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Agenda 09-13-12 CEMETERY BOARD AGENDA THURSDAY, SEPTEMBER 13, 2012 @ 3:30 P.M. COMMISSION CHAMBERS, 100 E. BOYNTON BEACH BLVD. BOYNTON BEACH, FLORIDA 1. CALL TO ORDER 2. ATTENDANCE 3. AGENDA APPROVAL 4. APPROVAL OF MINUTES — March 8, 2012 5. RECEIPT OF REVENUE /EXPENSE SHEETS — March, April & May, June, July & August 2012 6. RECEIPT OF SALES REPORTS — March, April & May, June, July & August 2012 7. UNFINISHED BUSINESS A. Parks Division Reports — March, April & May, June, July & August 2012 B. Status report on the fountain filtration (Tabled on 03/08/12) C. Update on gate at the pit area (Tabled on 03/08/12) 8. NEW BUSINESS A. Ratify the request of Frances M. Del Casino for a refund of Crypt C26, Serenity Building, Section A, Boynton Beach Mausoleum. Original purchase price was $6,450 less 50% ($3,225) for a total refund of $3,225.00. (All paperwork is in order.) Telephone poll was conducted. B. Ratify the request of Eugene & Gloria Klein for a refund of Niche 32, Sunrise Building, Section H, Boynton Beach Mausoleum. Original purchase price was $825; however, the City's resale price is $700. Therefore, the $700 is reduced by 20% ($140) for a total refund of $560. (All paperwork is in order.) Telephone poll was conducted. C. Ratify the request of Mildred J. Hopkins for a refund of Crypt C9, Sunset Building, Section D, Boynton Beach Mausoleum. Original purchase price was $4,550 less 20% ($910) for a total refund of $3,640. (All paperwork is in order.) Telephone poll was conducted. D. Approve the request from Ruth Rzeznik for a refund of Lots 165 & 266, Block M, Boynton Beach Memorial Park in the amount of $1,200. (Original purchase price was $1,500 less 20% which is a reduction of $300). (All paperwork is in order.) E. Approve the request from Carolyn E. Edwards for a refund of Crypt D -8, Section D, Sunset Building, Boynton Beach Mausoleum in the amount of $2,080. (Original purchase price was $2,600 less 20% which is a reduction of $520.) (All paperwork is in order.) F. Approve the request from W. Ray Morgan for a refund of Niche E -2, Section L, Benediction Building, Boynton Beach Mausoleum in the amount of $425. (Original purchase price was $850 less 50% which is a reduction of $425.) (All paperwork is in order.) G. Approve the request from Brenda Banas for a refund of Lot 71B, Block N, Boynton Beach Memorial Park in the amount of $140. (Original purchase price was $175 less 20% which is a reduction of $35.) (All paperwork is in order.) H. Approve the request of Joan Lev for the disinterment of Jay E. Stem from Sunset Building, Section G, Niche D6. (All paperwork is in order.) 9. OTHER None 10. ADJOURNMENT NOTICE IF A PERSON DECIDES TO APPEAL ANY DECISION MADE BY THE CEMETERY BOARD WITH RESPECT TO ANY MATTER CONSIDERED AT THIS MEETING, HE /SHE WILL NEED A RECORD OF THE PROCEEDINGS AND, FOR SUCH PURPOSE, HE /SHE MAY NEED TO ENSURE THAT A VERBATIM RECORD OF THE PROCEEDING IS MADE, WHICH RECORD INCLUDES THE TESTIMONY AND EVIDENCE UPON WHICH THE APPEAL IS TO BE BASED. (F.S. 286.0105) THE CITY SHALL FURNISH APPROPRIATE AUXILIARY AIDS AND SERVICES WHERE NECESSARY TO AFFORD AN INDIVIDUAL WITH A DISABILITY AN EQUAL OPPORTUNITY TO PARTICIPATE IN AND ENJOY THE BENEFITS OF A SERVICE, PROGRAM, OR ACTIVITY CONDUCTED BY THE CITY. PLEASE CONTACT CITY CLERK'S OFFICE , (561) 742 -6060 AT LEAST TWENTY -FOUR HOURS PRIOR TO THE PROGRAM OR ACTIVITY IN ORDER FOR THE CITY TO REASONABLY ACCOMMODATE YOUR REQUEST. S: \CC \W P \CEM ETERY\AGEN DA \2012 \AGENDA - 09- 13 -12. Doc The Cittj of Boij nton Beach City Clerk's Office 100 E BOYNTON BEACH BLVD BOYNTON BEACH FL 33435 (561) 742 -6060 FAX: (561) 742-6090 e -mail: prainitoj @ci.boynton- beach.fl.us www.boynton- beach.org MAUSOLEUM REFUND CEMETERY BOARD CITY CLERK'S OFFICE CITY OF BOYNTON BEACH 100 E BOYNTON BEACH BLVD. BOYNTON BEACH FL 33435 I (We), the undersigned, do hereby submit the certificate of ownership and Mausoleum agreement verifying the purchase price for the following described space in the Boynton Beach Mausoleum: BUILDING Serenity Original Certificate SECTION B Contract CRYPT D27 I (We) respectfully request a refund of the purchase price less 20 % which we understand is the established policy. PURCHASE PRICE: $ 3,600.00 LESS 20 % $ 720.00 X AMOUNT TO BE REFUNDED: $ 2,880. g g �C & .L.lam, ) GZ j ,J ; � \ Signature: Signature: �-- Print Name: Richard Parks -"` Print Name Julie Parks Mailing Address: 6949 Main Street, Trumble, CT 06611 Telephone # 203 - 445 -1610 Date: Ct`0 `l STATE OF u I"\ etA. CA COUNTY OF I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgements, personally appeared and \L.,4 t' C i(5 , to me known to be the person(s) described in and who executed the foregoifid instrument that he she acknowledged before me that he /she executed the same; that the individual was personally known to me or provided the following proof of identification: u-k-v Z 'V7`, WITNESS my hand and official seal in the County and State last aforesaid this 0 day of c, . + ti \r v , 20_1•?j- ( (Notary Seal) Seal) Notary Public Print Name t`� \ _SfW 0 My Commission Expires. ZZ :01:'J C."1 sS It3 \ /1'. S. \CC \WP \CEMETERY \REFUNDS \Blank Refund Form - Mausoleum - Parks.doc The City of Boynton Beach City Clerk's Office 100 E BOYNTON BEACH BLVD BOYNTON BEACH FL 33435 (561) 742-6060 ` FAX: (561) 742 -6090 ", , .. e-mail: prainitoj @ci.boynton - beach.fl.us www.boynton-beach.org August 14, 2012 Mr. and Mrs. Richard Parks 6949 Main Street Trumble, CT 06611 Dear Mr. and Mrs. Parks: Per your telephone conversation with Cindy requesting a refund for Mausoleum space in the Serenity Building, Section B, Crypt D27, I have enclosed a "Refund" request form. Please fill out all areas that have been highlighted and return it to me along with the original Certificate of Ownership and Sales Agreement in the enclosed envelope. Please remember to have this document notarized before you return it. Your request for a refund must be approved by the Cemetery Board, which meets quarterly on the second Thursday. Once the Cemetery Board approves your request, I will forward a request to our Finance Department to process your refund in the amount of $2,880.00. If I can offer any additional information, please contact me. Very truly yours, CITY OF BOYNTON BEACH (tn. Pit.&-LiLto et M. Prainito, MMC City Clerk Enclosures S: \CC \W P \CEMETERY \Mausoleum \Refunds \2012 \Parks.doc America's Gateway to the Gulfstream *(>. 'a , .. ' . * t n 0+- CI) - 1 - 1 oot a ° �. Q 0 Z m Z 510 o m � Q o � �m ,„ ° o 0 v G) C z� �� C) v, mm T z � -om� C) ;C <„ O o� ° y 3 °� m 00 O o 0 (D °� C - '‹ T -1 A ° Q Z, CO m,. m - i m = vm�~ ooZO a 0 n 4p cn � m-I Q0 ti `�O v a ° z O r o mp 0 Q % 1 . c..,., o r �n °v Q� sin �.... �, -< o .6).- � St -.). y T° 2 V m co --.. ° Z m O ° T CD 3 LU s .Z7 Q, CD � -� - ov a 3 a m 0 i o m ��CD 00 Cr 3n Zi N • o a- g � o Q C cD G) — 0 (- o 00 -' o 0 ° r • '`= M:10 75 _ .-.. < CD ` p- (.D O- z , i . .� ' - C� v CD o ° ° O Co N y � �'� tb y ` y C Q y' v C D V 0 c a 4'- • q. al i , Q Q. CO o .3' 7) Z Q� 0 Co m a � C a. rn W Q °v_ -. C �� a rn Q • y v =-1 Q. a a3 o n m`° Z ri: Q -< a yo u 4 n • 8 0 0 CD y � -,^ s ° _ n o ° � , c ~ °v ,1 O z °° ° cn O o ' oync V o f °. - c oo ( 0 (D ■ m Cnm 0 C) n o Q z" z 0 < o - 0 Q) r Q a v, Z • `7‹ a •z a Oo°_ st -c3 ° cu ° •. v `c C _ IN ? o m Co o ° ° O o m Q o v Z Q Q. CD CD O � Z X Q ♦ _-.� ♦ Q BOYNTON BEACH MAUSOLEUM, INC. Telephones 000114 1611 South Seacrest Blvd. • P.O. Box H H • Boynton Beach, Florida 33435 Sales Office 734 -6404 Business Office: 395 -1006 PRECONSTRUCTION MAUSOLEUM AGREEMENT Area Code 407 ' THIS AGREEMENT, made this f r day of �- , 19', between the CITY OF BOYNTON BEACH, FLORIDA (hereinafter "City "), by and through its authorized agent, BOYNTON BEACH MAUSOLEUM, INC., a Florida corporation (hereinafter "Corporation "); and / t 1 v (hereinafter "Purchaser ") // Street City State Zip Code Reside within the corporate limits of Boynton Beach? ❑ YES ❑ NO WITNESSETH: Purchaser agrees to buy and City agrees to sell, in accordance with the terms hereof, the exclusive right of entombment in the Mausoleum space described as: Buildin ., ` / f t Section: Crypt: - Niche: in the BOYNTON BEACH MAUSOLEUM, Boynton Beach, Florida (hereinafter "Mausoleum Space "). Purchaser agrees to pay the following sum to the Corporation for the Mausoleum Space $ If this is a cash sale, the Total Purchase Price is $ - ' - . If this is a deferred payment sale, the interest rate on the deferred purchase price is % per annum and the Total Purchase Price, including all finance charges, is $ /14/. . Purchaser agrees to pay to the Corporation % consecutive monthly installments of $ --' beginning on the first day of , 19 and continuing on the first day of each month thereafter. The Total Purchase Price and finance charges must be paid in full before entombment. ITEMIZATION OF AMOUNT FINANCED / A. Cash Price $ ' 6. B. Less Down Payment $ C. Amount Financed, Unpaid Balance (A - B) $ - D. Insurance $ E. Taxes /Official Fees F Finance Charge $ G. Total of Payments r� 6 (C + D +E +F) $ H. Total Sales Price or Total Deferred Payment Purchase i A Li , - ti- - Price (B + G) $ - In case of default by Purchaser for more than thirty (30) days in any of the payments herein provided, Corporation may, at its option, on fifteen (15) days notice sent by registered mail to Purchaser at the address designated above, declare this Agreement cancelled and retain all sums which shall have been paid hereunder as liquidated damages. City shall deposit twenty percent (20%) (15% plus 5 %) of the purchase price, which shall be carried on City's books as and for the perpetual care fund for the maintenance of the Mausoleum . City shall install individual memorialization. Said memorialization shall bear the name, year of birth and year of death of the individual, and shall consist of bronze letters commonly used for such purposes. City shall provide for the opening and closing of the above - described spaces upon request by Purchaser. Said opening and closing shall include the use of the chapel, lift and other equipment as is usually provided for this purpose. Current rules and regulations do not permit potted plants or artificial flowers within the Mausoleum at any time. Fresh flowers are permitted to remain for a period of three (3) days. Certificates of Ownership shall be issued only upon payment in full Purchaser acknowledges that entombment in a crypt or inurnment of ashes in a niche can take place only once in the above described Mausoleum Space. Purchaser acknowledges that this is a preconstruction sale and that the space is not available at this time; However, the construction will commence in conformity with Florida Statute, Section 559.482. Advanced payments made pursuant to this contract will be disbursed only in accordance with Florida Statute, Section 559.482. Certificates of Ownership shall be issued only upon payment in full and completion of construction. In the event of death before completion, the purchase price shall be applied against the purchase price (discounted by 10 %) of a substituted space in the completed section of the,Mausoleum. The conveyance for said Mausoleum Space shall be made subject to all rules and regulations now existing and which may be hereafter promulgated for the operation, care and control of the Mausoleum, all of which rules and regulations, whether now existing or hereinafter promulgated, are incorporated herein by reference. NOTICE TO BUYER A. DO NOT SIGN THIS CONTRACT BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK SPACES B. YOU ARE ENTITLED TO AN EXACT COPY OF THE CONTRACT YOU SIGN KEEP IT TO PROTECT YOUR LEGAL RIGHTS. BUYER'S RIGHT TO CANCEL IF THIS IS A HOME SOLICITATION SALE, AND IF YOU DO NOT WANT THE GOODS OR SERVICES, YOU MAY CANCEL THIS AGREEMENT BY PROVIDING WRITTEN NOTICE TO THE SELLER IN PERSON, BY TELEGRAM, OR BY MAIL THIS NOTICE MUST INDICATE THAT YOU DO NOT WANT THE GOODS OR SERVICES AND MUST BE DELIVERED OR POST MARKED BEFORE MIDNIGHT OF THE THIRD BUSINESS DAY AFTER YOU SIGN THIS AGREEMENT. IF YOU CANCEL THIS AGREEMENT THE SELLER MAY NOT KEEP ALL OR PART OF ANY CASH DOWNPAYMENT By signing this Agreement, the Purchaser hereby acknowledges that this Agreement was completed as to all essential provisions prior to signing and Purchaser further acknowledges that a copy of this Agreement has been delivered to Purchaser at the time of signing this Agreement. • The parties heKeto - have executed this Agreement on the day and year first above written. PURCHASER:' BOYNTON BEACH MAUSOLEUM, INC. , 1 , A (rti (SEAL) By •' t Y f ,'l (SEAL) Date: - - Date Telephone: CITY OF BOYNTON BEACH, FLORIDA STATEMENT OF REVENUES & EXPENDITURES - COMPARATIVE BUDGET TO ACTUAL For the Month Ended Aug 31, 2012 FISCAL YEAR 2012 TO DATE Current YTD Revenues - 631 (Memorial Park) Aug -12 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments $ 1,500 $ 30,000 $ 48,150 161% Cemetery/Equipment Rental 200 8,000 10,100 126% Cemetery/Sale of Lots 2,100 30,000 53,525 178% TOTAL CHARGES 3,800 68,000 111,775 164% MISCELLANEOUS REVENUE Interest Income 5,274 5,000 19,003 380% Miscellaneous Income 450 3,000 3,700 123% Fund Balance Appropriated 0 183,825 0 0% TOTAL MISCELLANEOUS REVENUE 5,724 191,825 22,703 12% Total Revenues $ 9,524 $ 259,825 $ 134,478 52% FISCAL YEAR 2012 TO DATE Current YTD Revenues - 632 (Mausoleum) Aug-12 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments 0 0 500 0% Mausoleum/Sale of Crypts 0 0 51,150 0% TOTAL CHARGES 0 0 51,650 0% MISCELLANEOUS REVENUE Interest Income 4,795 5,000 17,278 346% Miscellaneous Income 400 3,000 2,750 92% Fund Balance Appropriated 0 60,000 0 0% TOTAL MISCELLANEOUS REVENUE 5,195 68,000 20,028 29% Total Revenues $ 5,195 $ 68,000 $ 71,678 105% Grand Total Revenues $ 14,719 $ 327,825 $ 206,156 63% S :\Finance\Cemeteries - Mausoleum1Cemetary Monthly Report12012 Monthly Report.xis FISCAL YEAR 2012 TO DATE Current r Expenditures -631 (Memorial Park) Aug -12 BUDGET EXPENSES PERCENT PERSONNEL. Regular Salaries $ 13,839 9 -24,084 3 '4 208 92 °% Holiday Pay 7 0C 3c'/G Overtime '65 3,000 2,828 94% Cell Phone Allowance 15 1 80 165 92% Employer FICA 1, 036 9,548 8,659 91% General Employees Pension 21,564 21,564 100% Life Insurance _ 42 35 84 °A Disability Insurance 29 563 348 62% Health Insurance 1 438 17,255 1 5,81: 92% Dental Insurance ': 963 875 91% Vision Insurance 10 127 106 83% TOTAL PERSONNEL 16,61 178,026 164,603 92% OPERATING Audit Fees $ 400 $ 2,100 $ ',600 '6% Cellular Phone /Beeper 23 280 233 83% Electnc Service 177 2,000 7 29 35% Water /Sewer Service 53 800 _ 50% Building Repairs 'i 1,000 0% Vehicle Maint- Garage 9,235 1 0 753 ' 16% Irrigation Maintenance 2,000 226 %, Self Insurance Chgs (W /C) 196 2,35' ‘ 155 92% Warehouse Service Chg 88 1 05 963 92% Other Contractual Svcs 3,946 30,000 18,798 53% Office Supplies #DIV/0' Operating Equip < $750 900 '3 Chemicals 1,850 4 9C ?6 °/° Uniforms 50C 50 100 Safety Clothing/Equip 59C 9� i 6% Gardening Supplies 5,000 309 6% Equipment Parts/Supplies 115 2,500 1,748 7 0% TOTAL OPERATING 4,998 62,157 39,076 F3% NON - OPERATING Transfer to General Fund $ 1,000 $ 12,000 $ 11,000 =32°r° Transfer to Vehicle Svc Fund 428 5,142 4,7' : 32% Refund on Cemetery Lots 0 2,500 4,760 190% TOTAL NON-OPERATING 1428 19,642 204 ' 74 %a Expenditures - 632 (Mausoleum) OPERATING Litigation Fees & Costs $ $ 15,000 $ 0'% Electric Service 717 600 2,590 432% Water /Sewer Service 858 2,500 4 ,651 1 86% Building Repairs 0 2,000 c, c') °A Other Contractual Services ) 520 11,600 6,655 57% Supplies 5,500 933 ; 7 ° A Equipment Parts/Supplies C 0 o% Refund -Sale of Crypts 0 30,800 27,727 90% TOTAL OPERATING 2,895 68,000 42,556 53% Total Expenditures $ 25,935 $ 327,825 $ 266,708 81% Net Income Increase(Decrease) $ (11,216) $ - $ (60,552) S 1Finance\Cemetenes - Mausoleum\Cemetary Monthly Repo"t12012 Monthly Report xis CITY OF BOYNTON BEACH, FLORIDA STATEMENT OF REVENUES & EXPENDITURES - COMPARATIVE BUDGET TO ACTUAL For the Month Ended July 31, 2012 FISCAL YEAR 2012 TO DATE Current YTD Revenues - 631 (Memorial Park) Jul -12 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments $ 4,150 $ 30,000 $ 46,650 156% Cemetery/Equipment Rental 1,000 8,000 9,900 124% Cemetery/Sale of Lots 625 30,000 51,425 171% TOTAL CHARGES 5,775 68,000 107,975 159% MISCELLANEOUS REVENUE Interest Income 845 5,000 13,730 275% Miscellaneous Income 0 3,000 3,250 108% Fund Balance Appropriated 0 183,825 0 0% TOTAL MISCELLANEOUS REVENUE 845 191,825 16,980 9% Total Revenues $ 6,620 $ 259,825 $ 124,955 48% FISCAL YEAR 2012 TO DATE Current YTD Revenues - 632 (Mausoleum) Jul -12 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments 0 0 500 0% Mausoleum/Sale of Crypts 7,650 0 51,150 0% TOTAL CHARGES 7,650 0 51,650 0% MISCELLANEOUS REVENUE Interest Income 768 5,000 12,483 250% Miscellaneous Income 200 3,000 2,350 78% Fund Balance Appropriated 0 60,000 0 0% TOTAL MISCELLANEOUS REVENUE 968 68,000 14,833 22% Total Revenues $ 8,618 $ 68,000 $ 66,483 98% Grand Total Revenues $ 15,238 $ 327,825 $ 191,438 58% S:1Finance\Cemeteries - Mausoleum \Cemetery Monthly Report12012 Monthly Report FISCAL YEAR 2012 TO DATE Current Y1 L Expenditures - 631 (Memorial Park) Jul -12 BUDGET EXPENSES PERCENT PERSONNEL Regular Salaries 9,522 $ 124,084 $ 100,369 '''')/o Holiday Pay c, 700 ,: °!° Overtime 70 3,000 ,/ 663 89% Cell Phone Allowance 15 180 1 50 83% Employer FICA Y10 9,548 ',623 80% General Employees Pension 21,564 21,564 100% Life Insurance ,,, 42 32 76% Disability Insurance 58 563 319 57% Health Insurance 1 438 17,255 "4 372 83% Dental insurance ° 't' 963 7 94 82% Vision Insurance 10 127 96 76% TOTAL PERSONNEL 11,908 178,026 147,989 83% OPERATING Audit Fees $ $ 2,100 $ 1,200 i% Cellular PhonelBeeper r 280 215 " 5"% Electric Service 88 2,000 551 28% Water /Sewer Service 49 800 -24 ~3% Building Repairs 1,000 ° s° Vehicle Maint- Garage 393 9,235 10,753 '16% Irrigation Maintenance r, 2,000 226 , rc. Self Insurance Chgs (WIC) 196 2,351 1 959 33% Warehouse Service Chg 88 1,051 575 83% Other Contractual Svcs 1 7 " 30,000 14,852 50% Office Supplies ` }47 Operating Equip < $750 5 900 �r :) °r° Chemicals 250 1,850 490 S% Uniforms 500 ',iC `00°1° Safety Clothing /Equip 590 -,4 16% Gardening Supplies , 5,000 305 5% Equipment Parts /Supplies 27 2,500 1,633 65% TOTAL OPERATING 2,802 62,157 34,078 55 °/4, NON - OPERATING Transfer to General Fund $ 1,000 $ 12,000 $ 10,00C 5356 Transfer to Vehicle Svc Fund 429 5,142 4,285 n°0 Refund on Cemetery Lots ., 2,500 '';v Refund on Sale of Crypts 4,760 0 4,760 0% TOTAL NON - OPERATING 6 189 19,642 19.045 97% Expenditures - 632 (Mausoleum) OPERATING Litigation Fees & Costs 5 $ 15,000 $ 0% Electric Service 279 600 1,873 312% Water /Sewer Service 270 2,500 3,993 160% Building Repairs 0 2,000 5 0% Other Contractual Services 2 11,600 5,135 44% Supplies 391 5,500 933 17% Equipment Parts /Supplies 0 0 0 0% Refund -Sale of Crypts 10,040 30,800 27,727 90% TOTAL OPERATING 10,980 68,000 39,661 58% Total Expenditures $ 31,879 $ 327,825 $ 240,773 73% Net Income Increase(Decrease) $ 20,399 $ - $ (64,573) S: \FinancelCemetenes - Mausoleum\Cemetary Monthly Report12012 Monthly Report CITY OF BOYNTON BEACH, FLORIDA STATEMENT OF REVENUES & EXPENDITURES - COMPARATIVE BUDGET TO ACTUAL For the Month Ended June 30, 2012 FISCAL YEAR 2012 TO DATE Current YTD Revenues - 631 (Memorial Park) Jun -12 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments $ 4,600 $ 30,000 $ 42,500 142% Cemetery/Equipment Rental 1,000 8,000 8,900 111% Cemetery/Sale of Lots 8,700 30,000 50,800 169% TOTAL CHARGES 14,300 68,000 102,200 150% MISCELLANEOUS REVENUE Interest Income 447 5,000 12,885 258% Miscellaneous Income 0 3,000 3,250 108% Fund Balance Appropriated 0 183,825 0 0% TOTAL MISCELLANEOUS REVENUE 447 191,825 16,135 8% Total Revenues $ 14,747 $ 259,825 $ 118,335 46% FISCAL YEAR 2012 TO DATE Current YTD Revenues - 632 (Mausoleum) Jun -12 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments 250 0 500 0% Mausoleum /Sale of Crypts 36,650 0 43,500 0% TOTAL CHARGES 36,900 0 44,000 0% MISCELLANEOUS REVENUE Interest Income 406 5,000 11,715 234% Miscellaneous Income 225 3,000 2,150 72% Fund Balance Appropriated 0 60,000 0 0% TOTAL MISCELLANEOUS REVENUE 631 68,000 13,865 20% Total Revenues $ 37,531 $ 68,000 $ 57,865 85% Grand Total Revenues $ 52,278 $ 327,825 $ 176,200 54% S:\Finance\Cemeteries - Mausoleum\Cemetary Monthly Report\2012 Monthly Report FISCAL YEAR 2012 TO DATE Current YT L' Expenditures - 631 (Memorial Park) Jun -12 BUDGET EXPENSES PERCENT PERSONNEL Regular Salaries $ 9,482 $ ' 24,084 $ 90,847 3% Holiday Pay 700 l% Overtime 145 3,000 2,593 86% Cell Phone Allowance 15 180 135 75% Employer FICA %13 9,548 6,913 72% General Employees Pension 21,564 21,564 100% Life Insurance 42 26 62% Disability Insurance 563 261 46 °is, Health Insurance 1 ,438 17,255 12,941 )5% Dental Insurance 75 963 7 ` 4 14% Vision Insurance 10 127 86 68% TOTAL PERSONNEL 11,882 178,026 136,080 76% OPERATING Audit Fees $ $ 2,100 $ 8,200 D: Cellular Phone /Beeper 23 280 2" 0 '5% Electric Service 9 2,000 463 3 °,4, Water /Sewer Service 53 800 ? ='% Building Repairs 1 ,000 :°k, Vehicle Maint - Garage 818 9,235 1 0,369 ' 1 2% Irrigation Maintenance C, 2,000 226 , °/ Self Insurance Chgs (W /C) 196 2,351 ` 763 , 5% Warehouse Service Chg 88 1,051 788 75% Other Contractual Svcs 30,000 , 3.' ` 1 44% Office Supplies � 9% Operating Equip < $750 900 r °'n Chemicals 1,850 240 o Uniforms 500 ` - . , 100% Safety Clothing /Equip 60 590 16 '6°/ Gardening Supplies 0 5,000 309 6% Equipment Parts /Supplies 236 2,500 1,606 64% TOTAL OPERATING 1,474 62,157 31,275 50°4 NON - OPERATING Transfer to General Fund $ 1,000 $ 12,000 $ 9,000 '5% Transfer to Vehicle Svc Fund 429 5,142 3,857 'F: 04, Refund on Cemetery Lots 0 2,500 v 0°l0 TOTAL NON - OPERATING 1,429 19,642 4 2 857 65% Expenditures - 632 (Mausoleum) OPERATING Litigation Fees & Costs S $ 15,000 $ 3% Electric Service 0 600 1,595 266% Water /Sewer Service 1,048 2,500 3,724 149% Building Repairs 0 2,000 0 `j °/a Other Contractual Services 0 11,600 5,135 44% Supplies 0 5,500 541 ' 0°I° Equipment Parts /Supplies 0 0 0 o% Refund -Sale of Crypts 17,687 30,800 17,687 57% TOTAL OPERATING 18,735 68,000 28,682 42% Total Expenditures $ 33,520 $ 327,825 $ 208,894 64% Net Income Increase(Decrease) $ 18,758 $ - $ (32,694) S: \Finance \Cemeteries - MausoieumlCemetary Monthly Report12012 Monthly Report CEMETERY REPORT 8/1/2012 BOYNTON BEACH MEMORIAL FUND (CEMETERY TRUST FUND) SALES THIS CURRENT FROM CUMULATIVE $$ MONTH MONTH $ 10/01/2011 YEAR TO DATE SALES OF LOTS BBM PARK 1 41 $2,100.001 891 $47,600.00 14 @$525.00= $2,100,00 SARA SIMMS 0 $0.00 0 0.00 CONTRACT SALES 0 $0.00 9 $5,154.20 MAUSOLEUM Crypts & Niches 1 $3,000.00 11 $44,800.00 Contract Sales 0 $0.00 3 $9,150.00 1 @ 3,000 Mausoleum Open and Close 1 61 $0.001 661 $250.00 f Refunds - Cemetery Refunds - Mausoleum 0 $0.00 7 - $32,486.60 GENERAL FUND Cemetery Open and Close 1 61 $3,100.001 1001 $45,100.00 12 @ $400.00 / 3 @ $500.00 / 1 @ $800,00 = $3,100.00 Use of Equipment 1 71 $700.001 951 $9,400.00 17 @ $100.00 = $700.00 Transfer of Deeds 0 $0.00 3 $225.00 Disinterments 0 $0.00 5 $3,100.00 Setting of Markers 9 $0.00 63 $0 Mausoleum Vases 0 $0.00 14 $1,925.00 1 Mausoleum Emblems 0 $0.00 4 $300.00 Urn Vaults 0 $0.00 7 $875.00 1 $8,900.00 $135,392.60 TYPE OF SALES Resident Regular 4 69 Resident ,Cremains 0 4, Non - Resident Regular 0 14 Non - Resident Cremains Infant Lots Infant 0 5 S \CC \WP \CEMETERY \Cemetery Report\2012 \CEMETERY REPORT 8 -12 xis CEMETERY REPORT JULY 2012 BOYNTON BEACH MEMORIAL FUND (CEMETERY TRUST FUND) SALES THIS CURRENT FROM CUMULATIVE $$ MONTH MONTH $ 10/01/2011 YEAR TO DATE SALES OF LOTS BBM PARK 1 21 $625.00 *851 $45,500.00 1 �a $525.00 = $525,00 / 1 te $100.00 = $625.00 SARA SIMMS CONTRACT SALES 0, $170.84, 10 $5,154.20 1 1,125.00 (100.00 down w/6 payments of 170.84) MAUSOLEUM Crypts & Niches 1 $7,650.00 10 $41,800.00 Contract Sales 0 $0.00 3 $9,150.00 1 6 $7,650.00 Mausoleum Open and Close 1 41 $0.00 701 $250.00 1 Refunds - Cemetery Refunds - Mausoleum 0 - $14,800.00 7 - $32,486.60 GENERAL FUND Cemetery Open and Close 1 81 $2,950.001 1001 $42,000.00 11 $100.00 / 1 $250.00 / 4 @ $400.00 / 2 $500.00 = $2,950.00 Use of Equipment 1 71 $700.001 951 $8,700.00 7 $100.00 = $700.00 Transfer of Deeds 0 $0.00 3 $225.00 Disinterments 0 $0.00 5 $3,100.00 Setting of Markers 6 69 Mausoleum Vases 0 $0.00 14 $1,925.00 1 Mausoleum Emblems 0 $0.00 4 $300.00 Urn Vaults 0 $0.00 7 $875.00 1 - $2,704.16 $126,492.60 TYPE OF SALES Resident Regular 1 69 Resident Cremains 0 4 Non - Resident Regular 0 14 Non - Resident Cremains Infant Lots Infant 1 5 S \CC \WP \CEMETERY \Cemetery Report\2012 \CEMETERY REPORT 7 -12 xls CEMETERY REPORT JUNE 2012 BOYNTON BEACH MEMORIAL FUND (CEMETERY TRUST FUND) SALES THIS CURRENT FROM CUMULATIVE $$ MONTH MONTH $ 10/01/2011 YEAR TO DATE SALES OF LOTS BBM PARK 1 131 $8,700.001 *721 $44,875.00 110 c1 $525.00 = $5,250,00, 1 @ $1,200.00, 2 @ $1,125.00 = $2,250.00 SARA SIMMS CONTRACT SALES 2 $1,220.84 8 $4,983.36 1/ @ 1,125.00 (100.00 down w/6 payments of 170.84), 2 @ $525.00 = $1,050.00 MAUSOLEUM Crypts & Niches 9 $28,000.00 1 $34,150.00 Contract Sales 3 $9,150.00 0 $9,150.00 1 @a $7,150.00 = $7,150.00, 2 @ $1,000.00 = $2,000.00 Mausoleum Open and Close 1 131 $0.001 531 $250.00 11 c $250.00 = $250,00 Refunds - Cemetery Refunds - Mausoleum 7 - $17,686.60 0 - $17,686.60 GENERAL FUND Cemetery Open and Close 1 111 $4,950.001 891 $39,050.00 11 ca $250,00, 3 Ca) $400.00, 7 @ $500.00 = $4,950.00 Use of Equipment 1 91 $900.001 861 $8,000.00 19 @ $100.00 = $900.00 Transfer of Deeds 0 $0.00 3 $225.00 Disinterments 2 $1,800.00 3 $3,100.00 Setting of Markers 4 54 Mausoleum Vases 1 $150.00 13 $1,925.00 1 Mausoleum Emblems 1 $75.00 3 $300.00 Urn Vaults 0 $0.00 7 $875.00 1 $37,259.24 $129,196.76 TYPE OF SALES Resident Regular 11 57 Resident Cremains 0 4 Non - Resident Regular 1 13 Non - Resident Cremains Infant Lots Infant 5 * Includes two (2) Double Depth Lots S \CC \WP \CEMETERY \Cemetery Report\2012 \CEMETERY REPORT 6 -12 xls The City of Boynton Beach City Clerk's Office S100 E BOYNTON BEACH BLVD i BOYNTON BEACH FL 33435 I (561) 742 -6060 -_ _� FAX: (561) 742-6090 _ e -mail: prainitoj @ci.boynton - beach.fl.us a -ry www.boynton - beach.org sv ; - 7, REFUND - .., N r , CEMETERY BOARD — -01 CITY CLERK'S OFFICE '- '' CITY OF BOYNTON BEACH z` 100 E BOYNTON BEACH BLVD. BOYNTON BEACH FL 33435 I (We), the undersigned, do hereby submit the deed to Cemetery lots, more particularly described as: LOT(S) 265 & 266 BLOCK M , BOYNTON BEACH MEMORIAL PARK. I (We) respectfully request a refund of the purchase price less 20% which we understand is the established policy. - PURCHASE PRICE: $ 1,500.00 LESS 20% $ 300.00 AMOUNT TO BE REFUNDED: $ 1,200.00 Signature: Signature: 467$ " ev Print Name: Print Name: RUTH RZENIK Mailing Address: 12943 S.E. Papaya Street, Hobe Sound, FL 33455 Telephone # 77.E n '� -• 1 -5 (., Date: S — x` 71 ' / .- STATE OF , ,4 COUNTY OF l' i (1, , 1A L. - I HEREBY CERTIFY that on this day, before me, an officer vly aithor,4zed in the, State aforesaid and in the County aforesaid to take acknowledgements, personally appeared tic , / /� ,,,,e✓- 0 -_'12. and -- - , to me known tb be the person(s) described in and who executed the foregoing instrument that he /she acknowledged before me that he /she executed the same; that the individual was personally known to ry�e or provided the following proof of Identification: ,r'�rx, ^'r ( ' -, ' - r.-- 7 - {r -- z- • t 3 WITNESS my ha and official seal in the County and State last aforesaid this x nd day of r _k. . ".« f , 2010. i ar'"'% LISA BEAUDREAU t; �' , , , a +_a /V C , z ' - -- MY COMMISSION 11 D D934323 (Notary Seal) � EXPIRES November 27, 2013 Notary Public � ,, 1.1014-NOTARY n Wiry Gram Aeoc Co I v F i t L' r r Print Name S: \CC \WP \CEMETERY\REFUNDS \2012 \Blank Refund Rzeznik.doc x In ire U 1--( 04 itt w L cil g:::1 z $, � W W PETNI CM) M v a XI 14 V Z ra W r E-• w w *II 4 m • p x d ,=, 1 .. al , O N (n o N �y W Z U� PP 1* Q o a U a x 0 A a s • 61 - - - -_ _ = _ dx uoissiwwoo a ,iy�p �s�a{uwepun ai4 "d Air rttt {{ _ pap — - ; ��: ? .:� 3 saii E361 ' 12PUPV S3Lf!dX7 rya • •a2it11t tpuop3 3o a1t1S 1 mni 33 # I,OsssIMo3 Ail =:%-: .• 4 a 1.to uu ui align �1oN a __ ra. d -_7VI ; ^ - -' tiv ,. d • ,, , .- • 96 61 ITV .zaquia4des 3o Aep 1 14LT aq1 `ut:1 ` tpoaag uoqu) og w pas Kui paxijjt put putq ,(ui 1as olunaaaq aneq `spaap jo sluaui2paimou3iot a)iu1 01 1puoi3 Jo smti aq1 .iapun pazuoglne ,{pnp aaotww0 ut `I `3O32IIHM SSIIN LIM NI •olaiagi uoiueiodioo pus jo is ale.iodioo aqi paxi33e aq 1eg1 put `ppsaiojt ioiiey p aql Aq paap 2uto2aioj aqi jo uonnoaxa aq1 `31.1a0 st Aliotdeo siq ui `paisaut aq Imp papapmou3poe put 'Sip pits Jo 3i.iaij aql se umou31 ppam auz 01 asnzx •W auutzns pamadde osp aw aiolaq put :joaiagl JoiCeynp si iCltoideo siq ut put 'Alp pres Jo paap aq1 .ioj pue se aoutAanuoo 2uioaioj alp poinoaxa aq 1eg1 pa2papmoure put `uoiliaodioo pidioiunw a `ipuoi3 `goeag uoluXog Jo /Cup ag13o ioAriN aqi se umouDj pm aw o1 ioTApa, pTu.zaj paieadde ACppeuos.iad aw aiojag VQI21013 30 3IV'S SS HDV3g ININid 3O A.INfIOD •)paalD •�7Di-rj3 '' r / • S3.i_IY � "40Ido 49 /6 .4r - owl, , _ r U t = • t $ 0 r .- 3o aauasaid am ut palan� rap / gy p .. "4. 1 : 2 4,. o ' • ,› pue pajeas `pau2ls •AIN U 3g NO.LAIAOI dO A,LID • 9661 'O'd .zaquia ;das jo 'cup ipquaaquanas sup `peas a1Jodioo s1t grim papas put 5piaiD su siq pa1sa11t `ioAuw s1t Aq pau2is aq o1 sluasaid asagl pasnto siq `uoutiodioo pedtotunw t `gotag uoluICog Jo'C1tj pits ag SSaNIIM (III MUNICIPAL CEMETERY City of Boynton Beach LOT DEED Know .off Men by These Presents, That the City of Boynton Beach, Florida, a municipal corpora- tion organized under and by virtue of the laws of the State of Florida, having its pnncipal place of business in the County of Palm Beach of said State, party cad the first part, in consideration of Fifteen Hundred Dollars, which is hereby acknowledged to have been paid by Ruth Rzeznik , party of the second part, of the County of Palm Beach , State of Florida , doth hereby grant, bargain, sell and convey to the said part y of the second part, her heirs or assigns (subject to the conditions herein 'et forth), the following described lot or parcel of land in Municipal Cemetery, in said City and County, to -wit: Lot numbered 2 6 5 and 2 6 6 Block M _ according to the plat or plan of said cemetery on file in the office of the Clerk of the Circuit Court in and for the County of Palm Beach. TO HAVE AND TO HOLD the same unto the said part y of the second part, her heirs of assigns, forever, with the sole and exclusive right of burying the dead therein, subject, however, at all times to all rules, regulations and by -laws of said City or of the Board of Governors of said cemetery, now existing or that may hereafter be adopted relating to the government or management of said cemetery (which are to be considered as incorporated herein) and any law or laws of the State of Florida which may affect the same. Where the title to any lot is vested in more than one person, the signature of any one of the grantees named in the deed of conveyance. heirs or assigns, to an application for burial permit shall be full and sufficient authority to said City for the issuance of such permit and allowing the burial to be made in accordance therewith And the said City of Boynton Beach does hereby covenant with the said party__ __ of the second part, her heirs and assigns, that said City is lawfully seized in fee simple of the aforemen- tioned premises and of the ways leading to the same from the highway; that the granted premise are free from all encumbrances and that the said city has good right to sell and convey the same to the said part of the second part, in the manner and for the purposes aforesaid,,, and will warrant and defend the same unto the said part y _ of the' second part, her heirs and assigns, forever. 77 10 / * / ry N NOTICE TO LOT OWNERS IN BOYNTON BEACH MUNICIPAL CEMETERIES Rules and Regulations Amended March 19. 1996 GENERAL 1. Lot owners shall not allow interments to be made in their lots for remuneration; nor shall any transfer, assignment, or conveyance of any lot or any interest therein be valid without the consent in writing of the City of Boynton Beach and same endorsed upon such transfer, assignment or conveyance. No transfer, assignment, or conveyance of a lot can be made after fin ri tural interment in it, except with the nrm.gere of th, City of anynton Beach after the body is lawfully removed therefrom. No disinterment shall be allowed except by the consent of the City of Boynton Beach and upon written request of the owner or owners of the lot and in every case shall only be made by the proper authorities. (NOTE: Authorized disinterment and shipment of body may be made only by a licensed funeral director licensed in Florida to another licensed funeral director at terminal point.) 2. The City of Boynton Beach is reluctant to interfere with the tastes of individuals in regard to the style of their improvements at the cemetery; but in justice to the interest of the whole and all cemetery lot owners, it reserves to Itself the right of preventing or removing any erection, enclosure, monument, inscription, tree or shnts which is inconsistent with the purpose of these rules and which the City considers injurious to the grounds. Under no circumstances will lots be allowed to have on them growing or live plants, tree:, or bushes fitly planted in the ground and such wI! be removed by City employees. 3. In addllton to the grave marker, there will be a limit of three items placed on a grave site. In general, these three items can be those chosen by the owner, but must be able to be moved with one hand and flowers must be in a container that has a solid base so that It will easily stand erect or in a container with a point on the bottom that is easily stuck into the ground. These items must be tastefully placed at grave sites. Employees will, for cemetery maintenance purposes, move and replace these items with care, but the Ctty does not accept responsibility for replacing broken items unless there is a clear negligence on the part of the City employees. (NOTE: City employees may remove any item placed on a grave site that becomes untidy or unsightly to the appearance of the Cemetery) 4. Ai: lot encloa'ires of (-ay kind t hatever are piohit ed. Comer stones properly numbered and set flush with the surface of the ground will be allowed. No brick work will be allowed above ground level in any portion of the cemeteries. No mounds are permitted over graves. The grade of all lots will be determined by the Board of Governors. 5. No person shall be allowed to perform any modification or construction on a lot without a permit from the City. No money should be paid to any person in the employ of the City for services or attention, other than their salaries and wages paid by the City. BOYNTON BEACH MUNICIPAL CEMETERIES RULES & REGULATIONS 6. To protect the grounds and especially improved Tots from injury, all excavations shall be made by the City. 7. Ail permanent grave markers must be ground level, of bronze, marble or granite material and placed on a six (6) inch concrete base, subject to proper permit and fees. 8. All temporary grave markers will be allowed for a period of six months from date of burial. Temporary markers will be removed by cemetery workers ihci 9. All urns, vases, or grave markers damaged or lost will not be the responsibility of the cemetery. 10. No wooden boxes may be used for interment. Casket must be encased in a solid container - concrete container or vault. 11. The Board of Governors from time to time may initiate and recommend the laying out, altering, or closing of such avenues or walks and make such rules and regulations for the government and improvement of the cemetery as it may deem requisite and proper, subject to City Commission approval. 12. No purchaser shall be entitled to a deed to any lot nor will a burial be permitted in any lot until all accounts relating thereto and due the City are paid. rt. Lots, not needed, may be returned to the City for a refund of the purchase price less 20 percent. The deed must be surrendered. No sign indicating that a lot Is For Sole' will be permitted on the grounds. 14. On Veterans' Day and other national holidays, the Veterans' organizations may join in memorial services at the cemeteries upon scheduling with the Secretary of the Cemetery Board, the City Clerk. MAUSOLEUM 15. Mausoleum Crypts or Niches - Prior to interment, an owner may transfer or resell the mausoleum crypt or niche provided the owner first obtains thewritten consent of the City of Boynton Beach and Boynton Beach Mausoleum, Inc. Such consent shall be given automatically provided that the new purchaser's name, r d& es6 and phone, number are on file with the City Clerk and an administrative fee equal to the cost of relettering the mausoleum, crypt, or niche is paid to Boynton Beach Mausoleum, Inc. After interment, resale or transfer of ownership shall be allowed only to the City of Boynton Beach at a cost of 8096 of the original purchase price paid for the crypt or niche and provided that disinterment has occurred and implemented by the proper authorities. The City may not offer these crypts or niches for sale until the termination of the contract with Boynton Beach Mausoleum, Inc. BOYNTON BEACH MUNICIPAL CEMETERIES RULES & REGULATIONS No disinterment shall be allowed except by the consent of the City of Boynton Beach following written request by the owner or owners of the crypt /niche and in every case shall only be made by the proper authorities. (NOTE: Authorized disinterment and shipment of !' dy or remains may be made only by a licensed funeral director licensed in Florida to another licensed funeral director at terminal point.) 16. The City reserves to itself the right to approve any erection, enclosure, rilc•numeft, iflscnptiion, tree co shrub. 17. In addition to the bronze letters, there will be a limit of two emblems allowed per crypt /niche. These bronze letters and emblems may be obtained from Boynton Beach Mausoleum, Inc., who is the City's exclusive sales agent, and shall be installed by the City of Boynton Beach. 18. Potted plants or artificial flowers are not permitted on the Mausoleum complex at any time. Fresh flowers are permitted to remain for a period of three (3) days. One bouquet per crypt /niche will be allowed. Vases are available at the Mausoleum Office. Flowers must be in a container that hos a solid base so that it will easily stand erect. This item must be tastefully placed at crypt /niche sites. Employees will, for maintenance purposes, move-and replace these items with care, but the city does not accept responsibility for replacing broken items unless there is a clear negligence on the part of the City employees. MOTE: Cty employees may icmove any item pIa ed on a crypt /niche site that becomes untidy or unsightly to the appearance of tt!e Mausoleum.) 19. No person shall be allowed to perform any modification on anything without wdllen permission from the City. No money should be paid to any person in the employ of the City for services or attention, other than their salaries and wages paid by the City. 20. All original sales of mausoleum crypts or niches shall be originated by Boynton Beach Mausoleum, Inc. Boynton Beach Mausoleum, Inc. shall then forward an executed request for the issuance of a certificate of ownership within 30 days which shall include the purchaser's complete name, address and phone number_ Upon receipt of a request for the issuance of a certificate of ownership, the City shall issue a certificate of ownership and forward it to the purchaser within 14 days. There shall be no fee for issuance for the certificate of ownership 21. Boynton Beach Mausoleum Inc. shall provide copies of every sales contracts for each crypt /niche sold to the City within 30 days of the sale. There shall be no requirement for an annual audit. 22. Any veterans' organization may erect a flag and /or memorial at the entrance to the Mausoleum Chapel on Memorial Day. 3 BOYNTON BEACH MUNICIPAL CEMETERIES RULES & REGULATIONS 23. The Board of Governors from time to time may recommend the altering of the Rules and Regulations for the govemment and improvement of the mausoleum as it may deem requisite and proper, subject to City Commission approval. At any time the Board of Governors proposes amending or altering the Rules and Regulations for the mausoleum, they must notify Boynton Beach Mausoleum, Inc. by certified mail retum receipt requested of the proposed changes, at the same time any City Commission action is sought regarding the rules. Boynton Beach Mausoleum, Inc. shall be given - f-' !y!ve (45\ cae from t! d :a .b .+e�i n. e �t .: o� .... "r a; . a` s _ � � � . .r w .. .....r r o w.r ..L..7Try r � ..T.d vC. i iG./� 1 ►i � the fe Board of Governors prior to any City Commission action being taken. All Rules and Regulations shall be applied prospectively from the date of adoption. No Rule or Regulation shall be construed in a manner which would negate or alter any contractual right between Boynton Beach Mausoleum, Inc. and any party to a purchase agreement with Boynton Beach Mausoleum, Inc. or any contractual right between the City of Boynton Beach and Boynton Beach Mausoleum, Inc. S CMvCARRIE CEMETERY WPD 4 The City of Boynton Beach (Sty Clerk's Office �J " 100 E BOYNTON BEACH BLVD BOYNTON BEACH FL 33435 (561) 742 -6060 FAX: (561) 742-6090 e -mail: prainitoj ©d.boynton- beach.fi.us _ www.boynton-beach.org MAUSOLEUM REFUND CEMETERY BOARD CITY CLERK'S OFFICE CITY OF BOYNTON BEACH 100 E BOYNTON BEACH BLVD. BOYNTON BEACH FL 33435 I3, the undersigned, do hereby submit the certificate of ownership and Mausoleum agreement verifying the purchase price for the following described space in the Boynton Beach Mausoleum: BUILDING 2 /4h , .r g U r /C /r fvq Original Certificate ,f SECTION n �J Contract CRYPT /NICHE t n - e I (We) respectfully request a refund of the purchase price or current selling price, whichever is less, less which we understand is the established policy. PURCHASE PRICE: $ .244t0 LESS 0-U % $ °- 53 (? - AMOUNT TO BE REFUNDED: $ Signature: (11--r-c") 'e sizeiroNdi Signature: Print Name: ti'c:_v_yN Print Name Mailing Address: 2 .261 LAKE .LJR /Oc SEA, - ) ,c 3,9 2 75 cl Telephone #(N) 868 - D7` /5 Date: 'r#"( L) ? 6.-3 -- A\3 - / eN / STATE OF f'ii71 G COUNTY OF i I HEREBY CERTIFY that on this day, before me, an officerduly authorized in the State aforesaid and in the County aforesaid to take acknowledgements, personally appeared O.,YOkli leIw'x vr :l• and , to me known fo be the person(s) described in and who executed the foregoing instrument that he /she acknowledged before me that he /she executed the same; that the individual was personally known to me or provided the following proof of identification: F! 0 -r .- C.3 o -11 3- L-l� - s -c1- (`) .. WIT my hand and official seal in the County and State last aforesaid this (3 day of '} -I∎lt ?SA- , 200 (Notary Seal) Notary Public dge►I & Print Name . A. 11. L'l ,L♦i My Commission Expires: • •411 di a — ( °'e'' SAMANTHA A MCCLELLAND e �� 6 . % Notary Public . State of Florida s^. '�j'`tio J My Comm Expires Jan 26, 2015 II S: \CC\WP \CEMETERY\Mausoleum \Refunds \2012 \Blank Refund Form TEMPLATE.doc '�.'�� d �.. • • Commission # EE 59067 r ..\ \ ..:,,- ,,, ,i,,..„,.. 6 • .Z .:,„ , , _ ',, r --,,-, ,,,..... d ----- - - , ,, ,/ g''''' 4 / ,c;; 4 f "''' 1,... ', ' ! ,C ,,,,.-,-`,,,,,,\'' - , ' _ 1,0 ' f e i ' i , ,,,,'''''" \ " 7. -,--, , '-'\''), - iliti v ,- , rtil . „ , , 6 n,, .. ,,,,, ‘,. , (i ,,, ‘,.7 ,,, iff,.:, _ ) �; twf� ..7,,,%.',_, •' °s`�.yk '�v'• v , `iw'�_'4iv` x*•5.�..?rr�:- ' w 3wu5n `Mgr "_ - '' 4 2 ' �F ,_ '�� . V ,_„,______-, 9 1. its 1� 2 C t "E •-II , . f i",.. , Fj C1) . . _ „.:.,7 .., v .. O Zt Z o o° °p U ° C.; ' I - ...... ..... __ co , ., 0 o h / y O Q ■ Ift E tt., as ' cn Al �, v O i l' '' R I 11 b 1.- h 0, Q Z Q q l U JI y O Zt o� p c U r , 44 . o '� a , y m a o, ,, �o , o, „ 1-s c a C CD 9 ,2,.„ . �: 'Z.1 t15 � C O N O d O , , > CtZ Cg ■,-'' ' '''' ....s., G Q 1 I IIIII 1 0 „,k,,,,,.., w 1 ,.. , , ,„ 1' Q c., v o o a Q E W o , Ni 1 W rY < h: co +.�.r� `� . o q "o U z O �. ° O U Is +0..r O O ° eo z W 0. O U e Q . d i t �. z m O % h c' 3 s O Ci W 1 Cc v O o O Cu O ' O o it..... > „,j, al k 4, W p TC "t3 o, Q E r o', O a r V o '' o o > v e •2 c '.1 ... W o> W U Q U O � ~ �° ' 7::; < - O E. O - W % E. '.'2— E-1144 4H.4'11_ CO N �, m 6 .'''''''Th ( 0 , l 7 wi ur „ ;ec , ur 'u •F i kj {( 1_ I _ _ T` 'ir rI ; .' u u �� r! 1 �„� • -/ P t ' ”, � , - 4�� ' ',(f rr ` } 1 F J r � ,: f � u ! 114j ) , r , F, ■ ' ` 7 ' t ' ' 11 33!! -r �f 4/ p 4�1� ! .1. �. �/ �� ' \'�\ `�' J, ', ;/ • BOYNTON BEACH MAUSOLEUM, INC. 1611 South Seacrest Blvd. P 0 Drawer HH, Boynton Beach, Florida 33435 Telephones Sales Office 734 -6404 Business Office 395 -1006 Area Code 305 MAUSOLEUM AGREEMENT THIS AGREEMENT, made this "7 day of eL 7 -O C , 19 ' , between the CITY OF BOYNTON BEACH, FLORIDA (hereinafter "City "), by and through its authorized agent, BOYNTON BEACH MAUSOLEUM, INC , a Florida Corporation (hereinafter "Corporation "); and G. j,7' L ,/4c . (hereinafter "Purchaser ") / /rF GV . s ae.? Fri . 0o7,J , D , o ( - 5/ 3 `x Street City State Zip Code Reside within corporate limits of Boynton Beach? 131 0 No WITNESSETH Purchaser agrees to buy and City agrees to sell, in accordance with the terms hereof, the exclusive right of entombment in/the Mausoleum space described as Building: ` V42 - Section' �• Crypt �-��) Niche in the BOYNTON BEACH MAUSOLEUM, Boynton Beach, Florida. Purchaser agrees to pay the following sum to the Corporation o Cash Price $ —"�' Down Payment (receipt whereof is hereby acknowledged) $ / Balar e /Li 6 V / / 9 ftf $ /3 C . n .1U 1/. , /, ' � / OD • , i�� Fire /!%I Must be paid in full before ent- bment / In case of default by Purchaser for more than thirty (30) days in any of the payments herein provided, Corporation may, at its option, on fifteen (15) days notice sent by registered mail to Purchaser at the address designated above, declare this Agreement cancelled and retain all sums which shall have been paid hereunder as liquidated damages Upon receipt of the full sum set out above, City shall deliver to Purchaser a Certificate of Ownership of the above - described entombment space City shall deposit twenty percent (20 %) (15% plus 5 %) of the purchase price in a perpetual care fund for the maintenance of the Mausoleum City shall install individual memonalization Said memorialization shall bear the name, year of birth and year of death of the individual, and shall consist of bronze letters commonly used for such purposes City shall provide for the opening and closing of the above - described spaces upon request by Purchaser Said opening and closing shall include the use of the chapel, lift and other equipment as is usually provided for this purpose Current rules and regulations do not permit potted plants or artificial flowers on the Mausoleum Complex at any time Fresh flowers are permitted to remain for a period of three (3) days. The conveyance for said entombment spaces shall be made subject to all rules and regulations now exist- ing and which may be hereafter promulgated for the operation, care and control of the Mausoleum complex BUYER'S RIGHT TO CANCEL In the event this is a "home solicitation sale" as defined by Florida Law, and if you do not want the goods or services, you may cancel this Agreement by mailing a notice to seller This notice must indicate that you do not want the goods or services and must be postmarked before midnight of the third business day after you sign this Agreement If you cancel this Agreement, the seller may keep all or part of any cash down payment, not to exceed the lesser of five percent (5 %) of the cash price or fifty dollars ($50 00) IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year first above written PURCHASER BOYNT N EACH MAUSOLEUM, INC (f. / ,,, . (SEAL) By c [ rl/ (SEAL) (SEAL) r / Telephone / � 7 IN THE CIRCUIT COURT IN AND FOR HIGHLANDS COUNTY, FLORIDA IN RE: WILL OF WILL NUMBER: 99000170WLS ETHEL MILLER OLCSVARY WILL FILED FOR SAFEKEEPING THIS IS TO CERTIFY THAT I HAVE RECEIVED FROM CAROLYN E EDWARDS THE LAST WILL AND TESTAMENT OF ETHEL MILLER OLCSVARY SAID LAST WILL BEING DATED 04/10/1997 FOR CERTIFICATE OF DEPOSIT & INDEXING. WITNESS MY HAND AND SEAL THIS 19th day of November, 1999 GGY Ir f g e Cs �� ,� _ �z L ` ` . DEPUTY CLERK OF CIRCUIT COURT PCLWFILE -WILLS FILED FOR SAFEKEEPING LAST WILL AND TESTAMENT OF ETHEL OLCSVARY _ I Ethel Olcsvar , residing at 6/0 SW . (es+ C ' L"d; , P County, Florida, hereby revoke all prior wills and codicils and declare this to be my Last Will. FIRST: I direct that all my debts, expenses of last illness, funeral expenses and administration costs of my estate be paid and satisfied by my Personal Representative herein named, as soon after my death as is convenient. SECOND: I hereby give, devise and bequeath $5,000 each to my grandchildren, Christine Hjelmeir and James Mark Casella. THIRD: I hereby give, devise and bequeath my entire estate, of whatever nature and wherever situate, including all property which I may acquire after the execution of this Will, and all property over which I may have a power of powers of appointment to Carolvn Ethel Edwards In the event that Carolyn Ethel Edwards shall predecease me or die prior to receiving the gifts hereinabove provided, then I give devise and bequeath my entire estate to Dennis Edwards . In the event that Dennis Edwards shall predecease me or die prior to receiving the gifts hereinabove provided, then I desire that such share shall pass to his or her issue who shall be living at my death, such issue to take by representation and per stripes the share which his or her parent would have taken had such parent survived me. THIRD: Taxes. I direct my Personal Representative to pay out of the property which would otherwise become a part of my residuary estate, all estates, inheritance, transfer and succession taxes, including interest and penalties thereon, which may be lawfully assessed by reason of my death. I hereby waive on behalf of my estate any right to recover any part of such taxes, interest, or penalties from any person, including any beneficiary of insurance of my life and anyone who may have received from me or my estate any property which is taxable as part of my estate. FOURTH: Shares of Persons under 21 years of Age. Except as otherwise provided herein, whenever under the terms of this Will any property would vest in ownership in a person prior to his or her attaining the age of 21 years, my Personal Representatives may in their discretion continue to hold such property in trust for such person until he or she shall have attained the age of 21 years, or deliver such property to his or her lawful guardian or custodian pursuant to the Florida Uniform Gift to Minors Act and such person's receipt shall discharge my Personal Representatives. FIFTH: Catch -A11 Provisions. Any share or portion of a share of any trust created hereunder, or any other property of mine that is not disposed of under any other provision of this Will, shall go and be distributed to my heirs -at -law. Their identity and respective shares shall be determined in all respects as if my death had occurred immediately following the happening of the event requiring such distribution, and according to the laws of the State of Florida then in force governing the distribution of the estate of an intestate. SIXTH: Spendthrift Clause. No interest of any beneficiary in the corpus or income of my estate or of any trust created hereunder shall be subject to assignment, alienation, pledge, attachment or claims of creditors of such beneficiary and may not otherwise be voluntarily or involuntarily alienated or encumbered by such beneficiary, except as may be otherwise expressly provided herein. SEVENTH: Encumbrances. Any mortgage, lien, or other encumbrance upon any property bequeathed or devised hereunder, either outright or in trust, shall be assumed by the legatee, devisee, or trustee of such property. EIGHTH: Saving Clause. If any provision of this Will shall be unenforceable, the remaining provisions shall nevertheless be carried into effect. NINTH: Appointment of Fiduciaries. I hereby nominate, constitute and appoint Carolyn Ethel Edwards to be my Personal Representative under this Will. In the event that Carolyn Ethel Edwards shall predecease me, or survive me but be unable to qualify for any reason, then I nominate, constitute and appoint Dennis Edwards to serve as my Alternate Personal Representative under this Will. I direct that all of the same, or their successors shall not be required to post bond for the faithful performance of their duties in this or any other jurisdiction. TENTH: Personal Representative Powers. My Personal Representative, and the successor or successors of them, shall have all of the powers and duties authorized to fiduciaries in accordance with the laws of the State of Florida, unless inconsistent herewith. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this J/' day of April, 1997. Declared, published, signed and sealed by the Testator as her Last Will an Testament, in the presence of the undersigned as witnesses, V'O✓'7PS D. �� vtvt. . �?,�( �_ I �COy�.Ra� , first signing in our presence, and we then, at her special instance and request, signing in the presence of each other, the day and year first above written. residing at 4/ S , � �� residing at 7 . /� S� O) f ? l Q_ e s . :eve �- Le4 p :call ?T345 • /_' S7 residing at S,,7 t3 ,C:f( 2. (9V`'S1 _ - SELF -PROOF OF WILL STATE OF FLORIDA COUNTY OF BROWARD ) We '�Otl't, e.s 1 ' &edow' and 31M e. Old -e. , and Ethel Olcsvary , the Testat or , and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned officer that the Testator signed the instrument as _ his Last Will and Testament and that he signed voluntarily, and that each of the witnesses in the presence of the Testator , at his request, and in the presence of each other, signed the Last Will and Testament as a witness, and that to the best of the knowledge of each witness, the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. ! — i(It.Lr • es • , - eabh., /� e. 0 tile 1 0 day of April, 1997, before me p p came '�7 a <" 7:CrzeS 1? P1=- Jet }'`Lc. e to me Known to be the individual(s9 described in and who executed the foregoing instrument and acknowledged that they executed the same. WITNESS my hand and official seal, this Jt day o April, 1997. : y // Nota y Pu lic f My commission a Tres: V Personally !known Produced Identification Type of I. D . : r � � „ "" MARC J. ROW _ y a e WIRES: October / 20,'1000 . -' 1' ; Bonded 71Nn Nary Pubic thseem en The City of Boynton Beach City Clerk's Office 100 E BOYNTON BEACH BLVD �. BOYNTON BEACH FL 33435 i - (561) 742 -6060 � \ FAX: (561) 742 -6090 ; e-mail: prainitoj @cl.boynton - beach.fl.us www.boynton-beach.org MAUSOLEUM REFUND CEMETERY BOARD CITY CLERK'S OFFICE CITY OF BOYNTON BEACH 100 E BOYNTON BEACH BLVD. BOYNTON BEACH FL 33435 I (We), the undersigned, do hereby submit the certificate of ownership and Mausoleum agreement verifying the purchase price for the following described space in the Boynton Beach Mausoleum: BUILDING Benediction Original Certificate SECTION L Contract CRYPT /NICHE E2 I (We) respectfully request a refund of the purchase price less 50 % which we understand is the established policy. PURCHASE PRICE: $ 850.00 LESS 50 % $ 425.00 AMOUNT TO BE REFUNDED: $ 25.00 Signature: Signatur : • Print Name: Print Na •• - Yvonne V smarms g/ 9( / pi 4ift: ' Mailing Address: - _• ._._,! �' Air 01.--v4-1,===k, Telephone # W. Ray Morgan 954 - 941 -0364 Date: ,1 / STATE OF r 13 0 , cif) n COUNTY OF S'3r.-,,,.> cc.X. I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgements, personally appeared and , to me known to be the person(s) described in and who executed the foregoing instrument that he /she acknowledged before me that he /she executed the same; that the individual was personally known to me or provided the following proof of identification: . WITNESA my hand and official g sGi f� the County and State last aforesaid this 1 `"6 day of 0 Attu (Notary Seal) % •.••••••••••• t' Public � — NOte s •1 y lint N.Sine 1 � ' � c5 / e My Commiss on Expir: : V Y COm • i ! a N � Q �Q L 7, . 65 ; • •• S \CC \WP \CEMETERY \REFUNDS \Blan ••• u • arais.doc YVONNE B. DESMARAIS GENERAL DURABLE POWER OE ATTORNEY - DATED DECEMBER 3,2008 KNOW ALL MEN BY THESE PRESENTS: That I, WONNE B. DESMARAIS, residing at 5928 Coral Lake Drive, Margate, Florida 33063, do make, constitute and appoint; (i) (a) My friend, W. RAY MORGAN, of Pompano Beach, Florida, my true and lawful attorney -in -fact so long as he is living and not incapacitated as hereafter defined; and (b) Upon the death or incapacity of my friend, W. RAY MORGAN, then I make, constitute and appoint my friend, EARL R. HARRIS, of Pompano Beach, Florida, my true and lawful successor attorney -in -fact to fill such vacancy. 1. Incapacity. If at any time two (2) practicing physicians shall determine that any attorney in fact then serving, from mental or physical cause, is no longer capable of properly performing his or her duties hereunder, a written statement to that effect, signed by said physicians and delivered to any joint attorney in fact also then serving and to the next successor attorney in fact or attorneys in fact named above, shall serve to terminate the authority of the incapacitated attorney in fact and simultaneously to bring into existence the authority of the successor attorney in fact or attorneys in fact named above. Upon the death or incapacity of an attorney in fact serving hereunder, the successor attorney in fact or attorneys in fact named above shall thereafter have all of the power and authority herein originally granted my original attorney in fact to the same extent as though my successor attorney in fact or attorneys in fact were originally name as attorney in fact hereunder. 2. Durable Power of Attorney. In accordance with Section 709.08, Florida Statues, this Durable Power of Attorney shall not be affected by the disability of the principal except as provided by Statute. 3. General Purpose. The purpose of this General Power of Attorney is to authorize and empower my attorney in fact named herein to act in, manage and conduct all my estate and all my affairs as fully and effectually to all intents and purposes as I might or could do in my own proper person, if personally present. 4. Full General Powers. My attorney in fact named herein, from time to time acting hereunder, shall have full power and authority, for me and in my name, place and stead, and -1- I w H 0 W W H N z MI z x 0 H H — U Z in N W icq D H • o H P4 a A ',` In r6 CI) H `- u) H a 6' 1 i I co w w ..c l a o z 11S fo (,) -0 c0 O N t 2) H , €' _` 5 O Q 1 0 U) `� a 2 •••• a) L 2 0) 0 H a 9 a CO E n 0) C o z u o w w z U�w m o w a Q ^" MI o H a ` a H o H E4 W cc = •� i- m 0 0 a w 0 x 0 V Q • zz 0 O H 41 0 M Z H �> u H co 0 z o 1-1 ; 3 .�� )"`� Z U 0 4 u) a o • \+ H ol W H 4 H W ' S 0 W A z W a z 3 H H A 4 H CJ) H H "'' r2.1 v i Z o M z • H o CZ r-- 3 4 w 0 ( z p %- 0 H o H W a \ • • • BOYNTON BEACH MAUSOLEUM, INC. 161 � I 1611 South Seacrest Blvd. P.O. Drawer HI-I, Boynton Beach, .Florida 33435 Telephones Sales Office. 734 -6404 Business Office 395 -1006 Area Code 305 MAUSOLEUM AGREEMENT THIS AGREEMENT, made this day of C- LjA) , 19 / ,.between the CITY OF BOYNTON BEACH, FLORIDA (hereinafter "City "), by and through its authorized agent, BOYNTON BEACH MAUSOLEUM, INC., a Florida Corporation (hereinafter "Corporation "); and %t " = (hereinafter "Purch ser "). --- CORAL //• E 1/" ®2/ ��C �`�i Ai'. 33 0 &L3 Street City State Zip Code Reside within corporate limits of Boynton Beach? ❑ Yes D'No WITNESSETH: Purchaser agrees to buy and City agrees to sell, in accordance with the terms hereof, the exclusive right of entombment the Mausoleum space described as: Building: �✓C�C ,6 ! % / G O /1.)• Section: - Crypt: Niche • in the BOYNTON BEACH MAUSOLEUM, Boynton Beach, Florida. Purchaser agrees to pay the following sum to the Corporation: Cash Price $ e O • Down Payment (receipt whereof is hereby acknowledged) $ 50 • O D i✓ Balance $ ' 0 Must be paid in full before entombment In case of default by Purchaser for more than thirty (30) days in any of the payments herein provided, Corporation may, at its option, on fifteen (15) days notice sent by registered mail to Purchaser at the address designated above, declare this Agreement cancelled and retain all sums which shall have been paid hereunder as liquidated damages. Upon receipt of the full sum set out above, City shall deliver to Purchaser a Certificate of Ownership of the above- described entombment space. City shall deposit twenty percent (20 %) (15% plus 5 %) of the purchase price in a perpetual care fund for the maintenance of the Mausoleum. City shall install individual memorialization. Said memorialization shall bear the name, year of birth and year of death of the individual, and shall consist of bronze letters commonly used for such purposes. City shall provide for the opening and closing of the above - described spaces upon request by Purchaser. Said opening and closing shall include the use of the chapel, lift and other equipment as is usually provided for this purpose. Current rules and regulations do not permit potted plants or artificial flowers on the Mausoleum Complex at any time. Fresh flowers are permitted to remain for a period of three (3) days The conveyance for said entombment spaces shall be made subject to all rules and regulations now exist- ing and which may be hereafter promulgated for the operation, care and control of the Mausoleum complex. BUYER'S RIGHT TO CANCEL: In the event this is a "home solicitation sale" as defined by Florida Law, and if you do not want the goods or services, you may cancel this Agreement by mailing a notice to seller This notice must indicate that you do not want the goods or services and must be postmarked before midnight of the third business day after you sign this Agreement. If you cancel this Agreement, the seller may keep all or part of any cash down payment, not to exceed the lesser of five percent (5 %) of the cash price or fifty dollars ($50.00). IAA LA /ITAICCC ,n/uC tha nartlac haratn have executed this Agreement on the day and year first The City of Boynton Beach City Clerk's Office 100 E BOYNTON BEACH BLVD BOYNTON BEACH FL 33435 \ (561) 742 -6060 __ • FAX: (561) 742-6090 e -mail: prainitoj @ci.boynton- beach.fl.us , www.boynton - beach.org r) —_ REFUND CEMETERY BOARD ` -,-- CITY CLERK'S OFFICE (=) ; :> CITY OF BOYNTON BEACH 100 E BOYNTON BEACH BLVD. BOYNTON BEACH FL 33435 I (We), the undersigned, do hereby submit the deed to Cemetery lots, more particularly described as: LOT(S) 71B BLOCK N , BOYNTON BEACH MEMORIAL PARK. 3 - I (We) respectfully request a refund of the purchase price less 20% which we understand is the ? eltabliS,F ed policy. _3 rn PURCHASE PRICE: $ 175.00 ro - LESS 20% $ 35.00 /MOUNT TO BE REFUNDED: $ 140.00 N Signature: t el, e . - .V4 r "11... - � . Signature: f. , t, .' , d, Print Name: t' r e W2? eeZ a i 0 `> Print Name: BRENDA LOWDER BANAS Mailing Address: 187 Andover H, West Palm Beach, FL 33417 Telephone # 561 - 688 -8187 Date: �� l /� STATE OF Czi■''i • ick- COUNTY OF ' PQ,IM . K Geh I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgements, personally appeared -end o► I— bu)ci€v .f�4nQ5 and , to me known to be the person(s) described in and who executed the foregoing instrument that he /she acknowledged before me that he /she executed the same; that e individual was personally known to me or provided the following proof of identification: c \Cot c3 0. be∎ Jiti (.,.i C-er\S-€ WITNESS my hand and official seal in the County and State last aforesaid this .0 day of fd - S ,2-04.e'• 0 i ,_ — — — — Notary Public (Notary Seal) � _ , I - - — ,, VtVtCin VaJP9a_ r o » VIVIAN VALEGA * ;ki Notary Public - State of Florida I Print Name N� � of My Comm. Expires May 10, 2015 S: \CC \WP \CEM�Ef2�if,�'S�"r DS\ 2(!✓171BI400RerJrEargrlSs. MUNICIPAL CEMETERY City of Boynton Beach LOT DEED pithy All Alen b tt 41resents, That the City of Boynton Beach, Florida, a municipal corpora- tion organized under and by virtue of the laws of the State of Florida, having its principal place of business in the County of Palm Beach of said State, party of the first part, in consideration of Three hundred fifty Dollars, w hich is hereby acknowledged to have been paid b Micheal T . Banas , party of the second part, of the County of Pahl Beach State of Florida , doth hereby grant, bargain, sell and convey to the said party of the second part, his heirs or assigns (subject to the conditions herein set forth), the following described lot or parcel of land in Municipal Cemetery, in said City and Coun- ty, to-wit: Lot numbered 71 A & B Block N according to the plat or plan of said cemetery on file in the office of the Clerk of the Circuit Court in and for the County of Palm Beach. TO HAVE AND TO HOLD the same unto the said part_Z.__ of the second part, his heirs of assigns, forever, with the sole and exclusive right of burying the dead therein, subject, however, at all times to all rules, regulations and by -laws of said City or of the Board of Governors of said cemetery, now existing or that may hereafter be adopted relating to the government or management of said cemetery (which are to be considered as incorporated herein) and any law or laws of the State of Florida which may affect the same. Where the title to any lot is vested in more than one person, the signature of any one of the grantees named in the deed of conveyance, heirs or assigns, to an application for burial permit shall be full and sufficient authority to said City for the issuance of such permit and allowing the burial to be made in accordance therewith. And the said City of Boynton Beach does hereby covenant with the said part___ of the second part, _bis_ __heirs and assigns, that said City is lawfully seized in fee simple of the aforemen- tioned premises and of the ways leading to the same from the highway; that the granted premises are free from all encumbrances and that the said city has good right to sell and convey the same to the said part_Y__ of the second part, in the manner and for the purposes aforesaid, and will warrant and defend the same unto the said part_Y _ of the second part, his heirs and assigns, forever. 'tn ?s instrument was prepared by TEREESA PADGETT City Clerk P.O. BOx 910 Bayeiton Beach, Florida 33435 IN WITNESS WHEREOF the said City of Boynton Beach, a municipal corporation, has caused these presents to be signed by its Mayor, attested by its Clerk, and sealed with its corporate seal, this 31st day of.. August A. D. 19 7 CITY OF BOYNTON BEACH By ?_L1 -' =e•J � 2 ' - s t _,1 ,,,,+ Mayor. I Signed, sealed, and delivered in presence of ,� , ATTEST: Z Clerk. COUNTY OF PALM BEACH ) )} SS. STATE OF FLORIDA Before me personally appeared Emily M. Jackson to me well known as the Mayor of the City of Boynton Beach, Florida, a municipal corporation, and acknowledged that he executed the foregoing conveyance as and for the deed of said city, and in his capacity as Mayor thereof ; and before me also appeared Tereesa Padgett to me wejl known as the Clerk of said city, and acknowledged that he attested, in his capacity as Clerk, the execution of the foregoing deed by the Mayor aforesaid, and that he affixed the cor- porate seal of said corporation thereto. IN WITNESS WHEREOF, I, an officer duly authorized under the laws of Florida to take acknowledgments of deeds, have hereunto set my hand and affixed my seal at Boynton Beach Florida, the__3.1st day of__ August A. D. 19_2$ Notary Public in and for the NOTARY PUBLIC STATE OF FLORIDA AT LARGE State of Florida at Large. MY CO3\9MIS3101 EXPIRES MAY 11, 1979 My commission expires BONDED THROUGH MUROSKI - HUCKLEBERRY. INC. 19 ____. C C n t" g 'd pq H tn Cr) 'a 1.3 H w 0 VI a P v f 000..4 Y n 4 O R° H W H "J Pu ?r td H ¢ P o : ' Q 4 b ) 0 Z cin ''y p r ' 0-3 0 n w l' `.1 CP t:0 CS : Ro L cm n t z • I xrth 'L t an-Lent OF MICHAEL THOMAS BANAS 1, MICHAEL THOMAS BANAS, being of sound mind and disposing memory, do hereby make, publish, and declare this Instrument as and for my Last Will and Testament, in manner and form as follows: ARTICLE I I hereby revoke all Wills and Codicils heretofore made by me, if there - be any. ARTICLE II I hereby direct that my Personal Representative, hereinafter nominated, pay all of my debts legally due, funeral expenses, and costs of administration of my Estate as soon after my death as may be practicable. ARTICLE III If my Wife, BRENDA LOWDER BANAS, survives me, I give, devise, and bequeath unto her, all of my property of all kinds, both real and personal, wheresoever situate, belonging to me at the time of my death, including any and all proceeds of any insurance policies which are payable to my Personal Representative or my estate, or any interest in any pension or other benefit which may pay death benefits to my estate, and any and all powers of appoint - went exercisable by me, by Will, all of whic.i is hereinafter referred to as my estate, absolutely and in fee simple. In the event my Wife and I die simultaneously or under such circumstanc- es that there is not sufficient evidence that we died other than simultaneous- ly, my Wife shall be considered, for the purposes of the operation of my Will, to have survived me. ARTICLE tV In the event that my Wife does not survive me, then I give, devise, and bequeath all of my property of all kinds, both real and personal, wheresoever situate, belonging to me at the time of my death, including any and all proceeds of any insurance policies which are payable to my Personal Represen- tative or my estate, or any interest in any pension or other benefit which may pay death benefits to my estate, and any and all powers of appointment exercisable by my Will, all of which is hereinafter referred to as my estate, absolutely and in fee simple, to SUSAN GAIL EVERETT, who is my Wife's daugh- ter, and DOUGLAS MICHAEL BANAS, who is my son, to be split equally per st i.rpes . ARTICLE V I hereby nominate and appoint my Wife, BRENDA LOWDER BANAS, as my PAGE ONE OF FIVE k6Y Personal Representative under my Last Will and Testament, and I direct that she shall serve without bond or security for the faithful performance of the duties of this office. If my Wife, BRENDA LOWDER BANAS, does not perform the duties of this office, for any reason whatsoever, I hereby nominate and appoint REGINA SALUSTRI, my sister, as my Personal Representative under my Last Will and Testament and I direct that she shall serve without bond or other security for the faithful performance of the duties of this office. Whenever used in this Will, the term "Personal Representative" shall include BRENDA LOWDER BANAS, and her substitute, REGINA SALUSTRI, and their substitutes and successors. ARTICLE VI I hereby authorize and empower my Personal Representative as heretofore named to hold and retain as investments, all investments, securities, and other property, both real and personal, except as specifically devised herein, which shall, at the time of my death, be included in my Estate; to make division and distribution as set forth specifically above and then in kind or partially in kind or partially in money; to sell and dispose of for the purpose of paying my debts or making distribution or for any other purpose whatsoever, any and all of my property, except as specifically devised herein, either at public or private sale, for such prices and on such terms as my Personal Representative shall deem proper, and to reinvest the proceeds thereof as my Personal Representative shall see fit; to make, execute, and deliver all assignments, transfers, and other legal instruments, either necessary or convenient for the passing of title or the ownership thereto, freed and discharged of all trusts, without liability on the purchaser to see to the application of the purchase money and, in general, to do any and every act and thing to enter into and carry out any and every agreement with respect to the property included in my Estate as if my Personal Representative was the absolute owner thereof without being in any way limited by grants of power heretofore made. The specific power I have conferred upon my Personal Representative shall not be construed as a limitation upon the powers conferred upon execu- tors at law, but shall be in addition to any such powers. I do also hereby release my said Personal Representative from any and all liability for any loss or damage that may result to my Estate by reason of my Personal Representative's management thereof as directed hereunder, and my Personal Representative shall not be liable for any mistakes in judgment, but shall only be liable for actual fraud or misappropriation. In the event that any beneficiary under this Will shall be under the age of twenty - five (25) years or legally incompetent, then the share of that beneficiary shall vest, but its possession may be retained in the sole and PAGE TWO OF FIVE _�`_ absolute discretion of my Personal Representative until the minor has attained twenty -five (25) years of age or has had the disabilities of non -age removed or the otherwise incompetent shall have had his or her competency judicially restored. The vested shares shall be held by my Personal Representative (as Guardian of the minor's or incompetent's property), subject to all of the powers conferred in this Will regarding management, investment, and reinvest- ment of the shares. My Personal Representative shall collect and receive the income and pay over or apply to the net income of the share to the respective beneficiary or apply it to his or her benefit to the extent required for the support, maintenance, health, and education of the beneficiary, and, if the income be sufficient, in the sole and absolute discretion of the Personal Representative, for those purposes, then my Personal Representative shall pay over or apply such portion of the principal of the share as may be required for these purposes. Any payments of income or principal for the benefit of a minor or other incompetent beneficiary may be made by my Personal Representa- tive by payment directly to the beneficiary or to any adult, whether or not related, with whom the beneficiary may be temporarily or permanently residing, or by application directly to my Personal Representative to the payment of the obligation of a minor or other incompetent for the above purposes. The receipt of these payments or applications of income or principal by the guardian, adult, or creditor shall be a full receipt and discharge to my Personal Representative and my Personal Representative shall not be required to see to the prop'!r application of any of those payments. My Personal Representative shall respectively have the power to determine whether a beneficiary is a minor or otherwise incompetent. ARTICLE VII It is my intent that Florida law should govern the validity and the operative effect of this Will as far as it is pertinent. ARTICLE VIII If any part of this Will and Testament be held by a court of competent jurisdiction to be invalid or inoperative, for any reason, it is my intent that the remaining provisions have operative effect and be carried out as far as it is reasonable to do so. ARTICLE IX (LIVING WILL) I willfully and voluntarily make known my desire that my dying not be artificially prolo,iged under the circumstances set forth below, and I do hereby declare: If at any time I should have a terminal condition and if my attending physician has determined that there can be no recovery from such condition and that my death is imminent, I direct that life - prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die PAGE THREE OF FIVE , /ie' naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain. I desire that nutrition and hydration (food and water) be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying. In the absence of my ability to give directions regarding the use of such life- prolonging procedures, it is my intention that this declaration be honored by my family and physician as the final expression of my legal right to refuse medical or surgical treatment and to accept the consequences for such refusal. I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration. IN WITNESS WHEREOF, I have hereunto set my Hand and Seal at Palm Beach Gardens, Florida, this /3 day of August, 1996. Mic ae T omas Banas The above and foregoing instrument consisting of four (4) pages and including the self- proving page immediately following, was signed, sealed, declared and published by MICHAEL THOMAS BANAS, as and for his Last Will and Testament, in the presence of us, the undersigned, who at his special instance and request, do attest as witnesses after said Testator signed his name thereto, and in the presence of each other, and in his presence, this /3 -day of August, 1996. • A , . 6)4/41S residing at L 5q() T : A J ) . ra S. Wrig It ' / 7 j ce? - " residing at / 5 Frances S. Cox � y AL-- 5 g O re PAGE FOUR OF FIVE SELF PROOF OF WILL STATE OF FLORIDA ) ) SS COUNTY OF PALM BEACH ) WE, MICHAEL THOMAS BANAS, Debra S. Wright , and Frances S. Cox , the Testator and witnesses respectively, whose names are signed to the attached or foregoing instrument, having been sworn, declared to the undersigned officer that the Testator in the presence of witnesses, signed the instrument as his Last Will, and that he signed, and that each of the witnesses, in the presence of the Testator and in the presence of each other, signed the Will as a witness. &€ ! 1 2 -*`ate ,ear` — Ric ae omas Banas, Testator .� 1�� ra S.Wright S.t 6J/� - ) �� Z C Frances S. Cox Witness SWORN TO AND SUBSCRIBED before me on this 13th day of August, 1996, by MICHAEL THOMAS BANAS, the Testator, who is ersonally known to me or who has produced as identification, and by Debra S. Wright , a witness, who is (iersonally known to me or who has produced as identification, and by Frances S. Cox , a witness, who is ersonally known)to me or who has produced - -----__ as ident'�`tion. �- ca, kotary Pu' ic, Sta e o or .a Jack S. Cox (print name) ' Co ,..'ssion Expires: z ti:�: JACK S. COX ,s MY COMMISSION I CC 462446 .,�. EXPIRES: Aid 11, 1 9IA�9 ` -t k Bonded Thu Notary P a /e Underw Iter: PAGE FIVE OF FIVE dw: banes \ wi t 1 .mtb(081396) This instrument Prepared By: Jack S. Cox, Esq. Jack Schramm Cox, P.A. 4400 PGA Blvd., Suite 201 Palm Beach Gardens, FL 33410 DURABLE POWER OF ATTORNEY CONTAINING HEALTH CARE SURROGATE PROVISIONS AND PROVISIONS RELATING TO TRANSFER OF REAL PROPERTY INCLUDING HOMESTEAD PROPERTY (per. Florida Statute §709.08 as amended in 1995) BY TFHIS DURABLE POWER OF ATTORNEY I, MICHAEL THOMAS BANAS, ( "Principal ") of Palm Beach County, Florida, appoint as my attorney in fact to manage my affairs as indicated below, my wife, BRENDA LOWDER BANAS. This Durable Power of Attorney is not affected by my subsequent incapac- ity except as provided by Florida Statute Section 709.08, and is exercisable from the date of execution, 1. General Grant of Power I hereby grant to my Agent full power and authority to exercise or perform any act, power, duty, right or obligation whatsoever that I now have or may hereafter acquire, relating to any person, matter, transaction, or any interest in property owned by me, including, without limitation, my interest in all real property, including homestead real property; all personal proper- ty, tangible or intangible; all property held in any type of joint tenancy, including a tenancy in common, joint tenancy with right of survivorship, or a tenancy by the entirety; all property over which I hold a general, limited, or special power of appointment; choses in action; and all other contractual or statutory rights or elections, including, but not limited to, any rights or elections in any probate or similar proceeding to which I am or may become entitled; all as to such property now owned or hereafter acquired by me. I grant to my Agent full power and authority to do everything necessary in exercising any of the powers herein granted as fully as I might or could do if personally present, with full power of substitution or revocation. Except as otherwise limited by applicable law, or by this durable power of attorney, my attorney in fact has full authority to perform, without prior court approval, every act authorized and specifically enumerated in this durable power of attorney. I hereby ratify and confirm that my Agent shall lawfully have, by virtue of this durable power of attorney, the powers herein granted, includ- ing, but not limited to, the following: a. Collect all sums of money and other property that may be payable or belonging to me, and to execute receipts, releases, cancellations or discharges. b. Settle any account in which I have any interest and to pay or receive the balance of that account as the case may require. c. Borrow money on such terms and with such security as my attorney may think fit and to execute all notes, mortgages and other instru- ments that my attorney finds necessary or desirable. d. Draw, accept, endorse or otherwise deal with any checks or other commercial or mercantile instruments for my benefit, specifically including the right to make withdrawals from any savings account or savings and loan deposits. e. Redeem bonds issued by the United States government or any of its agencies, any other bonds and any certificates of deposit or other similar assets belonging to me. f. Sell bonds, shares of stock, warrants, debentures, or other assets belonging to me, and execute all assignments and other instruments necessary or proper for transferring them to the purchaser or purchasers, and give good receipts and discharges for all money payable in respect to them. Also, to execute stock powers or similar documents on my behalf and delegate to a transfer agent or similar person the authority to register any stocks, bonds, or other securities either into or out of my name or nominee's name. g. sell, rent, lease for any term, mortgage or exchange any real estate or interests in it, including homestead property, for such considerations and upon such terms and conditions as my attorney may see fit and execute, acknowledge and deliver all instruments conveying or encumbering title to property owned by me alone as well as any owned by me and by any other person, jointly. If I am married, the attorney in fact may not mortgage or convey my homestead property without joinder of my spouse or my spouse's legal guardian. Joinder by my spouse may be accomplished by the exercise of authority in a durable power of attorney executed by my joining spouse, and either my spouse or I may appoint the other as attorney in fact. Specific Real Estate Powers The attorney in fact herein named and her successor(s) are all granted the authority to sell, to convey, to maintain, to mortgage or to dispose of, the following described property, and to execute any and all documents necessary to effectuate the sale and /or conveyance, and to encumber, and to dispose of, the following described real property, to wit: Any and all real property in which I own any interest in Florida or in any other state. and such documents shall include, but not be limited to, contracts, deeds, affidavits, bills of sale, closing statements, mortgages, notes and such other instruments as may be required to carry out the purposes herein expressed, and I, MICHAEL THOMAS BANAS, hereby give and grant unto the attorney in fact named herein and her successor(s), said attorney, full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in and about the premises as fully to, all intents and purposes, as I, MICHAEL THOMAS BANAS, might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said attorney or her successor(s), shall lawfully do or cause to be done by virtue hereof. h To represent me before the Treasury Department in connection with any matter involving any federal taxes in which I am a party, to make, sign, execute, verify and file any return required to be made under the revenue laws of the United States, or the Internal Revenue Code; or under the statutes of any state and to file any claim for refund, offer and compromise or application for a closing agreement, receive refund checks, execute waivers of any period of limitation, request extensions of time, execute any waiver of restrictions on assessment for collection of any tax, and execute Petition of Appeal to the United States Tax Court. The above powers conferred upon my attorney in fact extend to all of my right, title and interest in such property as I have described above and in which I may have an interest jointly with any other person, whether in an estate by the entirety, joint tenancy or tenancy in common. 2. Limitation Notwithstanding the powers contained in this durable power of attorney, my attorney in fact may not: a Perform duties under a contract that requires the exercise of my personal services; b. Make any affidavit as to my personal knowledge; c Vote in any public election on my behalf; cl_ Execute or revoke any will or codicil on my behalf; e Create, amend, modify, or revoke any document or other disposition effective at my death or transfer assets to any existing trust created by me unle,;s expressly authorized by this power of attorney; or f. Exercise powers and authority granted to me as trustee or as court - appointed fiduciary. 3 Health Care Surrogate Provisions Designation of Health Care Surrogate (Pursuant to F.S. § §709.08 and 765) In the event that I have been determined by a court of competent jurisdiction to be incapacitated to provide informed consent for medical treatment and surgical and diagnostic procedures, I wish to designate as my surrogate for health care decisions, the attorney in fact named herein: BRENDA LOWDER BANAS, telephone number: (561) 439 -2942. This designation revokes any prior health care surrogate designa- tion which I may have made. I fully understand that this designation will permit my surrogate to make health care decisions and to provide, withhold, or withdraw consent on my behalf; to apply for public benefits to defray the cost of health care; and to authorize my admission to or transfer from a health care facility. Additional Instructions Without limitation on the rights and authority of my Surrogate, my 2 Surrogate may, among other acts and decisions: 1. Have final authority to act for me and to make health care decisions tor me in matters regarding my health care during my said incapaci- ty; 2. Consult with appropriate health care providers to provide informed consent in my best interests as the Surrogate perceives same; 3 Give any consent in writing using the appropriate consent forms; 4. Have access to all of my appropriate clinical records and may authorize the release of information and clinical records to appropriate persons to ensure the continuity of my health care; 5. Apply for public benefits, including but not limited to, Medicare and Medicaid, for me, and to have access to information regarding my income and assets to the extent required to make application; 6 Authorize the transfer and admission of me to or from a health care facility; 7. Withhold or withdraw life-prolonging or death - delaying procedures in accordance with a written declaration, living will or last illness will and testament I may have or will in the future make; 8. Seek Court orders providing for the withholding and with- drawal of life- prolonging or death - delaying procedures in accordance with a living will or last illness will and testament or declaration I may have made; 9. Do all acts and make all decisions regarding my health care as authorized by law. My Surrogate shall not be liable or responsible for any costs or expenses of my medical treatment or care except as expressly stated by Statute and my Surrogate's signature on any admission papers for a health care facility shall not make the Surrogate liable or responsible for any costs and expenses incurred for my care at such health care facility, it being under- stood that the Surrogate acts for me and in my stead, and I, alone, would be liable or responsible for such costs and expenses. I further affirm that this designation is not being made as a condition of treatment or admission to a health care facility. I will notify and send a copy of this document to the following person other than my Surrogate, so they may know who my Surrogate is. Name: DOUGLAS MICHAEL BANAS Address: 345 MacArthur Dr., Williamsville, New York Phone: (716) 626 -4972 4. Standard of Care Except as otherwise provided herein, any attorney in fact named herein is a fiduciary who must observe the standards of care applicable to trustees as described in Florida Statute Section 737.302. My attorney in fact is not liable to third parties for any act pursuant to this durable power of attorney if the act was authorized at the time. If the exercise of the power is improper, my attorney in fact is liable to interested persons as described in Florida Statute Section 731.201 for damage or loss resulting from a breach of fiduciary duty by my attorney in fact to the same extent as the trustee of an express trust. If my attorney in fact has accepted appointment either expressly in writing or by acting under the power, my attorney in fact is not excused from liability for failure either to participate in the administration of assets subject to the power or for failure to attempt to prevent a breach of fiduciary obligations thereunder. 5. Interpretation and Governing Law This instrument is executed by me in the State of Florida, but it is my intention that this power of attorney shall be exercisable in any other state or jurisdiction where I may have any property or interests in property. This instrument is to be construed and interpreted as a durable power of attorney as provided for in Florida Statute Section 709.08, and as a health care surrogate as provided for in Florida Statute Section 765, as these statutes may be amended from time to time. The enumeration of specific powers herein is not intended to, nor does it, limit or restrict the general powers herein granted to my Agent. This instrument is executed and delivered in the State of Florida, and the laws of the State of Florida shall govern all questions as to the validity of this power and the construction of its 3 provisions. 6. Third Party Reliance a. Any third party may rely upon the authority granted in my durable power of attorney until the third party has received notice as provided herein. b. Until a third party has received notice of revocation pursuant to the terms contained herein, partial or complete termination of the durable power of attorney by adjudication of incapacity, suspension by initiation of proceedings to determine incapacity, my death, or the occurrence of an event referenced in this durable power of attorney, the third party may act in reliance upon the authority granted in this durable power of attorney. c. A third party that has not received written notice hereunder may, but need not, require that my attorney in fact execute an affidavit stating that there has been no revocation, partial or complete termination, or suspension of the durable power of attorney at the time the power of attorney is exercised. A written affidavit executed by my attorney in fact under this paragraph may, but need not, be in the following form: STATE OF COUNTY OF BEFORE ME, the undersigned authority, personally appeared ( "Affiant ") who swore or affirmed that: 1. Affiant is the attorney in fact named in the durable power of attorney executed by (Principal) on the day of , 19 2. To the best of Affiant's knowledge after diligent search and inquiry: a. The Principal is not deceased, has not been adjudicated incapacitated, and has not revoked, partially or completely terminated, or suspended the durable power of attorney; and b. A petition to determine the incapacity of or to appoint a guardian for the Principal is not pending. 3. Affiant agrees not to exercise any powers granted by the durable power of attorney if Affiant attains knowledge that it has been revoked, partially or completely terminated, suspended, or is no longer valid because of the death or adjudication of incapacity of the Principal. Affiant Sworn to and subscribed before me this day of , 19 by who is personally known to me or who provided as identification. Notary Public, State of (print name) My Commission Expires: d. Third parties who act in reliance upon the authority granted to my attorney in fact hereunder and in accordance with the instructions of the attorney in fact will be held harmless by me from any loss suffered or liability incurred as a result of actions tagen prior to receipt of written notice of revocation, suspension, notice of a petition to determine incapaci- ty, partial or complete termination, or my death. A person who acts in good faith upon any representation, direction, decision, or act of my attorney in fact is not liable to me or to my estate, beneficiaries, or joint owners for those acts. e. My attorney in fact is not liable for any acts or decisions made by him or her in good faith and under the terms of the durable power of attorney. 7. Notice a. A notice, including, but not limited to, a notice of revocation, partial or complete termination, suspension, or otherwise, is not effective until written notice is served upon my attorney in fact or any third persons relying upon this durable power of attorney. b. Notice must be in writing and served on the person or entity to be bound by such notice. Service may be by any form of mail that requires a signed receipt or by personal delivery as provided in the Florida Statutes for service of process, and must otherwise be in accordance with Florida Statute Section 709.08. 4 S. Damages and Costs In any judicial action regarding this durable power of attorney, including, hut not limited to, the unreasonable refusal of a third party to allow an attorney in fact to act pursuant to the power, and challenges to the proper exercise of authority by the attorney in fact, per statute, the prevailing party is entitled to damages and costs, including reasonable attorney's fees. 9. Validity This durable power of attorney shall be non - delegable, except as to the stock powers which may be delegated to a transfer agent per Paragraph 1.f. hereunder, and shall be valid until such time as I shall die, revoke the power, or shall be adjudged totally or partially incompetent by a court of competent jurisdiction. I may revoke the power only by providing written notice to my Agent. All acts of my Agent taken or done without actual knowledge of 1) my death, 2) an adjudication of my incompetency, or 3) my revocation are valid and effective, and are hereby ratified and confirmed. 10. Revocation of Prior Instruments By this instrument I hereby revoke any power of attorney, durable or otherwise, that I may have executed prior to the date of this durable power of attorney. I hereby confirm all acts of my attorney in fact pursuant to this power. Any act that is done under this power between the revocation of this instrument and notice of that revocation to my attorney shall be valid unless the person claiming the benefit of the act had notice of that revocation. IN WITNESS WHEREOF, I have set my hand and seal on this ) 3 day of August, 1996. Signed, sealed and delivered in e presence •f: 4 A .! /QQ ness Michas Thomas Banas, �r incipal �, (, / �� = > > ' --_, / 'i 7 PIETIess STATE OF FLORIDA COUNTY OF PALM BEACH SWORN TO AND SUBSCRIBED before me this )3 day of August, 1996 by MICHAEL THOMAS BANAS, who is personally kno • to me. —S, otary P . S to of Florida (pint name) My c_ommis,ion Expires: .1.0'iiV_ JACK S. COX I.: a. ..i MY COMMISSION i CC 452 , b(PIRES: April 11, 1999 Yt Banded Tfvu *WY Public Ur/dem/te a dw :banas \power.aty(081396) 5 CITY OF BOYNTON BEACH Control No. DISINTERMENT /DISINURNMENT /DISENTOMBMENT ORDER AND AUTHORIZATION FOR RENTERMENT OR OTHER DISPOSITION Location No File Reference Contract No Date (gig/day/year) C l / l /off Original Internment No Original Intemmvint D DismtemmenUDismumment /Disentombment No Date Disinterment /Disinumment/Disentombment Time 0 7� 1 Lg1/ Scheduled ❑ AM 0 PM No disinterment /d sinumment/disentombment shall take place until a written authonzatron, signed by the proper relative or legal representative of the deceased, has been given to the Cemetery performing the disf nterment /disinurnment/disentombment The undersigned hereby requests and authorizes: Name of Cemetery 1 in accordance with and subject to its rules and regulations, to disinter /disinurn/disentomb the remains of: �j Name of Decedent (First) �tb11 j (Last) Q �je of Birth l'1 t 3 Sex IV From the t Ilowm descn / /C�il g d 1 RI( ( I( space grlglnal nn sp descnption) b1`" 7 OL(,frl 0770 m - T t Y�h and to reinter the remains in l el following described intt�rment space, or to make other disposition of the remains as directed below. di, New Interht Space scnptwn ti / � j / 1 l( /, �G 4#41,4 Other Disposition (des be) 1�/a �l- I� Property Owner J OA ,rst) (M 1) Lit T i t i N g (, -a 8 a I k Fun Home r+r1. 1� t / Dire � Telephone Numbe FuneyV9(J��meBddressJ 1 �. r ^'�c �� ity 1G.a^'�/ r „ t Steen ) Zip3 1/3 y Outer Bunal / taal l ner Descn J Manufactur % u Provided by �j•tt' Casket/Um Description Manufacturer Provided by Memorial Instructions REMARKS The undersigned hereby certify that they are the legal custodian(s) of the herein named deceased, having the full legal authority to direct the disinterment/ disinurnment/disentombment of the remains of the deceased, and certify that they are the owner(s) or authorized representative(s) of the owner(s) of the Interment Rights described above, and hereby authorize the above named cemetery to make disposition of the remains as Indicated above. Must be ai ed by (1 propert owna (2) next -of -kin (or other legally a thonzed.representative) X z '/ASK t S7RN SF Al Authonzed Representative Signatur to Print Name Relationship ii . )T EI� t i9 P ■rr.E71A) /V r eJci' SVO 9 2/ me dress r/ City State Zip elephone Number i , O Do? a_<?- je S. LEV Y / Authonzed Representative Signature Dat Print Name R hip • ,, / /g7 7 iF) .c) r ip a I .dress, City to Zip Telephone Number 1' STATE OF FLORIDA I COUNTY OF PALM BEACH BEFORE ME, the undersigned authority, appeared as authorized representative, who is personally known to the or has produced as identification and who did (did not) take an oath, and who acknowledged to and before me that he /she executed the foregoing instrump}gipfottrenitsww therein expressed, pursuant to due authority. _ E ll a PTASHNIK NOTARY FU I EW YO RK NOTARY PIIR WITN S, my hand ano ma rmi day of ! tic 02P-STATE F �p /�/ ` —'' rI No. 0 2PT6233852 q Zr v No 02PT6233852c� rORK �'�� \ In Westchester County sc 1n Westchester Court} NOTARY PUBLIC ( ---- Y Commission Expires January 03 2015 M Y CSZ1!+mtsaiQpf y My Commission Expires' I t /S , x{�iretr January 03, 203E_ t DISINTERMENT /DISINURNMENT /DISENTOMBMENT, REMOVAL AND KEINTERMENT RECORD Condition of Casket/Um Condition of Outer Bunal Container . REMARKS Prepared By (Signature) Date Interment ID Committed By (Signature) Date Info Verified By (Signature) Date Interment ID Placed By (Signature) Date Site Layout By (Signature) Date Interment Card Recorded By (Signature) Date Joan Lev 958 East 24 Street Brooklyn, New York 11210 August 27, 2012 Re: Disinurnment of Jay E. Stern Janet Prainito, MMC City Clerk 100 E. Boynton Beach Boulevard Boynton Beach, Florida 33435 Dear Ms. Prainito: As per your letter of August 16. 2012, I am enclosing: •Completed Authorization Form •A check in the amount of $400. •A copy of NOTICE OF SUCCESSOR TRUSTEE'S AUTHORITY TO ADMINISTER TRUST •A copy of CERTIFICATION OF ATTORNEY •A copy of my driver's license. If there are any questions, my home telephone number is: 718 - 258 -8218; e-mail address: midwood24 @verizon.net Thank you for all of your help. Sincerely, z}r_ J an Lev CRAIG DONOFF, P.A. ATTORNEYS AT LAW TOWN EXECUTIVE CENTER - SUITE 301 6100 GLADES ROAD CRAIG DONOFF, J.D., LL.M. BOCA RATON, FLORIDA 33434 ESTATE and TAX ATTORNEY AvENTT.rRA/ MIAMI OFFICE infomiation@craigdonoffpa.com CONCORDE CENTRE IL SUTTE 809 2999 N.E 191 STREET TELEPHONE (561) 451 -8220 AVENTURA, FLORIDA 33180 ANDREW S. wn czoREK, J.D. Andrew@craigdonoffpa.com FAX (561) 451 -8223 SHARI B. Co11FiN, J.D. Shan®craigdonoffpa.com DADE (305) 935-0496 SOPI IA A. LOPEZ, J.D. Sophia@craigdonnoffpa.com FAx (305) 935 -9542 DANIEL T. FtEISCHER, J.D., MBA dtf@craigdonoffpa.com LINDSEY K DoNovF, J.D. Llndsey®craigdonoffpa com CERTIFICATION OF ATTORNEY I, CRAIG DONOFF, Attorney -at -Law, hereby certify that Joan Lev is the duly appointed and is the presently qualified Successor Trustee of the Rafaela Stern Revocable Trust Agreement u /a /d January 15, 1988, as Restated and Amended, and that a copy of the Rafaela Stern Revocable Trust Agreement dated January 15, 1988, as Restated and Amended and its Amendments attached are the best true and correct copies available of the original which I prepared, and to the best of my knowledge, are still in full force and effect and have not been revoked. L /t CRAIG DONOFF, ATTORNEY AT LAW STA'T'E OF FLORIDA ) ) 5s: COUNTY OF PALM BEACH ) The foregoing was acknowledged before me this? thisiZ, of 2012, by CRAIG DONOFF, who is personally known to me and who' d not take an oath. Notary Public, State of Flori — - 410 LORRNIE MARIE POL1ArA -EH 1 e. My commission expires: _ MY COMMISSION It EE 188260 g -� -� EXPIRES: April 30, 20t f •„p -.0 Bonded Thru Notary Public UndE,n..'- : 6 • WILLS • TRUSTS • ESTATE PLANNING • TRUST ADMINISTRATION • PROBATE • ES a " 2757 DR. R. J. LEV 21 ,; 4201452 5 i I i ,J J. LEV ? q h ATE 4 ' g d... II JI TV n e PAY IOT — I $ L/ b INVOICE I � ,- # a-o �� n. ;, 30530 6 • * - AR IJ M.-.. r � V CHASE 0 1 JPMorgan Chase Bank, N A � New Ya New York 10017 M1 New ch ase com _ j�� TE 8/15/12 1__x3 �S NIEK _ _ _ _ _ ___ -- - W 9/14/12 L ':0 0000t: 4 20 1 4 5 28 36 5n' 5 7 -s-__-_,=====..1 YPE # 6606/6823 QUANTITY DESCRIPTION PRICE TOTAL 1.00 MAUS DISENTOMB /DISINURN 400.00 400.00 Jay E. Stern Sunset Building, Section G, Niche D6 TOTAL DUE: $400.00 PLEASE DETACH THIS PORTION AND RETURN WITH YOUR PAYMENT. REMIT TO CUSTOMER NAME CITY OF BOYNTON BEACH LEV, JOAN ATTN: CITY CLERK PO BOX 310 BOYNTON BEACH FL 33425 CUSTOMER/TYPE NUMBER INVOICE DATE INVOICE NUMBER AMOUNT DUE 6606/6823 8/15/12 30530 $400.00 NOTICE OF SUCCESSOR TRUSTEE'S AUTHORITY TO ADMINISTER TRUST PLEASE TAKE NOTICE: That I, Joan Lev, the Successor Trustee under that certain Trust Agreement, hereinafter referred to as the "Rafaela Stern Residuary Trust Agreement dated January 15,1988, as Restated and Amended ", a copy of which is attached hereto and made a part hereof by this reference, hereby gives notice that I have assumed the duties as Successor Trustee as provided under Article VIII, of said Rafaela Stern Revocable Trust Agreement dated January 15, 1988, as Restated and Amended; and in support thereof, a copy of the following document is attached hereto and made a part hereof: DEATH CERTIFICATE OF RAFAELA STERN WHEREFORE, I, the undersigned Successor Trustee, hereby gives notice that in my capacity of such Successor Trustee, all of the Trustee's rights, title and interest in and to the assets comprising the RES of said Rafaela Stern Revocable Trust Agreement dated January 15, 1988, as Restated and Amended, has been assumed by my this date; and that the same will be administered in accordance with the discretionary provisions set forth in Article IX of said Trust Agreement. Dated this Ps day of \ 0 77 , 2012. 1!X/1A /LA JOAN LEV,,uccessor Trustee STATE OF NEW YORK ) )ss.: COUNTY OF K< < r1 ) On this / .�' day of .9 GI) , 2012, before me, the undersigned Notary Public, personally appeared Joan Lev, who is personally known to me or w has produced a driver's license as identification and who did e an oath. f t e„ , 17 N , VARY PUBLIC, State of New York My commission expires: 1 i 1 " PEDRITA N. DORSAINVIL Notary Public. State of New York Qualified In Kings County No. 01D06174397 My Commission Expires Sept 17. 2015 WILLS • TRUSTS • ESTATE PLANNING • TRUST ADMINISIRATION • PROBATE • ESTATE SETTLEMENT 2