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Home My WebLink AboutFinal Agenda Packet CITY OF RENTON FIREMEN'S PENSION BOARD Regular Meeting 7th Floor-Mayor's Conference Room Thursday, July 21, 2005 2:30 P.M. 1. CALL TO ORDER 2. APPROVAL OF MINUTES OF JUNE 16, 2005 3. CORRESPONDENCE Fire Insurance Premiums Distribution 4. MONTHLY STATEMENT TO JUNE 30, 2005 5. MONTHLY BILLS AND PENSION PAYMENTS 6. UNFINISHED BUSINESS 7. NEW BUSINESS 8. ADJOURNMENT tiase `rnr MINUTES FIREMEN'S PENSION BOARD CITY OF RENTON June 16, 2005 Kathy Keolker-Wheeler, Mayor Don Persson, Council Finance Committee Chair Bonnie Walton, City Clerk Ray Barilleaux, Fire Department Representative William Henry, Fire Department Representative William Larson, Fire Department Alternate The regular meeting of the Firemen's Pension Board was called to order by Acting Chairman Don Persson at 2:30 p.m. in Councilman Persson's office, 7th floor of Renton City Hall. In attendance were Board members Don Persson, William Henry, and Bonnie Walton; and Jill Masunaga, Finance Department Representative. MINUTES APPROVAL MOVED BY HENRY, SECONDED BY WALTON, THE PENSION BOARD APPROVE THE MINUTES OF THE MAY 19, 2005, MEETING. CARRIED. MONTHLY STATEMENT The financial report as of May 31, 2005, was reviewed. Total cash/investment balance was $4,878,448.65. MONTHLY BILLS AND PENSION PAYMENTS MOVED BY HENRY, SECONDED BY WALTON, THE BOARD APPROVE THE PENSION/MEDICAL PAYMENTS FOR JUNE 2005, IN THE TOTAL AMOUNT OF $33,684.78. CARRIED. ADJOURNMENT MOVED BY HENRY, SECONDED BY WALTON, THE MEETING OF THE FIREMEN'S PENSION BOARD BE ADJOURNED. CARRIED. Time: 2:32 p.m. (4.)aLt r., Bonnie I. Walton, City Clerk Member and Secretary, Firemen's Pension Board JUL-14-05 THU 01 :47 PM WA STATE TREASURER FAX NO. W05866499 P. 02 Noe CITY OF R5NTON JUL 1 4 2fl05 RECEIVED CITY CI ERIK'S OFFICE June 1, 2005 TO: Cities, Towns and Fire Districts Receiving Fire Insurance Premium Distribution FROM: Linda Lund, Distribution Assistant Office of the State Treasurer SUBJECT: May 2005 Distribution RCW 41.16.050 provides that twenty-five percent of moneys received from the tax on fire insurance premiums be distributed to cities, towns and fire districts for the credit of local pension funds. Enclosed is a copy of a worksheet showing the number of firefighters certified by the city or district and the amount that will be distributed on May 31, 2005. If you have any questions please call me at (360) 902-8960. J•UL-14-05 THU 01 :47 PM WA STATE TREASURER FAX NO. ? 85866499 P. 03 State of Washington Revenue Distribution rrrl' Dale: 07/14/2005 Treasury Management System Time: 01:44:55 PM Fire Insurance Premiums Report Id:rird nsPrcm,rpt 05/31/2005 Page 1 of 1 Ratio Value: 68 3.0541077518 CITY or Rt-1vTt^;N Number of City/District _ J U L i 4 200 Paid 0010 Aberdeen uFiVp,D Firefighters Amount 0060 ATlIcortes CITY Ci.,,E11K'S OFFICE 35 $ 23,906,89 0090 Auburn 18 12,294.97 0120 13ellevuc 77 52,595.17 0130 13ellu,gharn 190 129,780.28 0190 Bothell 134 91,529.25 0200 Bremerton 48 32,786.60 0260 Camas 56 38,251.03 0320 Centralia 34 23,223.84 0330L"hc1,.71is 21 14,344.14 0630 Edmonds 13 8,879.70 0660 Ellensburg 52 35,518.81 0730 nverelt 21 14,3.44.14 0960 I loquiam 181 123,632.79 1050 Kelso 22 15,027.19 1060 Kennewick 12 8,196.65 1070 Kent 74 50,546.00 1090 Kirkland 138 94,261.47 1230 Longview 69 47,130.73 1250 Lynnwood 43 29,37L33 1350 Mercer Island 53 36,201.87 1460 Moses Lake 29 19,808.57 1490 Mount Vernon 27 18,442.46 1180 Mountlake'terrace 33 22,540.79 1660 Olympia 26 17,759.41 1730 Pasco 79 53,961.27 1770 Port Angeles 47 32,103.54 1790 Port Townsend 22 15,027.19 1830 Pullman 11 7,513.60 1840 Puyallup 21 14,344.14 1870 Raymond 56 38,251.03 1890 Redmond 13 8,879.70 1900 Menton 128 87,430,93 1920 Richland 106 72,403.73 2030 Seattle 52 35,518.81 2070 Shelton 1,015 693,299.91 2160 Spokane 7 4,781.38 7250 Sumner 291 198,763.74 2260 Sunnyside 17 11,611,92 2270 Tacoma 14 9,562.76 2330 Toppenish 406 277,319.97 2340 Tukwila 5 3,415.27 2400 Vancouver 60 40,983.25 2420 Walla Walla 177 120,900.58 2490 Wenatchee 46 31,420.49 2630 Yakima 34 23,223.84 0179King County Fire fist'/10 80 54,644.33 0178 Kine, County fire Dist#2 121 82,649.55 0327 Spokane Fire fist. 1,1 35 23,906.89 150 102,458.12 Totals 4,399 $ 3,004,755,02 • L.. CITY OF RENTON - FIREMEN'S PENSION FUND CASH & INVESTMENT ACTIVITY REPORT AS OF JUNE 30, 2005 Fireman's Pension Fund Comparison of Cash and Investment Activity 6 ■2005 ❑2004 iu1I1ur : Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec CURRENT 2005 2005 LAST YEAR 2004 2004 ACTIVITY: MONTH YTD BUDGET CURR MO YTD ADJ BUDGET BEGINNING CASH/INV BALANCE $4,878,448.65 $4,976,122.73 $4,976,123 $5,050,830.03 $5,133,315.47 $5,133,315.47 RECEIPTS: Property Taxes 0.00 0.00 $0 0.00 0.00 $0 i Fire Insurance Premium Tax 0.00 72,403.73 $60,000 0.00 70,249.69 $40,000 Investment Interest 1,129.45 4,633.02 $100,000 463.90 8,559.73 $110,000 DISBURSEMENTS: Fire Pension 32,920.52 203,626.90 $400,000 30,864.32 188,801.28 $375,000 Office/Operating Supplies 0.00 0.00 $400 0.00 0.00 $400 Actuarial/Firemen's Pens 0.00 0.00 $5,000 0.00 0.00 $0 Reimb General/Clerical&Acct 575.00 3,450.00 $6,900 558.00 3,352.00 $6,700 ENDING CASH/INV BALANCE $4,846,082.58 $4,846,082.58 $4,723,823 $5,019,871.61 $5,019,971.61 $4,901,2 CURRENT PREVIOUS LAST YEAR LAST YEAR ACTIVITY: MONTH MONTH CURR MO PREV MO CASH $194,708.49 $227,074.56 $61,340.53 $92,298.95 INVESTMENTS CD's&State Investment Pool 545,767.46 545,767.46 529,767.46 529,767.46 Snohomish County Housing Authority 0.00 0.00 0.00 0.00 Federal National Mortgage Assn 99,555.84 99,555.84 99,555.84 99,555.84 Treasury Strips&Zero Coupon Bonds 4,006,050.79 4,006,050.79 4,329,307.78 4,329,307.78 Corporate Bonds 0.00 0.00 0.00 0.00 Convertable Bonds 0.00 0.00 0.00 0.00 Mutual Funds 0.00 0.00 0.00 0.00 TOTAL CASH AND INVESTMENTS $4,846,082.58 $4,878,448.65 $5,019,971.61 $5,050,930.03 The State Investment Pool interest 3.0411% 2.9758% 1.0312% 1.0169% H:\FINANCE\FINPLAN\FIREPEN\1_Fire_Pension_2005.xls\Jun05 Page 1 7/15/2005 • Now 'impo' FIREMEN'S PENSION BOARD PENSION/MEDICAL PAYMENTS FOR JULY, 2005 Recipient Pension Amt Medicals Total ANKENY, Charlie (Captain) $136.47 136.47 ASHURST, James (Assistant Chief) $4,045.50 - 4,045.50 BANASKY, George (Captain) $1,066.36 1,066.36 BARILLEAUX, Ray (Battalion Chief) - - BEATTEAY, Karlen (Widow) $214.62 214.62 BERGMAN, Claudette (Widow) $147.07 147.07 CHRISTENSON, Chuck (Firefighter) $303.50 303.50 CONNELL, Robert(Captain) $666.15 666.15 GEISSLER, Dick (Fire Chief) - - GOODWIN, Charles (Captain) $3,670.50 760.14 4,430.64 GOODWIN, Donald (Firefighter) $896.72 896.72 * HAWORTH, Constance (Widow) $2,521.49 2,521.49 HAWORTH, Jack(Firefighter) $2,768.50 - 2,768.50 HENRY, Teresa A. (Widow) $287.80 287.80 HENRY, William, Jr. (Captain) $1,178.98 1,178.98 HURST, Gerald (Firefighter) $572.30 572.30 JONES, Gerald D. (Firefighter) $231.25 231.25 LARSON, William (Firefighter) - - LAVALLEY, Theodele (Captain) $330.83 330.83 MATTHEW, James (Deputy Chief) - - MC LAUGHLIN, JACK(Battalion Chief) $732.60 732.60 NEWTON, Gary (Lieutenant) $253.38 253.38 NEWTON, Roger(Firefighter) - - NICHOLS, Gerald (Battalion Chief) $348.06 348.06 PARKS-ANDREASON, Arlene (Widow) $307.26 307.26 PARKS, John (Firefighter) $2,873.50 213.59 3,087.09 PHILLIPS, Bruce H. (Deputy Chief) $84.41 84.41 PRINGLE, Arthur(Captain) $434.48 434.48 * PRINGLE, S. Joan (Widow) $2,166.25 2,166.25 RIGGLE, David E. (Firefighter D Step) $85.84 85.84 RUPPRECHT, Jim (Firefighter D Step) $115.99 115.99 SMITH, Leroy (Firefighter) $367.79 367.79 STROM, Karl (Firefighter) $2,768.50 - 2,768.50 TODD, Franklin (Firefighter) $419.44 419.44 TONDA, Ernie (Captain) $30.26 30.26 VACCA, Nick (Lieutenant) $285.53 285.53 WALLS, Kenneth (Firefighter D Step) $140.65 140.65 WALLS, Mercedes (Widow) - - WALSH, David (Firefighter) $936.93 936.93 WALSH, Patrick(Captain) $868.71 868.71 WEISS, Larry (Battalion Chief) $534.64 534.64 WOOTEN, Marilyn E. (Widow) $220.18 220.18 Total Expenses: Pension/Medical 33,012.44 973.73 33,986.17 Prior Year Pension/Medical Payments: Total Pension Payments for July, 2004 30,932.24 Total Medical Bills Reimbursed in July, 2004 295.33 Total Expenses: Medical/Pension 31,227.57 * Received a 2.0% CPI increase effective July 1. 47/15/2005 2005.XLS 7/15/2005 Nue V FIREMEN'S PENSION BOARD MEDICAL BILLS TO BE REIMBURSED IN JULY, 2005 PAYMENT Page Name Pharmacy/Medical Facility Amount of Bill James Ashurst 0.00 2 Charles Goodwin Bartell Drugs 65.85 2 Charles Goodwin Bartell Drugs 65.85 2 Charles Goodwin Bartell Drugs 6.35 2 Charles Goodwin Bartell Drugs 15.97 2 Charles Goodwin Bartell Drugs 49.88 2 Charles Goodwin Bartell Drugs 14.75 3 Charles Goodwin Bartell Drugs 62.36 3 Charles Goodwin Bartell Drugs 278.41 3 Charles Goodwin Bartell Drugs 128.21 3 Charles Goodwin Bartell Drugs 72.51 760.14 Jack Haworth 0.00 5 John Parks Olympic Drug 23.22 5 John Parks Olympic Drug 103.62 5 John Parks Olympic Drug 20.62 5 John Parks Olympic Drug 66.13 John Parks 213.59 Karl Strom 0.00 TOTAL 973.73 3_2005 FP Medical.XLS 7/15/2005 *we Noe SEND CLAIM TO: City of Renton Finance Dept.-Fire Pension 1055 South Grady Way Renton, WA 98055 CITY OF RENTON FIREMEN'S PENSION BOARD Pharmacy/Medical Claim Reimbursement Request 1) DATE 1 -02 - 05- 2) -02 - 05- 2) DISABILITY RETIREE'S NAME (print) C khri - iS A < ccOOI) C )) N 3) ADDRESS P//L( /1OAUIO& AVE /0 # -b &AJ7 J1 o,4 C�'�c6 � a 4) DISABILITY AT TIME OF RETIREMENT 21 i . 0/ /464 , 5) DESCRIPTION OF CLAIM: (Supporting documentation must be attached.) (Note: Medical coverage is limited to current treatment of the retiree's disability as determined at the time of retirement. (RCW 41.18) Submit only claims that relate to item#4.) 9 - (?red-d- 6) TOTAL AMOUNT OF CLAIM q" -- 16 G. I 7) I certify that I have not been and will not be compensated by any other organization, insurance carrier or Medicare for the above-mentioned claim for reimbursement ether than the City of Renton. I further certify that the above statements are complete and accurate to the best of my knowledge, and that all claims submitted are related to my disability as determined at the time of my retirement from the Renton Fire Department. Signature: Note: Supporting documentation must be attached. PAS1 - -US To : /66..44.A...),.., bi)e.4....., 6-71.41^JJ7t-c6C)e-/-19-. ,,.... 4,4 co- A . .� OD(- i A) -/ �- �� BARTELL DRUGS I—Washington's Own Drugstores I BARTELL DRUGS RX# 45- 223189 E DR. MOSLEY Wash ••Owr•r3Z7 DATE: 06/13/05 R (425) 899-3123 RX# 45- 223189 E DR. MOSLEM DATE: 05/14/05 R (425) 899-3123 NAME: CHARLES GOODWIN 201 UNION AVE SE 99 NAME: CHARLES GOODWIN 201 UNION AVE SE 99 AGGR O CAP 200/25 00597- 0 60 52467410 AGGRENOX CAP 200/25 00597-0001-60 46380572 REFILL +0 QUANTITY 6.00 REFILL 1 QUANTITY 30.00 BARTELL DRUGS PRICE= $24.99 G 7 BARTELL DRUGS PRICE= $88.99 WITH XPS THE AMOUNT DUE=$15.97 �C '/ WITH XPS THE AMOUNT DUE=$65.85 bS-4'tc--) BARTELL DRUGS#45 (425)793-1015 BARTELL DRUGS#45 4700 NE 4TH STREET (425)793-1015 RENTON,WA 98059 4700 NE 4TH STREET RENTON,WA 98059 BARTELL DRUGS . m... Washington's Own Drugstores..� BARTELL 1_0 WWIWI RX# 45- 263241 E DR. MOSLEY ��Washin on's Own Drugstores�� DATE: 06/13/05 N (425) 899-3123 RX# 45- 22389 E DR. MOSLEM DATE: 05/28/05 R (425) 899-3123 I NAME: CHARLES GOODWIN NAME: CHARLES GOODWIN 201 UNION AVE SE 99 201 UNION AVE SE 99 AGGGS O)(CAP 200/25 AGGRENOX CAP 200/25 005 0 01- 0 52966014 00597-0001-60 49744270 REFILL 4 QUANTITY 3(.0,M Q4 REFILL 1 QUANTITY 30.00 BARTELL DRUGS PRICE= $88.99 BARTELL DRUGS PRICE= $88.99 �i WITH XPS THE AMOUNT DUE=$65.85 C�.8 WITH XPS THE AMOUNT DUE=$65.85 �'OBARTELL DRUGS#45 P . I `- BARTELL DRUGS#45 (425)793-1015 4700 NE 4TH STREET' a1 (425)793-1015 RENTON,WA 98059 Ai +�-1 e',� BARTELL :DRUGS BARTELL DRUGS Washington's Own Drugstores ........ .........Washington's OW.Drugstores RX# 45- 254492 E DR. LORCH,GERALD RX# 45- 246621 E DR. FLO DATE: 06/03/05 R (425) 251-5110 L DATE: 06/16/05 R 0- NAME: CHARLES GOODWIN ' NAME: CHARLES GOODWIN 201 UNION AVE SE 99 201 UNION AVE SE 99 ALLOPURINOL 100MG TABLET (MYL ATENOL 50MG TABLET(SAN) 00378-0137-01 / 50894372 00781-15 10 52874750 REFILL YES QUANTITY 30.00 REFILL "1 QUANTITY 100.00 BARTELL DRUGS PRICE= $10.99 / BARTELL DRUGS PRICE= $26.99 • WITH XPS THE AMOUNT DUE=$6.35 ( WITH XPS THE AMOUNT DUE=$14.75 N BARTELL DRUGS#45 BARTELL DRUGS#45 (425)793-1015 (425)793-1015 Iffidt . 4700 NE 4TH STREET 4700 NE 4TH STREET RENTON,WA 98059 RENTON,WA 98059 P / THANK YOU THANK YOUAlai: WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOttI WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR 6 WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR V.�� 2/ - der.A.A..e,( 1-6 ,, P."2„:14,91,, _. iegid,,Jik, /0 BARTELL DRUGS BARTELL DRUGS '-'� EW ahingian'.Own Drugstores sms... ..s ��...Wwbinttan'.ch.D .�.fo....aa_� Rx# 45-263241 RX# 45- 246623 E DR. FLO E DR. MOSLEY DATE: 06/23/05 R 0 - DATE: 06/17/05 N (425) 899-3123 NAME: NAME: CHARLES GOODWIN CHARLES GOODWIN 201 UNION AVE SE 99 201 UNION AVE SE 99 G55034-0 IL 600MG TABLET(APO AGGRENOX CAP 200/25 00597-0001-60 605 5-003�4-0 53573709 52543 \ REFILL 4 \\ REFILL 2 QUANTITY 180.00 QUANTITI:-G(� 0 BARTELL DRUGS PRICE- BARTELL DRUGS PRICE= $91.78 7) / - $167.99 • WITH XPS THE AMOUNT DUE �sh (43 WITH XPS THE AMOUNT DUE=$72.51 BARTELL DRUGS#45 :J BARTELL DRUGS#45 (425)793-1015 c o (425)793-1015 4700 NE 4TH STREET 4700 NE 4TH STREET RENTON, WA 98059 RENTON, WA 98059 BARTELL DRUGS: THANK YOU WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU RX# 37521•SDR WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR E MOSLEY - REFILLS 24-48 HOURS IN ADVANCE DATE: 06/23/05 R (425) 899-3123 I ' NAME: CHARLES GOODWIN BARTELL `DRUGS 201 UNION AVE SE 99 —w.ahingten'.Own Drugstores RX# 45- 237521 E DR. MOSLEY C� OPA 276 MG/100M DATE: 06/23/05 R (425) 899-3123 000 -0293- 53764709 p NAME: CHARLES GOODWIN o� �d �f REFILL 1 QUANTITY 540.00 201 UNION AVE SE 99 ( BARTELL DRUGS PRICE= $388.9 CA' : I OPA/LEVODOPA 25MG/100M ARTIA 000:3-0293-01 WITH XPS THE AMOUNT DUE=$278.41 "Fig53764709 1 THI REFILL BARTELL DRUGS#45 1 QUANTITY 540.00 (425)793-1015 ,..,,,i tea. 4700 NE 4TH STREET O No.oF�RX WI®F BARTELL DRUGS PRICE= $388.99 RENTON,WA 98059 WITH XPS THE AMOUNT DUE=$278.41 BARTELL DRUGS BARTELL DRUGS#45 (425)793-1015 ..,,-,..„.,,, ,„,,,...king,*„,,. -wy .�D�°re'�"�� 4700 NE 4TH STREET RX# 45-263241 E DR. MOSLEY RENTON,WA 98059 DATE: 06/23/05 R (425) 899-3123 CHARLES GOODWIN "NNW THANK YOU NAME: WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU 201 UNION AVE SE 99 WITH THE BEST SERVICE POSSIBLE PLEASE ORDER VOUR - REFILLS 24-48 HOURS IN ADVANCE AGG: ► IX CAP 200/25 ' 005: -0001-6# 53097709 O4:„,ye/ REFILL 3 QUANTITY 60.00 __I r ,p �� BARTELL DRUGS PRICE_ $167.99 ;�� /� WITH XPS THE AMOUNT DUE=Mill �j e%�UD ► I� L 9w'�� BARTELL DRUGS#45 (425)793-1015 4700 NE 4TH STREET RENTON,WA 98059 THANK YOU ae"?/217 WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR �J � vim, rrn` SEND CLAIM TO: City of Renton Finance Dept.-Fire Pension 1055 South Grady Way Renton, WA 98055 O��Y 0 ''P- -4'N'ro� CITY OF RENTON FIREMEN'S PENSION BOARD Pharmacy/Medical Claim Reimbursement Request I) DATE ,J 0 / >/ I )'&4,-.6- 2) 'D4,-.62) DISABILITY RETIREE'S NAME (print) SJ O ii 7'1 A. Pc '-PS 3) ADDRESS ),333--- 3-4---A v 1)s 2-,(1 )755 V; i6 W a. GIG 3 i 4) D SABILITYT TIME OF RET � MENT I - -1 eI C Ci I e TS �'Tani �? C� -re-PIVX 'se c ri4 4 -45( iei r ►if-yo 5) DESCRIPTION OF CLAIM: (Supporting documentation must be attached.) (Note: Medical coverage is limited to current treatment of the retiree's disability as determined at the time of retirement. (RCW 41.18) Submit only claims that relate to item#4.) d-t (i_ise cr-r s' 0-4127 ch /old *--j1 , t j '-r )ikrnS 6) TOTAL AMOUNT OF CLAIM t.>,—___,. 7) I certify that I have not been and will not be compensated by any other organization, insurance carrier or Medicare for the above-mentioned claim for reimbursement ether than the City of Renton. I further certify that the above statements are complete and accurate to the best of my knowledge, and that all claims submitted are related to my disability as determined at the time of mretirement from the Renton Fire Department. Signature: -[ kin AA -d (-) Note: Supporting documentation must be attached. V *NOV ��//'' Value at the smiling 1). /�f�� Value at the smflinq'O' 1io24c 5Ave.wLoew,2482,2..narea.nmepa(36a0)423re�-3360 1244 15th Ave.,Longview,WA 98632 Ph.(360)423-3360 vwwrrGorF.a.ylew ,tercMdNadWb�i'P�aalsemeepawnmrxeamtwr,�.meea RX#C492998 DR. RICHARDS ACCEPTED 6/7/05 TMG RX# 508973 DR.RICHARDS PARKS, JOHN ACCEPTED 6/8/05 DS l��l��l�trll� I II I II PARKS, JOHN QATY# 120 AM 00 M1077-05B GENEV METOCLOPRAMIDE TAB 5MG QTY#120 QTY#100 NDC#50111-0517-01 NO REFILLS CALL PHARMACY Generic For:REGLAN 5MG PRICE: $23.22 5 REFILLS UNTIL: 6/8/06 �IIIII�IIII II II IIIIIIIIIIIIIII III II I II II PRICE: $20.62 IIIIIIII II II IIIIIIIIIIIIIIII IIII IIIIN II RECEIPT • RECEIPT value at the smlling'o• Value al the smillnq'O• ' YMPIC DMA_ DRUG 124415th Ave.,Longview,WA 98632 Ph.(360)423-3360 124 G15thQ vey�Longvltrew aWA46n? .2.(36,09)423-3 3600 w,vwx�o:sear«�l...v�aarsa�raa�amwn+�,'aasaaanan.,uea�br.�aat.xsRnatea RX# 492990 DR. RICHARDS RX# 457086 DR. RICHARDS ACCEPTED 6/7/05 TMG ACCEPTED 6/7/05 TMG PARKS, JOHN PARKS, JOHN 1111111111111111011111 II I i II if I I��I�I�Il if�O��YI�i� �II`�� IIII II i III II REMERON SOLTAB 45MG PRILOSEC OTC 20MG TAB" QTY#30 NDC#00052-0110-30 ORGAN QTY#84 NDC#37000-0455-03 P&G NO REFILLS CALL PHARMACY 1 REFILLS UNTIL: 12/1/05 PRICE: $103.62 PRICE: $66.13 II II II 111111111 II I IIII III II IIII II ll IIII 11 11 II IIII 10111 ill II ilI� II II RECEIPT I RECEIPT