HomeMy WebLinkAboutFlorida Safe Invest. Pool Registration 10-1-13 I
i * FLORIDA * FLSAFE ADMINSTRATOR
1 SAIF E JEFF CARSON,FMAS
Tel: 407-496-1597
Fax: 407-542-3791
1 Website: www.flsafe.org
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ACCOUNT REGISTRATION FORM
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DATE 10/1/2013
GOVERNMENT
NAME: City of Cape Canaveral
ADDRES
S: 105 Polk Ave PO Box 326
CIT
1 Y: Cape Canaveral STATE: Florida ZIP CODE: 32920
ATTENTIO Jeff TAX 868-
N: Larson ID: 59-0974636 TEL: 321-868-1230 FAX: 1248
YOUR FLSAFE
IACCOUNT#: REP: Jeff Larson
AUTHORIZED REPRESENTATIVES
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REP#1 REP#2 REP#3
1
NAME David L.Greene Angela Apperson John Deleo
City Manager Assistant City Manager/City Finance Director
TITLE Clerk
1 SIGNATURE (9c 4 n, v /,
d.greenePcitvofcap a.ap erson@ t ofcapecan i.deleo @citvofcap
EMAIL ecanaveral.org ateb€ral.org ecanaveral.org
PASSWORD (F/L)
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PARTICIPANT STANDARD BANK WIRE INSTRUCTIONS
P.O. Box 63020
BANK NAME: Wells Fargo Bank, N.A. ADDRESS: San Francisco, Ca 94163
1 ABA 063107513 236122-00433720
,
ROUTING#: ACCOUNT#:
WIRE INSTRUCTIONS TO SEND FUNDS TO FLSAFE
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BANK NAME: BMO HARRIS BANK, N.A. ADDRESS: ORLANDO, FLORIDA
1 ABA
ROUTING#: 071000288 ACCOUNT#: 253-898-1
FOR FURTHER CREDIT
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* FLORIDA * FLSAFE ADMINSTRATOR
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JEFF CARSON, FMAS
S Ili F Tel: 407-496-1597
Fax: 407-542-3791
* INVESTMENT POOL * Website: www.flsafe.org
ACCOUNT REGISTRATION FORM
SIGNATURE AUTHORIZATION
AUTHORIZATION:This authorizes FLSAFE to transfer the proceeds of any redemption of the Participant's share in FLSAFE when telephoned,
oral,electronic or written requests are received by FLSAFE from anyone of the Authorized Representatives names above by transferring such
proceeds to the above-named Primary/Standard or Alternate instructions(or additional accounts as denoted on an attached sheet)in the
accordance with such requests.
TERMINATION:This Agreement and the authorizations contained therein will remain effective,communicating on the date as set forth above,
until FLSAFE receives written notice of termination.The Participant is required to notify FLSAFE of any changes to either the authorized
1 representatives or the wiring instructions.
LIMITATION ON LIABILITY:The FLSAFE Board of Trustees,the Investment Advisor,Administrator and Custodian known collectively as FLSAFE
shall have limited liability as indicated in the Indenture of Trust or Custodial Agreement.
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BY: BY: 4,9Gu.4( Z p-1 —..
Signature Signature
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* FLORIDA *
H .A1 r ADMIN..,I RA:
SAFE
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*INVESTMENT POOL *
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ACCOUNT RECISTRATION FORM
SIGNATURE AUTHORIZATION
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