HomeMy WebLinkAboutFinal Agenda Packet `war, frr+'
CITY OF RENTON
FIREMEN'S PENSION BOARD
Regular Meeting
7th Floor-Mayor's Conference Room
Thursday, March 15, 2007
1:30 P.M.
1. CALL TO ORDER
2. APPROVAL OF MINUTES OF FEBRUARY 15, 2007
• 3. CORRESPONDENCE ••
4. MONTHLY STATEMENT TO FEBRUARY 28, 2007
5. MONTHLY BILLS AND PENSION PAYMENTS
6. UNFINISHED BUSINESS
7. NEW BUSINESS
8. ADJOURNMENT
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MINUTES
FIREMEN'S PENSION BOARD
CITY OF RENTON
February 15, 2007
Kathy Keolker, Mayor
Don Persson, Council Finance Committee Chair
Bonnie Walton, City Clerk
Ray Barilleaux, Fire Department Representative
Bruce Phillips, Fire Department Representative
William Larson, Fire Department Alternate
The regular meeting of the Firemen's Pension Board was called to order by Chairman Kathy
Keolker at 1:30 p.m. in the Mayor's conference room, 7th floor of Renton City Hall. In
attendance were Board members Kathy Keolker, Ray Barilleaux, Bruce Phillips and Bonnie
Walton. Also in attendance was Finance Department representative, Jill Masunaga.
MINUTES APPROVAL
MOVED BY BARILLEAUX, SECONDED BY PHILLIPS, THE PENSION BOARD
APPROVE THE MINUTES OF THE JANUARY 18, 2007, MEETING. CARRIED.
MONTHLY STATEMENT
The final financial report as of December 31, 2006, was reviewed. Total cash/investment
balance was $4,672,241.19. The financial report as of January 31, 2007, was reviewed. Total
cash/investment balance was $4,633,555.29.
MONTHLY BILLS AND PENSION PAYMENTS
MOVED BY BARILLEAUX, SECONDED BY PHILLIPS, THE BOARD APPROVE THE
PENSION/MEDICAL PAYMENTS FOR FEBRUARY 2007, IN THE TOTAL AMOUNT OF
$38,722.07 TO BE PAID FROM THE FIREMEN'S PENSION FUND. CARRIED.
(Mr. Persson arrived 1:35 p.m.)
ADJOURNMENT
MOVED BY BARILLEAUX, SECONDED BY PHILLIPS, THE MEETING OF THE
FIREMEN'S PENSION BOARD BE ADJOURNED. CARRIED. Time: 1:36 p.m.
Bonnie I. Walton, City Clerk
Member and Secretary, Firemen's Pension Board
CITY OF RENTON - FIREMEN'S PENSION FUND
CASH & INVESTMENT ACTIVITY REPORT
AS OF FEBRUARY 28, 2007
Fireman's Pension Fund Comparison of Cash and Investment Activity
6
❑2007 ■2006
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Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
CURRENT 2007 2007 LAST YEAR 2006 2006
ACTIVITY: MONTH YTD BUDGET CURR MO ACTUAL ADJ BUDGET
BEGINNING CASH/INV BALANCE $4,633,555.29 $4,672,241.19 $4,459,523 $4,772,242.74 $4,811,901.62 $4,713,823
RECEIPTS:
Fire Insurance Premium Tax 0.00 0.00 $73,000 0.00 77,820.55 $73,000
Investment Interest 3,563.52 3,563.52 $175,000 2,388.02 215,553.19 $150,000
DISBURSEMENTS:
Fire Pension 38,005.90 76,011.80 $463,500 36,755.06 414,281.42 $450,000
Fire Pension Medical 887.83 887.83 $20,000 3,165.75 11,536.51 $20,000
Office/Operating Supplies 0.00 0.00 $450 0.00 316.24 $400
Actuarial/Firemen's Pens 0.00 0.00 $12,000 0.00 0.00 $0
Reimb General/Clerical&Acct 686.00 1,366.00 $8,226 575.00 6,900.00 $6,900
ENDING CASH/INV BALANCE $4,597,539.08 $4,597,539.08 $4,203,347 $4,734,134.95 $4,672,241.19 $4,459,523
CURRENT PREVIOUS LAST YEAR LAST YEAR
ACTIVITY: MONTH MONTH CURR MO PREV MO
CASH $391,826.81 $427,843.02 $311,662.94 $349,770.73
INVESTMENTS:
CD's&State Investment Pool 454,767.46 454,767.46 454,767.46 454,767.46
Federal National Mortgage Assn 99,555.84 99,555.84 99,555.84 99,555.84
Treasury Strips&Zero Coupon Bonds 3,651,388.97 3,651,388.97 3,868,148.71 3,868,148.71
TOTAL CASH AND INVESTMENTS $4,597,539.08 $4,633,555.29 $4,734,134.95 $4,772,242.74
The State Investment Pool interest 5.2768% 5.2113% 4.4223% 4.2322%
H:\FINANCE\FINPLAN\FIREPEN\1_Fire_Pension_2007.xls\Feb07 Page 1 3/9/2007
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FIREMEN'S PENSION BOARD
PENSION/MEDICAL PAYMENTS FOR MARCH, 2007
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ANKENY, Charlie (Captain) $252.74 252.74
ASHURST, James (Assistant Chief) $4,436.00 467.81 4,903.81
BANASKY, George (Captain) $1,070.83 1,070.83
BARILLEAUX, Ray (Battalion Chief) - -
BEATTEAY, Karlen (Widow) $306.15 306.15
BERGMAN, Claudette (Widow) $234.99 234.99
CHRISTENSON, Chuck(Firefighter) $408.27 408.27
CONNELL, Robert(Captain) $800.85 800.85
GEISSLER, Dick(Fire Chief) $163.20 163.20
GOODWIN, Charles (Captain) $3,893.50 1,040.05 4,933.55
GOODWIN, Donald (Firefighter) $1,031.98 1,031.98
HAWORTH, Constance (Widow) $2,592.09 2,592.09
HAWORTH, Jack (Firefighter) $2,937.00 - 2,937.00
HENRY, William, Jr. (Captain) $1,352.08 1,352.08
HURST, Gerald (Firefighter) $588.63 588.63
JONES, Evelyn M. (Widow) $325.95 325.95
LARSON, William (Firefighter) $52.36 52.36
LAVALLEY, Theodele (Captain) $452.97 452.97
MATTHEW, James (Deputy Chief) - -
MC LAUGHLIN, JACK (Battalion Chief) $1,068.80 1,068.80
NEWTON, Gary(Lieutenant) $361.02 361.02
NEWTON, Roger(Firefighter) $60.15 60.15
NICHOLS, Gerald (Battalion Chief) $629.33 • 629.33
PARKS-ANDREASON,Arlene (Widow) $1,269.15 1,269.15
PARKS, John (Firefighter) $3,048.00 144.09 3,192.09
PHILLIPS, Bruce H. (Deputy Chief) $411.87 411.87
PRINGLE, Arthur(Captain) $562.18 562.18
PRINGLE, S. Joan (Widow) $2,226.91 2,226.91
RIGGLE, David E. (Firefighter D Step) $173.32 173.32
RUPPRECHT, Jim (Firefighter D Step) $204.38 204.38
SMITH, Leroy (Firefighter) $462.37 462.37
STROM, Karl (Firefighter) $2,937.00 - 2,937.00
TODD, Franklin (Firefighter) $515.58 515.58
TONDA, Lila Jean (Widow) $168.67 168.67
VACCA, Nick (Lieutenant) $389.90 389.90
WALLS, Kenneth (Firefighter D Step) $232.62 232.62
WALLS, Mercedes (Widow) $273.99 273.99
WALSH, David (Firefighter) $1,073.41 1,073.41
WALSH, Patrick (Captain) $1,007.10 1,007.10
WEISS, Larry(Battalion Chief) $854.03 854.03
WILLIAMS, Alta (Widow) $136.71 136.71
WOOTEN, Maril n E. Widow $308.97 308.97
Prior Year Pension/Medical Payments:
Total Pension Payments for March, 2006 36,755.06
Total Medical Bills Reimbursed in March, 2006 1,630.47
Total Expenses: Medical/Pension 38,385.53
4_SUMMARY 2007.XLS 3/9/2007
FIREMENS PENSION BOARD
MEDICAL BILLS TO BE REIMBURSED IN MARCH, 2007 PAYMENT
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2 James Ashurst Safeway 7.75
2 James Ashurst Safeway 185.75
2 James Ashurst Safeway 83.79
2 James Ashurst Safeway 183.77
2 James Ashurst Safeway 6.75
467.81
4 Charles Goodwin Bartell Drugs 14.75
4 Charles Goodwin Bartell Drugs 6.35
4 Charles Goodwin Bartell Drugs 138.38
4 Charles Goodwin Bartell Drugs 72.51
5 Charles Goodwin Bartell Drugs 217.19
5 Charles Goodwin Bartell Drugs 6.35
5 Charles Goodwin Bartell Drugs 138.38
5 Charles Goodwin Bartell Drugs 23.00
6 Charles Goodwin Bartell Drugs 278.41
6 Charles Goodwin Bartell Drugs 138.38
6 Charles Goodwin Bartell Drugs 6.35
Charles Goodwin 1,040.05
Jack Haworth 0.00
8 John Parks Olympic Drug 61.62
8 John Parks Olympic Drug 25.27
8 John Parks Olympic Drug 57.20
John Parks 144.09
Karl Strom 0.00
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• *we SEND CLAIM TO: .,,,r+ City of Renton
Finance Dept.-Fire Pension
1055 South Grady Way
Renton, WA 98055
OS�Y 0
jv CITY OF RENTON
FIREMEN'S PENSION BOARD
Pharmacy/Medical Claim Reimbursement Request
1) DATE r7
2) DISABILITY RETIREE'S NAME(print) /1-----/)'-7 f ? , _� Ali %4 u -3 j
3 ADDRESS j // ! C ntT- ° V V c.si
4) DISABILITY AT TIME OF RETIREMENT ,/ I-E /511 /r
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.)
/ :e 17 r?'" 4 i r )r/ - .; t%1y %'r.
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6) TOTAL AMOUNT OF CLAI 7 �"'/ 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 other 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
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-RENTON,WA 98055 RENTON,WA 98055
(425)226-0325 #(5) (425)226-0325
• Official Receipt - Please retain for tax or insurance
ASHURS�.' tS (425)255-6154 ASHURST,JAMES (425)255-6154
223 GARDEN AVE N. 12/17 223 B GARDEN AVE N. 12/17
RENTON,WA 98055 RENTON, WA 98055
DR. GRAVES,DANIEL [RF] DR. GRAVES,DANIEL [RF]
17900 TALBOT RD S 17900 TALBOT RD S
RENTON, WA 98055 RENTON,WA 98055
Rx:6673803 Jan 30, 2007 Safety Cap: Yes Rx:6684872 Feb 13, 2007 Safety Cap: Yes
FUROSEMIDE 40MG TAB (SAND)Qty: 100 TAB LIPITOR 40MG TAB (PFIZ) Qty: 50 TAB
Generic for:LASIX 40MG TAB A
Ref:A4074302008081 NDC:00781.1966.10 BKP) HSGIMRT
Ref:A4074443112891 NBC:00071-0157-23
REGENCE BLUESHIELD WASHINGTN REGENCE BLUESHIELD WASHINGTN
Amount Due: $7.75 Amount Due: $183.77
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REFILL
@ SAFEWAY.COM PRESCRIPTIONS
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MCIFANANWitikViAcYd' NACY
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RENTON,WA 98055 RENTON,WA 98055
(425)226-0325 #10 (425)226-0325
Official Receipt- Please retain fur taA or insurance Official Receipt- Please retain for tax or insurance
ASHURST,JAMES (425)255-6154 ASHURST,JAMES (425)255-6154
223 B GARDEN AVE N. 12/17 223 B GARDEN AVE N. • 12/17
RENTON,WA 98055 RENTON,WA 98055
DR. GRAVES,DANIEL [NW] DR. GRAVES,DANIEL [RF]
17900 TALBOT RDS 17900 TALBOT RD S
RENTON,WA 98055 RENTON,WA 98055
Rx:6688797 Jan 31, 2007 Safety Cap: Yes Rx:6684874 Feb 13, 2007 Safety Cap: Yes
PROTONIX 40MG TAB (WYET)Qty: 50 TAB METOPROLOL 50MG TAB (URL ) Qty: 100 TAB
Generic for:METOPROLOL 50MG TAB
Ref:A3074318546271 NDC:00008-0841-81 BBAISDP Ref:A1074445431901 NDC:00677-1482.10 HSG(MRT
REGENCE BLUESHIELD WASHINGTN REGENCE BLUESHIELD WASHINGTN
Amount Due: $185.75 Amount Due: $6.75
11111111111111111111011
REFILL
Ld SAfEWAY.COM PRESCRIPTIONS
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RENTON,WA 98055
(425)226-0325
Official Receipt- Please retain fur tax or insurance
ASARPtlAM% (425)255-6154
23 B GARDEN AVE N. 12/17
RENTON,WA 98055 •
DR. GRAVES,DANIEL [NW]
17900 TALBOT RD S
RENTON,WA 98055
Rx:6688798 Jan 31, 2007 Safety Cap: Yes
COZAAR 50MG TAB (MERC)Qty:50 TAB
Ref:A6074312056671 NDC:00006.0952.54 BBNSDP
REGENCE BLUESHIELD WASHINGTN
Amount Due: $83.79
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SEND CLAIM TO: City of Renton
Finance Dept.- Fire Pension
1055 South Grady Way
Renton, WA 98055
;NTS CITY OF RENTON
FIREMEN'S PENSION BOARD
Pharmacy/Medical Claim Reimbursement Request
77
1) DATE _ % _ 0 7
2) DISABILITY RETIREE'S NAME(print) C t//141 L C
3) ADDRESS /41/7 /nO/ se 4-1) - /J / k%/filnn��� 9aU��
4) DISABILITY AT TIME OF RETIREMENT ,'1'7 (3/JJ)/ %/pdfl Cl , AfitaliM_
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.)
ittreLelud
•
6) TOTAL AMOUNT OF CLAIM IF:/ d Q,ei
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: e #
Note: Supporting documentation must be attached.
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Rx# 45- 3390 3 E DR. FLO, GAYLE DATE: 12/01/06 R (425)899-3123
DATE: 11/09/06 _4425)251-5110
NAME: CHARLES GOODWIN NAME: CHARLES GOODWIN
1414 MONROE AVE NE#306
1414 MONROE AVE NE#306
ATENOLOL 50MG TABLET(*SAN) 00597-1101-60 R ' ' 200/2529477662
00781-1506-10 27394682
REFILL QUANTITY 60.00
REFILL YES QUANTITY 100.00 i41r 7 3
BARTELL DRUGS PRICE= $181.99 J
BARTELL DRUGS PRICE= $26.99
WITH XPS THE AMOUNT DUE:$138.38
WITH XPS THE AMOUNT DUE 414.75
BARTELL DRUGS#45
BARTELL DRUGS#45 (425)793-1015
(425)793-1015 4700 NE 4TH STREET
4700 NE 4TH STREET RENTON,WA 98059
RENTON,WA 98059 •
THANK YOU THANK YOU
WE TRULY APPRECIATE YOUR BUSINESS.TO PROVIDE YOU
WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
WI]'yi THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR L REFILLS 24-48 HOURS IN ADVANCE
REFILLS 24-48 HOURS IN ADVANCE
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Rx# 45- 3105 E DR. LORCH,GERALD Rx# 45. NtItt rek gt •b--teritE
DATE: 11/24/06 R (425)251-5110 DATE: 12/21/06 R (425)251-5110
NAME: CHARLES GOODWIN NAME: CHARLES GOODWIN
1414 MONROE AVE NE#306 1414 MONROE AVE NE#306
ALLOPURINOL 100MG TABLET(MYL GE. 1.R0 600MG TABLET(*AP
00378-0137-01 28599997 60 -0034-04 31902284
REFILL YES QUANTITY 30.00 REFILL NO QUANTITY
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BARTELL DRUGS PRICE= $10.99
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WITH XPS THE AMOUNT DUE 46.35 WITH XPS THE AMOUNT DUE=$72.51 --/cA
BARTELL DRUGS#45 BARTELL DRUGS#45
(425)793-1015 (425)793-1015
4700 NE 4TH STREET 4700 NE 4TH STREET
RENTON,WA 98059 RENTON,WA 98059
THANK YOU THANK YOU
WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU
WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
REFILLS 24-48 HOURS IN ADVANCE WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
REFILLS 24-48 HOURS IN ADVANCE
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DATE: 12/21/06 R (425)251-5110 DATE: 12/30/06 R (425)899-3123
NAME: CHARLES GOODWIN NAME: CHARLES GOODWIN
1414 MONROE AVE NE#306 1414 MONROE AVE NE#306
NORVAS6 10MG TABLET AGGRENOX CAP 200/25
00069-1 -68 31919418 0059180-60 32654741
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REFILL NO QUANTITY 100.00 REFILL 1 QUANTITY
60.00
BARTELL DRUGS PRICE= $265.29f BARTELL DRUGS PRICE= $181.99
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WITH XPS THE AMOUNT DUE-$217.19 )1 ) I ( WITH XPS THE AMOUNT DUE 4138.38
BARTELL DRUGS#45 BARTELL DRUGS#45
(425)793-1015 (425)793-1015
4700 NE 4TH STREET 4700 NE 4TH STREET
' RENTON,WA 98059 RENTON,WA 98059
THANK YOU THANK YOU
WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU WE TRULY APPRECIATE YOUR BUSINESS.TO PROVIDE YOU
WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
t REFILLS 24-48 HOURS IN ADVANCE REFILLS 24-48 HOURS IN ADVANCE
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Rx# E
DATE: 12/28/06 R (425)251-5110 DATE: 01/04/07 N (425)255-9310
NAME: CHARLES GOODWIN NAME: CHARLES GOODWIN
1414 MONROE AVE NE#306
1414 MONROE AVE NE#306
ALLOPURINOL 100MG TABLET(MYL
00378-0137-01 32343498 SULI :AC 200MG TABLET(*WAT) a6 Z J c 00591- 101 33146682
REFILL YES QUANTITY 30,00
REFILL 1 QUANTITY 40.00
BARTELL DRUGS PRICE= $10.99 BARTELL DRUGS PRICE= $24.49
WITH XPS THE AMOUNT DUE 46.35
WITH XPS THE AMOUNT DUE 423.00
BARTELL DRUGS#45 BARTELL DRUGS#45
(425)793-1015 425 793-1015
4700 NE 4TH STREET 4700 NE 4TH STREET
RENTON,WA 98059 RENTON,WA 98059
THANK YOU THANK YOU
WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU
WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
REFILLS 24-48 HOURS IN ADVANCE , REFILLS 24-48 HOURS IN ADVANCE 1
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RX# 45-350910 E DR. GRIFFITH,ALIDA RX# -----..f. .Own, oreRCH,.._
DATE: 01/26/07 N (425)899-3123 45-310592 E DR. LORCH,GERALD
DATE: 01/30/07 R (425)251-5110
NAME: CHARLES GOODWIN
1414 MONROE AVE NE#306 NAME: CHARLES GOODWIN
1414 MONROE AVE NEE#306#306
CARB9OPA/LEVODOPA 25MG/100M
00093- 3 01 35075967 ALLOPURINOL 100MG TABLET(*PA
',�.�,, 49884-0602-10 36614091
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REFILL 4 QUANTITY 3 3
REFILL YES QUANTITY 30,00
BARTELL DRUGS PRICE= $388.99
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WITH XPS THE AMOUNT DUE:$278.41 '7' WITH XPS THE AMOUNT DUE$6.35 (�.•3 S
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
THANK YOU
WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU THANK YOU
WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU
L REFILLS 24.48 HOURS IN ADVANCE WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
I REFILLS 24-48 HOURS IN ADVANCE
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WWash' 's Ogg-trial
45- 332519 FFITH,ALIDA
DATE: 01/26/07 R (425)899-3123 A.! . 1 J//; /
NAME: CHARLES GOODWIN / ,,�,IJ/ G I _41.
1414 MONROE AVE NE#306 Ai q j
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00597-0�1-60 35663374Ip
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BARTELL DRUGS#45
(425)793-1015
4700 NE 4TH STREET
RENTON,WA 98059
THANK YOU
WE TRULY APPRECIATE YOUR BUSINESS. TO PROVIDE YOU
WITH THE BEST SERVICE POSSIBLE PLEASE ORDER YOUR
REFILLS 24-48 HOURS IN ADVANCE I
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SEND CLAIM TO: City of Renton
Finance Dept.-Fire Pension
1055 South Grady Way
Renton, WA 98055
CO� Y 0
ANT° CITY OF RENTON
FIREMEN'S PENSION BOARD
Pharmacy/Medical Claim Reimbursement Request I
1) DATE f v/a A, / 'crV. 0 0 1
2) DISABILITY RETIREE'S NAME (print) V p h v L. Pd 1 IR.j
3) ADDRESS /33c ' 3 M y Or 10, 1 'ng if 1 t W (Na9 3
4) DISABILITY AT TIME OF RETIREMENT--S C t/
1 / 1 ._ e4
X11cers1I-1`r 1•1-dI,. /-j&in ;
42t> ua RECEIPT
1244 15th Ave.,Longview,WA 98632 Ph.(360)423-3360
SAVE FOR INSURANCE
656896 OR TAX RECORDS
Rx# For: JOHN PARKS
2.01-07 CRN A9074326339931 1335 3RD AVE.#109
LONGVIEW,WA 98632 )360! 517-6584
MIRTAZAPINE SOLTAB 45MG
30 NDC: 3 0712-30
RICHARDS,JOHN E
DR. ZHA COPAY: $61.62
III 11111111 IIllIJII I11 I I II II I Price
vvuY1�IP1�oRV� RECEIPT
124415th Ave.,Longview,WA 98632 Ph.(360)423-3360 SAVE FOR INSURANCE
OR TAX RECORDS
Rx# 65690 For. JOHN PARKS
2.01.07 CRN:A8074329637611 1335 3RD AVE a109
LONGVIEW,WA 98632 (360) 577-6684
LACTULOSE SOL 10GI15ML
DR. CHARDS,
60432-0037-32 0NDC:
HARDS,JOHN EZHA COPAY: $25.27
III
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YMPIORV�i RECEIPT
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124415th Ave.,Longview,WA 98632 Ph.(360)423-3360
save OR TA "'SOR DS
C656899 OR TA:.._t�RDS
Rx# For: JOHN PARKS
2-01-07 CRN:A4074326336411 1335 3RD AVE#109
LONGVIEW,WA 98632 )360) 577-6684
AMBIEN 10MG TABS####
I4 NBC: 00024-5421-50
RICHARDS,JOHN E
DR. ZHA COPAY: $57.20
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