CITY OF WALTHOURVILLE Mayor Sarah B. Hayes Elected Officials Mitchell Boston Patrick Underwood Bridgettel Kelly Luciria L. Lovette Robert Dodd CityA Administration Nicolas Maxwell, Fire Chief Mrs. Ivy Norris, Finance Manager Christopher Reed, Police Chief Lukel R. Moses, City Attorney nIS Mr. Dave Martin, Public Works Administrator Mayor and Council Meeting February 11, 2025 @ 6:00 PM Walthourville Police Department AGENDA I. Call to Order II. Roll Call III. Invocation IV. Pledge of Allegiance V. Adoption of Meeting Agenda VI. Adoption of] Regular Meeting Minutes Mayor Sarah B. Hayes City Clerk Appointee Inl Unison Councilmembers Councilmembers January 14, 2025--- Executive Session Minutes January 28, 2025---Regular Meeting Minutes February 4, 2025 Special Called Meeting Minutes February 4, 2025---Executive Session Minutes VII. Presentation(s) VIII. Agenda Item(s) 1. LCPC 2.LCPC None Mr. Todd Kennedy Mr. Todd Kennedy Home-based Business License Request for Stealth Lawn Cuts. Business License Request for a Mobile Veterinarian for Family Paws Mobile Veterinarian. 3. City of Walthourville 4. City of Walthourville Fire Code and Fee. Adoption. 5. City ofWalthourville Millage Discussion. 6. City of Walthourville Town of Allenhurst Fire Service. Attorney Luke R. Moses & Ms. Shana T. Moss 2025 Defined Benefit Retirement Plan Ordinance Adoption. ChiefNicolas Maxwell Mayor and Council Mayor and Council 7. City of Walthourville Charter Review Dates. Department Comments Water Department Fire Department Police Department Citizens Comments Mayor's Update Mayorand Council City of Walthourville Mr. Patrick Golphin ChiefNicolas Maxwell ChiefChristopher Reed Walthourville Citizens Mayor Sarah B. Hayes City of Walthourville IX. X. XI. XII. Elected Officials' Comments Mayor Pro Tem Luciria L. Lovette Councilmember Mitchell Boston Councilmember Patrick Underwood Councilmember Bridgette Kelly Councilmember Robert Dodd XIII. Executive Session None XIV. Adjournment Mayor and Council When an Executive Session is needed, iti is called for the following: (Litigation, Personnel and Real Estate) City of Walthourville Mayor and Council Meeting Minutes January 28, 2025 @ 6:00PM Walthourville Police Department LC Call to Order: The meeting was called to order by Mayor Sarah B. Hayes at 6:00 PM II. Roll Call: The roll was taken by the City Clerk and in addition to Mayor Hayes the following members were present: Mayor Pro Tem Luciria L. Lovette Councilmemeber Patrick Underwoood Councilmember Mitchell Boston Councilmember Bridgette Kelly Councilmember Robert (Bob)) Dodd The attendance oft the Counéilconstituted: a quorum. Attorney M. Ruberti was present int the absence of Attorney Luke R. Moses III. Invocation was given by Mayor Sarah B. Hayes and a moment ofsilence was observed for Mr. Keontae Grider. IV. Pledge of Allegiance was recited in unison. V. Adoption of Agenda: Mayor Pro Tem Lovetteand Councilmember Boston motioned to second with an amendment to the agenda. He stated he had a meeting'schéduled withbiberty County that he wanted to address. Mayor Hayes asked what thismeeting was pertaining toand she was not aware ofa any meeting. Councilmember Boston added that he wanted to inform theelected body. Mayor Hayes stated it would be respectful toi inform her of the meeting and givel her an opportunity to discuss theinformation. Mayor Hayes stated she would not allow this amendment, the Cityhasa Special Called Meetings scheduled for February 4th and that those items could be addressed then. Mayor Hayes did-not entertain the amendment. She asked for a counter motion to approve the agenda as it was written. Councilmember Doddmade the motion to approve, as second was not provided; therefore, Mayor Hayes sought the advice of Attorney Ruberti who stated the Mayor had the purview to continue the meeting. She asked the City Clerk, Shana T. Moss, who stated she should follow the advice ofthe City Attorney. the motion died foralack ofas second. VI. Adoption of Minutes January 14, 2025 Regular Meeting Minutes. The motion to approve was made by Councilmember Boston and the second was added by Councilmember Dodd. Vote: 4-1: Motion Carried. Members voting favorably were: Boston, Underwood, Kelly and Dodd. Member opposed: Mayor Pro Tem Lovette who stated she had not had time to read the minutes. January 14, 2025 Executive Session Minutes were taken by City Attorney Luke R. Moses and he was not present to present them. VII. Presentation(s) None 1 VIII. Agenda Items 1.HB 581 Update Attorney Andrew Ruberti Presented an overview ofHB 581. Key components ofHB 581 which include: Statewide homestead exemption: Limits the annual increase in property values for tax purposes to the Property tax process reforms: Includes procedural changes to property tax assessments and appeals Revenue reduction: Limits the ability of school districts to collect local property taxes as property values Local Governments are giving the option to opt ofthe statewide homestead exemption by advertising and holding three public hearings, passing ar resolution to opt out and filing the resolution with the Secretary of fState by March prior year's inflation rate Local option sales tax: Provides an optional sales tax to offset property taxes rise 1,2025. IX. Department Comments: Water Department Mr. Patrick Golphin Reported that the new bills were generated and submitted to QS1. He stated the trash fee would be reflect on the bill as $16.50 with a $3.00 Administrative Fee. Fire Department Deputy Chief Chance Chandler Reported the department responded to 92 calls. They answered the call for one structure fire in Allenhurst. Currently, Allenhurst does not have an IGA with'the Cityand Councilmember Kelly wanted to know who would pay for the services. Mayor Hayes stated the TownofAllenhurst would be-voting ont the Fire Fee IGA on Monday February 3rd at their Council Meeting. Councimember Underwood complimented the Fire Department for assisting with Long County Fire, He thanked the department for beinggood neighbors. Police Department ChiefChristopher Reed Reported the department.would baginholdineNeigbourigos Watch meetings on February 20. 2025 at 6:00 PM at the department. February21,2025, BINGO willbeheld atthe Department. He stated that Officer Wright had resigned, and several other officers haves stâted they mightbe exiting the department. X. Citizens Comments Walthourville Citizens Mr. Brenton Nobles statedthe city isi in bad shape. He referenced the outsourcing of Sanitation to Atlantic Waste. He posed the question, "what are wé getting out of this? "Why are the citizens being charged for?" He Ms. Alma Wells stated the city isi in bad shape. The Elected Officials don't get along and it shows. She stated the Fire Fee was supposed to have been eliminated in 2024. Now, the Fire Fee is still $25.00. She stated the Mayor and Council lied to the citizens. She looked at the bottled water sitting on the dais by the Elected Officials and she asked them, why they were drinking bottled water if the water is SO good? Councilmember Boston stated he did not want al Fire Fee. The city was supposed toi implement a millage; however, they did not want toi immediately burden the citizens and they opted for al Fire Fee which was cheaper. He: stated the Fire Fee was ongoing to defray the expenses of the Fire Department. He stated the city cannot continue operating at a deficit and that payroll needs to be downsized. Some employees might lose theirj jobs or reduce their pay. Ms. Wells said, "we asked for an audit and one hasn't been done." Mayor Pro Tem Lovette said the money for the audit was spent somewhere else. Councilmember Boston said the money was for a Forensic Audit and the city had to upgrade the computers recommended the GBI be calledin toseewhere the money has gone. 2 at City Hall. Mayor Hayes stated she had been in communication with the GBI, and an audit was not ruled out, Ms. Patricia Green, stated the exchange between the Elected Officials over the agenda, blew her mind and upset her sO badly she had to exit the Chamber. She stated she was disappointed; she has never seen the city in such bad conditions. She stated she was a member of the Council from 1983-2020 and she has never seen these interactions. She said the Mayor and Council must work together, there is no getting around it. She said shei iss SO upset she feels that it would be best ifHinesville took it over. She said the Mayor and Council talk to each other Mr. Hakeem Cleary stated that perhaps citizens could research some city matters themselves and see how other cities operate. He stated disagreements between the elected officials will occur and some disagreements are good, but it is how you navigate those disagreements. He stated he does-nothave a problem with the Fire Fee. she is in favor of an audit. sO rudely and they should be on the same team. XI. Mayor's Update Mayor Sarah B. Hayes Reported she has been in talks with Allenhurst about the Fire Fee for them.Atlantic Waste is doing a great job, she has been in constant communication with Mr. Sam'Sullivan. The $3.00 admin fee is for the billing. XII. Elected Officials' Comments: Mayor Pro Tem Luciria L. Lovette stated she has been pushing fora Forensic Audit, and she is still in favor of Councilmember Mitchell Boston stated all publie.metingsshould be assessable to all citizens. There are: miliary members who are outside oft thec country, and they nèed to beableto see whât is happening in the city. He added that people are going to bump heads, he wishes it was better The budget needs to be balanced, he has been in business for over 15 years, and he has aj plan to lower expenses. He has a plan to save the city millions. Councilmember Patrick Underwood added that he agreeswith everything that Councilmember Boston said. He Councilmember. Bridgette Kelly asked whatyear the audits stopped and why did the auditors quit. Mayor Hayes Mayor Hayes stated she stopped the reçording due to the interactions of the Mayor and Council. She added that the behavior of the elected officials is embarrassing, our vendors and creditors watch the meeting, and they don't want anything to do with the city. She stated the behavior and climate of the Elected officials must get back to civility. She stated she began haying work sessions and they stopped attending the work sessions. The work sessions were being conducted for the Elected Officials to hash out any differences prior to the regular meeting. Councilman Robert (Bob) Dodd reported the snow is gone; he doesn't foresee any snow within the next few Adjournment: At 6:59 the motion to adjourn was made by Mayor Pro Tem Lovette and the second was added by the audit. referenced the agénda and requested the agenda berevertedtoay prior format. stated the last complèted audit is 2020. She closed by saying we must get better. weeks. Councilmember Underwood. 3 City ofWalthourville Special Called Meeting Minutes February 4, 2025 @ 6:00 PM Walthourville Police Department I. II. The meeting was called to order at 6:001 PM by Mayor Sarah B. Hayes. Roll Call was taken by the City Clerk with the following members present in addition to Mayor Hayes. Councilmember Mitchell Boston Councilmember Bridgette Kelly Councilmember Patrick Underwood Councilmember Robert (Bob) Dodd Member/ Absents Mayor Pro TemLuciriaL. Lovette The alemdme-@eCouel. constituteda quorum. Attorney Luke R. Moses was present. III. Meeting Discussion Mayor and Council FY2025 Budget. Councilmember Boston statedt the city still needs to be conservative, because we are still spending more money than_we have revenue for. Councilmember Kelly stated she reviewed thebankstatemehtand she thinksthe city is depositing the money into the wrong fund. She referençed a check from December 318L that was for a utility bill, and it was placed in the General Fund instead ofthe WaterFund. She wanted to know why this was done. Water Supervisor, Mr. Patrick Golphin stated, City Hall is provided with a guide to deposit the amounts in from the city' 's software company. Every item on the city's bill is provided with a code and the system captures the amount for the Daily Cashier Report. City Hall runs the Cashier Report every morning and' itis'annotated what amounts are to be deposited into each fund. He added that City Hall does not perform the calculations; the city's accounting software provided accurate Councilmember Boston inquired about the vehicles that the council approved to sell. The Finance Manager, Mrs. Ivy Norris stated that some pertinent information that is needed for Gov Deals was not initially provided. Shei is working with the city'sr mechanic to obtain the necessary information. He also added that he thinks an account needs to be created for Atlantic Waste, who is the city's private solid waste collection company. He further added that the city's audits should be the number one priority. The city needs to have audits for 2021,2022,2023, and 2024. information to the city. 1 He additionally added thati in hiring an auditorl he feels the city should make a request forj proposals. Mayor Hayes stated that Councilmember Kelly is spearheading the city's search for an auditor. Councilmember Kelly added that she isi in communication with several auditors. Councilmember Boston informed his colleagues that he met with the county, and it is no secret about the city's financials. He began to speak about personnel and Attorney Moses stated if the conversation involved personnel it would need to be done in Executive Session. Councilmember Boston asked if the lift stations have generators? Mr. Golphin.replied, "No, the city's main lift station has the generator. Councilmember Boston asked Councilmember Dodd ifthe city can get generators? Councilmember Dodd who is the county's EMA Director stated yes and no. Generators are available during natural disasters but to just obtain a generator, typically that doesn't happen. Councilmember Dodd said the generators cost alotto maintain and during natural disasters everyone throughout the state is vying forgenerators. Councilmember Boston said he has been speaking with Liberty, County Tax Assessor Mr. Keith Payne. Mr. Payne stated Ms. Moss hast been a great resource. The city needs to certify the rollback rate before March. Councilmember Underwood asked Mayor Hayes, ift the city has advertised for as grant writer. Mayor Hayes stated, "yes. The council stated théy needed to set dates forthécity's 's chartèr.review. The Council stated they would bring some dates to the February 11, 2025 regular Mayor and Council meeting. At 6:25 PMai motion toenter into Executive. Session for personnel was made by Councilmember Kelly andthe second was added by Councilmember Boston. Vote: 4-0: Motion Carried Unanimously. At 7:10 PM a motion to exit Executive Session and re-enter into Special Called Meeting open session was made by Councilmember Boston and the second was added by Councilmember IV. Adjournment: At 7:11 PM a motion to adjourn was made by Councilmember Dodd and the Underwood. Vote: 4-0: Motion Carried Unanimously. Vote: 4-0: Motion Carried Unanimously. second was added by Councilmember Kelly. 2 Liberty Consolidated Planning Commission = Report Governing Authority: The City of Walthourville Camal LCPC * ExL2005 gComm Mayor & Council Date: February 11, 2025 Type of Permit: Owner of Business: Business License = Home Based Business Nateisha Magruder Business Managed By: Nateisha Magruder Property Zoned: Comments: MFR (Multi-Family Residential) This proposed business is a Home-Based Business that does full-service lawn care. The name of the business is Stealth Lawn Cuts, LLC. The location is 25 Broad Leaf Road. The Parcel Number is 064A049. LCPCZoning Recommendation: APPROVAL * Contingent upon any other applicable requirements. LCPCStaff: Pteis 2/3/25 Date Todd Kennedy City of Walthourville Business License Division NALTHOU URVILLE unaI Arey you, the applicant, the corporation, LLC or any shareholder currently delinquent in payment of anyt taxes or feest to any state or local government? No Ifyes, pleasei indicate thei type of tax or fee, and the amount due with the reason thet taxi is delinquent. NM Ifthis property is zoned residential, no clients, employees, sales, deliveries, storage ofi inventory, or equipment (initals) are allowed ont the premises. Only one commercial vehicle not to exceed 12,500 Ibs Gross weight used as NM Iswear or affirm that I have obtained or will obtain within thirty days of the date of this applicationa a City of transportation byt the occupant may! be parked at the residence. (initals) Walthourville Certificate of Occupancy: as required by the city ordinances. NM Iwill comply with the Zoning Restrictions stated above. (initals) Nateisha Mogruder affirm that the facts stated by me are true, lunderstand any misrepresentation or fraudulent statement is grounds for automatic dismissal oft this application and/revocation of the license.! understand that alls signs displayed on my premise must be permitted by the City of Walthourville, Ifurther understand that my business must operate in compliance with all applicable state, federal and local laws, ordinances and regulations, and that the granting of this occupation tax certificate or payment oft this occupation tax does not waive the right of any federal, state or local entity to regulate ande enforce laws, ordinances andi regulations. lunderstand that all decisions of the Business License Division may be appealed to the City of Walthourville. This2ist dayo of Jancary Legibly print name 2025 Natriha Magrader Signature of applicant_ b AA This application must be approved by the Liberty Courty Planning Commission Tax Map & Parcel#_ 064A049 Approved by:9 SLR -loldkemgy Datei the request willl be presented to Mayor and Council: Mailing Address:P.O Box K, Walthourville, GA: 31333 Office Location: 222 Busbee Road, Walthourville, GA: 31333 Zoning Classification 2-11-35 MFR Date Approved: 1/27/25 **APPLICANT MUST COMPLETE THE AFFIDAVITS ANDI PROVIDE A SECURE AND VERIFIABLE DOCUMENT*** Phone: (912)368-7501 Web site address: wahohalhouplecon 0CG.AS06100. AFFIDAVIT By executing this affidavit under oath, as an applicant for al loan, grant, tax credit and/or other public benefit, as referenced in O.C.G.A. $ 50-36-1, administered by the Georgia Department of Community Affairs, the undersigned applicant verifies one oft the following with respect to my application for a public benefit: 1) 2)_ 3)_ Iam al United States Citizen. Iam a legal permanent resident of the United States. Iam a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by thel Department ofl Homeland Security or other federal My alien number issued by the Department of Homeland Security or other federal immigration agency. immigration agency is: The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided atl least one: secure and verifiable document, as required by O.C.G. A. $ 50-36-1(e)(1), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: Inr making the above representation under oath, Iunderstand that any person who knowingly and willfully makes a false fictitious, or fraudulent statement or representation in an affidavit shall be guilty ofa violation ofO.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute. Executed this a2iye of Jaruar,205 in Walhourvillciy), "Signgture of Applicant Printedl Maul 77 Magruder of ApplicaN SUBSCRIBED AND SWORN BEFORE MEONTHISTHE 2LDAYOF Auaiy 2015 ua Kecsno NOTARY PUBLIC My Commission Expires: Comm. Exp. 07/26/27 UEL COU 7-d0-37 *This Afidavit must be signed by thes same) person who executes the Application Certification Form Letter MALTHOU City of Walthourville Business License Division APPLICATION FOR CHANGE INI LICENSE DURVILLESS uman. aoas FOR THE' YEAR_ $25.00 CHARGE FORF RELOCATION $25.00 CHARGE FORI NAME CHANGE OF BUSINESS INDICATE THE CHANGE YOU ARE APPLYING FOR: DATE_ al JoAuany ACCOUNT NUMBER ) )NAME )ADDRESS )NAME AND ADDRESS Current business name_ Owner: Manager:. CURRENTI INFORMATION OF BUSINESS: Stecllh Lan Cuts LIC Address:, as Broad Leaf Rd Allenhurst, GA 3130) Nateisha Magruder Natcishe Magruder Nature ofbusiness: Full Service Lawn Cart Phone number: (913)402-2907 COMPLETE ONLYTHE SPACE THAT WOULD APPLY1 TO YOUR CHANGE: New name oft business: New address ofb business:. New manager:. New phone number: The undersigned affirms that the above statements are true and oreztoihgbestofns/Aey-powledge and belief. Thisc?1 AAuaaaas PERSONNALIYbefore the undersigned: appeared Nateisha Magruder A4 GAORIZEOSIGNATURÉC 4 who on Oath! has sworn thatt the abovei information given therein ist true and correct. Sworn andsubscribed! before me this OL eouuany SATofeoria COUNTYOF Ebene hDcow p0as CITYOF Hinesville ONYA. TARI Comm. Exp. 07/26/27 UELIO NOTARYPUBUE Mailing Address: P.O Box K, Walthourville, GA3 31333 Office Location: 222 Busbee Road, Walthourville, GA: 31333 Phone: (912)368-7501 Web'sité address: oohathounlecen CITY OF WALTHOURVILLE BUSINESS LICENSE DIVISION = PRIVATE EMPLOYER. AFFIDAVIT By executing this affidavit under oath, the undersigned private employer verifies one oft the following with respect to its appliçation fora a business license, occupational tax certificate, or other document required to operate al business as referenced in O.C.G.A. $36-60-6(d): Section 1. Please check only one: (A). On January Isofthel below-signed year, thei individual, firm, or corporation employed more than ten (10) employees'. *** Ifyous select Section 1(A), please fill out Section 2 and then execute below. (B). * On January ISt of the below-signed year, thei individual, firm, or *** Ifyou select Section 1(B), please skip Section 2 and execute below. corporation employed ten (10) or fewer employees. Section 2. The employer has registered with and utilizes the federal work authorization program in accordance with the applicable provisions and deadlines established in O.C.G.A. $36-60-6. The undersigned private employer also attests that its federal work authorization useri identification number and date of authorization are: as follows: Stealth Lawn Cuts LLC. Name of Private Employer Federal Work Authorization User Identification Number 21 January 2025 Authorization Date of Ihereby declare under penaltyofperjuryl that the foregoingi is true and correct. Executed ony Jonuariayst 2025 in Walhsurville (city), GA (state). 1572 Signature of Authorized' Officer or Agent Natisha Magnuder Printed Name and' Title ofAuthorized Officer or Agent SUBSCRIBED: ARPSWORYBEROREME ONTHIS THE 21 yapot Comm. Exp. f 07/26/27 Arantanyas NOTARY PUBLIC My Commission Expires: 2-26-27 To determine the number ofe employees for purposes oft this affidavit, ab business musto counti its total number ofe employees company- wide, regardless oft the city, state, or country in which they are based, working at least 35 hours a week. Mailing Address: P.O Box K, Walthourville, GA: 31333 Office Location: 222 Busbee Road, Walthourville, GA31333 Phone: (912)368-7501 Web: site address: wapohalthouplecon AMHOL CityofWalthourville Business License Division Application for corporation or Limited Liability Company LLC Occupation Tax Certificate CURYTLLKS *Thea application must bet filled out completelyt to obtain a City of Walthourville Occupation Tax Certificate. Payment must be filed witht the application to obtaina a City of Walthourville Occupation tax Certificate. This application willr not be processedifitisnot accompanied byt the appropriate tax fee. Youy will not be billed. Please print withi ink or type. In order for the appropriate tax orf fee tol be determined thea application accompanied bya all appropriate documents must be submitted in person. Pursuant tol The Georgia Immigration Reform Act that was passed byt the State Legislature and signed by the Governor all persons applying for renewing a City of Walthourville Tax Certificate must provide as secure and verifiable document as required by O.C.G.A 50-36-1(e) (1) and: sign andr notarize the affidavit required by O.C.G.A! 50-36-1 (e) (2) and the affidavit required by 0.C.G.A36-60-6 (d). This Business is: (X) New Application )Ownership Change/D Date ownership changed & Certificate #_ )lamf fillingan name/or address change for Certificate#_ Nameb business as_ Stealth Lawn Cwts,LLC Business Phone#9W) Name of Corporation/lLC". (912)402-2907 Business Address_ 25 Broad Leaf Bd, Allenhwrst GA 31301 Mailing Address_ 25 Broad Leaf hd Alenhurst GA 31301 Home Addrèss_ 25 Broad Leaf Rd Citvy Allenhwrst State_ GA Zip 31301 Email Address_ alallalnah@gaaila Lom Full Detailed Description of Business Full Service Lawn Core Number of employees (including ownership) in City ofWalthourville, a Owner Name_ Nateisha Magruder SS#_ DOES THIS BUSINESS REQUIRE ASTATE LICENSE? X_(YES). (Please attacha a copy ofy yours state license or certification) E-verify# (Required if1 11 or more employees), State Sales Taxl ID#_ Federal ID# (NO) DOB_YDec 1979 *** Alle electrical, mechanical, plumbing, well drilling contractors, salon, mobile! home dealers, mobile! home installers, anda any other contractort thatisr required to ***Alld commercially used buildingr may bes subjectt toa ani inspection forf fire and safety code compliance prior to anyo certificate ofc occupancy orb businessI license! being havea as Statec ofG Georgial License willl ber requiredt toa attacha copy oft thel licenset tot thisa application beforei insurance. issued. ZONING DEPT FIRE DEPT CITY COUNCIL BUSINESS LICENSE DEPT DATE RECEIVED BUSINESS LICENSEI ISSUANCE DATE. FOR OFFICE USEONLY DANPAOKDIDSWPODH, DAPAODIDSWPROVDH, DAPAOKDIDSWPAOED8, DATE_ DATE_ DATE_ Mailing Address: P.O Box K, Walthourville, GA3 31333 Office Location: 222 Busbee Road, Walthourville, GA: 31333 Phone: (912)368-7501 Web site address: wwcirolatnoumliecon STATE OF GEORGIA Secretary of State Corporations Division 313 West Tower 2N Martin Luther King, Jr. Dr. Atlanta, Georgia 30334-1530 ANNUAL REGISTRATION *Electronically Filed* Secretary of State Filingl Date: 1/10/2025 12:02:09 PM BUSINESSINFORMATION CONTROL: NUMBER BUSINESS NAME BUSINESS TYPE EFFECTIVEDATE 23063277 Stealth Lawn Cuts LLC Domestic Limited Liability Company 01/10/2025 2025 ANNUAL REGISTRATION PERIOD PRINCIPALOFFICE ADDRESS ADDRESS REGISTEREDAGENT NAME Nateisha Magruder 251 Broad Leafr rd, Allenhurst, GA, 31301, USA ADDRESS COUNTY Liberty 25 Broad Leaf Rd, Allenhurst, GA, 31301, USA AUTHORIZERI INFORMATION AUTHORIZER TITLE AUTHORIZER SIGNATURE Nateisha Magruder Registered Agent EoadlGRd 064A019/ 4030 LIBEA Ca66 0BAD90 OGGA0S 064A097 064A093 064A098 064A092 Liberty Consolidated Planning Commission - Report Governing Authority: The City of Walthourville Consoli * LCPC * EL9 2005 e Commy Mayor & Council Date: February 11, 2025 Type of Permit: Owner of Business: Business License - Mobile Veterinarian Kenneth Kinnard Business Managed By: Kenneth Kinnard Property Zoned: Comments: C-3 (Highway Commercial) This proposed business is a Mobile Veterinarian Clinic that services cats and dogs with exams, vaccines, labs and weliness. The name of the business is Family Paws Mobile Vet. The location is! 5782 W Oglethorpe Hwy. The Parcel Number is 041B012. LCPC Zoning ecommendation: APPROVAL * Contingent upon any other applicable requirements. LCPCStaff: AR Todd Kennedy 2/3/25 Date NALTHOL City of Walthourville Business License Division Mailing Address: P.OBox K Office Location 222 Busbee Road Walthourville, GA: 31333 Walthourville, GA31333 Phone1912/368-7501 Web site address- wwwdbohattonilecen Application For corporation or limited Liability Company LLC Occupation Tax Certificate *The application must be filled out completely to obtain a City of Walthourville Occupation Tax Certificate. Payment must bet filed with the application to obtain a City of Walthourville Occupation tax Certificate. This application will not be processed ifi it is not accompanied by the appropriate taxi fee. You will not be billed. Please print withi ink or type, In order for the appropriate tax or fee to be determined the applicatonatcompanied by all appropriate documents must be submitted in person. Pursuant to The Georgia Immigration Reform Act that was passed by the State Legislature and signed by the Governor all persons applying for renewing a City of Walthourville Tax Certificate must providea secure and verifiable document as required by O.C.G.A5 50-36-1(e) (1) and sign and notarize the affidavit required by O.C.G.A! 50-36-1(e)(2): and the affidavit required by 0.C.G.A36-60-6(d). This Business is: X New Application )Ownership Change / Date ownership changed & Certificate # )lam filling a name/or address change for Certificate# Name business as_ Family Pws Mobile VeBusiness Phone#! 912)_ 419-5 5756 Name of Corporation/LLC" Fammily Paws Mokile Vet Business Address_ 12 Butler Ave PO Box 10 Miduay GA 3/320 Mailing Address_ 12 Butler Ave Po Box 10 Milwayi GA 3/320 Email Address Fammilylaw/oble a outlvok. com Full Detailed Business Mobile Clinic that AtiV-terindan bervices cats andlags vh eXams gipaa. and wellness No Surseries or Ewthinasiss. All services will becenducfed in ow mokile vehicles. Date Business began in City of Walthourville #ofe employees in City of Walthourville State Sales Taxl ID#_ Owner Name_ Kenneth Kinngrd E-verify# (Required if 11 or more employees Federal ID#_ SS# DOB_ 1-22-30 Home Address_ 340 Brigan tine DunmoreApt# CityMidway State GA Zip_ 3/320 *** Alle electrical, mechanical, plumbing, well drillingo contractors, mobileh home dealers, mobile! homei installers, and any other contractort thatis requiredt tol havea aState of Georgial License will ber requiredt toa attacha copy oft the licenset tot this application beforei insurance. ***Allc commercially used! building may bes subject to ani inspection forf fire ands safety code compliance priort toa any certificate ofc occupancyo or business license beingi issued. Are you, the applicant the corporation, LLC or any shareholder currently delinquent in payment of any taxes or fees to any state or local government? No Ifyes, please indicate the type oft tax or fee, and the amount due withi the reason the taxi is delinquent. If this propertyi is zoned residential, no clients Iswear or affirm that Ihave obtained or will obtain Employees, sales, deliveries, storage of inventory, within thirty days of the date of this applicationa Ore equipment are allowed on the premises. Only City of Walthourville Certificate of Occupancy as One commercial vehicle not to exceed 12,500 Ibs required byt the city ordinances. Gross weight used as transportation by the occupant May be parked at the residence. Iwill comply with the Zoning Restrictions stated above: KK Signature: (initals) Keneth Kinveifimt that thei facts stated byr me are true, lunderstand any misrepresentation orf fraudulent statement is grounds for automatic dismissal oft this pplatonandfrevocation oft the license. lunderstand that all signs displayed on my premise must be permitted by the City of Walthourville, Ifurther understand that my business must operated in compliances with all applicable state, federal & local laws, ordinances & regulations, & that the granting oft this occupation tax certificate or payment of this occupation tax does not waive the right of any federal, state or local entity to regulate & enforce laws, ordinances & regulations. lunderstand that all decisions of Business License Division may be appealed to the City of Walthourville. This_ day of 20_25. Signature of applicant legibly print name_ Kenneth Kinnerd This application must be approved by the Liberty County Planning Commission Tax Map & Parcel# Approved by: Zoning Classification Date Approved: Date the request willl be presented to Mayor and Council: ***APPLICANT MUST COMPLETETHE/ AFFIDAVITS ANDI PROVIDE AS SECURE ANDI VERIFIABLE DOCUMENT** ACGAISAIOOATIANT By executing this affidavit under oath, as an applicant for a loan, grant, tax credit and/or other public benefit, as referenced in O.C.G.A. $ 50-36-1, administered by the Georgia Department of Community Affairs, the undersigned applicant verifies one oft the following with respect to my application for aj public benefit: 1) X 2)_ 3). Iam al United States Citizen. Iam a legal permanent resident of the United States. Iam a qualified alien or non-immigrant under the Federal Immigration and Nationality. Act with an alien number issued by thel Department of Homeland Security or other federal My alien number issued by the Department of Homeland Security or other federal immigration agency. immigration agency is: The undersigned applicant also hereby verifies that he or shei is 18 years ofa age or older and has provided at least one secure and verifiable document, as required by O.C.G. A. $50-36-1()(), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: Inr making the above representation under oath, I understand that any person who knowingly and willfully makes a false fictitious, or fraudulent statement or representation in an affidavit shall be guilty ofa violation ofO.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute. Executed this theanday aigauaf 2085 in Jlidiny (cit),8A. (state). Kekel *Signature of Applicant Kenneth Kinnerd Printed Name of Applicant P MIGD C Exp. E 03/19/28 E4 SUBSCRIBED ANDSWORN BEFOREI MEONTHISTHE, aDAY OF Canuduy Whuu) Suk NOTARY PBLICLO My Commission Expires: 3-19-28 2085 0 *This Afidavit must be signed by thes same person who executes the Application Certification Form Letter Secure and Verifiable Documents Under 0.C.G.A.S50-362 Issued August 1, 2011 by the Office of the. Attorney General, Georgia The Illegal Immigration Reform and Enforcement Actof2011 ("TIREA") provides that "[njot later than August 1, 2011, the. Attorney General shall provide and make public on the Department ofLaw's website al list of acceptable secure and verifiable documents. Thel list shall bei reviewed and updated annually by the Attorney General."O.C.G.A. $ 50-36-2(f). The Attorney General may modify this list on a more frequent basis, ifi necessary. The following list of secure and verifiable documents, published under the authority of O.C.G.A. $50-36-2, contains documents that are verifiable for identification purposes, and documents on this list may not necessarily bei indicative of residency or immigration status. AUnited States passport or passport card [O.C.G.A. S 50-36-2(b)(3); 80 CFR 8 274a.2] AUnited States military identification card IO.CGA8036200): 8 CFR 8 274a.2] Adriver's license issued by one oft the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the Commonwealth oft thel Northern Marianas Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided that it contains aj photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable thei identification of the bearer [O.C.G.A. $: 50-36-2(b)(3); 8 CFR $ 274a.2] Ani identification card issued by one oft the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Marianas Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided that it contains aj photograph of thel bearer or lists sufficienti identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification oft thel bearer [O.C.G.A. $50-36-20b)(3); 80 CFR 8 274a.2] A tribal identification card of ai federally recognized Native. American tribe, provided that itc contains aj photograph of thel bearer or lists sufficient identifying information regarding the bearer, such as name, dateofbirth, gender, height, eye color, and address to enable thei identification of thebearer.n Alisting of federally recognized Native American tribes htp/ypybiagay/wholeAmIAgISTrhiGommensmise/TibalDiectorv/ind AUnited States PermarenResdegCand or Alien Registration Receipt Card [O.C.G.A. An Employment Authorization Document that contains aj photograph of the bearer A passport issued by a foreign government [O.C.G.A. $50-36-2(b)(3); 8 CFRS274a.2] may be found at: a ex.htm OCGAB3036209:; 8 CERS 274a.2] . $50-36-2(b)(3); 8 CFR'S274a-2y [O.C.G.A. $ 50-36-2(b)(3); 8CFR 8 274a.2] Al Merchant Mariner Document or Merchant Mariner Credential issued by the United AFree and Secure Trade (FAST) card IO.CGA83036200): 22CFRS41.2) States Coast Guard O.CGA.8503620); 8CFR $274a.2] AN NEXUS card [O.C.G.A. $50-36-2(b)(3); 22 CFR $41.2] ASecure Electronic Network: for Travelers Rapid Inspection (SENTRI) card [O.C.G.A. A driver's license issued by a Canadian government authority [O.C.G.A. 8: 50-36-2(b)(3); ACertificate of Citizenship issued by the United States Department of Citizenship and Immigration Services (USCIS) (Form N-560 or Form NS6DIOCGA1386200A ACertificate of Naturalization issued by the United States Department of Citizenship and Immigration Services (USCIS) (Form N-550 or Form N-570) [O.C.G.A. $5 50-36-2(b)(3); In addition to the documents listed herein, if, in administering aj public benefit or program, an agency is required by federal law to accept a document or other form of identification forj proof of or documentation ofi identity, that document or other form of identification will be deemed a secure and verifiable document solely for that particular program or administration of that particular public benefit. [O.C.G.A. $50-36-2(c)] $50-36-2(b)(3); 22 CFR $41.2] 8CFR $ 274a.2] 6CFRS37.11) 6CFR $37.11] Private Employer Affidavit Pursuant To O.C.G.A. $3 36-60-6(d) By executing this affidavit under oath, the undersigned private employer verifies one of the following with respectt toi its application for a business license, occupational tax certificate, or other document required to operate al business as referençed in O.C.G.A. $ 36-60-6(d): Section 1. (A). Please check only one: On. January 1"d of the below-signed year, the individual, firm, or corporation employed more than ten (10) employees'. *** If you select Section 1(A), please fill out Section 2 and then execute below. (B). X On. January 1 of thel below-signed year, the individual, firm, or ***] If you select Section 1(B), please skip Section 2 and execute below. corporation employed ten (10) or fewer employees. Section 2. The employer has registered with and utilizes the federal work authorization program in accordance with the applicable provisions and deadlines established in O.C.G.A. $3 36-60-6. The undersigned private employer also attests that its federal work authorization useri identification number and date of authorization are as follows: Name of Private Employer Federal Work Authorization User Identification Number Date of Authorization Ihereby declare under penalty of perjury that the foregoing is true and correct. Executed on 2035in (city), GA_( (state). Signature of Authorized Officer or Agent Kenneth Kinneird Lowner) Printed Name and' Title of Authorized Officer or Agent SUBSCRIBED. AND: SWORN BEFOREI ME ON THIS THE. NOTARY PUBLIC My Commission Expires: DAYOF. ,201 'To determine the number of employees forp purposes oft this affidavit, a business must counti its total number of employees company-wide, regardless oft thec city, state, or country in which they are based, working atl least 35 hours a week. 8 BUSBEE RD a BUSBEE RD O 880 pyeegsng Siz LIBER EDVISO GEORGIA MUNICIPALEMPLOYEES BENEFIT SYSTEM DEFINED BENEFIT RETIREMENT PLAN AN ORDINANCE and for ADOPTION AGREEMENT CivyofWalthourville Form Pre-approved Plan Adoption Agreement Amended and Restated for Third Six-Year Cycle, 2020 Cumulative List City of Walthourville (2023-2025 Restatement) TABLEOF CONTENTS PAGE I. AN ORDINANCE. II. GMEBS DEFINED BENEFIT RETIREMENT PLAN ADOPTION AGREEMENT 1. ADMINISTRATOR ADOPTING EMPLOYER. GOVERNING AUTHORITY PLAN REPRESENTATIVE. PENSION COMMITTEE. 6. TYPE OF ADOPTION. 7. EFFECTIVE DATE. PLAN YEAR. 2. 3. 4. 5. 8. 9. CLASSES OF ELIGIBLE EMPLOYEES. A. Eligible Regular Employees 10. ELIGIBILITY CONDITIONS. 11. WAITING PERIOD.. 13. CREDITED SERVICE. .5 .5 .5 .6 6 B. Elected or Appointed Members of the Governing Authority A. Hours Per Week (Regular Employees). B. Months Per Year (Regular Employees): 12. ESTABLISHING PARTICIPATION IN THE PLAN. A. Credited Past Service with Adopting Employer. 8 9 10 12 .13 .13 14 16 .20 .20 .20 .21 23 .25 .25 .26 .26 B. Prior Military Service C. Prior Governmental Service.. Vacation, or Personal Leave). 14. RETIREMENT ELIGIBILITY. A. Early Retirement Qualifications B. Normal Retirement Qualifications. C. Alternative Normal Retirement Qualifications. D. Disability Benefit Qualifications 15. RETIREMENT BENEFIT COMPUTATION. A. Maximum Total Credited Service.. B. Monthly Normal Retirement Benefit Amount. C. Monthly Early Retirement Benefit Amount D. Monthly Late Retirement Benefit Amount (check one):. E. Monthly Disability Benefit Amount. F. Minimum/Maximum Benefit For Elected Officials 16. SUSPENSION OF BENEFITS FOLLOWING BONA FIDE SEPARATION OF SERVICE; COLA. D. Leave Conversion for Unused Paid' Time Off(e.g., Sick, -i- City of Walthourville (2023- -2025 Restatement) A. Re-Employment as Eligible Employee After Normal, Alternative Normal, or Early Retirement and Following Bona Fide Separation of Service (see Basic Plan Document Section 6.06(c) Regarding Re-Employment as an Ineligible Employee and Basic Plan Document Section 6.06(e)and( Regarding Re-Employment After Disability Retirement) 26 .28 .28 28 .29 .30 .30 .31 32 .33 33 34 B. Cost OfLiving Adjustment. A. Eligible Regular Employees 18. RERETREMENTDEATH BENEFITS A. In-Service Death Benefit.. B. Terminated Vested Death Benefit. 19. EMPLOYEE CONTRIBUTIONS. 17. TERMINATION OF EMPLOYMENT BEFORE RETIREMENT; VESTING B. Elected or Appointed Members ofthe Governing Authority 20. MODIFICATION OF THE TERMS OF THE. ADOPTION 21. TERMINATION OF THE. ADOPTION AGREEMENT. 22. EMPLOYER ADOPTION AND AUTHORIZATION FOR AGREEMENT. AMENDMENTS ii- City of Walthourville (2023-2025 Restatement) I.A AN ORDINANCE An Ordinance to amend and restate the Retirement Plan for the Employees oft the City of Walthourville, Georgia, in accordance with and subject to the terms and conditions set forth in the attached Adoption Agreement, any Addendum to the Adoption Agreement, the Georgia Municipal Employees Benefit System (GMEBS) Basic Plan Document, and the GMEBS Trust Agreement. When accepted by the authorized officers of the City and GMEBS, the foregoing shall constitute a Contract between the City and GMEBS, all as authorized and provided by O.C.G.A. $ 47-5-1 et seq. BEI IT ORDAINED by the Mayor and Council oft the City of Walthourville, Georgia, and Section 1. The Retirement Plan for the Employees of the City of Walthourville, Georgia, is hereby amended and restated as set forth in and subject to the terms and conditions stated in the following Adoption Agreement, any Addendum to the Adoption Agreement, the Georgia Municipal Employees Benefit System (GMEBS) Basic Plan Document, and the GMEBS Trust itis hereby ordained by the authority thereof: Agreement. Ordinance continued on page3 37 City of Walthourville (2023- 2025 Restatement) II. GMEBS DEFINED BENEFIT RETIREMENTPLAN ADOPTION AGREEMENT 1.A ADMINISTRATOR Georgia Municipal Employees Benefit System 201 Pryor Street, SW Atlanta, Georgia 30303 Telephone: 404-688-0472 Facsimile: 404-577-6663 2. ADOPTING EMPLOYER Name: City of Walthourville, Georgia 3. GOVERNING AUTHORITY Name: Mayorand Council Phone: (912)368-7501 Facsimile: (912)368-2903 Address: P.O. Box K, Walthourville, GA: 31333-0911 4. PLAN REPRESENTATIVE (See Section 2.49 of Basic Plan Document) [To represent Governing Authority in all communications with GMEBS and Employees) Name: City Clerk Phone: (912) 368-7501 Facsimile: (912)368-2903 Address: P.O. Box K, Walthourville, GA 31333-0911 City of Walthourville (2023-2025 Restatement) 5. PENSION COMMITTEE [Please designate members by position. Ifnot, members of Pension Committee shall be determined in accordance with Article XIV oft the Basic Plan Document Pension Committee shall be as provided in Article XIV oft the Basic Plan Document, except that the two employee representatives will be appointed annually by the Governing Authority. Pension Committee Secretary: City Clerk Address: P.O. Box K, Walthourville, GA 31333-0911 Phone: (912)368-7501 Facsimile: (912)368-2903 6. TYPE OF ADOPTION This Adoption Agreement is for the following purpose (check one): D This is a new defined benefit plan adopted by the Adopting Employer for its Employees. This is an amendment and restatement of the Adopting Employer's preexisting B This is an amendment and restatement ofthe Adoption Agreement previously adopted by This plan does not replace or restate an existing defined benefit plan. non-GMEBS defined benefit plan. the Employer, as follows (check one or more as applicable): R To update the Plan to comply with the PATH Act, and other applicable federal laws and guidance under IRS Notice 2020-14 (the 2020 Cumulative List). To make the following amendments to the Adoption Agreement (must specify below revisions made in this Adoption Agreement; all provisions must be completed in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)()): 7. EFFECTIVE DATE NOTE: This Adoption Agreement and any Addendum, with the accompanying Basic Plan Document, is designed to comply with Internal Revenue Code Section 401(a), as applicable toa governmental qualified defined benefit plan, and is part of the GMEBS Defined Benefit Retirement Plan. Plan provisions designed to comply with certain provisions of the Protecting Americans from Tax Hikes Act of2015 ("PATH Act"); and Plan provisions designed to comply with certain provisions of additional changes in federal law and guidance from the Internal Revenue Service under Internal Revenue Service Notice 2020-14 (the 2020 Cumulative List) are effective as of the applicable effective dates set forth in the Adoption Agreement and Basic Plan Document. By adopting this Adoption Agreement, with its accompanying Basic Plan Document, the Adopting Employer is adopting a plan document intended to comply with Internal Revenue 3- City of Walthourville (2023-2025 Restatement) Code Section 401(a), as updated by the PATH Act and the 2020 Cumulative List with the (1) Complete this item (1) only ifthis is a new defined benefit plan which does not replace applicable effective dates. or restate an existing defined benefit plan. The effective date ofthis Plan is (insert effective date of this Adoption Agreement but not earlier than the first day of (2) Complete this item (2) only if this Plan is being adopted to replace a non-GMEBS Except as otherwise specifically provided in the Basic Plan Document or in this Adoption this Adoption Agreement but not earlier than the first day oft the current Plan Yeari in which the Plan is adopted (unless a retroactive corrective amendment is permitted under EPCRS, Rev. Proc. 2021-30 (or subsequent updated guidance)). This Plan is intended to replace and serve as an amendment and restatement of the Employer's the current Plan Year in which the Plan is adopted). defined benefit plan. Agreement, the effective date of this restatement shall be (insert effective date of preexisting plan, which became effective on (insert original effective date of preexisting plan). (3) Complete this item (3) only if this is an amendment and complete restatement of the Except as otherwise specifically provided in the Basic Plan Document or in this Adoption Agreement, the effective date of this restatement shall be the date of its approval by the Governing, Authority (insert effective date of this Adoption Agreement but not earlier than the first day of the current Plan Year in which the Plan is adopted (unless a retroactive corrective amendment is permitted under EPCRS, Rev. Proc. 2021-30 (or This Plan is adopted as an amendment and restatement of the Employer's preexisting GMEBS Adoption Agreement, which became effective on January 28. 2020 (insert effective date of most recent Adoption Agreement preceding this Adoption The Employer's first Adoption Agreement became effective January 1, 2003 (insert effective date of Employer's first GMEBS Adoption Agreement). The Employer's GMEBS Plan was originally effective December 1, 1992 (insert effective date of Employer's original GMEBS Plan). (Ifthe Employer's Plan was originally a non-GMEBS Adopting Employer's existing GMEBS defined benefit plan. subsequent updated guidance)). Agreement). Plan, then the Employer's non-GMEBS Plan was originally effective insert effective date of Employer's original non-GMEBS Plan).) (ifapplicable, City ofWalthourville (2023-2025 Restatement) 8. PLAN YEAR Plan Year means (check one): Calendar Year Employer Fiscal Year commencing R Other (mustspecify month and day commencing): December1. 9. CLASSES OF ELIGIBLE EMPLOYEES Only Employees of the Adopting Employer who meet the Basic Plan Document's definition of "Employee" may be covered under the Adoption Agreement. Eligible Employees shall not include non-governmental employees, independent contractors, leased employees, nonresident aliens, or any other ineligible individuals, and this Section 9 must not be completed in a manner that violates the "exclusive benefit rule" of Internal Revenue Code Section 401(a)(2). A. Eligible Regular Employees Regular Employees include Employees, other than elected or appointed members of the Governing Authority or Municipal Legal Officers, who are regularly employed in the services of the Adopting Employer. Subject to the other conditions of the Basic Plan Document and the Adoption Agreement, the following Regular Employees are eligible to participate in the Plan B ALL - All Regular Employees, provided they satisfy the minimum hour and other (check one): requirements specified under "Eligibility Conditions" below. ALL REGULAR EMPLOYEES EXCEPT for the following employees (must specify; specific positions are permissible; specific individuals may not be named): B. Elected or Appointed Members ofthe Governing Authority An Adopting Employer may elect to permit participation in the Plan by elected or appointed members of the Governing Authority and/or Municipal Legal Officers, provided they otherwise meet the Basic Plan Document's definition of "Employee" and provided they satisfy any other requirements specified by the Adopting Employer. Municipal Legal Officers to be covered must be specifically identified by position. Subject to the above conditions, the Employer hereby elects the following treatment for elected and appointed officials: (1) Elected or Appointed Members oft the Governing Authority (check one): ARE NOT eligible toj participate in the Plan. 3 ARE eligible to participate in the Plan. date, or special waiting period provision): Please specify any limitations on eligibility to participate here (e.g., service on or after certain 5- City ofv Walthourville (2023-2025 Restatement) (2) Municipal Legal Officers (check one): B ARE NOT eligible to participate in the Plan. ARE eligible to participate in the Plan. The term "Municipal Legal Officer" shall include only the following positions (must specify - specific positions are permissible; specific Please specify any limitations on eligibility to participate here (e.g., service on or after certain date) (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable equirementofTresury individuals may not be named): Regulation 1.401-1(b)0)0): 10. ELIGIBILITY CONDITIONS A. Hours Per Week (Regular Emplovees) The Adopting Employer may specify a minimum number of work hours per week which are required to be scheduled by Regular Employees in order for them to become and remain "Eligible Regular Employees" under the Plan. It is the responsibility of the Adopting Employer to determine whether these requirements are and continue to be satisfied. The Employer hereby elects the following minimum hour requirement for Regular Employees: D D No minimum Other: R 201 hours/week (regularly scheduled) 301 hours/week (regularly scheduled) (must not exceed 40 hours/week regularly scheduled) Exceptions: Ifa different minimum hour requirement applies to a particular class or classes of Regular Employees, please specify below the classes to whom the different requirement applies Class(es) of Regular Employees to whom exception applies (must specify - specific positions and indicate the minimum hour requirement applicable to them. are permissible; specific individuals may not be named): Minimum hour requirement applicable to excepted Regular Employees: D No minimum D 201 hours/week (regularly scheduled) 301 hours/week (regularly scheduled) Other: (must not exceed 401 hours/week regularly scheduled) B. Months Per Year (Regular Employees) The Adopting Employer may specify a minimum number of work months per year which are required to be scheduled by Regular Employees in order for them to become and remain "Eligible Employees" under the Plan. It is the responsibility of the Adopting Employer to determine whether these requirements are and continue to be satisfied. The Employer hereby elects the following minimum requirement for Regular Employees: 6- City ofWalthourville (2023- -2025 Restatement) No minimum Atl least 5 months per year (regularly scheduled) Exceptions: If different months per year requirements apply to a particular class or classes of Regular Employees, the Employer must specify below the classes to whom the different Regular Employees to whom exception applies (must specify - specific positions are requirements apply and indicate below the requirements applicable to them. permissible; specific individuals may not be named): The months to year requirement for excepted class(es) are: D D No minimum At least months per year (regularly scheduled) 11. WAITING PERIOD Except as otherwise provided in Section 4.02(b) of the Basic Plan Document, Eligible Regular Employees shall not have a waiting period before participating in the Plan. Likewise, elected or appointed members of the Governing Authority and Municipal Legal Officers, if eligible to participate in the Plan, shall not have a waiting period before participating in the Plan. 12. ESTABLISHING PARTICIPATION IN THE PLAN Participation in the Plan is considered mandatory for all Eligible Employees who satisfy the eligibility conditions specified in the Adoption Agreement, except as provided in Section 4.03(e) of the Basic Plan Document. However, the Employer may specify below that participation is optional for certain classes of Eligible Employees, including Regular Employees, elected or appointed members of the Governing Authority, Municipal Legal Officers, City Managers, and/or Department Heads. If participation is optional for an Eligible Employee, then in order to become a Participant, the Employee must make a written election to participate within 120 days after employment, election or appointment to office, or if later, the date the Employee first becomes eligible to participate in the Plan. The election is irrevocable, and the failure to make the election within the 120 day time limit shall be deemed an irrevocable election not to participate in the Plan. Classes for whom participation is optional (check one): None (Participation is mandatory for all Eligible Employees except as provided in Participation is optional for the following Eligible Employees (must specify - specific positions are permissible; specific individuals may not be named; all Section 4.03(e) oft the Basic Plan Document). positions or classes specified must be Eligible Employees): 13. CREDITED SERVICE In addition to Current Credited Service the Adopting Employer may include as Credited Service the following types ofservice: -7- City of Walthourville (2023- - 2025 Restatement) A. Credited Past Service with Adopting Employer Credited Past Service means the number of years and complete months of Service with the Adopting Employer prior to the date an Eligible Employee becomes a Participant which are treated as credited service under the Plan. (1) Eligible Employees Employed on Original Effective Date of GMEBS Plan. With respect to Eligible Employees who are employed by the Adopting Employer on the original Effective Date oft the Employer's GMEBS Plan, Service with the Adopting Employer prior to the date the Eligible Employee becomes a Participant (including any Service prior to the Effective Date oft the Plan) shall be treated as follows (check one): B All Service prior to the date the Eligible Employee becomes a Participant shall be credited (as Credited Past Service). D All Service prior to the date the Eligible Employee becomes a Participant shall be credited (as Credited Past Service), except for Service rendered prior to All Service prior to the date the Eligible Employee becomes a Participant shall be credited (as Credited Past Service), except as follows (must specify other limitation in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)d)0): No Service prior to the date the Eligible Employee becomes a Participant shall be (2) Previously Employed, Returning to Service after Original Effective Date. If an Eligible Employee is not employed on the original Effective Date of the Employer's GMEBS Plan, but returns to Service with the Adopting Employer sometime after the Effective Date, said Eligible Employee's Service prior to becoming a Participant (including any Service prior the (insert date). credited (as Credited Past Service). Effective Date) shall be treated as follows (check one): All Service prior to the date the Eligible Employee becomes a Participant shall be credited (as Credited Past Service), subject to any limitations imposed above with All Service prior to the date the Eligible Employee becomes a Participant shall be credited (as Credited Past Service), provided that after returning to employment, the Eligible Employee performs Service equal to the period of the break in Service or one (1) year, whichever is less. Any limitations imposed above with respect to Eligible Employees employed on the Effective Date shall also apply. No Service prior to the date the Eligible Employee becomes a Participant shall be respect to Eligible Employeese employed on the Effective Date. R credited (as Credited Past Service). Other limitation(s) on Recognition of Credited Past Service (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) -8- City of Walthourville (2023- - 2025 Restatement) and the definitely determinable requirement of Treasury Regulation .401-1(b)0)0): In addition to the above limitations. Credited Past Service shall not include any tenure of office as an elected or: appointed member oft the Governing Authority unless the Participant was serving as an elected or appointed member of the Governing Authority or Eligible Regular Employee on December 1,1992. (3) Eligible Employees Initially Employed After Effective Date. If an Eligible Employee's initial employment date is after the original Effective Date of the Employer's GMEBS Plan, said Employee's Credited Past Service shall include only the number ofy years and complete months of Service from the Employee's initial employment date to the date the Employee becomes a Participant ini the Plan. (4) Newly Eligible Classes of Employees. If a previously ineligible class of Employees becomes eligible to participate in the Plan, the Employer must specify in an addendum to this Adoption Agreement whether and to what extent said Employees' prior service with the Employer shall be treated as Credited Past Service under the Plan. B. Prior Military Service Note: This Section does not concern military service required to be credited under USERRA See Section 3.02 of the Basic Plan Document for rules on the crediting of USERRA Military Service. (1) Credit for Prior Military Service. The. Adopting Employer may elect to treat military service rendered prior to al Participant's initial employment date or reemployment date as Credited Service under the Plan. Unless otherwise specified by the Employer under "Other Conditions" below, the term "Military Service" shall be as defined in the Basic Plan Document. Except as otherwise required by federal or state law or under "Other Conditions" below, Military Service shall not include service which is credited Military Service credited under this Section shall not include any service which is otherwise required to be credited under the Plan by federal or state law. Prior Military Service shall be under any other local, state, or federal retirement or pension plan. treated as follows (check one): R D Prior Military Service is not creditable under the Plan (if checked, skip to Prior Military Service shall be counted as Credited Service for the following Section 13.C.- Prior Governmental Service). purposes (check one or more as applicable): Computing amount of benefits payable. Meeting minimum service requirements for vesting. Meeting minimum service requirements for benefit eligibility. D (2) Maximum Credit for Prior Military Service. Credit for Prior Military Service shall be limited to a maximum of years (insert number). -9- City of Walthourville (2023-20251 Restatement) (3) Rate of Accrual for Prior Military Service. Credit for Prior Military Service shall accrue at the following rate (check one): One month of military service credit for every number) ofCredited Service with the Adopting Employer. One year of military service credit for every Credited Service with the Adopting Employer. month(s) (insert year(s) (insert number) of L All military service shall be creditable (subject to any caps imposed above) after the Participant has completed with the Employer. years (insert number) of Credited Service D Other requirement (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-I(b)0)0): Participants shall not be required toj pay for military service credit. Participants shall be required to pay for military service credit as follows: (4) Payment for Prior Military Service Credit (check one): D J D D The Participant must pay. % of the actuarial cost of the service credit The Participant must pay an amount equal to (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement (as defined below). ofTreasury Regulation .401-1(b)0)0): Other Conditions for Award of Prior Military Service Credit (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)0)0): (5) Limitations on Service Credit Purchases. Unless otherwise specified in an Addendum to the Adoption Agreement, for purposes of this Section and Section 13.C. concerning prior governmental service credit, the term "actuarial cost of service credit" is defined as set forth in the Service Credit Purchase Addendum. In the case of a service credit purchase, the Participant shall be required to comply with any rules and regulations established by the GMEBS Board ofTrustees concerning said purchases. C. Prior Governmental Service Note: A Participant's prior service with other GMEBS employers shall be credited for purposes of satisfying the minimum service requirements for Vesting and eligibility for Retirement and pre-retirement death benefits as provided under Section 9.05 of the Basic Plan Document, relating to portability service. This Section 13(C) does not need to be completed in order for Participants to receive this portability service credit pursuant to Section 9.050 oft the Basic Plan Document. City of Walthourville (2023-2025 Restatement) 10- (1) Credit for Prior Governmental Service. The Adopting Employer may elect to treat governmental service rendered prior to a Participant's initial employment date or reemployment date as creditable service under the Plan. Subject to any limitations imposed by law, the term "prior governmental service" shall be as defined by the Adopting Employer below. The Employer elects to treat prior governmental service as follows (check one): R Prior governmental service is not creditable under the Plan (if checked, skip to Prior governmental service shall be counted as Credited Service for the following Section 13.D. - Unused Sick/Vacation Leave). purposes under the Plan (check one or more as applicable): Computing amount of benefits payable. Meeting minimum service requirements for vesting. Meeting minimum service requirements for benefit eligibility. D D D (2) Definition of Prior Governmental Service. Prior governmental service shall be defined as follows: (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)d)0): Unless otherwise specified above, prior governmental service shall include only full-time service (minimum hour requirement same as that applicable to Eligible Regular Employees). (3) Maximum Credit for Prior Governmental Service. Credit for prior governmental service shall be limited to a maximum of years (insert number). (4) Rate of Accrual for Prior Governmental Service Credit. Credit for prior governmental service shall accrue at the following rate (check one): D D One month of prior governmental service credit for every number) of Credited Service with the Adopting Employer. One year of prior governmental service credit for every number) ofCredited Service with the Adopting Employer. above) after the Participant has completed Credited Service with the Adopting Employer. month(s) (insert year(s) (insert D All prior governmental service shall be creditable (subject to any caps imposed years (insert number) of Other requirement (must specify in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)C)0): -11- City ofWalthourville (2023-2025 Restatement) (5) Payment for Prior Governmental Service Credit. D Participants shall not be required to pay for governmental service credit. Participants shall be required to pay for governmental service credit as follows: The Participant must pay. % oft the actuarial cost oft the service credit. The Participant must pay an amount equal to (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)d)0): Other Conditions for Award of Prior Governmental Service Credit (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401- 1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- D. Leave Conversion for Unused Paid Time Off (e.g.. Sick, Vacation, or Personal 1(b)(1)(i)): Leave) (1) Credit for Unused Paid Time Off. Subject to the limitations in Section 3.01 of the Basic Plan Document, an Adopting Employer may elect to treat accumulated days of unused paid time off for a terminated Participant, for which the Participant is not paid, as Credited Service. The only type of leave permitted to be credited under this provision is leave from a paid time off plan which qualifies as a bona fide sick and vacation leave plan (which may include sick, vacation or personal leave) and which the Participant may take as paid leave without regard to whether the leave is due to illness or incapacity. The Credited Service resulting from the conversion of unused paid time off must not be the only Credited Service applied toward the accrual ofa normal retirement benefit under the Plan. The Pension Committee shall be responsible to certify to GMEBS the total amount of Important Note: Leave cannot be converted to Credited Service in lieu of receiving a cash payment. Ifthe Employer elects treating unused paid time off as Credited Service, the conversion to Credited Service will be automatic, and the Participant cannot request a cash payment for the unused paid time off that is creditable hereunder. unused paid time off. The Employer elects the following treatment oft unused paid time off: B Unused paid time off shall not be treated as Credited Service (if checked, skip to The following types of unused paid time off for which the Participant is not paid shall be treated as Credited Service under the Plan (check one or more as Section 14-1 Retirement Eligibility). applicable): Unused sick leave Unused vacation leave -12- City of Walthourville (2023- - 2025 Restatement) Unused personal leave Other paid time off (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- 1(b)(1)()): (2) Minimum Service Requirement. In order to receive credit for unused paid time off, a Participant must meet the following requirement at termination (check one): The Participant must be 100% vested in ai normal retirement benefit. Credited Service (not including leave otherwise creditable under this Section). Other (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)()0): (3) Use of Unused Paid Time Off Credit. Unused paid time off for which the Participant is not paid shall count as Credited Service for the following purposes under the Plan D The Participant must have at least years (insert number) of Total (check one or more: as applicable): Computing amount of benefits payable. Meeting minimum service requirements for vesting. Meeting minimum service requirements for benefit eligibility. D (4) Maximum Credit for Unused Paid Time Off. Credit for unused paid time off for which the Participant is not paid shall be limited to a maximum of months (insert number). (5) Computation ofUnused Paid Time Off. Unless otherwise specified by the Adopting Employer under "Other Conditions" below, each twenty (20) days of creditable unused paid time off shall constitute one (1) complete month of Credited Service under the Plan. Partial months shall not be credited. (6) Other Conditions (please specify, subject to limitations in Section 3.01 of Basic Plan Document; must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401-I(b)d)0): 14. RETIREMENT ELIGIBILITY A. Early Retirement Qualifications Early retirement qualifications are (check one or more: as applicable): R Attainment of age 55 (insert number) 13- City ofWalthourville (2023-2025 Restatement) R Completion of 10: years (insert number) of Total Credited Service Exceptions: If different early retirement eligibility requirements apply to a particular class or classes of Eligible Employees, the Employer must specify below the classes to whom the different requirements apply and indicate below the requirements applicable to them. Eligible Employees to whom exception applies (must specify - specific positions are Early retirement qualifications for excepted class(es) are (check one or more as applicable): permissible; specific individuals may not be named): Attainment ofa age Completion of (insert number) years (insert number) ofTotal Credited Service B. Normal Retirement Oualifications Qualifications,' ifany, in Section 14.C. (1) Regular Employees Note: Please complete this Section and also list "Alternative" Normal Retirement Normal retirement qualifications for Regular Employees are (check one or more as applicable): B Attainment of age 65 (insert number) B Completion of5years (insert number) ofTotal Credited Service B In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if Participant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In-Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior to re-retirement. This rule shall apply to (check one): R all Participants D only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): Exceptions: Ifdifferent normal retirement qualifications apply to a particular class or classes of Regular Employees, the Employer must specify below the classes to whom the different Class(es) of Regular Employees to whom exception applies (must specify - specific positions Normal retirement qualifications for excepted class(es) are (check one or more as applicable): requirements apply and indicate below the requirements applicable to them. are permissible; specific individuals may not be named): D Attainment of age (insert number) 14- City of Walthourville (2023-2025 Restatement) Completion of years (insert number) of Total Credited Service In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if Participant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In-Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior to re-retirement. This rule shall apply to (check one): D all Participants D only the following class(es) of Participants (must specify specific positions are permissible; specific individuals may not be named): (2) Elected or Appointed Members ofGoverning Authority Complete this Section only if elected or appointed members of the Governing Authority or Municipal Legal Officers are permitted to participate in the Plan. Normal retirement qualifications for this class are (check one or more: as applicable): B D B Attainment ofage 65 (insert number) Completion of years (insert number) ofTotal Credited Service In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if Participant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In-Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior to re-retirement. This rule shall apply to (check one): R all Participants D only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): Exceptions: Ifdifferent normal retirement qualifications apply to particular elected or appointed members of the Governing Authority or Municipal Legal Officers, the Employer must specify below to whom the different requirements apply and indicate below the requirements applicable Particular elected or appointed members oft the Governing Authority or Municipal Legal Officers to whom exception applies (must specify - specific positions are permissible; specific Normal retirement qualifications for excepted elected or appointed members of the Governing Authority or Municipal Legal Officers are (check one or more as applicable): tot them. individuals may not be named):. Attainment ofa age (insert number) -15- City of Walthourville (2023-2025 Restatement) Completion of years (insert number) ofTotal Credited Service In-Service Distribution to Eligible Employees permitted (.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if Participant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In-Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior to re-retirement. This rule shall apply to (check one): D all Participants D only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): C. Alternative Normal Retirement Oualifications The Employer may elect toj permit Participants to retire with unreduced benefits after they satisfy service and/or age requirements other than the regular normal retirement qualifications specified above. The Employer hereby adopts the following alternative normal retirement qualifications: Alternative Normal Retirement Qualifications (check one or more, as applicable): (1) B Not applicable (the Adopting Employer does not offer alternative normal retirement benefits under the Plan). (2) D Alternative Minimum Age & Service Qualifications (if checked, please complete one or more items below, as applicable): D Attainment of age Completion of Service (insertnumber) years (insert number) of Total Credited In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring al Bona Fide Separation from Service), ifParticipant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In-Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior tor re-retirement. This rule shall apply to (check one): Dall Participants D only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): This alternative normal retirement benefit is available to: D All Participants who qualify. -16- City ofv Walthourville (2023-2025 Restatement) Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): Al Participant (check one): Dist required D is not required to be in the service of the Employer at the time the Participant satisfies the above qualifications in order Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- to qualify for this alternative normal retirement benefit. 1(b)(1)(i)): Rule of items below: (3) (insert number). The Participant's combined Total Credited Service and age must equal or exceed this number. Please complete additional To qualify for this alternative normal retirement benefit, the Participant (check one or more items below, as applicable): Must have attained at least age. D D a (insert number) Must not satisfy any minimum age requirement In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if the Participant meets the minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In- Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior to re-retirement. This rule shall apply to (check one): Dall Participants D only the following class(es) of Participants (must specify specific positions are permissible; specific individuals may not be named): This alternative normal retirement benefit is available to: D D All Participants who qualify. Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): AI Participant (check one): D is required D is not required to be in the service of the Employer at the time the Participant satisfies the Rule in order to qualify for Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) this alternative normal retirement benefit. -17- City ofWalthourville (2023-20251 Restatement) and the definitely determinable requirement of Treasury Regulation 1.401- Alternative Minimum Service. A Participant is eligible for an alternative normal 1(b)(1)()): (4) retirement benefit if the Participant has at least ofTotal Credited Service, regardless oft the Participant's age. years (insert number) In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if the Participant meets the minimum service requirement specified immediately above and satisfies the minimum age parameters for In-Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior tor re-retirement. This rule shall apply to (check one): Dalll Participants D only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): This alternative normal retirement benefit is available to: D Alll Participants who qualify. Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named):. AI Participant (check one): D is required Dis not required to be in the service of the Employer at the time the Participant satisfies the qualifications for this Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- alternative normal retirement benefit. 1(b)(1)()): (5) D Other Alternative Normal Retirement Benefit. Must specify qualifications (in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)0)0): D In-Service Distribution to Eligible Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), if the Participant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In- Service Distribution described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits -18- City of Walthourville (2023-2025 Restatement) received prior to re-retirement. This rule shall apply to (check one): Dall Participants D only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): This alternative normal retirement benefit is available to: D All Participants who qualify. D Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): Al Participant (check one): Dis required D is not required to be in the service of the Employer at the time the Participant satisfies the qualifications for this Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- Other Alternative Normal Retirement Benefit for Public Safety Employees Must specify qualifications (in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)0)0): alternative normal retirement benefit. 1(b)(1)(i)): Only. (6) D In-Service Distribution to Eligible Employees who are Public Safety Employees permitted (i.e., a qualifying Participant may commence receiving retirement benefits while in service without first incurring a Bona Fide Separation from Service), ift the Participant meets minimum age and service requirements specified immediately above and satisfies the minimum age parameters for In-Service Distribution Described in Section 6.06(a)(3) of the Basic Plan Document, subject to applicable Plan provisions concerning recalculation and offset applied at re-retirement to account for the value of benefits received prior to re-retirement. This rule shall apply to (check one): D all Participants D only the following class(es) of Participants (must specify specific positions are permissible; specific individuals may not be named): This alternative normal retirement benefit is available to: D All public safety employee Participants who qualify. Only the following public safety employee Participants (must specify specific positions are permissible; specific individuals may not be named): -19- City ofWalthourville (2023-2025 Restatement) A public safety employee Participant (check one): Di is required D is not required to be in the service oft the Employer at the time the Participant satisfies Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- Note: "Public safety employees" are defined under the Internal Revenue Code for this purpose as employees of a State or political subdivision of a State who provide police protection, firefighting services, or emergency medical services for any area within the the qualifications for this alternative normal retirement benefit. 1(b)(1)(i)): jurisdiction ofs such State or political subdivision. D. Disability Benefit Oualifications Subject to the other terms and conditions of the Basic Plan Document and except as otherwise provided in an Addendum to this Adoption Agreement, disability retirement qualifications are based upon Social Security Administration award criteria or as otherwise provided under Section 2.23 oft the Basic Plan Document. The Disability Retirement benefit shall commence as ofthe Participant's Disability Retirement Date under Section 2.24 ofthe Basic Plan Document. To qualify for a disability benefit, a Participant must have the following minimum number of years ofTotal Credited Service (check one): B Not applicable (the Adopting Employer does not offer disability retirement benefits under the Plan). No minimum. D years (insert number) ofTotal Credited Service. Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)()0): 15. RETIREMENT BENEFIT COMPUTATION A. Maximum Total Credited Service (check one or all that apply): R not limited. D limited to D limited to Employees: The number of years of Total Credited Service which may be used to calculate a benefit is years fora all Participants. years for the following classes of Eligible Regular All Eligible Regular Employees. -20- City of Walthourville (2023-2025 Restatement) D limited to Authority. limited to Only the following Eligible Regular Employees: years as an elected or appointed member of the Governing years as a Municipal Legal Officer. Other (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable quirementofTrensury Regulation 1.401-1(b)C)0): B. Monthly Normal Retirement Benefit Amount (1) Regular Emplovee Formula and complete one or more as applicable): The monthly normal retirement benefit for Eligible Regular Employees shall be 1/12 of (check B (a) Flat Percentage Formula. 1.25% (insert percentage) of Final Average Earnings multiplied by years of Total Credited Service as an Eligible Regular Employee. This formula applies to: R All Participants who are Regular Employees. Only the following Participants (must specify specific positions are permissible; specific individuals may not be named): D (b) Alternative Flat Percentage Formula. % (insert percentage) of Final Average Earnings multiplied by years of Total Credited Service as an Eligible Regular Employee. This formula applies to the following Participants (must specify specific positions are permissible; specific individuals may not be named): D (c) Split Final Average Earnings Formula. % (insert percentage) of Final Average Earnings up to the amount of Covered Compensation (see subsection (2) below for definition of Covered Compensation), plus %( (insert percentage) ofFinal Average Earnings in excess of said Covered Compensation, multiplied by years of Total Credited Service as an Eligible Regular Employee. This formula applies to: D All Participants who are Regular Employees. D Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): (d) Alternative Split Final Average Earnings Formula. % (insert percentage) of Final Average Earnings up to the amount of Covered -21- City of Walthourville (2023-20251 Restatement) Compensation (see subsection (2) below for definition of Covered Earnings in excess of said Covered Compensation, multiplied by years of Total Credited Service as an Eligible Regular Employee. Compensation), plus % (insert percentage) of Final Average This formula applies to: D All Participants. D Only the following Participants (must specify specific positions are permissible; specific individuals may not be named):. [Repeat above subsections as necessary for each applicable benefit formula and Participant class covered under the Plan.] (2) Covered Compensation (complete only ifSplit Formula(s) is checked above): Covered Compensation is defined as (check one or more as applicable): (a) A.I.M.E. Covered Compensation as defined in Section 2.18 of the Basic Plan Document. This definition of Covered Compensation shall apply to (check one): All Participants who are Regular Employees. are permissible; specific individuals may not be named): Only the following Participants (must specify specific positions (b) Dynamic Break Point Covered Compensation as defined in Section 2.19 of the Basic Plan Document. This definition of Covered Compensation shall apply to (check one): All Participants who are Regular Employees. Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): (c) Table Break Point Covered Compensation as defined in Section 2.20 of the Basic Plan Document. This definition of Covered Compensation shall D apply to (check one): D All Participants who are Regular Employees. I Only the following class(es) of Participants (must specify - specific positions are permissible; specific individuals may not be named): do not exceed $ apply to (check one): D D - (d) Covered Compensation shall mean a Participant's annual Earnings that (specify amount). This definition shall All Participants who are Regular Employees. Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): -22- City of Walthourville (2023-2025 Restatement) (3) Final Average Earnings Unless otherwise specified in an Addendum to the Adoption Agreement, Final Average Earnings is defined as the monthly average of Earnings paid to a Participant by the Adopting Employer for the 60 (insert number not to exceed 60) consecutive months of Credited Service preceding the Participant's most recent Termination in which the Participant's Earnings were the highest, multiplied by 12. Note: GMEBS has prescribed forms for calculation of Final Average Earnings that must be used for this purpose. This definition of Final Average Earnings applies to: B All Participants who are Regular Employees. specifici individuals may not be named): D Only the following Participants (must specify - specific positions are permissible; [Repeat above subsection as necessary for each applicable definition and Participant class (4) Formula for Elected or Appointed Members ofthe Governing Authority The monthly normal retirement benefit for members oft this class shall be as follows (check one): Not applicable (elected or appointed members of the Governing Authority or Municipal $10.00 (insert dollar amount) per month for each year ofTotal Credited Service as an elected or appointed member of the Governing Authority or Municipal Legal Officer (service of at least 6 months and 1 day is treated as a year of Total Credited Service; provided, however, than an elected or appointed member of the Governing Authority or Municipal Legal Officer may accrue a maximum of one year of Total Credited Service for every 12-month period of Service as an elected or appointed member of the covered under the Plan.] D B Legal Officers are not permitted to participate in the Plan). Governing Authority or Municipal Legal Officer). This formula applies to: B D All elected or appointed members of the Governing Authority or Municipal Legal Only the following elected or appointed members of the Governing Authority or Municipal Legal Officers eligible to participate (must specify specific positions are [Repeat above subsection as necessary for each applicable formula for classes of elected or Officers eligible to participate. permissible; specific individuals may not be named): appointed members covered under the Plan.] C. Monthly Early Retirement Benefit Amount Check and complete one or more as applicable: R (I) Standard Early Retirement Reduction Table. The monthly Early Retirement benefit shall be computed in the same manner as the monthly -23- City of Walthourville (2023-2025 Restatement) Normal Retirement benefit, but the benefit shall be reduced on an Actuarially Equivalent basis in accordance with Section 12.01 oft the Basic Plan Document to account for early commencement of benefits. This provision shall apply to: R All Participants. Only the following Participants (must specify specific positions are permissible; specific individuals may not be named): (2) Alternative Early Retirement Reduction Table. The monthly Early Retirement benefit shall be computed in the same manner as the monthly Normal Retirement benefit, but the benefit shall be reduced to account for early commencement of benefits based on the following table. This table shall apply to: All Participants. Only the following Participants (must specify - specific positions are permissible; specific individuals may not be named): Alternative Early Retirement Reduction Table [Age (Insert Normal Normal Retirement Benefit* Number ofYears Before Retirement Age)l (check as applicable) D 0 D 1 D 2 D 3 D 4 D 5 D 6 D 7 D 8 D 9 01 10 D 11 D 12 D 13 D 14 D 15 Percentage of (complete as applicable) 1.000 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. *Interpolate for whole months -24- City ofWalthourville (2023-2025 Restatement) D. Monthly Late Retirement Benefit Amount (check one): (1) The monthly Late Retirement benefit shall be computed in the same manner as the Normal Retirement Benefit, based upon the Participant's Accrued Benefit as oft the Participant's Late Retirement Date. (2) The monthly Late Retirement benefit shall be the greater of: (I)the monthly retirement benefit accrued as of the Participant's Normal Retirement Date, actuarially increased in accordance with the actuarial table contained in Section 12.05 of the Basic Plan Document; or (2)the monthly retirement benefit accrued as of the Participant's Late Retirement Date, without further actuarial adjustment under Section 12.06 of the Basic Plan Document. E. Monthly Disability Benefit Amount The amount of the monthly Disability Benefit shall be computed in the same manner as the Normal Retirement benefit, based upon the Participant's Accrued Benefit as of the Participant's Minimum Disability Benefit. The Adopting Employer may set a minimum Disability Benefit. Disability Retirement Date. The Employer elects the following minimum Disability benefit (check one): R D Not applicable (the Adopting Employer does not offer disability retirement benefits under the Plan). No minimum is established. No less than (check one): D 20% D 10% D % (ifother than 20% or 10% insert percentage amount) of the Participant's average monthly Earnings for the 120 calendar month period (excluding any period of unpaid leave of absence) immediately preceding the Participant's Termination of Employment as a result of a Disability. (Unless otherwise specified in an Addendum to the Adoption Agreement, no minimum will apply to elected or appointed members of the Governing Authority or Municipal Legal Officers.) No less than (check one): 0662/3.90, % (if other than 66 2/3%, insert percentage amount) of the Participant's average monthly Earnings for the 12 calendar month period (excluding any period of unpaid leave of absence) immediately preceding the Participant's Termination of Employment as a result of aD Disability, less any monthly benefits paid from federal Social Security benefits as a result of disability as reported by the Employer. (Unless otherwise specified ina an Addendum to the Adoption Agreement, no minimum will apply to elected or appointed members ofthe Governing Authority or Municipal Legal Officers.) -25- City of Walthourville (2023-2025 Restatement) F. Minimum/Maximum Benefit For Elected Officials In addition to any other limitations imposed by federal or state law, the Employer may impose a cap on the monthly benefit amount that may be received by elected or appointed members oft the Governing Authority. The Employer elects (check one): Not applicable (elected or appointed members oft the Governing Authority do not participate in the Plan). R No minimum or maximum applies. D Monthly benefit for Service as an elected or appointed member of the Governing Authority may not exceed 100% of the Participant's final salary as an elected or Other minimum or maximum (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401- appointed member ofthe Governing Authority. I(b)(1)()): G. Multiple Plans In the event that the Employer maintains multiple plans, the following provisions will apply to the extent necessary to satisfy Code $415. 16. SUSPENSION OF BENEFITS FOLLOWING BONA FIDE SEPARATION OF SERVICE; COLA A. Re-Employment as Eligible Employee After Normal, Alternative Normal, or Early Retirement and Following Bona Fide Separation of Service (see Basic Plan Document Section 6.06(c) Regarding Re-Employment as an Ineligible Employee and Basic Plan Document Section 6.06(e) and (f) Regarding Re-Employment After (1) Reemployment After Normal or Alternative Normal Retirement. In the event that a Retired Participant 1) is reemployed with the Employer as an Eligible Employee (as defined in the Plan) after the Participant's Normal or Alternative Normal Retirement Date and after a Bona Fide Separation from Service, or 2) is reemployed with the Employer in an Ineligible Employee class, and subsequently again becomes an Eligible Employee (as defined in the Plan) due to the addition of such class to the Plan after the Participant's Normal or Alternative Normal Retirement Date, the following rule shall apply (check one): Disability Retirement) D (a) The Participant's benefit shall be suspended in accordance with Section 6.06(a)(1) of the Basic Plan Document for as long as the Participant remains employed. -26- City ofWalthourville (2023-2025 Restatement) R (b) The Participant may continue to receive retirement benefits in accordance with Section 6.06(b) of the Basic Plan Document. This rule shall apply to (check one): B all Retired Participants D only the following classes of Retired Participants (must specify (specific positions are permissible; specific individuals may not be named) - benefits of those Retired Participants not listed shall be suspended in accordance with Section 6.06(a) of the Basic Plan Document if they return to work with the Employer): (2) Reemployment After Early Retirement. In the event a Participant Retires with an Early Retirement benefit after a Bona Fide Separation from Service 1)isr reemployed with the Employer as an Eligible Employee before the Participant's Normal Retirement Date; or 2)is reemployed with the Employer in an Ineligible Employee class, and subsequently again becomes an Eligible Employee (as defined in the Plan) before the Participant's Normal Retirement Date due to the addition of such class to the Plan, the following rule shall apply (check one or more as applicable): (a) D The Participant's Early Retirement benefit shall be suspended in accordance with Section 6.06(a)(1) of the Basic Plan Document for as This rule shall apply to (check one): D all Retired Participants; D only the following classes of Retired Participants (must specify - specific positions are permissible; specific individuals may not be named): (b) B The Participant's Early Retirement benefit shall be suspended in accordance with Section 6.06(a)I)ofthel Basic Plan Document. However, the Participant may begin receiving benefits after satisfying the qualifications for Normal Retirement or Alternative Normal Retirement, as applicable, and after satisfying the minimum age parameters of Section 6.06(a)(3) of the Basic Plan Document, in accordance with This rule shall apply to (check one): B all Retired Participants; D only the following classes of Retired Participants (must specify specific positions are permissible; specific individuals may not be named): (c) D The Participant's Early Retirement benefit shall continue in accordance with Section 6.06(b)(2)(B)(i) ofthe Basic Plan Document. This rule shall apply to (check one): D all Retired Participants; D only the following classes of Retired Participants (must specify - specific positions are permissible; specific individuals may not be named): long as the Participant remains employed. Section 6.06(b)(2)(B)0) ofthe Basic Plan Document. -27- City of Walthourville (2023-2025 Restatement) B. Cost OfLiving Adjustment The Employer may elect to provide for an annual cost-of-living adjustment (COLA) in the amount of benefits being received by Retired Participants and Beneficiaries, which shall be calculated and paid in accordance with the terms of the Basic Plan Document. The Employer hereby elects the following (check one): R (1) Noc cost-of-living adjustment. D (2) Variable Annual cost-of-living adjustment not to exceed % (insert % (insert percentage). percentage). D (3) Fixed annual cost-of-living adjustment equal to The above cost-of-living adjustment shall apply with respect to the following Participants (and their Beneficiaries) (check one): R All Participants (and their Beneficiaries). D Participants (and their Beneficiaries) who terminate employment Other (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401- 1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401-1(b)0)0); specific positions are permissible; specific individuals may not be named):. on or after (insert date). The Adjustment Date for the above cost-of-living adjustment shall be (if not specified, the 17. TERMINATION OF EMPLOYMENT BEFORE RETIREMENT; Adjustment Date shall be. January I): VESTING A. Eligible Regular Employees Subject to the terms and conditions oft the Basic Plan Document, a Participant who is an Eligible Regular Employee and whose employment is terminated for any reason other than death or retirement shall earn a vested right in the Participant's accrued retirement benefit in accordance with the following schedule (check one): D Nov vesting schedule (immediate vesting). R Cliff Vesting Schedule. Benefits shall be 100% vested after the Participant has a minimum of5years (insert number not to exceed 10) ofTotal Credited Service. Benefits remain 0% vested until the Participant satisfies this minimum. Graduated Vesting Schedule. Benefits shall become vested in accordance with the following schedule (insert percentages): -28- City of Walthourville (2023-2025 Restatement) COMPLETED YEARS OFTOTAL CREDITEDSERVICE VESTED PERCENTAGE % % % % % % % % % % 2 3 4 5 6 7 8 9 10 Exceptions: Ifa vesting schedule other than that specified above applies to a special class(es) of Regular Employees, the Employer must specify the different vesting schedule below and the Regular Employees to whom exception applies (must specify - specific positions are Vesting Schedule for excepted class (Must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401-1(b)CI)d). Must be at least as favorable as one of the following schedules: (i) 15-year cliff vesting, (ii) 20-year graded vesting, or (ii) for qualified public safety employees, 20-year cliffvesting.): B. Elected or Appointed Members of the Governing Authority class(es) to whom the different vesting schedule applies. permissible; specific individuals may not be named):. Subject to the terms and conditions oft the Basic Plan Document, a Participant who is an elected or appointed member of the Governing Authority or a Municipal Legal Officer shall earn a vested right in the Participant's accrued retirement benefit for Credited Service in such capacity ina accordance with the following schedule (check one): D Not applicable (elected or appointed members of the Governing Authority are not permitted to participate in the Plan). B No vesting schedule (immediate vesting). Other vesting schedule (Must specify in a manner that satisfies the definite written program requirement ofTreasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401-1(b)(1)0). Must be at least as favorable as one of the following schedules: () 15-year cliff vesting, (ii) 20-year graded vesting, or (iii) for qualified public safety employees, 20-year cliff vesting.): -29- City of Walthourville (2023-20251 Restatement) 18. PRE-RETIREMENT DEATH BENEFITS A. In-Service Death Benefit Subject to the terms and conditions of the Basic Plan Document, the Employer hereby elects the following in-service death benefit, to be payable in the event that an eligible Participant's employment with the Employer is terminated by reason of the Participant's death prior to (1) B Auto A Death Benefit. A monthly benefit payable to the Participant's Retirement (check and complete one): Pre-Retirement Beneficiary, equal to the decreased monthly retirement benefit that would have otherwise been payable to the Participant, had the Participant elected a 100% joint and survivor benefit under Section 7.03 of the Basic Plan Document. In order to be eligible for this benefit, a Participant must meet the D The Participant must be vested in a normal retirement benefit. following requirements (check one): D The Participant must have Credited Service. years (insert number) of Total R The Participant must be eligible for Early or Normal Retirement. Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401- 1(a)(2) and the definitely determinable requirement of Treasury Actuarial Reserve Death Benefit. A monthly benefit payable to the Participant's Pre-Retirement Beneficiary, actuarially equivalent to the reserve required for the Participant's anticipated Normal Retirement benefit, provided the Participant Regulation 1.401-1(b)()0): (2) D meets the following eligibility conditions (check one): The Participant shall be eligible upon satisfying the eligibility requirements of Section 8.02(c) of the Basic Plan Document. D The Participant must have years (insert number) of Total Credited Service. D Other eligibility requirement (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401- 1(a)(2) and the definitely determinable requirement of Treasury Imputed Service. For purposes of computing the actuarial reserve death benefit, the Participant's Total Credited Service shall include (check one): Regulation 1.401-1(b)C)0): Total Credited Service accrued prior to the date oft the Participant's death. -30- City ofWalthourville (2023-20251 Restatement) Total Credited Service accrued prior to the date of the Participant's death, fraction) of the Service between such date of death and what would otherwise have been the Participant's Normal Retirement Date. (See Basic Plan Document Section 8.02(b) regarding 10-year cap on additional plus (check one): Done-half (Y) D (insert other Credited Service.) Minimum In-Service Death Benefit for Vested Employees Equal to Terminated Vested Death Benefit. Unless otherwise specified under "Exceptions" below, ifa Participant's employment is terminated by reason of the Participant's death prior to Retirement, and ifa as ofthe date of death the Participant is vested but does not qualify for the in-service death benefit, then the Auto A Death Benefit will be payable, provided the Auto A Death Benefit is made available to terminated vested employees under the Adoption Agreement (see "Terminated Vested Death Benefit" below). (3) Exceptions: Ifan in-service death benefit other than that specified above applies to one or more classes of Participants, the Employer must specify below the death benefit payable, the class(es) to whom the different death benefit applies, and the eligibility conditions Alternative Death Benefit (must specify formula that satisfies the definite written program and definitely determinable requirements of Treasury Regulations Sections 1.401-1(a)(2) and 1.401-1(b)()0) and does not violate limits applicable to governmental plans under Participants to whom alternative death benefit applies (must specify specific positions are Eligibility conditions for alternative death benefit (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)0)0): for said death benefit. Code Sections 401(a)(17): and 415): permissible; specific individuals may not be named):. B. Terminated Vested Death Benefit (1) Complete this Section only if the Employer offers a terminated vested death benefit. The Employer may elect to provide a terminated vested death benefit, to be payable in the event that a Participant who is vested dies after termination of employment but before Retirement benefits commence. Subject to the terms and conditions of the Basic Plan Document, the Employer hereby elects the following terminated vested death benefit (check one): R Auto A Death Benefit. A monthly benefit payable to the Participant's Pre-Retirement Beneficiary, equal to the decreased monthly retirement benefit that would have otherwise been payable to the Participant had the Participant elected a 100% joint and survivor benefit under Section 7.03 of the Basic Plan Accrued Retirement Benefit. A monthly benefit payable to the Participant's Pre-Retirement Beneficiary which shall be actuarially equivalent to the Document. a -31- City of Walthourville (2023-2025 Restatement) Participant's Accrued Normal Retirement Benefit determined as of the date of (2) Exceptions: Ifa terminated vested death benefit other than that specified above applies to one or more classes ofParticipants, the Employer must specify below the death benefit payable, the class(es) to whom the different death benefit applies, and the eligibility conditions Alternative Death Benefit (must specify formula that satisfies the definite written program and definitely determinable requirements of Treasury Regulations Sections 1.401-1(a)(2) and 1.401-1(b)()0) and does not violate limits applicable to governmental plans under Participants to whom alternative death benefit applies (must specify - specific positions are permissible; specific individuals may not be named): Participants who Terminated employment prior to October 1.2016.and do not become reemploved on or aftersuch date. Eligibility conditions for alternative death benefit (must specify in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement of Treasury Regulation 1.401-1(b)0)0): Not death. for said death benefit. Code Sections 401(a)(17)and 415): No Terminated Vested Death Benefit. applicable. 19. EMPLOYEE CONTRIBUTIONS (1) Employee contributions (check one): R Are not required. D Are required in the amount of D Are required in the amount of % (insert percentage) of Earnings for all % (insert percentage) of Earnings for Participants. Participants in the following classes (must specify - specific positions are [Repeat above subsection as necessary if more than one contribution rate applies.] (2) Pre-Tax Treatment of Employee Contributions. If Employee Contributions are required in Subsection (1) above, an Adopting Employer may elect to "pick up" Employee Contributions to the Plan in accordance with IRC Section 414(h). In such case, Employee Contributions shall be made on a pre-tax rather than a post-tax basis, provided the requirements of IRC Section 414(h) are met. Ift the Employer elects to pick up. Employee Contributions, iti is the Employer's responsibility to ensure that Employee Contributions are paid and reported in accordance with IRC Section 414(h). The Adopting Employer must not report picked up permissible; specific individuals may not be named):. contributions as wages subject to federal income tax withholding. The Employer hereby elects (check one): To pick up Employee Contributions. By electing to pick up Employee Contributions, the Adopting Employer specifies that the contributions, although -32- City ofWalthourville (2023-2025 Restatement) designated as Employee Contributions, are being paid by the Employer in lieu of Employee Contributions. The Adopting Employer confirms that the executor of this Adoption Agreement is duly authorized to take this action as required to pick up contributions. This pick-up of contributions applies prospectively, and it is evidenced by this contemporaneous written document. On and after the date of the pick-up of contributions, a Participant does not have a cash or deferred election right (within the meaning of Treasury Regulation Section 1.401()-1(a)(3) with respect to the designated Employee Contributions, which includes not having the option of receiving the amounts directly instead of having them paid to the Plan. Not to pick up Employee Contributions. D (3) Interest on Employee Contributions. The Adopting Employer may elect to pay interest on any refund of Employee Contributions. D - Interest shall not be paid. by GMEBS from time to time. Interest shall be paid on a refund of Employee Contributions at a rate established Other rate of interest (must specify rate in a manner that satisfies the definite written program requirement of Treasury Regulation 1.401-1(a)(2) and the definitely determinable requirement ofTreasury Regulation 1.401-1(b)0)0): 20. MODIFICATION OF THE TERMS OF THE ADOPTION AGREEMENT Ifan Adopting Employer desires to amend any of its elections contained in this Adoption Agreement (or any Addendum), the Governing Authority by official action must adopt an amendment oft the Adoption Agreement (or any Addendum) or a new Adoption Agreement (or Addendum) must be adopted and forwarded to the Board for approval. The amendment of the new. Adoption Agreement (or Addendum) is not effective until approved by the Board and other The Administrator will timely inform the Adopting Employer of any amendments made by the procedures required by the Plan have been implemented. Board to the Plan. 21. TERMINATION OF THE ADOPTION AGREEMENT This Adoption Agreement (and any Addendum) may be terminated only in accordance with the Plan. The Administrator will inform the Adopting Employer in the event the Board should decide to discontinue this pre-approved plan program. -33- City of Walthourville (2023-2025 Restatement) 22. EMPLOYER ADOPTION AND AUTHORIZATION FOR AMENDMENTS Adoption. The Adopting Employer hereby adopts the terms oft the Adoption Agreement and any Addendum, which is attached hereto and made aj part ofthis ordinance. The Adoption Agreement (and, if applicable, the Addendum) sets forth the Employees to be covered by the Plan, the benefits to be provided by the Adopting Employer under the Plan, and any conditions imposed by the Adopting Employer with respect to, but not inconsistent with, the Plan. The Adopting Employer reserves the right to amend its elections under the Adoption Agreement and any Addendum, sO long as the amendment is not inconsistent with the Plan or the Internal Revenue Code or other applicable law and is approved by the Board of Trustees of GMEBS. The Adopting Employer acknowledges that it may not be able to rely on the pre-approved plan opinion letter ifit makes certain elections under the Adoption Agreement or the Addendum, and that the failure to properly complete the Adoption Agreement may result in a failure of the The Adopting Employer hereby agrees to abide by the Basic Plan Document, Trust Agreement, and rules and regulations adopted by the Board ofTrustees of GMEBS, as each may be amended from time to time, in all matters pertaining to the operation and administration oft the Plan. It is intended that the Act creating the Board of Trustees of GMEBS, this Plan, and the rules and regulations of the Board are to be construed in harmony with each other. In the event of a conflict between the provisions ofany oft the foregoing, they shall govern in the following order: (1) The Act creating the Board of Trustees of The Georgia Municipal Employees' Benefit System, O.C.G.A. Section 47-5-1 et seq. (a copy of which is included in the Appendix to the Basic Defined Benefit Plan Document) and any other Adopting Employer's Plan to be a qualified plan. applicable provisions of O.C.G.A. Title 47; (2) The Basic Defined Benefit Plan Document and Trust Agreement; (3) This Ordinance and Adoption Agreement (and any Addendum); and (4) The rules and regulations oft the Board. In the event that any section, subsection, sentence, clause or phrase oft this Plan shall be declared or adjudged invalid or unconstitutional, such adjudication shall in no manner affect the previously existing provisions or the other section or sections, subsections, sentences, clauses or phrases of this Plan, which shall remain in full force and effect, as if the section, subsection, sentence, clause or phrase SO declared or adjudicated invalid or unconstitutional were not originally a part hereof. The Governing Authority hereby declares that it would have passed the remaining parts of this Plan or retained the previously existing provisions ifit had known that such part or parts hereofwould be declared or adjudicated invalid or unconstitutional. This Adoption Agreement (and any Addendum) may only be used in conjunction with Georgia Municipal Employees Benefit System Basic Defined Benefit Retirement Plan Document approved by the Internal Revenue Service under opinion letter Q705465a dated August 31, 2023. The Adopting Employer understands that failure to properly complete this Adoption Agreement (or any Addendum), or to operate and maintain the Plan and Trust in accordance with the terms of the completed Adoption Agreement (and any Addendum), Basic Plan Document and Trust, -34- City of Walthourville (2023-2025 Restatement) may result in disqualification oft the Adopting Employer's Plan under the Internal Revenue Code. Inquiries regarding the adoption oft the Plan, the meaning of Plan provisions, or the effect oft the IRS opinion letter should be directed to the Administrator. The Administrator is Georgia Municipal Employees Benefit System, with its primary business offices located at: 201 Pryor Street, SW, Atlanta, Georgia, 30303. The business telephone number is: (404)688-0472. The Authorization for Amendments. Effective on and after February 17, 2005, the Adopting Employer hereby authorizes the pre-approved plan provider who sponsors the Plan on behalf of GMEBS to prepare amendments to the Plan, for approval by the Board, on its behalf as provided under Revenue Procedure 2005-16, as superseded by Revenue Procedure 2015-36, Revenue Procedure 2011-49, and Announcement 2005-37. Effective January 1, 2013, Georgia Municipal Association, Inc., serves as the pre-approved plan provider for the Plan. Employer notice and signature requirements were met for the Adopting Employer before the effective date of February 17, 2005. The Adopting Employer understands that the implementing amendment reads primary person to contact is: GMEBS Legal Counsel. as follows: On and after February 17, 2005, the Board delegates to the Provider the authority to advise and prepare amendments to the Plan, for approval by the Board, on behalfofall. Adopting Employers, including those. Adopting Employers who have adopted the Plan prior to the January 1,2 2013, restatement of the Plan, for changes in the Code, the regulations thereunder, revenue rulings, other statements published by Internal Revenue Service, including model, sample, or other required good faith amendments (but only if their adoption will not cause such Plan to be individually designed), and for corrections of prior approved plans. These amendments shall be applied to all Adopting Employers. Employer notice and signature requirements have been met for all Adopting Employers before the effective date of February 17, 2005. In any event, any amendment prepared by the Practitioner and approved by the Board will be provided by the Administrator to Adopting Employers. Notwithstanding the foregoing paragraph, no amendment to the Plan shall be prepared on behalf of any Adopting Employer as ofeither: the date the Internal Revenue Service requires the Adopting Employer to file Form 5300 as an individually designed plan as a result ofan amendment by the Adopting Employer to incorporate a type of Plan not allowable in a pre-approved plan as described in as of the date the Plan is otherwise considered an individually designed plan due to the nature and extent oft the amendments. Ifthe Adopting Employer is required to obtain a determination letter for any reason in order to maintain reliance on the opinion letter, the Provider's authority to amend the Plan on behalfofthe. Adopting Employeris conditioned on Revenue Procedure 2017-41; ;or the Plan receiving ai favorable determination letter. -35- City ofWalthourville (2023-2025 Restatement) The Adopting Employer further understands that, if it does not give its authorization hereunder or, in the alternative, adopt another pre-approved plan, its Plan will become an individually designed plan and will not be able to rely on the pre-approved plan opinion letter. Reliance on Opinion Letter. As provided in Revenue Procedure 2017-41, the Adopting Employer may rely on the Plan's opinion letter, provided that the Adopting Employer's Plan is identical to the GMEBS Plan, and the Adopting Employer has not amended or made any modifications to the Plan other than to choose the options permitted under the Plan, Adoption Agreement, and any Addendum. -36- City of Walthourville (2023-2025) Restatement) AN ORDINANCE (continued from page 1) Section 2. Except as otherwise specifically required by law or by the terms of the Basic Plan Document or Adoption Agreement (or any Addendum), the rights and obligations under the Plan with respect to persons whose employment with the City was terminated or who vacated office with the City for any reason whatsoever prior to the effective date of this Ordinance are fixed and shall be governed by such Plan, if any, as it existed and was in effect at the time of such termination. Section 3. The effective date of this Ordinance shall be the date of its approval by the Governing Authority (not earlier than the first day of the current Plan Year in which the Plan is adopted, unless a retroactive corrective amendment is permitted under EPCRS, Rev. Proc. 2021-30 (or subsequent updated guidance)). Section 4. All Ordinances and parts of ordinances in conflict herewith are expressly Approved by the Mayor and Council of the City of Walthourville, Georgia, this repealed. day of Attest: City Clerk (SEAL) Approved: City Attorney 20 CITY OF WALTHOURVILLE, GEORGIA Mayor The terms of the foregoing Adoption Agreement are approved by the Board ofTrustees IN WITNESS WHEREOF, the Board of Trustees of Georgia Municipal Employees Benefit System has caused its Seal and the signatures ofits duly authorized officers to be affixed ofGeorgia Municipal Employees Benefit System. this day of 20 Board ofTrustees Georgia Municipal Employees Benefit System (SEAL) Secretary -37- City of Walthourville (2023-2025 Restatement) Sec. 8-2. Fire prevention code--Adopted. (Amended) The city hereby adopts, for thep purposes of fire prevention and the enforcement of minimum fire prevention standards, the current state minimum fire prevention standards as promulgated pursuant tot the rules and regulations of the safety fire commissioner of thes state under authority contained in O.C.G.A. 525-2-1 et seq., including all subsequent revisions thereof, a copy of which is oni filei in City Hall and at the fire department. Such codei is hereby adopted andi incorporated as part oft this chapter as fully as ifs set out at length in this section, and the provisions of such code: shall be effective and controlling within the corporate limits of the city from and after the date of adoption and approval of this section. These standards shall henceforth be the code for fire prevention within the city jurisdiction, and thet fire chief and the city's building official shall apply such codei inj performing the duties oft their offices. (Insert Resolution Number) Sec. 8-3. Same-Penalty for violation. Any person who shall violate any of thep provisions oft thet fire prevention code adopted in section 8-2 or any person who shall aid, abet or assist any other person in violation oft the code shall, upon conviction ini the municipal court, be punished as provided in section 14-4 pursuant to provisions set forth in 0.C.G.A.516-8- 14(b)(1) (Insert Resolution Number) Sec. 8-4. Life safety code--Adopted. The rules andi regulations for safety tol life from firei in buildings and structures as recommended by the National Fire Protection. Association and as adopted and amended byt the Georgia Safety Fire Commissioner: are hereby adopted in their entirety as thel Life Safety Code of the city. Copies of such code are ont file in Cityl Halla and at thet fire department. Such codei is hereby adopted andi incorporated as part oft this chapter as fully as ifseto out at lengthi ini this section, and the provisions of such code shall be effective and controlling within the corporate limits of the city from and after the date of adoption and approval of this section. (Insert Resolution Number) Sec. 8-5. Same--Penalty for violation. Any person who shall violate any of thep provisions of the lifes safety code adopted in section 8-4, or any person who shall aid, abet or assist any other person iny violation of the code, shall, upon conviction int the municipal court, be punished as provided in section 14-4p pursuant to provisions set forthi in 0.C.G.A.516-8- 14(b)(1) (Insert Resolution Number) Sec. 8-6. Inspections; abatement of fire hazards. (a) Thet fire chief or his sworn designee is hereby given the authorityt toi inspect all construction or buildings within the city or upon property owned or controlled byt the city, whether public, private or business, and shalle enforce all laws oft thes state and the ordinances of the city relating to such construction or buildings for prevention, containment or investigation of fire and fire hazards, both as tot the construction or buildings and Created: 2023-06-13 07:50:00 [EST] (Supp. No.2 20) Page 1of3 as to the contents or occupancy thereof. At not time shalla a business license be approved or renewed without (b) Thei fire chief or one of his sworn designees, upon the determination by him of the existence of any fire hazard violating the provisions of the city's fire protection code or life safety codei in any construction or building, or within the construction or building, or on or within any premises within the city, immediately notify the owner or occupant thereof oft the existence oft thet fire hazard, andt that the owner: shall abate or remove the fire hazard within 15 days from the date of written notice. Upon failure of the owner or occupant sO to do, thef fire chief or one ofH his delegated assistants may, with the approval oft the Mayor or his/her designee, cause thei issuance ofa citation summoning the owner or occupant to appeari int the municipal court to answer for having violated the city's fire prevention code or life safety code, for violation of which the performance ofa al life safety inspection at a minimum. criminal penalties may be imposed pursuant to section 8-3 or section 8-5. (Insert Resolution Number) Sec. 8-7. Obstruction of fire chief in performance of duties. (a) No person shalli in any way obstruct or prevent or attempt to obstruct or prevent thei fire chief or any other fire personnel in the discharge of their duties by denying or attempting to deny them access to any premises owned or occupied by such person, or by failing orr refusing to furnish correct information requested byt the (b) No person shall in any way obstruct orp prevent or attempt to obstruct or prevent the fire chief or his designee whilei inspecting any construction, building or premises to determine the existence of any possible fire hazard, nor shall any person deny access to the fire chief to any construction, building or premises for fire chief in thei investigation into the cause, origin or circumstances of any fire. inspection thereof. (Insert Resolution Number) Sec. 8-8. Open Burning (a) Enforcement. The provisions of this article shall be enforced byt the Fire Chief and the Chief of Police or such subordinate officers of the Fire Department and Police Department as are necessaryt to effectuate the (b) Penalties. Any person who violates any provision oft this article shall be subject to at fine as provided in section 14-4 (b.)Action pursuant to subsection (a) of this section shall not be al bar tot the enforcement oft this article by injunction or other appropriate remedy, and the Chief of Police shall have the power to institute and maintain ini the name of the City any and all such enforcement procedings.cNothing ini this article shall be construed to abridge, limit or otherwise impair the right of any person to maintain any action or other appropriate proceeding for damages of other relief on account ofi injuries to persons or property. (c) Residential. Burn Permits. No permit shall be required in the cityl limits for burn types 1,2,4,5,6and9asset (d) Commercial. Burn Permits. Any open burning of burnt types 3,7, 80 or 10-13 as set forth by the GAI Forestry Commission shall require a written burn permit issued byt the fire chief and shall be subject to any applicable requirements set forth herein. forth by the GAI Forestry Commission fees. (Insert Resolution Number) Created: 2023-06-13 07:50:01 [EST] (Supp. No. 20) Page 2of3 Sec. 8-9. Application for permits. Application for burning permits shall be on forms provided! byt the Fire Chief and all permits willl be granted in compliance with the current guidelines set forth byt the Georgia Forestry Commission. The application shall be accompanied by at fee, as may be set byt the Mayor and City Council and as may be amended from time to time andi is on file int the office oft the City Clerk, thats shall be paid prior to the time of inspection. No burning shall commence prior to an inspection oft the site and the pit byt the Fire Chief or his designee. Upon approval oft the pit, the permit shall be valid for 30 days per pit. Permits may be extended for increments of 15-day periods without additional fees, with ar maximum oft two extensions. (Insert Resolution Number) Sec. 8-10. Fees (a) Prescribed. Fees. An inspection shall not be conducted untilt the fees as prescribed subsection (b) of this (b) Schedule ofl Inspection Fees. On all businesses requiringi inspections, at fee as may be set byt thel Mayor and City Council and as may be amended from time to time andi is on file in the office of the City Clerk, shall be section have been paid. paid prior tot thet time of inspection. (Insert Resolution Number) Created: 2023-06-13 07:50:01 [EST] (Supp. No.2 20) Page 3of3 WALTHOURVILLE FIRE DEPARMTMENT Schedule of Fees (insert adoption date) INSPECTIONS(EXISTING BUSINESSES) Initial annual inspection First Follow-up inspection Second follow-upir inspection Third follow-upinspection NOCHARGE $50.00 $100.00 $150.00 INSPECTIONS/INEW, CONSTRUCTION) 80%, Initial and first follow-up All subsequent follow-up $100.00 $150.00 PLANS REVIEW Sprinkler System Plans Review Fire. Alarm Plans Review Commercial Hood Plans Review Underground Fire Line Plans Review $100.00 plus S0.50 per head $100.00 plus S0.50 per device $100.00 $100.00 EXTRA INSPECTION FEE When extra inspections are necessary to enforce fire or otherapplicable codes, due to any of the following reasons, a charge of $75 fore each reinspection is required, as a result oft the same violation: Work noti in compliance with code and/or approved drawings Work not ready fori inspection upon arrival NoI representative present at time ofs scheduled inspection Wrong address VIOLATION OF CERTIFICATEOFOCCUPANCY/INCIDENT CAUSED BY NEGLIGENCE $500.00 fine PERMITS Residential Burn Permit Bonfire Permit Contractor Burn Permit LPGas/Compressed Gas No Charge No Charge $250.00 pers site $50.00 MOVINGV IMPROVING 0 AGENDA ITEM5 City of Wathourville Millage Discussion * o PURVILLE. 0 AGENDA ITEM I 6 City of Walthourville Town of Allenhurst Fire Agreement RVII LLE, AISAYS MOVING WHILET IMPRONING 0 AGENDA ITEM7 City of Walthourville Charter Review Dates