0721RESOLUTION NO. 721 (#16 - 2014)
A RESOLUTION AUTHORIZING THE MAYOR AND HUMAN RESOURCES
DIRECTOR TO ENTER INTO AN AMENDMENT TO THE CITY'S IRC SECTION
457(6) DEFERRED COMPENSATION PLAN; AND, FOR OTHER PURPOSES.
WHEREAS, Federal law provides that the City of Jacksonville may provide its
employees with an approved IRC Section 457(b) Deferred Compensation Plan. The City
Council approved doing so and has offered such a Plan for its employees for several
years;
WHEREAS, due to recent changes in federal law and circumstances, the City
Council needs to approve and authorize Mayor Fletcher and the Human Resources
Director to execute an Amendment and all other applicable documents to update and
modify the current 457(b) Plan so as to better provide for its employees; and,
WHEREAS, the Amendment, as proposed, shall better provide for the
administration of the Plan through the use of new definitions, alternative payment
elections, modified provisions for age qualifications, contribution eligibility changes, a
new designation for the Plan, and replacement designation for additional Plan Trustee.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OFIACKSONVILLE, ARKANSAS, THAT:
SECTION ONE; The Mayor and the Human Resources Director,
together with the City Attorney, are hereby authorized and designated to approve entry
of an Amended IRC Section 457(b) Deferred Compensation Plan with amended
provisions as designated on the attached Amendment and Memorandum of Action,
incorporated herein and made a part hereof.
SECTION TWO; Any and all other Resolutions in conflict herewith are
repealed to the extent of said conflict. This Resolution shall be in effect on and after
January 1, 2015.
RESOLUTION NO. 721 (#16-2014)
Page Two
APPROVED A ND ADOPTED THIS ELI DA Y OF DECEMBER, 2014.
CITY OF JACKSONVILLE, ARKANSAS
ATTEST. -
SUSAN DA 4TT, CITY CLERK
Eligible 457 Plan
ADOPTION AGREEMENT FOR
ELIGIBLE GOVERNMENTAL 457 PLAN
The undersigned Employer, by executing this Adoption Agreement, establishes an Eligible 4.57 Plan ("Plan"). The Employer, subject
to the Employer's Adoption Agreement elections, adopts fully the Plan provisions. This Adoption Agreement, the basic plan document and
any attached Appendices, amendments, or agreements permitted or referenced therein. constitute the Employer's entire plan document. All
Election" references within this Adoption Agreement or the basic plan document are Adoption Agreement Elections. All 'Article" or
"Section" references are basic plan document references. Numbers in parentheses which follow election numbers are basic plan document
references. Where an Adoption Agreement election calls for the Employer to supply text, the Employer may lengthen any space or line, or
create additional tiers. When Employer -supplied text uses terms substantially similar to existing printed options, all clarifications and
caveats applicable to the printed options apply to the Employer -supplied text unless the context requires otherwise. The Employer makes
the following elections granted under the corresponding provisions of the basic plan document.
EMPLOYER (LI 1).
Name: City of Jacksonville
Address: #1 Municipal Court
Street
Jacksonville Arkansas 72076
City State Zip
Telephone: 501-982-4671
Taxpayer Identification Number (TIN): 71-6042693
2. PLAN NAME.
Name: The City of Jacksonville Public Employees IRC Section 457 Deferred Compensation Plan
3. PLAN YEAR (1.25). Plan Year means the 12 consecutive month period (except for a short Plan Year) ending every (Choose one of
a. or b. and choose c. if applicable): [Note: Complete any applicable blanks under Election c. with a specific date, e.g., "June 30" OR "the
last day of February" OR "the first Tuesday in January. In the case of 'a Short Plan Year or a Short Limitation Year, include the year, e.g.,
"May 1, 2013.']
a. [X] December 31.
b. [ ] Plan Year: ending:
C. [ ] Short Plan Year: commencing:
and ending:
4. EFFECTIVE DATE (1.08). The Employer's adoption of the Plan is a (Choose one of a. or b. Complete c, if new plan OR complete c,
and d. if an amendment and restatement. Choose e. if applicable):
a. [ ] New Plan.
b. [X] Restated Plan. The Plan is a substitution and amendment of an existing 457 plan.
Initial Effective Date of Plan
[X] October 21 1997 (enter month day, year; hereinafter called the "Effective Date" unless 4d is entered below)
Restatement Effective Date (If this is an amendment and restatement, enter effective date of the restatement)
d. [X] January 2015 (enter month day, year)
Special Effective Dates: (optional)
e. [ ] Describe:
5. CONTRIBUTION TYPES. (If this is a frozen Plan (i.e., all contributions have ceased), choose a. only):
Frozen Plan
a. [ ] Contributions cease. All Contributions have ceased or will cease (Plan is frozen).
i. Effective date of freeze: [Note: F_ffective date is optional unless this is the amendment or
restatement to freeze the Plan.]
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Contributions. The Employer and/or Participants, in accordance with the Plan terms, make the following Contribution Types to the Plan
(Choose one or more of b. through d. if applicable):
b. [X] Pre -Tax Elective Deferrals. The dollar or percentage amount by which each Participant has elected to reduce his/her
Compensation, as provided in the Participant's Salary Reduction Agreement (Choose one or more as applicable):
And will Matching Contributions be made with respect to Elective Deferrals?
I . [ ] Yes. See Question 16.
2. [X] No.
And will Roth Elective Deferrals be made?
3. [ ] Yes. [Note: The Employer may not limit Deferrals to Roth Deferrals only.]
4. [X] No.
C. [ ] Nonelective Contributions. See Question 17.
d. [X] Rollover Contributions. See Question 30.
6. EXCLUDED EMPLOYEE (1.10). The following Employees are Excluded Employees and are not eligible to participate in the Plan
(Choose one of a. or b.):
a. [ ] No exclusions. All Employees are eligible to participate.
b. [X] Exclusions. The following Employees are Excluded Employees (Choose one or more of 1. through 4):
L [X] Part-time Employees. The Plan defines part-time Employees as Employees who normally work less than 40 hours
per week.
2. [ ] Hourly -paid Employees.
3. [X] Leased Employees. The Plan excludes Leased Employees.
4. [ ] Specify:
7. INDEPENDENT CONTRACTOR (1.16). The Plan (Choose one of a., b. or c.):
a. [ ] Participate. Permits Independent Contractors to participate in the Plan.
b. [X] Not Participate. Does not permit Independent Contractors to participate in the Plan.
C. [ ] Specified Independent Contractors. Permits the following specified Independent Contractors to participate:
[Note: If the Employer elects to permit any or all Independent Contractors to participate in the Plan, the term Employee as used in the
Plan. includes such participating Independent Contractors.]
8. COMPENSATION (1.05). Subject to the following elections, Compensation for purposes of allocation of Deferral Contributions
means:
Base Definition (Choose one of a., b. or c):
a. [X] Wages, tips and other compensation on Form W-2.
b. [ ] Code §3401(a) wages (wages for withholding purposes).
c. [ ] 415 safe harbor compensation.
[Note: The Plan provides that the base definition of Compensation includes amounts that are not included in income due to Code 0401(k),
125,1320(4), 403(b), SEP, 414(h)(2), & 457. Compensation for an Independent Contractor means the amounts the Employer pays to the
Independent Contractor for services, except as the Employer otherwise specifies below.]
Modifications to Compensation definition. The Employer elects to modify the Compensation definition as follows (Choose one of d.
or e):
No modifications. The Plan makes no modifications to the definition.
Modifications (Choose one or more of I. through 5.):
[ ] Fringe benefits. The Plan excludes all reimbursements or other expense allowances, fringe benefits (cash and noncash),
moving expenses, deferred compensation and welfare benefits.
[ ] Elective Contributions. [1.05(E)] The Plan excludes a Participant's Elective Contributions.
[X] Bonuses. The Plan excludes bonuses.
N
Eligible IRC 457(b) Plan
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4. [ ] Overtime. The Plan excludes overtime.
5. [ ] Specify:
Compensation taken into account. For the Plan Year in which an Employee first becomes a Participant, the Plan Administrator will
determine the allocation of matching and nonelective contributions by taking into account (Choose one off or g.):
f [ ] Plan Year. The Employee's Compensation for the entire Plan Year.
g. [X] Compensation while a Participant. The Employee's Compensation only for the portion of the Plan Year in which the
Employee actually is a Participant.
9. POST -SEVERANCE COMPENSATION (1.05(F)). Compensation includes the following types of Post -Severance Compensation
paid within any applicable time period as may be required (Choose one of a. or b):
a. [X] None. The Plan does not take into account Post -Severance Compensation as to any Contribution Type except as required under
the basic plan document.
b. [ ] Adjustments. The following Compensation adjustments apply (Choose one or more):
I [ ] Regular Pay. Post -Severance Compensation will include Regular Pay and it will apply to all Contribution' Types.
2. [ ] Leave-Cashouts. Post -Severance Compensation will include Regular Pay and Leave Cashouts and it will apply to all
Contribution Types.
3. [ ] Nonqualified Deferred Compensation. Post -Severance Compensation will include Deferred Compensation and it will
apply to all Contribution Types.
4. [ ] Salary Continuation for Disabled Participants. Post -Severance Compensation will include Salary Continuation for
Disabled Participants and it will apply to all Contribution Types.
5. [ ] Differential Wage Payments. Post -Severance Compensation will include Differential Wage Payments (military
continuation payments) and it will apply to all Contribution Types.
6. [ ] Describe alternative Post -Severance Compensation definition, limit by Contribution Type, or limit by
Participant group:
10. NORMAL RETIREMENT AGE (1.20). A Participant attains Normal Retirement Age under the Plan (Choose one of a. orb):
a. [X] Plan designation. [Plan Section 3.05(B)] When the Participant attains age 60 .[Note: The age may not exceed age 70112.
The age may not be less than age 65, or, if earlier, the age at which a Participant may retire and receive benefits under the
Employer's pension plan, if any.]
b. [ ] Participant designation. [Plan Section 3.05(B) and (13)(1)] When the Participant attains the age the Participant designates,
which may not be earlier than age and may not be later than age . [Note: The age may not exceed age
70 112. ]
Special Provisions for Police or Fire Department Employees (Choose c. and/or d. as applicable):
C. [ ] Police department employees. [Plan Section 3.05(B)(3)] (Choose 1. or 2):
1 [ ] Plan designation. [Plan Section 3.05(B)] When the Participant attains age . [Note: The age may not exceed age
70112 and may not be less than age 40.]
2. [ ] Participant designation. [Plan Section 3.05(B) and (13)(1)] When the Participant attains the age the Participant
designates, which may not be earlier than age _ (no earlier than age 40) and may not be later than age
[Note: The age may not exceed age 70112.]
d. [ ] Fire department employees. [Plan Section 3.05(B)(3)] (Choose 1. or 2):
1. [ ] Plan designation. [Plan Section 3.05(B)] When the Participant attains age . [Note: The age may not exceed age
70 112 and may not be less than age 40.1
2. [ ] Participant designation. [Plan Section 3.05(B) and (B)(1)] When the Participant attains the age the Participant
designates, which may not be earlier than age (no earlier than age 40) and may not be later than age
[Note: The age may not exceed age 70 112]
11. ELIGIBILITY CONDITIONS (2.01). (Choose one ofa. or b.):
a. [X] No eligibility conditions. The Employee is eligible to participate in the Plan as of his/her first day of employment with the
employer.
b. [ ] Eligibility conditions. To become a Participant in the Plan, an Eligible Employee must satisfy the following eligibility
conditions (Choose one or more of 1., 2. or 3.):
1. [ ] Age. Attainment of age
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2. [ ] Service. Service requirement (Choose one of a, or b.):
a. [ ] Year of Service. One year of Continuous Service.
b. [ ] Months of Service. momb(s) of Continuous Service.
3. [ ] Specify:
12. PLAN ENTRY DATE (1.24). "Plan Entry Date" means the Effective Date and (Choose one of a. through d.):
a. [ ] Monthly. The first day of the month coinciding with or next following the Employee's satisfaction of the Plan's eligibility
conditions.
K [ ] Annual. The first day of the Plan Year coinciding with or next following the Employee's satisfaction of the Plan's eligibility
conditions.
c
d.
[X] Date of hire. The Employee's employment commencement date with the Employer.
[ ] Specify:
13. SALARY REDUCTION CONTRIBUTIONS (1.30). A Participant's Salary Reduction Contributions under Election 5b. are subject to
the following limitation(s) in addition to those imposed by the Code (Choose one of a. or b.):
a. [ ] No limitations.
b. [X] Limitations. (Choose one or more of 1., 2. or 3.):
1. [ ] Maximum deferral amount. A Participant's Salary Reductions may not exceed: (specify
dollar amount or percentage of Compensation).
2. [X] Minimum deferral amount. A Participant's Salary Reductions may not be less than: X20.00 per month (specify dollar
amount or percentage of Compensation).
3. [ ] Specify:
[Note: Any limitation the Employer elects in b.1. through b.3. will appdv on a payroll basis unless the Employer otherwise specifies in b.3.]
Special NRA Catch -Up Contributions (3.05). The Plan (Choose one of e. or d.):
C. [X] Permits. Participants may make NRA catch-up contributions.
AND, Special NRA Catch -Up Contributions (Choose one of/. or 2.):
1. [X] will be taken into account in applying any matching contribution under the Plan.
2. [ ] will not be taken into account in applying any matching contribution under the Plan.
d. [ ] Does not permit. Participants may not make NRA catch-up contributions.
Age 50 Catch -Up Contributions (3.06). The Plan (Choose one ofe. orf):
e. [X] Permits. Participants may make age 50 catch-up contributions.
f [ ] Does not permit. Participants may not make age 50 catch-up contributions.
14. SICK VACATION AND BACK PAY (3.02(A)). The Plan (Choose one of a. or b.):
a. [X] Permits. Participants may make Salary Reduction Contributions from accumulated sick pay, from accumulated vacation pay or
from back pay.
b. [ ] Does Not Permit. Participants may not make Salary Reduction Contributions from accumulated sick pay, from accumulated
vacation pay or from back pay.
15. AUTOMATIC ENROLLMENT (3.02(B)). Does the Plan provide for automatic enrollment (Choose one of the following) [Note: if
Eligible Automatic Contribution Arrangement (EACA), select 15c and complete AMENDMENT FOR ELIGIBLE AUTOMATIC
CONTRIBUTIONARRANGEMENT (EA CA)]:
a. [X] Does not apply. Does not apply the Plan's automatic enrollment provisions.
b. [ ] Applies. Applies the Plan's automatic enrollment provisions. The Employer as a Pre -Tax Elective Deferral will withhold
% from each Participant's Compensation unless the Participant elects a different percentage (including zero) under
his/her Salary Reduction Agreement. The automatic election will apply to (Choose one of 1. through 3.):
L [ ] All Participants. All Participants who as of are not making Pre -Tax Elective
Deferrals at least equal to the automatic amount.
2. [ ] New Participants. Each Employee whose Plan Entry Date is on or following:
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3. [ ] Describe Application of Automatic Deferrals: ______
e. [ ] EACA. The Plan will provide an Eligible Automatic Contribution Arrangement (EACA). Complete amendment.
16. MATCHING CONTRIBUTIONS (3.03). The Employer Matching Contributions is (Choose one or more of a. through d.):
a. [ ] Fixed formula. An amount equal to of each Participant's Salary Reduction Contributions.
b. [ ] Discretionary formula. An amount (or additional amount) equal to a matching percentage the Employer from time to time
may deem advisable of each Participant's Salary Reduction Contributions.
C. [ ] Tiered formula. The Employer will make matching contributions equal to a uniform percentage of each tier of each
Participant's Salary Reduction Contributions, determined as follows:
NOTE: Fill in only percentages or dollar amounts, but not both. If percentages are used, each tier represents the
amount of the Participant's applicable contributions that equals the specified percentage of the
Participant's Compensation (add additional tiers if necessary):
Tiers of Contributions Matching Percentage
(indicate $ or %)
First %
Next %
Next %
Next
d [ ] Specify:
Time Period for Matching Contributions. The Employer will determine its Matching Contribution based on Salary Reduction
Contributions made during each (Choose one of e. through h.):
e. [ ] Plan Year.
f. [ ] Plan Year quarter.
g. [ ] Payroll period.
h. [ ] Specify:
Salary Reduction Contributions Taken into Account. In determining a Participant's Salary Reduction Contributions taken into account
for the above-specified time period under the Matching Contribution formula, the following limitations apply (Choose one of i. through t):
i. [ ] All Salary Reduction Contributions. The Plan Administrator will take into account all Salary Reduction Contributions.
j. [ ] Specific limitation. The Plan Administrator will disregard Salary Reduction Contributions exceeding % of the
Participant's Compensation.
k. [ ] Discretionary. The Plan Administrator will take into account the Salary Reduction Contributions as a percentage of the
Participant's Compensation as the Employer determines.
1. [ ] Specify:
Allocation Conditions. To receive an allocation of Matching Contributions, a Participant must satisfy the following allocation condition(s)
(Choose one of m. or n):
M [ ] No allocation conditions.
n. [ ] Conditions. The following allocation conditions apply to Matching Contributions (Choose one or more of I. through 4):
I. [ ] Service condition. The Participant must complete the following number of months of Continuous Service during the
Plan Year:
2. [ ] Employment condition. The Participant must be employed by the Employer on the last day of the Plan Year,
3. [ ] Limited Severance Exception. Any condition specified in 1. or 2. does not apply if the Participant incurs a Severance
from Employment during the Plan Year on account of death, disability or attainment of Normal Retirement Age in the
current Plan Year or in a prior Plan Year.
4. [ ] Specify:
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17. NONELECTIVE CONTRIBUTIONS (1.19). The Nonelective Contributions under Election Se. are made as follows: (Choose one):
a. [ ] Discretionary - Pro -Rata. An amount the Employer in its sole discretion may determine.
b. [ ] Fixed - Pro Rata. % of Compensation.
C. [ ] Other. A Nonelective Contribution may be made as follows:
Allocation Conditions. (3.08). To receive an allocation of Nonelective Contributions, a Participant must satisfy the following allocation
condition(s) (Choose one of d. or e.):
d. [ ] No allocation conditions.
e. [ ] Conditions. The following allocation conditions apply to Nonelective Contributions (Choose one or more of I. through 4.):
L [ ] Service condition. The Participant must complete the following number of months of Continuous Service during the
Plan Year:
2. [ ] Employment condition. The Participant must be employed by the Employer on the last day of the Plan Year.
3. [ ] Limited Severance Exception. Any condition specified in 1. or 2. does not apply if the Participant incurs a Severance
from Employment during the Plan Year on account of death, disability or attainment of Normal Retirement Age in the
current Plan Year or in a prior Plan Year.
4. [ ] Specify:
18. TIME AND METHOD OF PAYMENT OF ACCOUNT (4.02). The Plan will distribute to a Participant who incurs a Severance from
Employment his/her Vested Account as follows:
Timing. The Plan, in the absence of a permissible Participant election to commence payment later, will pay the Participant's Account
(Choose one of'a. through e.):
a. [ ] Specified Date. days after the Participant's Severance from Employment.
b. [X] Immediate. As soon as administratively practicable following the Participant's Severance from Employment.
C. [ ] Designated Plan Year. As soon as administratively practicable in the Plan Year beginning after the
Participant's Severance from Employment.
d. [ ] Normal Retirement Age. As soon as administratively practicable after the close of the Plan Year in which the Participant
attains Normal Retirement Age.
e. [ ] Specify:
Method. The Plan, in the absence of a permissible Participant election, will distribute the Participant's Account under one of the following
method(s) of distribution (Choose one or more off. through j. as applicable):
f. [X] Lump sum. A single payment.
g. [ ] Installments. Multiple payments made as follows:
h. [ ] Installments for required minimum distributions only. Annual payments, as necessary under Plan Section 4.03.
i. [ ] Annuity distribution option(s):
j. [ ] Specify:
Participant Election. [Plan Sections 4.02(A) and (B)] The Plan (Choose one of k., 1. or m.):
L [X] Permits. Permits a Participant, with Plan Administrator approval of the election, to elect to postpone distribution beyond the
time the Employer has elected in a. through e. and also to elect the method of distribution (including a method not described in
f. through j. above).
1. [ ] Does not permit. Does not permit a Participant to elect the timing and method of Account distribution.
m. [ ] Specify:
Mandatory Distributions. Notwithstanding any other distribution election, following Severance from Employment (Choose n. or o.):
n. [ ] No Mandatory Distributions. The Plan will not make a Mandatory Distribution.
o. [X] Mandatory Distribution. If the Participant's Vested Account is not in excess of $5,000 (unless a different amount selected
below) as of the date of distribution, the Plan will make a Mandatory Distribution following Severance from Employment.
I . [ ] Mandatory Distribution. If the Participant's Vested Account is not in excess of $ as of the date of
distribution, the Plan will make a Mandatory Distribution following Severance from Employment.
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Exclusion of rollovers in determination of $5,000 threshold. In determining the $5,000 threshold (or other dollar threshold above).
rollover contributions will be:
p. [ ] included.
q. [X] excluded.
19. BENEFICIARY DISTRIBUTION ELECTIONS. Distributions following a Participant's death will be made as follows (Choose one
of a. through d.):
a. [X] Immediate. As soon as practical following the Participant's death.
b. [ ] Next Calendar Year. At such time as the Beneficiary may elect, but in any event on or before the last day of the calendar year
which next follows the calendar year of the Participant's death.
C. [ ] As Beneficiary elects. At such time as the Beneficiary may elect, consistent with Section 4.03.
d. [ Describe:
[Note: The Employer under Election 19d. may describe an alternative distribution timing or afford the Beneficiary an election which is
narrower than that permitted under Election 19c., or include special provisions related to certain beneficiaries, (e.g., a surviving spouse).
However, any election under Election 19d. must require distribution to commence no later than the Section 4.03 required date.]
20. DISTRIBUTIONS PRIOR TO SEVERANCE FROM EMPLOYMENT (4.05). A Participant prior to Severance from Employment
may elect to receive a distribution of his/her Vested Account under the following distribution options (Choose one ol'a. or b.):
a. [ ] None. A Participant may not receive a distribution prior to Severance from Employment.
b. [X] Distributions. Prior to Severance from Employment are permitted as follows (Choose one or more of 1. through 4.):
L [X] Unforeseeable emergency. A Participant may elect a distribution from his/her Account in accordance with Plan Section
4.05(A).
2. [X] De minimis exception. [Plan Section 4.05(B)] If the Participant: (i) has an Account that does not exceed $5,000; (ii) has
not made or received an allocation of any Deferral Contributions under the Plan during the two-year period ending on the
date of distribution; and (iii) has not received a prior Plan distribution under this de minimis exception, then (Choose one
of a., b, or c.):
a. [X] Participant election. The Participant may elect to receive all or any portion of his/her Account.
b. [ ] Mandatory distribution. The Plan Administrator will distribute the Participant's entire Account.
C. [ ] Hybrid. The Plan Administrator will distribute a Participant's Account that does not exceed $ and
the Participant may elect to receive all or any portion of his/her Account that exceeds $ but that does
not exceed $5,000.
3. [X] Age 70 1/2. A Participant who attains age 70 1/2 prior to Severance from Employment may elect distribution of any or all
of his/her Account.
4. [ ] Specify:
[Note: An Employer need not permit any in-service distributions. Any election must comply with the distribution restrictions of Code
Section 457(d).]
21. QDRO (4.06). The QDRO provisions (Choose one of a., b. are.):
a. [X] Apply.
b. [ ] Do not apply.
C. [ ] Specify:
22. ALLOCATION OF EARNINGS (5.07(B)). The Plan allocates Earnings using the following method (Choose one or more of a.
through f.):
a. [X] Daily. See Section 5.07(13)(4)(a).
b. [ ] Balance forward. See Section 5.07(B)(4)(b).
C. [ ] Balance forward with adjustment. See Section 5.07(B)(4)(c). Allocate pursuant to the balance forward method, except treat
as part of the relevant Account at the beginning of the Valuation Period % of the contributions made during the
following Valuation Period:
d. [ ] Weighted average. See Section 5.07(B)(4)(d). If not a monthly weighting period, the weighting period is
e. [ ] Directed Account method. See Section 5.07(B)(4)(e).
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f. [ ] Describe Earnings allocation method:
[Note: The Employer under Election 22f may describe Earnings allocation methods from the elections available under Election 22 andlor
a combination thereof as to any: (i) Participant group (e.g., Daily applies to Division A Employees OR to Employees hired after "x" date.
Balance forward applies to Division B Employees OR to Employees hired on/before "x" date)(ii) Contribution Type (e.g., Daily applies
as to Discretionary Nonelective Contribution Accounts. Participant -Directed Account applies to Fixed Nonelective Contribution
Accounts); (iii) investment type, investment vendor or Account type (e.g., Balance forward applies to investments placed with vendor A and
Participant -Directed Account applies to investments placed with vendor B OR Daily applies to Participant -Directed Accounts and balance
forward applies to pooled Accounts). ]
23. HEART ACT PROVISIONS (1.31(C)(3)13.13). The Employer elects to (Choose one of a. orb. and c. or d.):
Continued Benefit Accruals.
a. [X] Not apply the benefit accrual provisions of Section 3.13.
b. [ ] Apply the benefit accrual provisions of Section 3.13.
Distributions for deemed severance of employment (1.31(C)(3))
C. [ ] The Plan does NOT permit distributions for deemed severance of employment
d. [X] The Plan permits distributions for deemed severance of employment
24. VESTING/SUBSTANTIAL RISK OF FORFEITURE (5.11). A Participant's Deferral Contributions are [Note: If a Participant incurs
a Severance from Employment before the specified events or conditions, the Plan will forfeit the Participant's non -vested Account. Caution:
if a Deferral is subject to vesting schedule or other substantial risk of forfeiture, it does not count as a deferral, for purposes of the annual
deferral limit until the year it is fully vested.] (Choose all that apply of a. through d.):
a. [X] 100% Vested/No Risk of Forfeiture. Immediately Vested without regard to additional Service and no Substantial Risk of
Forfeiture. The following contributions are 100% Vested:
I. [X] All Contributions. (skip to 25.)
2. [ ] Only the following contributions. (select all that apply):
a. [ ] Salary Reduction Contributions.
b. [ ] Nonelective Contributions.
C. [ ] Matching Contributions.
b. [ ] Forfeiture under Vesting Schedule. Vested according to the following:
Contributions affected. The following contributions are subject to the vesting schedule (Choose one or more of I., 2. or 3):
1. [ ] Salary Reduction Contributions.
2. [ ] Nonelective Contributions.
3. [ ] Matching Contributions.
4. [ ] Vesting Schedule.
Years of Service Vested Percentage
O/P
For vesting purposes, a "Year of Service" means:
5.
[Note: It is extremely rare to apply a vesting schedule to Salary Reduction Contributions.]
C. [ ] Substantial Risk of Forfeiture. Vested only when no longer subject to the following Substantial Risk of Forfeiture as follows:
Contributions affected. The following contributions are subject to the substantial risk of forfeiture under c. (Choose one or more of
I., 2. or 3):
I . [ ] Salary Reduction Contributions.
2. [ ] Nonelective Contributions.
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3. [ ] Matching Contributions.
Risk Provisions: Vested only when no longer subject to the following Substantial Risk of Forfeiture as follows (Choose one of 4. or
5.):
4. [ ] The Participant must remain employed by the Employer until unless earlier Severance from
Employment occurs on account of death or disability, as the Plan Administrator shall establish.
5. [ ] Specify:
Additional Provisions (Choose d ifapplicable)
d. [ ] Specify:
FORFEITURE ALLOCATION. [Plan Sections 5.11(A) and 5.14] The Plan Administrator will allocate any Plan forfeitures (Choose one
of the following):
e. [ ] Additional Contributions. As the following contribution type (Choose one of 1. or 2.):
1. [ ] Nonelective. As an additional Nonelective Contribution.
2. [ ] Matching. As an additional Matching Contribution.
f. [ ] Reduce Fixed Contributions. To reduce the following fixed contribution (Choose one of 1. or 2):
1. [ ] Nonelective. To reduce the Employer's fixed Nonelective Contribution.
2. [ ] Matching. To reduce the Employer's fixed Matching Contribution.
g. [ ] Specify:
25. TRUST PROVISIONS. The following provisions apply to Article VIII of the Plan (Choose as applicable; leave blank if not
applicable):
a. [ ] Modifications. The Employer modifies the Article VIII Trust provisions as follows: The
remaining Article VIII provisions apply.
b. [ ] Substitution. The Employer replaces the Trust with the Trust Agreement attached to the Plan.
26, CUSTODIAL ACCOUNT/ANNUITY CONTRACT (8.16). The Employer will hold all or part of the Deferred Compensation in one
or more custodial accounts or annuity contracts which satisfy the requirements of Code §457(g) (Choose a, or b., c. if applicable):
a. [ ] Custodial account(s).
b. [ ] Annuity contract(s).
C. [ ] Specify:
[Note: The Employer under c. may wish to identify the custodial accounts or annuity contracts or to designate a portion of the Deferred
Compensation to be held in such vehicles versus held in the Trust.]
27. VALUATION. In addition to the last day of the Plan Year, the Trustee (or Plan Administrator as applicable) must value the Trust
Fund (or Accounts) on the following Valuation Date(s) (Choose one of a. or b.):
a. [ ] No additional Valuation Dates.
b. [X] Additional Valuation Dates. (Choose one or more of 1., 2. or 3.):
1. [X] Daily Valuation Dates. Each business day of the Plan Year on which Plan assets for which there is an established market
are valued and the Trustee is conducting business.
2. [ ] Last day of a specified period. The last day of each of the Plan Year.
3. [ ] Specified Valuation Dates:
[Note: The Employer under Election 26b.3. may describe Valuation Dates.from the elections available under Election 26b, and/or a
combination thereof as to any. (i) Participant group (e.g., No additional Valuation Dates apply to Division A Employees OR to Employees
hired after 'x" date. Daily Valuation Dates apply to Division B Employees OR to Employees hired onfbefore 'x" date); (ii) Contribution
Type (e.g., No additional Valuation Dates apply as to Discretionary Nonelective Contribution Accounts. The last day of each Plan Year
quarter applies to Fixed Nonelective Contribution Accounts); (iii) investment type, investment vendor or Account type (e.g., No additional
Valuation Dates apply to investments placed with vendor A and Daily Valuation Dates apply to investments placed with vendor B OR Daily
Valuation Dates apply to Participant -Directed Accounts and no additional Valuation Dates apply to pooled Accounts).]
cO 2013 9 Eligible IRC 457(b) Plan
Eligible 457 Plan
28. TRUSTEE (Select all that apply; leave blank if not applicable):
a. [X] Individual Trustee(s) who serve as Trustee(s) over assets not subject to control by a corporate Trustee. (Add additional Trustees
as necessary.)
Name(s) Title(s)
Gary Fletcher --M--,-,-Y-or
Jill Ross Director Human Resources
Address and Telephone number (Choose one of 1. or 2.):
1. [ ] Use Employer address and telephone number.
2. [ ] Use address and telephone number below:
Address:
Street
City State Zip
Telephone:
b. [ ] Corporate Trustee
Name:
Address:
Street
City State
Telephone:
AND, the Corporate Trustee shall serve as:
C. [ ] a Directed (nondiscretionary) Trustee over all Plan assets except for the following:
d. [ ] a Discretionary Trustee over all Plan assets except for the following:
29. PLAN LOANS (5.02(A)). The Plan permits or does not permit Participant Loans (Choose one of a. orb):
a. [X] Does not permit.
b. [ ] Permitted pursuant to the Loan Policy.
30. ROLLOVER CONTRIBUTIONS (3.09). The Plan permits Rollover Contributions subject to approval by the Plan Administrator and
as further described below:
Who may roll over (Choose one of a. or b.):
a. [ ] Participants only.
b. [X] Eligible Employees or Participants.
Sources/Types. The Plan will accept a Rollover Contribution (Choose one of C. or d.):
C. [X] All. From any Eligible Retirement Plan and as to all Contribution Types eligible to be rolled into this Plan.
d. [ ] Limited. Only from the following types of Eligible Retirement Plans and/or as to the following Contribution Types:
Cc2013 10 Eligible IRC 457(b) Plan
Eligible 457 Plan
Distribution of Rollover Contributions (Choose one of e., f. or g.):
e. [X] Distribution without restrictions. May elect distribution of his/her Rollover Contributions Account in accordance with Plan
Section 4.05(C) at any time.
f. [ ] No distribution. May not elect to receive distribution of his/her Rollover Contributions Account until the Plan has a
distributable event under Plan Section 4.01.
g. [ ] Specify:
CQ 2013 ll Eligible IRC 457(b) Plan
Eligible 457 Plan
This Plan is executed on the date(s) specified below:
Use of Adoption Agreement. Failure to complete properly the elections in this Adoption Agreement may result in disqualification of the
Employer's Plan. The Employer only may use this Adoption Agreement only in conjunction with the corresponding basic plan document.
.Till Ro,s
TRUSTEE
&211
DATE SIGNED
f�/3115--
DATE SIGNED
DATE SIGNED
2013 12 Eligible IRC 457(b) Plan