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resolution 2 pages Scanned/OCR — text may contain errors

Also attached to this agenda item: May 8th Resolution 87-2024 LOSAP Authorization

2023 SPONSOR APPROVAL FORM SERVICE AWARD PROGRAM Croton Volunteer Fire Department Article 11-A of the New York State General Municipal Law requires that a list of volunteers who earned a year of Service Credit during 2023 be certified under oath by the Fire Department and submitted to the Program Sponsor by March 31, 2024. The Program Sponsor must then review and approve the 2023 Firefighter Records listing. To comply with Article 11-A, the Village Board must sign this form once the certified 2023 Firefighter Records listing has been reviewed and approved by the Board. Once signed, the entire 2023 Data Request Package should be returned to the Fire Department so that the approved certified listing can be posted for at least 30 days as required by Article 11-A. OPTION: You may submit a copy of the Board resolution adopted to approve the 2022 records listing for posting in lieu of having the Board members sign below. APPROVAL The Village Board has reviewed and approved the 2023 Firefighter Records listing. Mayor Date Trustee Date Trustee Date Trustee Date Trustee Date | APPROVAL (BLUE) 2023 SPONSOR AUTHORIZATION FORM SERVICE AWARD PROGRAM Croton Volunteer Fire Department This form is to be signed by the Mayor of the Village of Croton-on-Hudson after the 2023 Firefighter Records listing has been posted for at least 30 days, as certified by the completion of the 2023 Fire Department Posting Certification Form. Please sign and return the entire 2023 Data Request Package to: Penflex Actuarial Services, LLC. 50 Century Hill Drive, Suite 3 Latham, NY 12110 AUTHORIZATION | hereby authorize Penfiex Actuarial Services, LLC. to use the data submitted herein about active volunteer firefighter Service Award Program 2023 records. Furthermore, | have reviewed the plan provisions detailed in the most recent LOSAP Report and confirm there have been no subsequent changes to the plan provisions. Penflex Actuarial Services, LLC. will assume there have been no referendums, resolutions, or other plan provision admendments unless notified otherwise. | understand this data will be used to determine the funding requirements of the Service Award Program, the eligibility of participants to be paid Service Award Program benefits and the amount of benefits to be paid to such persons. | understand that if any of the administrative services provided by Penflex Actuarial Services, LLC. must be redone due to errors in the data submitted herein, there may be an additional charge payable by the Program Sponsor. | further understand that Penflex Actuarial Services, LLC. will not be liable for any errors in the calculation of the amounts due or payable from the Service Award Program Trust Fund which are the direct result of an error(s) in the data submitted herein. Signature tst—<“‘“‘s~s;s~S™S Dae Mayor AUTHORIZATION (PINK)