HomeMy WebLinkAboutRESOLUTION NO. 2016-95 Fairfax419915-23/WaterRevBAN Issric
MINUTES PROVIDING FOR THE
ISSUANCE OF A WATER REVENUE
BOND ANTICIPATION PROJECT NOTE
419915-23
Fairfax, Iowa
August 23, 2016
The City Council of the City of Fairfax, Iowa, met on August 23, 2016, at 6:00 o'clock
p.m,, at the City Hall, Fairfax, Iowa.
The meeting was called to order by the Mayor, and the roll being called, the ,following
named Council Members were present and absent:
Present: JoAnn Beer, Joe Kell, Nick Volk, Mike Daly, and Marianne Wainwright
Absent: None.
It was reported that, on August 9, 2016, the City Council had awarded the sale of its
Water Revenue Bond Anticipation Project Notes in the amount of $445,000 to Fairfax State
Savings Bank, and that it was now necessary for the Council to authorize the issuance of those
Notes.
Council Member Beer introduced and moved the adoption of the resolution next
hereinafter set out; seconded by Council Member Daly. After due consideration, the Mayor put
the question on the motion and the roll being called, the following named Council Members,
voted:
Ayes: Beer, Volk, Daly, and Wainwright
Nays: None
Abstain,: Kell,
Whereupon,the Mayor declared the resolution duty adopted, as hereinafter set out.
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At the conclusion of the meeting, and upon motion and vote,the City Council adjourned.
Burnell G. 1~rieden, Mayor
Attest:
hL'p,"J!! a.... o�e�ie iv�ati '@oaes1 4�
Cynt is K. Stimson,°City Clerk/Treasurer0 CL
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DORSEY&WHITNEY UP,ATTORNEYS,DRS MOINES,IOWA
'airffax419915-23/WaterRevBAN Tssac
RESOLUTION NO. 2016-95
RESOLUTION PROVIDING FOR. THE ISSUANCE OF A $445,000
WATER REVENUE BOND ANTICIPATION PROTECT NOTE
WHEREAS, pursuant to notice duly published and a hearing held thereon, the City
Council of the City of Fairfax, Iowa, has the legal authority to enter into a loan agreement (the
"'Loan Agreement") in a principal amount not to exceed $500,000 and to issue Water Revenue
:Bonds in evidence thereof pursuant to the provisions of Section 384.24A of the Code of Iowa,
for the purpose of paying the cost, to that extent, of constructing improvements to the Municipal
Waterworks System (the "Project") and
WHEREAS, pursuant to the provisions of Section 76.13 of the Code of Iowa, the City
has authority to issue project notes in anticipation of the receipt of the proceeds from the Loan
Agreement (the "Loan Proceeds"); and
WHEREAS, on August 9, 2016, the City Council awarded the sale of its Water Revenue
Bond Anticipation Project Notes in the amount of$445,000 to Fairfax State Savings Bank; and
WHEREAS, it is necessary at this time to make provision for the issuance of a project
note in the amount of$445,000 (the "Project Note") in anticipation of the receipt of and payable
from the Loan Proceeds;
NOW, THEREFORE, Be It Resolved by the City Council of the City of Fairfax, 'Iowa, as
follows:
Section 1. The Project Note is hereby authorized to be issued to Fairfax State Savings
Bank, Fairfax, Iowa (the "Purchaser"), in anticipation of the receipt of and being payable from
the Loan Proceeds or from other sources to be received and expended in connection with the
Project. The Project Note shall be signed by the Mayor and attested by the City Clerk, shall be
dated September 1, 2016, shall mature on June 1, 2019, and shall bear interest at the rate of
2.25% per annum, payable on each June 1 and December I to maturity, beginning June 1, 2017,
except as the provisions hereinafter set forth with respect to redemption prior to maturity may be
or become applicable hereto.
Section 2. Advances on the Project Note may be requested by the City Clerk, in such
amounts and at such times as are needed to pay costs of the Project, and the date and amount of
each advance shall be entered by the Purchaser on the Schedule of Advances and Payments on
the Project Note, and each advance shall bear interest from the date of such entry.
The City Clerk is hereby designated as the Registrar and Paying Agent for the Project
Niue and may be hereinafter referred to as the "Registrar" or the "Paying Agent."
The City reserves the right to prepay principal of the Project Note in whole or in part on
June 1, 2017 or any date thereafter prior to maturity upon. terms of par and accrued interest, All
principal so prepaid shall cease to bear interest on the redemption date,
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The Project Note shall be fully registered as to both principal and interest in the name of
the owner in the records of the City kept for such purpose, after which no transfer shall be valid
unless made on said records by the City Clerk, and then only upon a written instrument of
transfer satisfactory to the City, duly executed by the registered owner or the duly authorized
attorney for such registered owner.
The City shall maintain as confidential the record of identity of owners of the Project
Note, as provided by Section 22.7 of the Code of Iowa.
Section 3.. The Project Note shall be in substantially the following form.
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DORSEY&WHITNEY LLP,ATTORNEYS,DES MOINES,IOWA
Fairfax,119915-231WaterRevBAN Issnc
(Form of Project Note)
UNITED STATES OF AMERICA
STATE OF IOWA
COUNTY OF LINK
CITY OF FAIRFAX
WATER REVENUE BOND ANTICIPATION PROJECT NOTE
DATED DATE: September 1, 2016
MAXIMUM PRINCIPAL AMOUNT: $445,000
INTEREST RATE: 2.25%
MATURITY DAME: .lune 1, 2019
CUSIP:
The City of Fairfax, Iowa (the "City"), for value received, promises to pay on the
Maturity Date to Fairfax State Savings Bank, Fairfax, Iowa (the "Purchaser"), its successors or
assigns, the principal sum of FOUR HUNDRED FORTY-FIVE THOUSAND DOLLARS
($445,000), or so much thereof as has been advanced by the Purchaser hereunder and noted an
the Schedule of Advances and Payments hereon, in lawful money of the United States of
America upon presentation and surrender of this Project Note to the City Clerk, Fairfax, Iowa
(hereinafter referred to as the "Registrar" or the "Paying Agent"'), with interest thereon from the
date of each advance until paid at the rate of 2.25% per annum, payable on each rune 1 and
December 1 to maturity, beginning .lune 1, 2017, or upon prepayment of this instrument as
hereinafter provided.
The Purchaser has made a commitment to make advances (the "Advances") to the City in
an aggregate principal amount not to exceed $445,000 under this Project Note. Each such
Advance made by the Purchaser shall be entered by the Purchaser on the Schedule of Advances
and Payments and shall bear interest from the date of such entry.
This Project Note is issued by the City for the purpose of paying costs in connection with
constructing improvements to the Municipal Waterworks System (the "Project") and is issued
under authority of Section 76.13 of the Code of Iowa in anticipation of the receipt of and is
payable solely and only from the future proceeds (the "Loan Proceeds") of an authorized loan
agreement.
A sufficient portion of the Loan Proceeds has been appropriated to the payment of this
Project Note and may also be appropriated to the payment of other obligations issued to pay
costs of the Project.
The City reserves the right to prepay principal of this Project Note, in whole or in part, on
June 1, 2017, or on any date thereafter prior to its maturity upon terms of par and accrued interest
to the date of such prepayment. All principal of this Project Note so prepaid shall cease to bear
interest on the prepayment date..
This Project Note shall be fully registered as to both principal and interest in the name of
the owner in the records of the City kept for such purpose, after which no transfer shall be valid
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unless made on said records by the City Clerk, and thenn only upon a written instrument of
transfer satisfactory to the City, duly executed by the registered owner or the duly authorized
attorney for such registered owner.
And It Is Hereby Certified, Recited and Declared that all acts, conditions and things
required to exist, happen and be performed precedent to and in the issuance of this Project Note
have existed, have happened and have been performed in due time, form and manner, as required
by law, and that the issuance of this Project Note does not exceed or violate any constitutional or,
statutory limitation or provision.
1N TESTIMONY WHEREOF, the City of Fairfax, Iowa, by its City Council, has caused
this Project Note to be executed by its Mayor and attested by the City Clerk, as of September 1,
2016.
CITY OF FAIRFAX, IOWA
By_[DO NOT SIGN]
Mayor
Attest:
[DO NOT SIGNI
City Clerk
SCHEDULE OF ADVANCES AND PAYMENTS
Date of Signature of
Advance or Amount Authorized
1'a ment ,advanced Amount Repaid a � 01".6cel of Purchaser
$
$ $
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Section 4. The Loan Proceeds anticipated to be received tinder. the Loan Agreement
are hereby appropriated to the payment of the Project Note and may also be appropriated to the
payment of other obligations issued to pay costs of the Project.
The Project Note is a limited obligation of the City payable solely and only from the
Loan Proceeds and shall not constitute a general obligation of the City, nor shall it be payable in
any manner by taxation.
Section 5. It is the intention of the City that interest on the Project Note be and
remain excluded from gross income for federal income tax purposes pursuant to the appropriate
provisions of the Internal Revenue Code of 1986, as amended, and the Treasury Regulations in
effect with respect thereto (all of the foregoing herein referred to as the "Internal Revenue
Code"). In furtherance thereof, the City covenants to comply with the provisions of the Internal
Revenue Code as they may from time to time be in effect or amended and further covenants to
comply with the applicable future laws,regulations, published rulings and court decisions as may
be necessary to insure that the interest on the Project Note will remain excluded from gross,
income for federal income tax pin-poses. Any and all of the officers of the City are hereby
authorized and directed to take any and all actions as may be necessary to comply with the
covenants herein contained.
The City hereby designates the Project Note as a "Qualified Tax Exempt Obligation" as
that term is used in Section 265(b)(3)(B) of the Internal Revenue Code.
Section 6. All resolutions or parts tliereof in conflict herewith are hereby repeated to
the extent of such conflict.
Passed and approved August 23, 2016.
Burnell G. Frieden, Mayor
Attest:
�Nx
Cyntis K. Stimson, City Clerk Treasurer
X
oil
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STATE OF IOWA
CITY OF FAIRFAX SS,
I, the undersigned, City Clerk of the City of Fairfax, do hereby certify that attached
hereto is a true and correct copy of the proceedings of the City Council relating to a certain Loan
Agreement and the issuance of a$445,000 Water Revenue Bond Anticipation Project Note.
WITNESS MY HAND this 241h day of August, 2016.
Cynthia K. Stlrr'son, City Clerk/Treasurer
I
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Fairfax/419915-23!Closing Cert.-Water Rey, FOR YOUR RECORDS
CLOSING CERTIFICATE
We, the undersigned Mayor and City Clerk, of the City of Fairfax, Iowa (the "City"), do
hereby certify as of September 11, 2016 (the "Dated Date"), with respect to the Water Revenue
Bond Anticipation Project Note (the "Project Note") in the maximum principal amount of
$445,000, presently being delivered by the City, as follows:
1. The City is issuing and delivering the Project Note simultaneously with the
delivery of this certificate for the purpose of constructing improvements to the Municipal
Waterworks System (the "Project").
2. The Project Note is payable from the proceeds of an authorized loan. agreement
(the "Loan Agreement") and the corresponding issuance of water revenue bonds or notes, or
from other sources to be received and expended in connection with the Project.
3. Fairfax State Savings Bank (the "Purchaser") shall loan to the City the maximum
sura of$445,000, and the City's obligation to repay shall be evidenced by the issuance of the .
Project Note, in the maximum principal amount of$445,000. Advances on the Project Note may
be requested from time to time by the City, and the date and amount of each advance shall be
entered by the Purchaser on the Schedule of Advances and Payments to the Project Note. Each
advance shall bear interest from the date of such entry. The City has received an intial advance of
not less than $22,251 on the Dated Date.
4. Vire further certify that no controversy or litigation is pending, prayed or
threatened involving the incorporation, organization, existence or boundaries of the City, or the
titles of the aforesaid officers to their respective positions, or the validity of the Project Note, or
the power and duty of the City to provide for the full and prompt payment of the principal of and
interest on the Project Note, and that none of the proceedings incident to the authorization and
issuance of the Project Note has been repealed or rescinded.
5. We further certify that no petition of protest or objections of any kind have been
filed or made objecting to the Loan Agreement or to the issuance of the Project Note, and that no
appeal of the decision of the City Council to enter into the Loan Agreement or to issue the
Project Note has been tail=to the district court.
6. We further certify that all meetings held in cormection with the Loan Agreement
and the Project Note were open to the public at a place reasonably accessible to the public and
that notice was given at least 24 hours prior to the commencement of all meetings by advising
the news media who requested notice of the time, date, place and the tentative agenda and by
posting such notice and agenda at the City Hall or principal office of the City on a bulletin board
or other prominent place which is easily accessible to the public and is the place designated for
the purpose of posting notices of meetings.
7. The net sales proceeds of the Project Note are $445,000 (the "Net Sales
Proceeds"), the same being the Issue Price (hereinafter defined) thereof.
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8. ':1"he Net Sales Proceeds, including, investment earnings thereon will be invested
by'the City without restriction as to yield for a period not to exceed three years from the date
hereof(the "Three Year Temporary Period"), the following three tests being reasonably expected
to be satisfied by the City:
(a) Time Test: The City has entered into or, within six months of the date
hereof, will enter into binding contracts with third parties (e.g. engineers or contractors);
(i) which are not subject to contingencies directly or indirectly within.
the City's control;
(ii) which provide for the payment by the City to such third parties of
an amours equal to at least 5% of the Net Sales Proceeds;
(b) :expenditure Test, At least 85% of the Net Sales Proceeds will be applied
to the payment of the total cost of the Project within the Three Year Temporary Period.;
and
(c) Due Diligence Test: The Project and the application of the Net Sales
Proceeds to the payment of the total costs of the Project will proceed with due diligence.
9. The City Council adopted a resolution on May 17, 2016 declaring its official
intent to acquire and construct the Project and finance the same with bonds or other obligations
(the "Intent Resolution").
The City certifies that none of the costs of the Project to be paid for from the Net Sales
Proceeds are for expenditures made more than 60 days prior to the date of adoption of the Intent
Resolution, except for (i) costs of issuance of the Project Note; (ii) costs aggregating an amount
not in excess of the lesser of $100,000 or 5% of the Net Sales Proceeds; (iii) costs for
preliminary expenditures (including architectural, engineering, surveying, soil testing, and
similar costs incurred prior to commencement of acquisition or construction of the Project, other
than land acquisition, site preparation and similar costs) not in excess of 20% of the Net Sales _
Proceeds of the Project Note; the City will allocate Net Sales Proceeds to reimbursement of such
expenditures no later than 3 years after the later of (i) the date any such expenditure was
originally paid or (ii) the date the Project is placed in service (or abandoned); and such
allocations will be made by the City in writing.
The City will seek reimbursement of prior expenditures already paid by the City from the
proceeds of the Project Note in the amount of$139,362,08.
10. Not more than 50% of the Net Sales Proceeds will be invested in nonpurpose
investments [as defined in Section 148(f)(6)(A) of the Internal Revenue Code of 1986, as
amended (the "Code")] having a substantially guaranteed yield for four years or more (e.g., a
four-year guaranteed investment contract or a Treasury Obligation that does not mature for four
years).
11. The weighted average maturity of the Project Note, 2.750 years, does not exceed.
the reasonably expected economic life of the Project.
12. To our best knowledge and belief, there are no facts, estimates or circumstances
which would materially change the foregoing conclusions,
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13. On the basis of the foregoing, it isnot expected that the Net Sales Proceeds will
be used in a manner that would cause the Project Note to be an "arbitrage bond" under
Section 148 of the Code and the regulations prescribed under that section. The City has not been
notified of any listing or proposed listing of it by the Internal Revenue Service as a Note issuer
whose arbitrage certifications may not be relied upon.
14. We further certify that the City does not currently have outstanding tax exempt.
obligations issued during the current calendar year, including the Project Note, in excess of
$5,000,000, nor will the City issue additional tax exempt obligations during the current calendar:
year which, when added to the City's current tax exempt obligations issued during the current
calendar year, including the Project Note, would be in,excess of$.5,000,000.
IN WITNESS WHEREOF, we have hereunto affixed our hands on Dated Tate.
CITY OF FAIRFAX, IOWA
Mayor
Attest:
a
_ f2 ;;� 4
City ;Jerk
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DORSEY &WHITNEY LLP, ATTORNEYS,DES MOINES,IOWA
OQRSEY-
DORSEY & WH[r�`J','Y LLP
September 1, 2016
City of Fairfax Fairfax State Savings Bank
Fairfax, Iowa Fairfax, Iowa
We hereby certify that we have examined certified copies of the proceedings (the
"Proceedings") of the City Council of the City of Fairfax (the "Issuer"), in Linn County, Iowa,
passed preliminary to the issue by the Issuer of its Water Revenue Bond Anticipation Project
Note (the "Project Note") dated September 1, 2016, in a principal amount not exceeding
$445,000, or so much thereof as may be advanced to the Issuer pursuant to the terms of the
Project Note.
The Project Note matures on June 1, 2019, and bears interest at the rate of 2.25% per
annum, payable semiannually on each June I and December I to maturity, beginning June 1,
2017, Principal of the Project Note is subject to prepayment, in whole or in part, on June 1,
2017, or on any date thereafter upon terins of par and accrued interest to the date of such
prepayment.
Based upon our examination, we are of the opinion, as of the date hereof,that:
I. The Proceedings show lawful authority for such issue under the laws of the State
of Iowa,
2. The Project Note is a valid and binding special obligation of the Issuer.
3. The Project Note is being issued in anticipation of and is payable from loan
proceeds to be received pursuant to an authorized Loan Agreement of the Issuer in a principal
amount not to exceed $445,000 and the corresponding issuance of Water Revenue Bonds or
Notes, which proceeds the Issuer has appropriated to pay the principal of and interest on the
Project Note.
4. The interest on the Project Note is excluded from gross income for federal income
tax purposes and is not an item of tax preference for purposes of the federal alternative minimum
tax imposed on individuals and corporations; it should be noted, however, that for the purpose of
computing the alternative minimum tax imposed on corporations (as defined for federal income
tax purposes), such interest is taken into account in determining adjusted current earnings. The
opinions set forth in the preceding sentence are subject to the condition that the Issuer comply
with all requirements of the Internal Revenue Code of 1986 (the "Code") that must be satisfied
subsequent to the issuance of the Project Note in order that interest thereon be, or continue to be,
excluded from gross income for -federal income 'tax purposes. The Issuer has covenanted to
comply with each such requirement. Failure to comply with certain of such requirements may
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cause the inclusion of interest on the Project Note in gross income for federal income tax
purposes to be retroactive to the date of issuance of the Project Note.
5. The Project Note is a "qualified tax-exempt obligation" within the meaning of
Section 265(b)(3) of the Code. The opinion set forth in the preceding sentence is subject to the
condition that the Issuer comply with all requirements of the Code that must be satisfied
subsequent to the issuance of the Project Note in order that the Project Note be, or continue to be,
a qualified tax-exempt obligation. The Issuer has covenanted to comply with each such
requirement.
We express no opinion regarding other federal tax consequences arising with respect to
the Project Note.
The rights of the owners of the Project Note and the enforceability thereof may be subject
to bankruptcy, insolvency, reorganization, moratorium and other similar laws affecting creditors'
rights heretofore or hereafter enacted to the extent constitutionally applicable, and their
enforcement may also be subject to the exercise of judicial discretion in appropriate cases.
DORSEY & WHITNEY LLP
J, MAS ' -
DORSEY &WHITNEY LLP'
Fairfax/419915-23
Form8038-G information Return for Tax-Exempt Governmental Obligations
(Rev,September 2011) Jo-Under Internal Revenue Code section 149(e) OMH No.1545-0720
See separate Instructions.
Department of the Treasury 10-
Internal Revenue Service Caution:If the Issue price Is under$100,000,use Form 8038-GC.
Reporting Authority. if Amended Return,check here ► El
1 Issuer's name 2 Issuer's employer Identification number(ESN)
City of Fairfax,Iowa 42-0959452
3a Name of person(other than Issuer)with whom the iRS may cam monicate about this return(see instructions) 3b Telephone number of other person shown on 3.
4 Number and street(or P.O.box If mall is not delivered to street address) fioomdstuute 5 Report number(For IRS Use Only)
P.O.1337
6 city,town,or post office,state,and ZIP code 7 Date of Issue
—Fairfax,Iowa 52228 September 1,2016
8 Name of issue 9 CUSIP number
Water Revenue Bond Anticipation PrLPT 30400Q AA3
70a Name and title of officer or other employee of the Issuer whom the IRS may call for more Information(see 10b Telephone number of officer or other
Instructions) OMP10YOe ShOWT)On 108
Cynthia Stimson,City Clerk
319-846-2204
IM Type of Issue(enter the issue price). See the instructions and attach schedule.
11 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health and hospital . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Transportation . . . . . . . .. . . . . . . . . . . . . . . . . . . . . 13
14 Public safety . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Environment(including sewage bonds) . . . . . .FOR . S 15
16 Housing . . . . . . . . . . . tJR-RECORP -YO 16
17 Utilities . . . . . . . . . . . . . . . . 17 445,000
18 Other. Describe 10- 18
19 If:obligations are TANS or RAN$,check only box 19a ►
EJ
If:obligations are BANS,check only box 19b . . . . . . . . . . . . .
20 If obligations are in the form of a lease or Installment sale,check box . . . .
Description of Obligations. Complete for the entire issue for which this form is being filed.
(0)Stated redemption {d)Weighted
(e)Yield
(a)Final maturity date (b)Issue pric price at maturity average maturity
21 06/0112019
445,000 $ 445,000 2.750 years 2„2482 %
$
CM 2 Uses of Proceeds of gond Issue [including underwriters' discount)
22 Proceeds used for accrued interest . . . .. . . . . . . . . . . . . . 22
23 Issue price of entire issue(enter amount from line 21, column(b)) . . . . . . . . . . . 23 445,000
24 Proceeds used for bond issuance costs(including underwriters'discount) 24 15,450
25 Proceeds used for credit enhancement . . . . . . . . . . . . 25
26 Proceeds allocated to reasonably required reserve or replacement fund26 .........
27 Proceeds used to currently refund prior Issues . . . . . . . . _27
28 Proceeds used to advance refund prior Issues . . . . . . . . . 28
29 Total(add lines 24 through 28) . . . . . . . . . . . . . . . . . . . . . 29 15,450
30 Nonrefunding proceeds of the issue(Subtract line 29 from line 23 and enter amount here) . , , 30 429,550
FVM Description of Refunded Bonds.Complete this part only for refunding bonds.
31 'Enter the remaining weighted average maturity of the bonds to be currently refunded . . . . ► years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded . . . . ► years
33 Enter the last date on which the refunded bonds will be called(MM/DD/YYYY) . . . . . ►
34 Enter the date(s)the refunded bonds were issued 0-(MM/DDMYY)
For Paperwork Reduction Act Notice,see separate instructions. Cat.No.63773S Form 8038-G(Rev,9-2011)
Form 8038_e(Rev.9-2011)
Page 2
Miscellaneous
35 Enter the amount of the state volume cap allocated to the Issue under section 141(b)(6) . 35 _
36a Enter the amount of gross proceeds invested or to be Invested In a guaranteed investment contract
(GIC)(see instructions) . . . . . . . . . . . . . . . . . . . . . . . 36a
7777
b Enter the final maturity date of the GIC 0-
C
c Entter the name of the GIC provider 0-
37
37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans ,
to other governmental units . . . . . . . . . . . . . • • • • • . . • • • • 37
38a If this issue is a loan made from the proceeds of another tax-exempt issue,check box 00. ❑and enter the following information:
b Enter the date of the master pool obligation►
c Enter the EIN of the issuer of the master Ipool obligation►
d Enter the name of the issuer of the master pool obligation 110-
39
39 If the issuer has designated the issue under section 266(b)(3)(B)(i)(Ili)(small issuer exception),check box . . . , ► M
40 If the issuer has elected to pay a penalty In lieu of arbitrage rebate,check box ► ❑
41a if the Issuer has identified a hedge,check here► ❑ and enter,the following information:
b (Name of hedge provider*,
c Type of hedge►
d Term of hedge 0-
42
42 If the issuer has superintegrated the hedge, check box . . . . . . . . . . . . . . . . . . . . . ► ❑
43 lif the issuer has established written procedures to ensure that all nonqualifled bonds of this issue are remediated
according to the requirements under the Code and Regulations(see instructions),check box , , . . . . . .
44 If the issuer has established written procedures to monitor the requirements of section 148, check box .
45a If some portion of the proceeds was used to reimburse expenditures,check here► ✓❑ and enter the amount
of reimbursement , . . . . . . . . ► $138,352'08
b Enter the date the official intent was adopted► May 17,2016
Under penalties of perjury,I declare that I have examined this return arid accompanying schedules and statements,and to the best of my knowledge
Signature and belief,they aro true,correct,and complete,I further declare that t consent to the IRS's disdosure of the issuer's return information,as necessary to
aril proce this return,to the perso a th t I have authorized above.
Consent ( I Cynthla stimson,City Clerk
'Sig gat re of issuer's authorized representativamvL Type or print name and title
Paid Print/Typ preparer's name A4100.
er's s nal , fate Check ❑ if PTIN
Robert E.Jr35ten 3� / self-employed P01075995
Preparer __ 41-0223337'
Use Only Firm's name ► Dorsey&whlFirm's EIN ►
Firm's address ► 801 Grand,Sus cines,IA 50309-8002 Phone no. 515-2&3-10043
Form 8038^G(Rev.9-2011)