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10
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2018
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030618
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10
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3/1/2018 1:52:13 PM
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3/1/2018 1:52:06 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
3/6/2018
DESTRUCT DATE
15Y
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EXHIBIT 1C <br /> DATA REQUIREMENTS <br /> PARS will provide the Services under this Agreement contingent upon receiving the <br /> following information: <br /> I. Executed Legal Documents: <br /> (A) Certified Resolution <br /> (B) Adoption Agreement to the Public Agencies Post-Employment Benefits Trust <br /> (C) Trustee Investment Forms <br /> 2. Contribution — completed Contribution Transmittal Form signed by the Plan <br /> Administrator(or authorized Designee) which contains the following information: <br /> (A) Agency name <br /> (B) Contribution amount <br /> (C) Contribution date <br /> (D) Contribution method (Check, ACH, Wire) <br /> 3. Distribution — completed Payment Reimbursement/Distribution Form signed by the <br /> Plan Administrator (or authorized Designee) which contains the following <br /> information: <br /> (A) Agency name <br /> (B) Payment reimbursement/distribution amount <br /> (C) Applicable statement date <br /> (D) Copy of applicable premium, claim, statement, warrant, and/or administrative <br /> expense evidencing payment <br /> (E) Signed certification of reimbursement/distribution from the Plan Administrator <br /> (or authorized Designee) <br /> 4. Other information pertinent to the Services as reasonably requested by PARS and <br /> Actuarial Provider. <br /> Page 7 <br />
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