R-2021-223 - 8/26/2021 RESOLUTION NO. R-2021-223
WHEREAS, the City of Round Rock has previously adopted a Deferred Compensation Plan
for Public Employees("Plan"), and
WHEREAS, the City Council desires to add an "Indexed Principal Protection" option to the
Plan,Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK,TEXAS,
That the Mayor is hereby authorized and directed to execute on behalf of the City, an
Application for Group Flexible Purchase Payment Deferred Fixed Indexed Annuity Contract for the
Plan, a copy of same being attached hereto as Exhibit"A"and incorporated herein for all purposes.
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was
open to the public as required by law at all times during which this Resolution and the subject matter
hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act,
Chapter 551, Texas Government Code, as amended.
RESOLVED this 26th day of August, 2021.
CRAIG RGXX Mayor
City of Round Wock, Texas
ATTEST:
MIA
MEAGAN S INKS, DJputy City Cle
0112.20212;00479380
EXHIBIT
A
APPLICATION FOR
GROUP FLEXIBLE PURCHASE PAYMENT DEFERRED
Nationwide! FIXED INDEXED ANNUITY CONTRACT(Non-Participating)
underwritten by
Nationwide Life Insurance Company
One Nationwide Plaza
Columbus,Ohio 43215
1-877-677-3678
Nationwide Indexed Principal ProtectionsM
Please indicate for which product this application applies(one must be selected):
❑ 12-month Book Value Payment ® 5-year Book Value Payment
APPLICANT
City of Round Rock,Texas _ _ _(the"Applicant"), applies to be the Contract Owner
of a Group Flexible Purchase Payment Deferred Fixed Indexed Annuity Contract(the"Contract") underwritten by Nationwide Life
Insurance Company("Nationwide")
The Group Flexible Purchase Payment Deferred Fixed Indexed Annuity Contract applied for will become effective on the"Effective
Date of Contract" if the initial Purchase Payment and this application are accepted by Nationwide. In the event the initial Purchase
Payment or this application are not accepted,Nationwide's liability will be limited to a return of the initial Purchase Payment,and any
subsequent Purchase Payments remitted.
The applicant's plan qualifies under
® Section 457(b) ❑ Section 401(k) ❑ Section 401(a)
PURCHASE PAYMENT --— -- - -
Applicant agrees to permit Participants in its Plan to allocate Purchase Payments to the Contract as of the"Effective Date of Contract".
SIGNATURLS —--- - - - - - -- J
A market value adjustment may occur on the effective date of termination.
Signed on behalf of _ __-_--�this day
of - 2Q. -
❑ Yes ®No Do you have existing annuity contracts?
❑ Yes ®No Will the applied for Contract replace any existing life insurance or annuity contracts?
Applicant's signature below indicates that the applicant acknowledges and understands that he/she is applying
for an index-based product, and that the applicant acknowledges and understands that while the values of the
policy may be affected by an external index, the policy does not directly participate in any stock or equity
investments.
(Authorized Signature of Applicant) - -- -- Date
(Title)
NRAA-0153TX i (Texas)(6/2020)
SIGNATURES
❑ Yes No Do you have any reason to believe the Contract applied for is to replace existing annuities?
g- 9-- zc,a
(Authorized ationwide Agent/Representative Signature) Date
SA-r t+.,- 1 . t
(Authorized Nationwide Agent/Representative)—Please Print
Re 4i �-c wte ,�- S P e C i &I s f-
(Title)
7V V i S* r Re P re S e r,—�7c'1'r
NRAA-0153TX 2 (Texas)(6/2020)