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<br />Page 13 of 13 <br />ATTY/AGR/2017.217/PARS – SECTION 115 TRUST AGREEMENT <br />REV: 09-19-17 MI <br /> <br />EXHIBIT “C” <br /> <br />DATA REQUIREMENTS <br /> <br />Consultant will provide the Services under this Agreement contingent upon receiving the <br />following information: <br /> <br />1. Executed Legal Documents: <br />(A) Certified Resolution <br />(B) Adoption Agreement to the Public Agencies Post-Employment Benefits Trust <br />(C) Trustee Investment Forms <br />. <br /> <br />2. Contribution – completed Contribution Transmittal Form signed by the Plan <br />Administrator (or authorized Designee) which contains the following information: <br />(A) City name <br />(B) Contribution amount <br />(C) Contribution date <br />(D) Contribution method (Check, ACH, Wire) <br /> <br /> 3. Distribution – completed Payment Reimbursement/Distribution Form signed by the <br />Plan Administrator (or authorized Designee) which contains the following <br />information: <br />(A) City name <br />(B) Payment reimbursement/distribution amount <br />(C) Applicable statement date <br />(D) Copy of applicable premium, claim, statement, warrant, and/or administrative <br />expense evidencing payment <br />(E) Signed certification of reimbursement/distribution from the Plan Administrator <br />(or authorized Designee) <br /> <br />4. Other information pertinent to the Services as reasonably requested by Consultant <br />and Actuarial Provider. <br />It is expected that the City will provide the documents in numbers 1-4 above by November <br />30, 2017. <br />6.3.A. - Page 18