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Agenda 12-12-13 CITY OF BOYNTON BEACH, FLORIDA STATEMENT OF REVENUES & EXPENDITURES - COMPARATIVE BUDGET TO ACTUAL For the Month Ended September 30, 2013 FISCAL YEAR 2013 TO DATE Current YTD Revenues - 631 (Memorial Park) Sep -13 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments $ 6,800 $ 30,000 $ 58,400 195% Cemetery/Equipment Rental 1,200 8,000 10,500 131% Cemetery/Sale of Lots 6,025 30,000 75,025 0% TOTAL CHARGES 14,025 68,000 143,925 212% MISCELLANEOUS REVENUE Interest Income 1,399 5,000 1,005 20% Miscellaneous Income 1,125 3,000 6,475 216% Fund Balance Appropriated 0 186,575 0 0% TOTAL MISCELLANEOUS REVENUE 2,524 194,575 7,480 4% Total Revenues $ 16,549 $ 262,575 $ 151,405 58% FISCAL YEAR 2013 TO DATE Current YTD Revenues - 632 (Mausoleum) Sep -13 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments 0 0 0 0% Mausoleum /Sale of Crypts 24,000 0 77,250 0% TOTAL CHARGES 24,000 0 77,250 0% MISCELLANEOUS REVENUE Interest Income 1,272 5,000 913 18% Miscellaneous Income 0 3,000 3,325 111% Fund Balance Appropriated 0 64,300 0 0% TOTAL MISCELLANEOUS REVENUE 1,272 72,300 4,238 6% Total Revenues $ 25,272 $ 72,300 $ 81,488 113% Grand Total Revenues $ 41,821 $ 334,875 $ 232,893 70% S,\FinancelCemetenes - Mausoleum \Cemetery Monthly Report\2013 Monthly Report,xls FISCAL YEAR 2013 TO DATE Current YFD Expenditures - 631 jMemorial P ark) Sep-13 BUDGET EXPENSES PERCENT PERSONNEL Regular Salaries $ 8,737 $ 124,084 $ 116,117 94% Holiday Pay 0 250 0 0% Overtime 109 3,000 2,592 86% Cell Phone Allowance 15 180 180 100% Employer FICA 648 9,520 8,737 92% General Employees Pension 0 31,632 31,632 100% Life Insurance 0 42 0 0% Disability Insurance 0 561 0 0% Health Insurance 1,652 19,825 19,825 100% Dental Insurance 79 963 952 99% Vision Insurance 10 127 115 91% TOTAL PERSONNEL 11,250 190,184 180,150 95% OPERATING Audit Fees $ 400 $ 1,980 $ 1,600 81% Cellular Phone /Beeper 48 456 469 103% Electric Service 90 1,500 865 58% Water /Sewer Service 170 600 718 120% Building Repairs 0 500 0 0% Vehicle Maint- Garage 259 10,723 10,688 100% Irrigation Maintenance 0 2,000 34 2% Self Insurance Chgs (W /C) 207 2,483 2,483 100% Warehouse Service Chg 88 1,058 1,058 100% Other Contractual Svcs 2,015 21,000 28,876 138% Office Supplies 0 0 74 0% Operating Equip < $750 0 900 816 91% Chemicals 0 1,500 1,048 70% Uniforms 0 500 349 70% Safety Clothing /Equip 0 590 493 84% Gardening Supplies 387 3,324 1,031 31% Equipment Parts /Supplies 15 2,500 2,114 85% TOTAL OPERATING 3,679 51,614 52,716 102% NON - OPERATING Transfer to General Fund $ 1,000 $ 12,000 $ 12,000 100% Transfer to Vehicle Svc Fund 523 6,277 6,277 100% Refund on Cemetery Lots 5,817 2,500 6,417 257% TOTAL NON - OPERATING 7,340 20,777 24,694 119% Expenditures - 632 (Mausoleum) OPERATING Litigation Fees & Costs $ - $ 15,000 $ - 0% Electric Service 377 1,700 2,893 170% Water/Sewer Service 776 5,700 4,901 86% Building Repairs 0 2,000 215 11% Other Contractual Services 1,377 11,600 11,804 102% Supplies 400 5,500 1,918 35% Equipment Parts /Supplies 0 0 0 0% Refund -Sale of Crypts 0 30,800 9,099 30% TOTAL OPERATING 2,930 72,300 30,830 43% Total Expenditures $ 25,199 $ 334,875 $ 288,390 86% Net Income Increase(Decrease) $ 16,622 $ - $ (55,497) S Tinance\Cemeteries - Mausoleum\ Cemetery Monthly Report\2013 Monthly Report xis CITY OF BOYNTON BEACH, FLORIDA STATEMENT OF REVENUES & EXPENDITURES - COMPARATIVE BUDGET TO ACTUAL For the Month Ended October 31, 2013 FISCAL YEAR 2014 TO DATE Current YTD Revenues .631 (Memorial Park) Oct -13 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments $ 4,550 $ 40,000 $ 4,550 11% Cemetery/Equipment Rental 900 10,000 900 9% Cemetery/Sale of Lots 5,500 50,000 5,500 0% TOTAL CHARGES 10,950 100,000 10,950 11% MISCELLANEOUS REVENUE Interest Income 0 20,000 0 0% Miscellaneous income 1,000 3,000 1,000 33% Fund Balance Appropriated 0 147,664 0 0% TOTAL MISCELLANEOUS REVENUE 1,000 170,684 1,000 1% Total Revenues $ 11,950 $ 270,684 $ 11,950 4% FISCAL YEAR 2014 TO DATE Current YTD Revenues - 632 (Mausoleum) Oct -13 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Mausoleum /Sale of Crypts 0 30,000 0 0% TOTAL CHARGES 0 30,000 0 0% MISCELLANEOUS REVENUE Interest Income 0 14,000 0 0% Miscellaneous Income 600 2,800 600 21% Fund Balance Appropriated 0 0 0 0% TOTAL MISCELLANEOUS REVENUE 600 16,800 600 4% Total Revenues $ 600 $ 46,800 $ 600 1% Grand Total Revenues $ 12,550 $ 317,484 $ 12,550 4% FISCAL YEAR 2014 TO DATE Current YTO Expenditures - 631 (Memorial P ark) pct -13 BUDGET EXPENSES PERCENT PERSONNEL Regular Salaries $ 8,593 $ 110,300 $ 8,593 8% Holiday Pay 0 250 0 0% Overtime 58 3,000 58 2% Cell Phone Allowance 15 180 15 8% Employer FICA 633 8,800 633 7% General Employees Pension 32,975 32,975 32,975 100% Life Insurance 0 42 0 0% Disability Insurance 0 561 0 0% Health Insurance 1,652 23,791 1,652 7% Dental Insurance 79 910 79 9% Vision Insurance 10 127 10 8% TOTAL PERSONNEL 44,015 180,936 44,015 24% OPERATING Audit Fees $ - $ 2,020 $ - 0% Cellular Phone /Beeper 0 360 0 0% Electric Service 69 1,000 69 7% Water /Sewer Service 0 600 0 0% Building Repairs 0 300 0 0% Vehicle Maint- Garage 886 13,018 886 7% Irrigation Maintenance 0 2,000 0 0% Self Insurance Chgs (WIC) 257 3,086 257 8% Warehouse Service Chg 54 646 54 8% Other Contractual Svcs 0 21,000 0 0% Office Supplies 0 0 0 0% Operating Equip < $750 0 900 0 0% Chemicals 0 1,000 0 0% Uniforms 34 500 34 7% Safety Cfothing /Equip 0 590 0 0% Gardening Supplies 0 3,500 0 0% Equipment Parts /Supplies 0 3,200 0 0% TOTAL OPERATING 1,300 53,720 1,300 2% NON - OPERATING Transfer to General Fund $ 2,250 $ 27,000 $ 2,250 8% Transfer to Vehicle Svc Fund 544 6,528 544 8% Refund on Cemetery Lots 160 2,500 160 6% TOTAL NON - OPERATING 2,954 36,028 2,954 8% Expenditures - 632 (Mausoleum) OPERATING Litigation Fees & Costs $ - $ 5,000 $ - 0% Electric Service 343 2,200 343 16% Water /Sewer Service 0 4,000 0 0% Budding Repairs 0 2,000 0 0% Other Contractual Services 52 12,000 52 0% Supplies 24 1,600 24 2% Equipment Parts /Supplies 0 0 0 0% Refund -Sale of Crypts 0 20,000 0 0% TOTAL OPERATING 419 46,800 419 1% Total Expenditures $ 48,688 $ 317,484 $ 48,688 15% Net income Increase(Decrease) $ (36,138) $ - $ (36,138) CITY OF BOYNTON BEACH, FLORIDA STATEMENT OF REVENUES & EXPENDITURES - COMPARATIVE BUDGET TO ACTUAL For the Month Ended November 30, 2013 FISCAL YEAR 2014 TO DATE Current YTD Revenues - 631 (Memorial Park} Nov -13 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Cemetery Interments $ 3,100 $ 40,000 $ 7,650 19% Cemetery/Equipment Rental 700 10,000 1,600 16% Cemetery/Safe of Lots 3,150 50,000 8,650 17% TOTAL CHARGES 6,950 100,000 17,900 18% MISCELLANEOUS REVENUE Interest Income 0 20,000 0 0% Miscellaneous Income 75 3,000 1,075 36% Fund Balance Appropriated 0 147,684 0 0% TOTAL MISCELLANEOUS REVENUE 75 170,684 1,075 1% Total Revenues $ 7,025 $ 270,684 $ 18,975 7% FISCAL YEAR 2014 TO DATE Current YTD Revenues - 632 (Mausoleum) Nov -13 BUDGET REVENUE PERCENT CHARGES FOR SERVICES Mausoleum /Sale of Crypts 5,800 30,000 5,800 19% TOTAL CHARGES 5,800 30,000 5,800 19% MISCELLANEOUS REVENUE Interest Income 0 14,000 0 0% Miscellaneous Income 150 2,800 750 27% Fund Balance Appropriated 0 0 0 0% TOTAL MISCELLANEOUS REVENUE 150 16,800 750 4% Total Revenues $ 5,950 $ 46,800 $ 6,550 14% Grand Total Revenues $ 12,975 $ 317,484 $ 25,525 8% FISCAL YEAR 2014 TO DATE Current YTD Expenditures - 631 (Memorfaf P ark) Nov -13 BUDGET EXPENSES PERCENT PERSONNEL Regular Salaries $ 8,545 $ 110,300 $ 17,138 16% Holiday Pay 0 250 0 0% Overtime 155 3,000 212 7% Cell Phone Allowance 15 180 30 17% Employer FICA 637 8,800 1,270 14% General Employees Pension 0 32,975 32,975 100% Life Insurance 0 42 0 0% Disability Insurance 0 561 0 0% Health Insurance 2,011 23,791 3,663 15% Dental Insurance 89 910 168 18% Vision Insurance 8 127 18 14% TOTAL PERSONNEL 11,460 180,936 55,474 31% OPERATING Audit Fees $ - $ 2,020 $ - 0% Cellular Phone/Beeper 0 360 0 0% Electric Service 65 1,000 134 13% Water /Sewer Service 52 600 52 9% Building Repairs 0 300 0 0% Vehicle Maint - Garage 156 13,018 1,042 8% Irrigation Maintenance 0 2,000 0 0% Self Insurance Chgs (W /C) 257 3,086 514 17% Warehouse Service Chg 54 646 108 17% Other Contractual Svcs 0 21,000 0 0% Office Supplies 0 0 0 0% Operating Equip < $750 0 900 0 0% Chemicals 250 1,000 250 25% Uniforms 0 500 34 7% Safety Clothing /Equip 0 590 0 0% Gardening Supplies 271 3,500 271 8% Equipment Parts /Supplies 683 3,200 683 21% TOTAL OPERATING 1,788 53,720 3,088 6% NON - OPERATING Transfer to General Fund $ 2,250 $ 27,000 $ 4,500 17% Transfer to Vehicle Svc Fund 544 6,528 1,088 17% Refund on Cemetery Lots 0 2,500 160 6% TOTAL NON - OPERATING 2,794 36,028 5,748 16% Expenditures - 632 (Mausoleum) OPERATING Litigation Fees & Costs $ - $ 5,000 $ - 0% Electric Service 265 2,200 608 28% Water /Sewer Service 343 4,000 343 9% Building Repairs 0 2,000 0 0% Other Contractual Services 0 12,000 52 0% Supplies 0 1,600 24 2% Equipment Parts /Supplies 0 0 0 0% Refund -Sale of Crypts 0 20,000 0 0% TOTAL OPERATING 608 46,800 1,027 2% Total Expenditures $ 16,650 $ 317,484 $ 65,337 21% Net Income Increase(Decrease) $ (3,675) $ - $ (39,812) 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 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 `� � L VVA >+. Original Certificate C. 'A ' C , SECTION CAL Contract CRYPT / NICH E V. -- .;1 f1 I (We) respectfully request a refund of the purchase price or current selling price, whichever is less, less 20 which we understand is the established policy. PURCHASE PRICE: $� LESS 20 % $ �3 AMOUNT TO BE RE UNDED: $ LA Signature: Signature: Print Name: — R 1 Tp �. t? f( �°�Y Print Name ~-� C Mailing Address: �k , c �z LC. t , (L LL.. Telephone # .�L /— ? 3 7 — 7 7 go�o Date: g �� STATE OF LD)e i COUNTY OF "t I HEREBY CERTIFY that on this day, before me, an officer dyly authorized inL e State aforesaid and in the County aforesaid to take acknowledgements, personally appeared r `r0NCp,--Ie— 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: FL t1 • Ke VEX s " AJSZ . WIT NE S my hand and official seal in the County and State last aforesaid this y V41 day of G D�GIH GAY' 2Q_/ - (Notary Seal) Notary Public 4LW Print Name My Commission Expires: k k ? . JUDITH A. PYLE * * MY COMMISSION t EE 871796 EXPIRES: Apt9 21, 2017 or n(39 Battled Thm 6WO Ndery SeNim S \CC \WP \CEMETERY \Mausoleum \Refunds12012 \Blank Refund Form Frazier Am 1 1 LU o a� o o m o O � Q) LL cri O �_ w+ U V 2 uj `ryti M .' • S o A`t Q � ., o v n m U d CO a °'c C X-1 Q Z te ° NJ as co �a 0 CO a — �im� m c W = ca o fi o b co m } Tj Q o N m� z co m °' V b a o o. Q. U o o L m O Q -_ z p i N m U • Z U . o� W amm O FZ j � O Q) � W m wo � m LL LL Q p � � z N Z o U o V N V @ Z U Q m N V p W cc �� o 0 -a o LL W c W o z - 3 "'00 LLJ o o o p ss = Iz c y a co c- w U Z o i -c ` Q U o QQm o X70 c`B ° W o 0 O u W 0 m o W a 4 O ~ZJO = co cza, � m U) Liq Ljj 2 _ z z 0 0 ��m 2Q I = co m�Q Z o� o Q O O LL C) Q��m Z° W C) o o >` a U W m Q � W cn o m Q (D E ( D O o ', or p� avc ZO oZ C W o Q m tL U 1 1 FUNERAL PURCHASE AGREEMENT - �- •. - .� Boynton Memorial Chapel 800 W, BOYNTON BEACH BLVD. • BOYNTON BEACH, FLORIDA 33426 • PHONE (561) 734 -5600 INFORMATION ON DECEASED Name of Deceased: A /Q - rR ON C Date of Death: t` 2 - f Z - l L Charge to: ( l"q -rig Q ") c e M e Address: 3 7 7 ,S l� d E C c� C z R� E City: i� a ',� - r- ' 6 E A C i / State: Zip: 3 3 `{ 3 / 6 Phone: STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those Items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any Items, we will explain the reasons in writing below. Item 1. The following SERVICES were ordered: Basic Services of Funeral Director and Staff ................................................................. ............................... Special Services of Funeral Director and Staff 1. 2. Embalming (Including use of preparation room and sanitary care) .......................... .............................. , If you selected a funeral that may require embalming, such as a funeral with viewing you may have to pay for embalming. You do not have to pay for embalming you did not approve If you selected arrangements such as a direct cremation or Immediate burial. If we charged for embalming, we will explain why below. Other Preparation of The Body SanitaryCare, without Embalming ......................................................................... ............................... So Dressing. Caskeflng & Cosmetology ...................................................................... ............................... Refrigeration charge for unembalmed remains ................................................... ............................... Use of Facilities, Staff and Equipment for: Visitation (viewing) Funeral Ceremony ................................................................................................... ............................... Memorial Services ..................................................................................................... ............................... Graveside Services ........................................................................... ........................---- ................ ..... Shelteringof Remains .............................................................................................. ............................... Other: Transfer of Remains to Funeral Home ............................................................................. ............................... Hearse.............................................. ............................... .......... ............................... Limousine ............................................... ...................`......�.... -t`;� ... `......� . ........... ............................... Sedan ................................................................................................................................. ............................... FlowerCar ........................................................................................................................ ............................... Other Automotive Equipment Utilized .......................................................................... ............................... OPTIONAL PACKAGED SERVICES: Traditional Funeral Service ...................................................................................... ............................... MemodaiService ..................................................................................................... ............................... ImmediateBurial ....................................................................................................... ............................... DirectCremation ...................................................................................................... ............................... Other: Total Item 1 . .................................................................................................................................................. .. Item 2. The following MERCHANDISE and other services were ordered: a Casket ...................................................... ............................... ..................................... ............................... 3 3,.a AlternativeContainer ......................... ............................... ........................................ ............................... Outer Buda[ Container ................................................................................................. ............................... Outer Shipping Container ............................................................................................ ............................... CremationContainer ................................................................................................... ............................... Cremation .............................................. ............................... . ................................. ............................... CremationUrn ................................... ................................ ...... ........... ... .................................................. Disposition of Cremated Remains ....................................................................... ............................... Storage Cremated Remains . ............................... ........................................... ............................... Mailing of Death Certificate(s) ........................ Memorial Package ....................t.... ...4.. `.'..�.....: ``..`.' .,t "...:` ........... ....... .......... ....... ........................ Clothing Flowers ................ . i:..:.;.......: :... ,..... ;.:. Y ... .... .. .... . ........ .... ... ;.I — Other Merchandise + l F; �,,.,. `. . c (W, 4 s TotalItem 2 ...................................................................................................................... ............................... �, Page 1 of 2 Name of Deceased: "\ �"r `' ' (f //' ` j ` 4 Date of Death: f - Page 2 of 2 Item 3. The following ACCOMMODATION ITEMS were ordered at an estimated price. The actual price will be reflected In the final billing. We charge you for our services in obtaining any of the following: Cemetery .................................................................................................. ............................... Transportation- Remains ........................................................................................ ............................... Transportation- Escort .............................................................................................. ............................... ..Gratulty to Clergy .................................................................................................... ............................... -- Organist...................................................................................................................... ............................... t Cremation Documentation ... .............................:„ ... _, . ,............................. Certified Copies of Death Certificate ................. .; ........ ".........� .... �,. ..... ...........`. ...................I........... OS� Telephone.................................................................................................................. ............................... Advance to Out of Town Funeral Director ............................................................. ............................... Motorcycle Service ........................ ............................... •............................... ............................... O. Vault Installation .... ............................... ....... 1111.... .1111..... Newspaper notices: �� C ' Totalcash advanced .............................................................................................. ............................... SUMMARY OF ACCOUNT TOTAL •.. .......•.••.. ............• Less: Amounts paid at time of arrangements or Into preneed account ..... ..1............... r BALANCE DUE ........................................................................................................... ............................... 5 F T Terms and Method of payment: Notes: The undersigned, Individually and Jointly, agree to pay for all Items of merchandise and services listed above If such items are used or provided. We have examined the above stated items and found them to be correct and according to the arrangements requested and hereby agree for ourselves and the estate of the deceased to pay for the Items provided or used according to the terms set forth above but no later than the date the service and merchandise Is provided, Payment shall be made to Boynton Memorial Chapel at the address set out herein; and If not paid in full by such date a default charge at the rate of 18% per annum may be charged on any portion of the unpaid balance due. It Is agreed that any additional items ordered in connection with the above shall be cash at the time ordered. If suit Is brought for collection of said amount or any portion thereof, we agree to pay a reasonable attorney's fee to be fixed by the Court and Included in the Judgement in such suit. DISCLAIMER OF WARRANTIES BOYNTON MEMORIAL CHAPEL MAKES NO WARRANTIES OR REPRESENTATIONS CONCERNING THE PRODUCTS SOLD HEREIN. THE ONLY WARRANTIES, EXPRESSED OR IMPLIED, GRANTED IN CONNECTION WITH THE PRODUCTS SOLD WITH THIS FUNERAL SERVICE, ARE THE EXPRESSED WRITTEN WARRANTIES, IF ANY, EXTENDED BY THE MANUFACTURERS THEREOF. BOYNTON MEMORIAL CHAPEL HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES, EXPRESSED OR IMPLIED, RELATING TO ALL SUCH PRODUCTS, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. If any legal, or cemetery, or crematory requirement has required the purchase of any of the Items listed above, we will explain the requirement below. ( ) 1. Crematory requires container to surround the remains; ( ) 2. Your cemetery requires an outer burial container; or ( ) 3. Other: REASON FOR EMBALMING: (V Family authorized ( ) Preneed Contract Authorized ( ) Other I have prepared this Statement of Funeral Goods and Services Selected: , Print Name of Licensed Funeral Director 7' G^� P*� License ' " Signature of Licensed Funeral Director I have read and received a copy of the Statement of Funeral Goods and Services Selected this T. day of Name Relationship Name Relationship Street Address Sheet Address City / State Zip City / State Zip 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 REFUND CEMETERY BOARD CITY CLERK'S OFFICE CITY OF BOYNTON BEACH 100 E BOYNTON BEACH BLVD, BOYNTON BEACH FL 33435 I (We), the un dersigned, do hereby submit the deed to Cemetery lots, more particularly described as: LOT J S) s ' J U B LOCK BOYNTON BEACH MEMORIAL PARK ADDITION #1 I (We) respectfully request a refund of the purchase price less 20% which we understand is the established policy. PURCHASE PRICE: $ LESS 20% $ 1 , AMOUNT TO E REFUNDED: $ (�, C::>= Signature:` i k Signature: Print Name: Print Name: Mailing Address: 7jar6� r f v n Telephone 7 Y/ Date: f O — : 5 STATE OF Td COUNTY OF FA-C 14 I HEREBY CERTIFY that on this day, before me, an officer d y authorized in $h� Star aforesaid and in the County aforesaid to take acknowledgements, personally appeared jd� 1e1 A *3lv'<IA40 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: AL. Ar/.ew 4 Aj S E- my had and official sea the County and State last aforesaid this �'7`d ay of W MA (Notary Seal) AM A.PYLE No Publi y� * * MY COMMISSION t EE 671796 EXPIRES:Apd21,2011 print Name My Commission Expires: F�"`k WW dnm&4dNftySwIM a r S• \CC \WP \CEMETERY \Forms \Blank Refund Form.doc AFFIDAVIT OF LOST CEMETERY DEED BEFORE ME, the undersigned authority, personally appeared Cc "Affiant "), who, being first duly sworn on oath, deposes and says: 1. That on 2�5 e- T ,'1 f iE CITY OF BOYNTON BEACH executed a Deed in the amount of °7 5 C> in favor of C-.-n roc,, C \+1\ k 2. That the City of Boynton Beach delivered and Affiant accepted the Cemetery Deed for , dated 3. That 3 c, C, • t �, been unable to locate the original or copy of the Cemetery Deed, despite her best efforts to do so. 4. That „ nnot reasonably obtain possession of the instrument because the instrument was either destroyed or its whereabouts cannot be determined. AFFIANT FURTHER SAYETH NAUGHT. By: STATE OF FLORIDA COUNTY OF PALM BEACH ,,r�” The foregoing instrument was acknowledged before me on this b??" day of Gv , 20 /3 b , who is personally known to me or has produced a valid Florida Driver's License as identifica * MY COMMISSION 1 EE 871796 NOTARY PUBLI EXPIRES: Apd 21, 2D17 40 IrN S \CC \WP \CEMETERY \Forms \Affidavit of Lost Cemetery Deed doc MUNICIPAL CEMETERY City of Boynton Beach LOT DEED Know All Men by 2Fese 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 principal place of business in the County of Palm Beach of said State, party of the first part, in consideration of Seven Hundred Fifty Dollars, which is hereby acknowledged to have been paid by Anna C. Kline patty of the second pan, of the County of Palm Beach , State of __ Florida , doth hereby grant, bargain, sell and convey to the said pan v _ of the second pan, _ her 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 County, to -wit. Lot numbered _ 357 B Block S 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 pan 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 z l n:les, rt clations and S -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 u, 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 to accordance therewith And the said City of Boynton Beach does hereby covenant with the said pan of the second pan, 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 premises are free from all encumbrances and that the said city has good right to sell and convey the same to the said pan V_ of the second part, in the manner and for the purposes aforesaid, and will warrant and defend the same unto the said pan y the second pan, her heirs and assigns, forever r nt V£D O RM o �4 U v' �' ro ) m w ro� o u ^� 61 �, en, myi ,+wciR�oe �:�.: sa.iidxa uoisSTwwoo AIN [631 S Wjtl 1 - 22SE '1 le Epuold ;o 2 121 $ n)lidn 90191rJo I NotmnmW AA SNW903 3A3 „ oq1 io3 pue ui ollgnd kmION %61 Q•V zagwa aS JO fVP 14g8 a141'epuold gaeaH u o -4uXog' ie TEas 4w poxijE pug puey Aw las olun=g anrq 'spaap 3o swowSpafmouxor axe, of Epuold jo sMel aql i2pun pazpoglnz Alnp ioo►j}o uE 'I 'dogNM4M SSdNJIM NJ •oiwagp uopraodioo p irs ;o lEas 2miod 2141 pax33E at( 1Egl pug pmszjo v IOAVW 24 Aq paap S UTOS3.IOJ aq, ;o uotlnoaxa aq1 ' )IialJ su Wund2o siq ui'polsour ay 1241 pa$palMOROE PUB 'A lto pms ;O x aql SE um OUx Clam aw Ol usnsx • W auuEznS paieaddE oslu aw ato;oq pue 'joaiogi .iokuW SE kiio2dEO siq ui ptm q1to pigs ;o poap aqp .ioj pug sE aotmAonuoo SuloSaio3 2tp painoaxa 2g IEgi po2pGImou>I3E pu 'ummodioo lgdtoiunw E 'gpuold'goEag uolUXOG 3o fa!Z) agI }o.10AV v ag, sE umo" Ijam aw o, xoT ea, p l e xaJ pnn2dde AllEuostad 2w aiopq V X110 - H d0 FIIVIS 'SS HOVHS W'Ibd dO AJNfIOJ j -xiaiJ te r` )o 03insaid aqi m pWangap pue polEas•POUSIS 143VH1i NO.I.NAOR JO A.1.13 S661 Q V abgwa- aS ,loXup ggg Za siq, 'leas al eiOdtoa Sit gpim palEas puE ')P*I,) sil nq poisouE 'icAVyq sit Xq pou8is oq of s,uaswd 2sag1 pasnE:i se14 'uonwodm lEdiolunw E -bong uo,uAog,lo Api7 pies 241 .103UaHm SS3NLIM Ni i i 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 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) -S 5 1 - A SLOCK BOYNTON BEACH MEMORIAL PARK ADDITION 01 I (We) respectfully request a refund of the purchase price less 20% which we understand is the established policy. PURCHASE PRICE: $ LESS 20% $ i C AMOUNT T BE REFUNDED: $ � b � r.) Signature 1 � Signature: Print Name: K1 Print Name: Mailing Address: 7 7 Telephone # �� 7l�'- 110 �/ Date: f STATE OF COUNTY O I HEREBY CERTIFY that on this day, before me, an officer d�j�' authorized in the State aforesaid and in the County aforesaid to take acknowledgements, personally appeared >'/J'7x /A /C • /1 o /�/ N 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: ,�� - D s 61C W ESS ryiy hand and official seal in the County and State last aforesaid this day of �!3 (Notary Seal) No Public L '::r � Print Name My Commission Expires: S: \CC \WP \CEMEfERY\Forms \Blank Refund Form.doc CEMETERY REPORT NOVEMBER 2013 BOYNTON BEACH MEMORIAL FUND (CEMETERY TRUST FUND) SALES THIS CURRENT FROM CUMULATIVE $ MONTH MONTH $ 10/01/2012 YEAR TO DATE SALES OF LOTS BBM PARK 4 $2,100.001 108 $66,525.00 SARA SIMMS 0 $0.00 0 0.00 CONTRACT SALES 0 $0.00 0 $0.00 MAUSOLEUM Crypts & Niches 0 $0.00 17 $78,350.00 Contract Sales 0 $0.00 0 $0.00 Mausoleum Open and Close 1 $0.00T $0.00 Refunds - Cemetery 0 $0.00 3 - $1,560.00 Refunds - Mausoleum 0 $0.00 4 - $13,576.10 GENERAL FUND Cemetery Open and Close 5 $1,150.001 169 $63,000.00 Use of Equipment 5 $500.00 113 $11,300.00 Transfer of Deeds 0 $0.00 1 $75.00 Disinterments 0 $0.00 2 $1,700.00 Setting of Markers 0 $0.00 65 $0 Mausoleum Vases 0 $0.00 16 $2,425.00 Mausoleum Emblems /addl. Engraving 0 $0.00 11 $1,300.00 Urn Vaults 0 $125.001 9 $1,250.00 $3,875.00 $210,788.90 TYPE OF SALES Resident lReguiar 4 80 Resident lCremains 101 5 Non - Resident Regular 0 22 Non - Resident Cremains 0 0 Infant Lots Infant 0 7 S \CC\WP\CE METE RY\C E M E T E R Y MONTHLY REPORT \2013 \CE METE RY REPORT 11 -13 As AVAILABILITY BOYNTON BEACH MEMORIAL PARK AS OF NOVEMBER 2013 BLOCK # FOR SALE SOLD AVAILABLE B 219 219 0 C 219 219 0 D 219 219 0 E 219 219 0 F 219 219 0 G 208 208 0 H 44 44 0 I 132 132 0 ] 82 82 0 K 87 87 0 M 336 336 0 N 1,357 1,357 0 0 1,346 1,345 1 R 848 848 0 S 1,002 1,002 0 W 380 380 0 Y 416 416 0 TOTALS 7 333 7 332 1 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT REGULAR 220 220 0 CREMAINS 220 187 33 TOTALS 440 407 1 33 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT 2 REGULAR 278 278 0 CREMAINS 62 4 58 TOTALS 1 340 1 282 1 58 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT 3 REGULAR 360 286 74 DOUBLE DEPTH 30 2 28 TOTALS 390 288 102 INFANT LOTS FOR SALE SOLD AVAILABLE BLOCK L 304 304 0 REPLAT L 79 30 49 TOTALS 383 334 49 GRAND TOTALS 8 886 8 643 243 SARA SIMMS MEMORIAL GARDENS ADULT LOTS 9'X4' 659 212 447 INFANT LOTS 6'X4' 150 56 94 S \CC\WP \CEMETERY \C E M E T E R Y MONTHLY REPORT \2013 \CE METE RY REPORT 11 -13 As MAUSOLEUM AVAILABILITY AS OF NOVEMBER 2013 BUILDING FOR SALE CRYPT NICHE SOLD AVAILABLE Benediction 3 2 1 1 2 Chapel 0 0 0 0 0 Devotion 5 5 0 1 4 Serenity 10 10 0 3 7 Sunrise 2 0 2 1 1 Sunset 12 11 0 5 8 TOTALS 3 1 28 3 1 11 1 22 S \CC \WP \CEMETERY \C E M E T E R Y MONTHLY REPORT \2013 \CEMETERY REPORT 11 -13 As CEMETERY REPORT OCTOBER 2013 BOYNTON BEACH MEMORIAL FUND (CEMETERY TRUST FUND) SALES THIS CURRENT FROM CUMULATIVE MONTH MONTH $ 10/01/2012 YEAR TO DATE SALES OF LOTS BBM PARK 10 $6,625.001 104 $64,425.00 SARA SIMMS 0 $0.001 01 0.00 CONTRACT SALES 0 $0.00 0 $0.00 MAUSOLEUM Crypts & Niches 1 $14,500.00 17 $78,350.00 Contract Sales 0 $0.00 0 $0.00 Mausoleum Open and Close 1 2 $0.00 56 $0.00 Refunds - Cemetery 0 $0.00 3 - $1,560.00 Refunds - Mausoleum 0 $0.00 4 - $13,576.10 GENERALFUND Cemetery 0 en and Close 1 13 $4,900.001 164 $61,850.00 Use of Equipment r 8 $800.00 108 $10,800.00 Transfer of Deeds 0 $0.00 1 $75.00 Disinterments 0 $0.00 2 $1,700.00 Setting of Markers 0 $0.00 65 $0 Mausoleum Vases 3 $450.00 16 $2,425.00 Mausoleum Emblems /addl. Engraving 6 $675.00 11 $1,300.00 Urn Vaults 1 $125.001 9 $1,125.00 $28,075.00 $206,913.90 TYPE OF SALES Resident lRegular 91 76 Resident Icremains 1 01 5 Non - Resident Regular 3 22 Non - Resident Cremains 0 0 Infant Lots Infant 1 1 7 S \CC \WP \CEMETERY \C E M E T E R Y MONTHLY REPORT\2013 \CE METE RY REPORT 10 -13 As AVAILABILITY BOYNTON BEACH MEMORIAL PARK AS OF OCTOBER 2013 BLOCK # FOR SALE SOLD AVAILABLE B 219 219 0 C 219 219 0 D 219 219 0 E 219 219 0 F 219 219 0 G 208 208 0 H 44 44 0 I 132 132 0 3 82 82 0 K 87 87 0 M 336 336 0 N 1,357 1,357 0 0 1,346 1,344 2 R 848 848 0 S 1,002 1,002 0 W 380 380 0 Y 416 416 1 0 TOTALS 7,333 7 2 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT REGULAR 220 220 0 CREMAINS 220 187 33 TOTALS 440 407 33 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT 2 REGULAR 278 278 0 CREMAINS 62 4 58 TOTALS 340 282 58 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT 3 REGULAR 360 281 79 DOUBLE DEPTH 30 2 28 TOTALS 390 283 107 INFANT LOTS FOR SALE SOLD AVAILABLE BLOCK L 304 304 0 REPLAT L 79 30 49 TOTALS 383 334 49 GRAND TOTALS 8 886 8 249 SARA SIMMS MEMORIAL GARDENS ADULT LOTS 9'X4' 659 212 447 INFANT LOTS 6'X4' 150 56 94 S \CC\WP\CE METE RY\C E M E T E R Y MONTHLY REPORT \2013 \CEMETERY REPORT 10 -13 As MAUSOLEUM AVAILABILITY AS OF OCTOBER 2013 BUILDING FOR SALE CRYPT NICHE SOLD AVAILABLE Benediction 3 2 1 1 2 Chapel 0 0 0 0 0 Devotion 5 5 0 1 4 Serenity 10 10 0 3 7 Sunrise 2 0 2 1 1 Sunset 12 11 0 5 8 TOTALS 32 28 3 11 22 S \CC\WP\CE METE RY\C E M E T E R Y MONTHLY REPORT\2013 \CEMETERY REPORT 10 -13 As CEMETERY REPORT SEPTEMBER 2013 BOYNTON BEACH MEMORIAL FUND (CEMETERY TRUST FUND) SALES THIS CURRENT FROM CUMULATIVE $ MONTH MONTH $ 10/01/2012 YEAR TO DATE SALES OF LOTS BBM PARK 8 $5,400.001 94 $57,800.00 SARA SIMMS 0 $0.00 01 0.00 CONTRACT SALES 0 $0.00 0 $0.00 MAUSOLEUM Crypts & Niches 2 $10,750.001 16 $63,850.00 Contract Sales 0 $0.00 0 $0.00 Mausoleum Open and Close 4 $0.00 54 $0.00 Refunds - Cemetery 1 2 - $960.00 3 - $1,560.00 Refunds - Mausoleum 2 - $3,916.80 4 - $13,576.10 GENERAL FUND Cemetery Open and Close 15 $6,000.001 151 $56,950.00 Use of Equipment 91 $900.00 100 $10,000.00 Transfer of Deeds 0 $0.00 1 $75.00 Disinterments 0 $0.00 2 $1,700.00 Setting of Markers 6 $0.00 65 $0 Mausoleum Vases 0 $0.00 13 $1,975.00 Mausoleum Emblems /addl. Engraving 0 $0.00 5 $625.00 Urn Vaults 0 $0.00 8 $1,000.00 $18,173.20 $178,838.90 TYPE OF SALES Resident lRegular 61 67 Resident lCremains 1 01 5 Non - Resident Regular 2 19 Non - Resident Cremains 0 0 Infant Lots Infant 0 6 S \CC \WP \CEMETERY \C E M E T E R Y MONTHLY REPORT \2013 \CEMETERY REPORT 09 -13 As AVAILABILITY BOYNTON BEACH MEMORIAL PARK AS OF SEPTEMBER 2013 BLOCK # FOR SALE SOLD AVAILABLE B 219 219 0 C 219 219 0 D 219 219 0 E 219 219 0 F 219 219 0 G 208 208 0 H 44 44 0 I 132 132 0 1 82 82 0 K 87 87 0 M 336 336 0 N 1,357 1,356 1 0 1,346 1,344 2 R 848 848 0 S 1,002 1,002 0 W 380 380 0 Y 416 416 0 TOTALS 7 333 7 330 3 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT REGULAR 220 220 0 CREMAINS 220 187 33 TOTALS 440 407 33 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT 2 REGULAR 278 278 0 CREMAINS 62 4 58 TOTALS 340 282 58 ADULT LOTS FOR SALE SOLD AVAILABLE REPLAT 3 REGULAR 360 271 89 DOUBLE DEPTH 30 2 28 TOTALS 390 273 117 INFANT LOTS FOR SALE SOLD AVAILABLE BLOCK L 304 304 0 REPLAT L 79 29 50 TOTALS 383 333 50 1GRANDTOTALS1 8 886 1 8,625 261 SARA SIMMS MEMORIAL GARDENS ADULT LOTS 9'X4' 659 212 447 INFANT LOTS 6'X4' 150 56 94 S \CC \WP \CEMETERY\C E M E T E R Y MONTHLY REPORT \2013 \CEMETERY REPORT 09 -13 As MAUSOLEUM AVAILABILITY AS OF SEPTEMBER 2013 BUILDING FOR SALE CRYPT NICHE SOLD AVAILABLE Benediction 3 2 1 1 2 Chapel 0 0 0 0 0 Devotion 5 5 0 0 5 Sereni 10 10 0 3 7 Sunrise 2 0 2 1 1 Sunset 12 11 0 5 8 TOTALS 32 28 3 10 23 S \CC \WP \CEMETERY \C E M E T E R Y MONTHLY REPORT \2013 \CE METE RY REPORT 09 -13 As BOYNTON BEACH MEMORIAL PARK BURIAL AND ENTOMBMENT REPORT To: Janet Prainito, City Clerk From: Tom Balfe, Parks Manager XC: Christine Roberts, Assistant Public Works Director Dwight Saulter, Crew Supervisor File Date: November 26, 2013 SUBJECT: End of the Quarter Report- September, October & November 2013 Attached is a listing for all burials, entombments and inurnments for the City's cemeteries for the months of September thru November 2013. All names in red are weekend funerals. Mausoleum Entombments ------ - - - - -- 9 Mausoleum Inurnment ------------ - - - - -- 2 Ground Full Body Burials -------- - - - - -- 40 Ground Cremains ----------------- - - - - -- 4 Total Funera ls--------------------- --- - -- 55 Disentombment/Disinterment -- - - - - -- 0 Disinurnment--- --------------------------- 0 Please let me know if you need additional information. 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