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, <br /> SUGGESTED RESOLUTION FOR ADOPTION <br /> and <br /> SUGGESTED AFFIRMATIVE STATEMENT OF ADOPTION <br /> SUGGESTED RESOLUTION FOR ADOPTION OF THE <br /> VANTAGECARE RETIREMENT HEALTH SAVINGS (RHS) PLAN <br /> i'lan Number: 8 036�'1.3 <br /> Name of Gmployer: C� � ���— State: ��-1"1�d�S _ <br /> Resolurioil of the above-named EiTiployer(the"Ernployer"): <br /> W HLREAS, the Employer has employees rendering valuable services:and <br /> WHERF.AS, the estabfishmen�of a reriree health savings plan for such ernployees serves rhe inrcrests of�he Employer b}� <br /> enabling it to�rovide reasonable securicy regarding such employees' health needs during retirement, by providing inereased <br /> flcxibiliry in its persunnel man�zgemcnt�systeoi,and b�-assis�ing in �hc attractiun and retention of comperenr personnel; ai�d <br /> W H[?REAS, the Empluyer has determined ihat ehe establishment of c�he retiree healrh savings plan (rhe"Ylan")se•rves rhe <br /> above objectives; <br /> NOW,THFREFOK[?BE IT RFSOI�V[3D, that the E?mployer he�reb��adupts the Plan in the form of the ICM/� Retiremen� <br /> Corporation�s VantageCare Retiremenr Health Savings program. <br /> BE IT FURTNF.R RESOI.VED ehat the assets ot rhe Plan shall be held in trust,�vith �he Following entity or individual <br /> serving as trustee(Selecr one): <br /> ,� rhe Employer <br /> ❑ the following position wichin the Employer: _ <br /> �imcrr cidc nf�mdividwil acring�as rms�cc) <br /> ❑ the following group or committee within the Employer: <br /> (inxcr�gmuporcoinnii��cc aaingasrtuscc.) <br /> ❑ the following t�hird-parry trustee: <br /> (inscn namu ol[hird-parry��m�icc! <br /> fc>r �he exclusive benrtit of Plan parricapants and their�urvivors, and the asscts ot nc� Plan slaall not be c{ivertcd to any <br /> other purpose prior to the saeisfacrion of all liabilities of the Plan. Thc F,tnployer has executed the Declaration of Trust of <br /> the L�T� �F DEGKI(,�—, ��LWd15 Inte.gral Part�Trust i❑ �he brm of: (Select one) <br /> � The model trust made availablc by the ICMA Rerirernent Corporation <br /> ❑ The cnist provided by the Gmployer(esecured copy attachec{6ereto). <br /> BE IT FCJRTNER RI�:SOI.VI?D, d�ac the NUM� K�-5d1� 7`�/��� shall be rhe coordinator and contacc <br /> tor the Plan and shafl receive necessary r�ports, notices,ecc. <br /> I' --.--.---- -- ,Clerk of che .._._._._._ of , <br /> do hereby certify that the fore�oing resolution, proposed by ,�vas duly passed and <br /> adopred in the ot the of , <br /> ar a regular meeting thereof assembled this day of , �',0 , b,y the following vote: <br /> f�YES: <br /> NA�'S: <br /> A BS EN"I': <br /> (Seal) Clerk's Signature: <br /> Clerk's'l'itle: <br /> � <br />