02-217 ' VOLUME LXVII JUNE 12, 2002
IMRF BENEFIT PROTECTION LEAVE Resolution 02-217
R IMRF Form 6.32 (6/99)
F
INSTRUCTIONS ON REVERSE
PLEASE PRINT OR TYPE
MEMBER'S LAST NAME FIRST MIDDLE INITIAL SOCIAL SECURITY NUMBER
STANLEY JOHN T
STREET(MAILING)ADDRESS CITY,STATE AND ZIP
HAMPSHIRE IL 60140
CURRENT POSITION MEMBER'S TELEPHONE NUMBER
ELECTRICAIr WORKER
EMPLOYER NAME - EMPLOYER IMRF I.D.NUMBER
CITY—Or—ELGIN
CERTIFICATION BY MEMBER
I certify that I will be(or have been)on leave of absence beginning 6/13/01 and ending 7/23/01
DATE DATE
for a total of 1 months.(Indicate on Line 2 below)
I understand that•se• ' redits(not more than 12 months)for this leave cannot be established until I have paid to IMRF member contribu-
tions in a. a un .1 to the approximate contributions I would have made if actively employed during the leave of absence,plus interest.
MEMBER •' DATE
% �=
ERTIFICA•ON BY AUTHORIZED AGENT
I certify that(1)I have calculated the estimated employer cost of the above member's leave,(2)I have advised the governing body of the
amount of such cost and()that it will be paid through future monthly contributions.
1. AVERAGE MONTHLY EARNINGS
(Determine the monthly average by dividing by 12 the IMRF reported earnings 44091100x;
for the 12 months prior to the leave) j
2. NUMBER OF MONTHS LEAVE(LIMITED TO 12 MONTHS) o h
3. TOTAL ESTIMATED EARNINGS THAT WOULD HAVE BEEN PAID S �N � w
DURING THE LEAVE OF ABSENCE(LINE 1 TIMES LINE 2) 4409.00 f Z, a
x
4. AVERAGE EMPLOYER COST RATE (LINE 3 TIMES 11%) .s,7-,6� k.,
X 11.00% ,; f
S. ESTIMATED COST OF THIS LEAVE TO EMPLOYER sY ,
484.99 ; �� w .
' b ,
AUTHORIZED AGENT SIGNATURE
AM • . DATE t'/0 O�
i N is
CERTIFICATION BY CLERK OR SECRETARY OF GOVERNING BODY
I certify that at a regular or special meeting held on June 12, 20 02 the City Council
DATE NAME OF GOVERNING BODY
of the City of Elgin approved the leave of absence stated herein and the estimated employer cost as
NAME OF EMPLOYER
herein determined.
SIGN RE CLERK OR SECRETARY DATE
Dolonna Mecum June 13, 2002
Illinois Municipal Retirement Fund
Suite 500,2211 York Road, Oak Brook Illinois 60523-2374 630/368-1010
IMRF Form 6.32 (Rev.6/99) Service Representativee28b0/ASK-IMRF
4,
. �y OF ESC
L p\�� City of Elgin Agenda Item No. H
E 1/1
L ".;`
May 17, 2002 G 1
N �' ' .
,TO: Ma or and Members of the City Council Pa fN^
Y FINANCIALLY STABLE CITY GOVERNMENT
EFFICIENT SERVICES,
AND QUALITY INFRASTRUCTURE
FROM: Olufemi Folarin, Interim City Manager
SUBJECT: IMRF Benefit Protection Leave for William H. Potts,Jr. ,
John Stanley, Thomas Mogler and David Bennett
PURPOSE
The purpose of this memorandum is to provide the Mayor and members
of the City Council with information to authorize and endorse IMRF
Benefit Protection Leave for William H. Potts, Jr. , John Stanley,
Thomas Mogler and David Bennett .
BACKGROUND
el--
Wiliam Potts, Jr. has been employed by the City of Elgin since
April 22 , 1986 through the present . Mr. Potts was on an approved
leave of absence while conducting business activities on behalf of
the SEIU, Local #73 . The leave of absence began on September 10,
2000 and ended on November 13 , 2000 . During this period no
contribution was made to IMRF by the City or by Mr. Potts since he
was receiving no paycheck from the City.
John Stanley has been employed by the City of Elgin since February
16, 1976 through the present . Mr. Stanley was on a worker' s
compensation disability leave of absence beginning on June 13, 2001
and ending July 23 , 2001 . During this period no contribution was
made to IMRF by the City or by Mr. Stanley since he was receiving
no paycheck from the City.
Thomas Mogler has been employed by the City of Elgin since July 9,
1979 through the present . Mr. Mogler was on a worker' s
compensation disability leave of absence beginning on October 17,
2001 and ending January 1, 2002 . During this period no
contribution was made to IMRF by the City or by Mr. Mogler since he
was receiving no paycheck from the City.
David Bennett has been employed by the City of Elgin since January
21, 1985 through the present . Mr. Bennett was on a medical
disability leave of absence beginning on May 16, 2001 and ending
top- IMRF Benefit Protection Leave - Potts, Stanley, Mogler & Bennett
May 17, 2002
Page 2
June 25, 2001 . During this period no contribution was made to IMRF
by the City or by Mr. Bennett since he was receiving no paycheck
from the City.
Mr. Potts, Mr. Stanley, Mr. Mogler and Mr. Bennett meet the
requirements for the Benefit Protection Leave as established by
IMRF (see attached IMRF Form 6 . 32) .
COMMUNITY GROUPS/INTERESTED PERSONS CONTACTED
IMRF (Illinois Municipal Retirement Fund)
1411 FI • CIAL IMPACT
The employer' s contribution for IMRF Benefit Protection Leave
services is made through future contribution rates . A separate
payment is not required. The actuary will take the estimated
service cost (line 5 on attached IMRF form 6 . 32) into account when
annually determining the employer contribution rate .
IMPACT
v None
ALTERNATIVES
1 . Approve the attached IMRF Benefit Protection Leave request .
2 . Not approve the attached IMRF Benefit Protection Leave
request .
RECOMMENDATION
It is recommended that the City Council approve the request to take
the necessary action to obtain the IMRF Benefit Protection Leave
for William H. Potts, Jr. , John Stanley, Thomas Mogler and David
Bennett .
Respectfully submitted,
Olufemi Fo =r n
Interim Cit Ma .= -r
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