S 10156 92
r~rcnn ~.isn cnty ~a) RETAIN PINK COPY AND RETURN WHITE COPY WITH FORM 3.13
_. _ _ ._ _ _ ~~~~nvw mun~wra~
_ ~ ~ 100 S. WALKER DRIVE CHICAGO, ILLINOIS 60606 PAGE Of PAGES
,,,.,K.,•~.::..
~ .,~~`~ ~ ~ QUARTERLY NON-PARTICIPATING EMPL
_ OYEE REPORT
' x CONTINUATION FORM 3.13A
~ ~ EMPLOYER NAME ~`~f ~=`~~;:"~~I ' .QUARTER ENDING EMPLOYER NO.
~ ;..
~ •.PLEASE SHOW EACH EMPLOYEE'S NAME AND NUMBER EXACTLY AS THEY APPEAR ON HIS.30CIAL SECURITY CARD.
lliY ONE EMMAVC~ *n ~ uue _ -.,,ti -.
~,~:..s ,~ :,..> ,~-+.~`^'
EAAPLQYEESjSOCIAI SECURITY NlIMBE~
'"''~ '~''" = ~'~ ~ - ' uk:;~;~~~,,~~~~.:' .,;:;~`~sa~,;.~ `ter =s ~ .(~l
~ -
NAME OF EMPLOYEE ~ - ., l3)
COVERED WAGES PAID TO EMPLOYEE
DURING QUARTER (EEFORE DEDUCTK)NS)
:,
DOLLARS - •CENTS
y.
.351 22 04$7
_ - ~ `_ ~
>~asa>: E. v •r'
sg ' •
o
329 60 5505 Polhans _. Bea~amin A. 82 0
334 52 9494 Snider _-_ James W. 40 0
333 40 2583 Staako ,' J.alha 6 0
,_
330 32 4860 Pil rim, Jr._~. Earl 180 7
=- 360 ~48 2019 Rica ..«~, Miltoa _ E. 2748 6
329 42 2041 Jarvis .~ '• Francis L. 2318 8
.. - 42 9601 Voorhees _ .~... Jahn J. 524 3
!
J
358 42 7669 Cannon - .~ .CLyde W. `2074 0
329 44 ..2146 Duttoa ..- Lawrence .. •~ E. 2777 0
327 18 6532 Stouffer . -_ ~ Bertha ~,~~. `~--_ E. 729 4
346 46 3641 Reed . _ _ Bi,1,1y ~ ~ 0
~ ~ 1y6~. ~nrnha'at Ditvld ,,, ~ _ 600
• , 8 6 F Ord ~ s
a; }'OTAI WAGES REPORTED ON THIS PAGE ~--
~r,e.. ~ i
~~~i7
- ~~ -• -• • -•~ • - R~~rur~ ring wrT Anu KtILJRN WRITE COPY WITH FORM 3.13
NAME ~~ C'E~ /~(AI h C~ ~/ ~ L -~/~/~ n" DISTRICT ~~~~~ ~ C /L'...~
ADDRESS ~~!' f/~-'Q~/~ ~~~ - r ~ , r0'' ~~~ ~'~'~`MARITAL STATUS ' L
PHONE O ~~ ~~"~ ~ DATE OF BIRTH / ~~~v
SPOUSE NUMBER OF EXEMPTS ~ ,-~"
PERSON TO NOTIFY
IN EMERGENCY
REGULAR OVERTIME
DATE HOURS HOURS GROSS FED, W,H. F.I.C .A, STATE MISC.
5
1/1//b 40 / .00 210.66 25.80 12.32 4.30
1/9/76 40 / .00 210.66 25.80 12.32 4.30
1J23/76 40 ~~ 30,.00 210.66 30.70 12.32 26
5
1/28/76 40 ~~~'~ .00 .
210.66 30.70 1 2.32 ~}.yD .
5.26 ,
2/13/76
40
.00
210.66 .fi
30.70
12.32
5.26
2/20/76 40 ,I,~.00" 210.66 30.70 12.32 4 5.26
.0~ 210.69 30,..70' 12.3 5.26
3/12/76 40 T~~~ ~ .00 213.92 311.70 ~ 1 2.51 , 5.3 3
3/26/76 40 ~~' .00 213.92 30.70 12.51! 5.33
4/2/76 40 .00 213.92 30.70 12.51 5.33
4/1 /76
40 •
.00 f.
213.92 •
30.70 •
12.51 i.
5.33
4j2 / 40 @~9.~a .00 21 92 30.70 t2.51~~~ 5.33
3-
5/7/76
40
9~ .00
213.92
30.70
12.51 __
5.33
5 /14/76 .2 c I~~a. ,~.s~ .00
'~ 106.96
2 2 2
~~ g 10.40
Tin E .26 ,iR
0 2 3~ ~
1 2.66
5
~ 6
. . ^
,7
NAME '~I.l L ~'! I, `~G ti~~ _~ F ~yI ~ ~~'I L~ IY / ' / )<. /! ~ j
/~•" ~/] ///~ /y /y T DISTRICT L' [ ~ ~ lU
ADDRESS ~~ ~ T-! ~~*~UL~~ /Y ~ ~ E. ~(~~//T ~..L LL MARITAL STATUS •~
PHONE y ~ / ~~~ DATE OF BIRTH ~ ~ ~/ =~
SPOUSE NUMBER OF EXEMPTS
PERSON TO NOTIFY
IN EMERGENCY
REGULAR OVERTIME
DATE HOURS HOURS GROSS FEO. W,H, F.I.C.A, STATE MISC,
J
1 z/z4/75 40 ;~~UI''°.00 210.66 25.80 t 2:32 ~~;~^ 4.30
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:TY OOr~eF CANTON t~a~nw;~~~~IIa ~-C {L~cs~~,~ ~"
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nployee'e social security 1 Federal Income tax withheld
mbar
36t~8••2~9 X6.30
pe or print Employee's name, addross, and ZIP code below.
'aQ .' ~t~dCW 1~ZTL •
at~t P^orla, ~,, Ii.'zcis
and Tax Statement ~~ ~'~
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Type or print EMPLOYER'S
name. address. ZIP code ~ C ~G~
and Federal Identifying pY
number land State I.D. ~.J.~,.~.~rI
number, if applicable.) e111~er7v~s ~~_
2 Wages, tips, and other 3 FICA employee tax 4 Total FICA wages
compensation withheld
Wes employee catered by • I 6
awliHad wnsion Dbn, ate.1
tax with• ~ 9 State or local wages ~ 10 State or locality
3 i
11 State or local tax withhNd 12 fate or local wages a or oeallty
arm W-2 Department of the Treasury-Internal Revenue Service This information is being furnished to the Internal Revenue Service.
~:'"•. ~ 32 St~~t~ X87.6000876
3'Y JF CA~~TTUN
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nployee's social security I 1 Federal income tax withheld
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Wage and Tax Statement ~ °0 7~
Type or Dnnr EMPLOYER'S Y• rv ~
name, address ZIP cods v~Dy rDf
and Federal wennfylnq
number loud Stars LD, .mployet:~s fi:COf~S
number d oDOiicoble i.
2 Wages, tips, ono other I 3 FICA employee tax 4 Total FICA wages
compensation withheld ,
n ~ '~
5 Was employee covered bye 6 7 °
pualilied pension plan, eta? `
at J
B State or local tax with• 9 State or local wages 10 State or locality
held
11 State orloealtax wrthneid 12 State or local wages ~ 1 State or locality
~ W-z '~15e32 This informatOn is being furnished to the Internal Revenue ServlCe. Department of the inaury-Internal Revenw Service __
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~~ ~ Illinois Munici al Retirement F -
p u_
~ Drake Oak Brook Plaza Suite 500 2211 S. York Road Oak Brook IL 60521-2374 708-368-1010
Service Representatives 1-800-ASK-IMRF
July 19, 1995
PAST SERVICE REMITTANCE FORM
MILTON E RICE SPECTRUM
600 MEADOW AVE
EAST PEORIA, IL 61611
Scci31 Security Number: ~50-48-2019 EMPLOYEE;: ~Ov^
T,~pe of service: Reciprocal - REINSTATEMENT - REGULAR St;RVICE
PLEASE RECORD YOUR PAYMENT BELOW:
I enclose payment of $ Ip?~.~, ~~'~ to purchase /~ months of
IMRF service credit.
****************a**************x***,e**x**~**************x**x*s********
CERTIFICATION BY APPLICANT
Please complete the section which applies to you:
I certify that I am currently a contributing member of IMRF.
Write the name of your current employer on the line below:
I certify that I am currently a contributing member of an
Illinois Public Retirement System covered by the Illinois
Retirement Systems Reciprocal Act. Write the name of the
system below:
G,
~I also certify that I have completed two years of contributing
service with that system since the date of my IMRF refund.
I certify that I am no longer a contributing member. Complete
the following:
Date participating employment terminated
IMRF Employer Name:
Recipro al Ret. System Name:
i
i~~l ~-~
APPLICANT SIGNATURE
APPLICANT S ADDRESS (if new)
OR,
DATE
CITY, STATE & ZIP CODE
~,,•,. _r_ ~ .,._ ,_.. ,__
~k3404
RESOLUTION
FOR TEMPORARY CLOSURE
OF ASTATE-MAINTAINED ROADWAY FOR A PUBLIC EVENT
WHEREAS, the /~~-~ J ~ • W d -'"~*~'~ ~-~~~' is sponsoring a ~ Q, r~ in
the C ~ of C~-~. ,which event constitutes a public purpose; ~J
WHEREAS, this ~Q,r,o..dsz will require the temporary closure of SL I~ow'~e 9
'~ ~ $ , a state highway in the of ~ Q,~'~n from ~_ Locust
s~. ~ /,~~o ~ ;
WHEREAS, Section 4-408 of the Illinois Highway Code authorizes the Department of
Transportation to issue permits to local authorities to temporarily close portions of state
highways for such public purposes; //~~
NOW, THEREFORE, B/1E IT RESOLVED by the 1. A.rtf~7-'~ ~ o
of the i'`' of Ca.,~'~ that permission to clospe L ~~~~~ 9
a-•~c~ ~ O ,from ~ -, L.o c we ~ to ~ S* / ~ OF , as above
designated, be requested of the Department of Transportation.
BE IT FURTHER RESOLVED that this closure shall occur during the approximate time
period between /4: 00 ~- and ~/ • ~0 ~r-on .Sa%~~ rcQav N a Ve ~be.r ~~' ~ ~ / q 9
BE IT FURTHER RESOLVED that this closure is for the public purpose of a
D
BE IT FURTHER RESOLVED that traffic from that closed portion of highway shall be
detoured over routes with an all weather surface that can accept the anticipated traffic, which
will be maintained to the satisfaction of the Department and which is conspicuously marked for
the benefit of traffic diverted from the state highway. (The parking of vehicles shall be
prohibited on the detour routes to allow an uninterrupted flow of two-way traff?c.)* The detour
route shall be as follows:
* (To be used when appropriate.) I
BE IT FURTHER RESOLVED that the i ~ assumes full responsibility for the
direction, protection and regulation of the traffic during the time the detour is in effect.
BE IT FURTHER RESOLVED that police officers or authorized flaggers shall, at the
expense of the ~ , be positioned at each end of the closed section and at other
points (such as intersections) as may be necessary to assist in directing traffic through the
detour.
BE IT FURTHER RESOLVED that police officers, flaggers and officials shall permit
emergency vehicles in emergency situations to pass through the closed area as swiftly as is safe
for all concerned.
Be it further resolved that all debris shall be removed by the ~ i ~ prior to reopening
reopening the state highway(s). /
Resolution for Temporary Closure of a Sheet 2 of 2
State-Maintained Roadway for a Public Ebent
BE IT FURTHER RESOLVED that such signs, flags, barricades, etc., shall be used by the
as may be approved by the Illinois Department of Transportation. These
items shall be provided and installed by the i ~'
BE IT FURTHER RESOLVED that the closure and detour shall be marked according to
the Illinois Manual on Uniform Traffic Control Devices for Streets and Hi¢hways.
BE IT FURTHER RESOLVED that an occasional break shall be made in the procession so
that traffic may pass through. In any event, adequate provisions will be made for traffic on
intersecting highways pursuant to conditions noted above. N( OTE: This paragraph is
applicable when the RESOLUTION pertains to a parade or when no deto~ir is required.)
BE IT FURTHER RESOLVED that the ~ ~~" hereby agrees to assume all liabilities
and pay all claims for any damage which shall be__Ioccasioned by the closing described above.
BE IT FURTHER RESOLVED that the ~ `T shall provide a comprehensive general
liability insurance policy or an additional insured endorsement in the amount of X100,000 per
person and $500,000 aggregate which has the Illinois Department of Transportation and its
officials, employees and agents as insureds and which protects them from all claims arising
from the requested road closing.
BE IT FURTHER RESOLVED that a copy of this RESOLUTION be forwarded to the
Department of Transportation to serve as a formal request for the permission sought in this
56resolution and to operate as part of the conditions of said permission.
Adopted by the City Crnmcil of the City
of Canton
this 20th day
of October 1998 A.D. .
6'
MU ICIPAL CLERK
Approved by the r~fayor of the Old' of Canton this 20th
of October ~ 1998~A.D.
f'
,/~ ~'~ ,~
ATTEST: / ~ ,,~,~ ' .' ~.~' -~'cc-.-~
MUNI PAL CLERK MAYOR
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