Backup Documents 11/10/2015 Item #16D15 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPI. 6 {� �(
5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO („� J.
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office
UVB
4. BCC Office Board of County
Commissioners VA\V5/ t.t‘\Z\\S
5. Minutes and Records Clerk of Court's Office
nAfi 410415 5•'41
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Tanya R. Willia s Phone Number 593-3511,ext. 2
Contact/ Department
Agenda Date Item was 11/10/2015 Agenda Item Number 16.D.15
Approved by the BCC
Type of Document Resolution&Receipt Number of Original 2
Attached . (5 2-21 Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature?
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. Ozs- -erai.> •
3. Original document has been signed/initialed for legal sufficiency. (All documents to be ('4t - ..,�,�•\��< •-s
signed by the Chairman,with the exception of most letters,must be reviewed and signed `-t%% ) \ 4_
by the Office of the County Attorney. , E.1 -134:7
:11.-
4. All handwritten strike-through and revisions have been initialed by the County Attorney's Y,/ ox-R
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's n w
signature and initials are required. .:APA)')
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE. t . 1
Some documents are time sensitive and require forwarding to Tallahassee within a certain �WP"`
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 11/10/15 (enter date)and all
changes made during the meeting have been incorporated in the attached document. HC art rpt eiry
The County Attorney's Office has reviewed the changes,if applicable. thi Ul :
9. Initials of attorney verifying that the attached document is the version approved by the
BCC, all changes directed by the BCC have been made,and the document is ready for the � .a"dor,
Chairman's signature. �1atie}
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
1 6 01 '5
Co tnty Qf Collier
CLERK OF THE CIRC IT COURT
COLLIER COUNTY` OUR"I OUSE
3315 TAMIAMI TRL E STE 102 Dwight E. Brock\`tkerk of circuit Court
NAPLES, FL 34112-5324 , P.O. BOX 413044
NAPLES,FL 34101-3044
Clerk otC:ourts • Comptroller • Audit() • Citstodian olCounty Funds
November 13, 2015
The Northern Trust Company
Attn: Kimberly Spiker, VP
4001 Tamiami Trail North
Suite 100
Naples, Florida 34103
Re: Resolution 2015-227 & Receipt
Transmitted herewith is a one (1) copy of the following:
Resolution 2015-227
Receipt
W-9 — Board of County Commissioners
Certificate of Exemption — Collier County Board of County Commissioners
Copy of Declaration of Trust Amendment
The above referenced document are for your records, as adopted by the Collier
County Board of County Commissioners of Collier County, Florida on Tuesday,
November 10, 2015, during Regular Session.
Very truly yours,
DWIGHT E. BROCK, CLERK
$1P
Martha Vergara, De u y Cl-
Enclosure
l-Enclosure
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.comEmail- CoilierClerk�c�c�,II;Pr�lt�ri r•,,,,,
16015
RESOLUTION NO. 15- 227
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA RECOGNIZING AND ACCEPTING A
$10,000 DONATION FROM THE WILLIAM G. HENDRICKSON TRUST
TO SPECIFICALLY BENEFIT YOUTH EDUCATION PROGRAMS AT
THE COLLIER COUNTY PUBLIC LIBRARIES.
WHEREAS, the Board of County Commissioners was notified by The Northern Trust
Company that the Collier County Public Library is a beneficiary of the William G. Hendrickson
Trust in the amount of$10,000 for Youth Education Programs at the Library; and
WHEREAS, the Trust provides that the gift to the Collier County Public Library be used
specifically for the youth education programs; and
WHEREAS, the Board formally agrees with this Resolution to abide by the gift
provisions set forth in the Trust as described herein.
NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that
The Board of County Commissioners hereby accepts and recognizes the $10,000
Donation from the William G. Hendrickson Trust to benefit the Collier County Public Library,
and further the Board agrees to abide by the terms of the Trust such that the donation will be
used specifically for youth education programs at the Public Libraries.
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier
County, Florida, thisy
Iv da of September, 2015.
ATTEST: '••.q BOARD OF COUNTY COMMISSIONERS
DWIGHT E. . 'C7£K CLERK COLLIER CO INTY, F ORIDA
��. B
Attest as to Chat'`` at '� TIM ANCE, CHAIRMAN
signature only. "
pproved as to form an41
_alz //,/ < 1311 0
'olleen M. Greene
Assistant County Attorney
[15-LIB-00118/1204661/1]
16015
RECEIPT
To The Northern Trust Company (Northern Trust), Julie Hendrickson and Thomas
Hendrickson as Co-Trustees of the Virginia M. Hendrickson Trust under agreement dated
April 18, 1990 as amended and restated in full on March 29, 2013. Virginia M.
Hendrickson's Trust directs that her Trust be distributed to the William G. Hendrickson
Trust and distributed pursuant to Article VI of that Trust. Northern Trust, Julie
Hendrickson and Donald Hendrickson are Co-Trustees of the William G. Hendrickson
Trust. Article VI of the William G. Hendrickson Trust provides for the below referenced
bequest to be paid at Virginia M. Hendrickson's death(the"Trust"):
I, TIM NANCE , am an official of Collier County Public
Library, Naples, Florida. The Trustee informed the Collier County Public Library, that
the below referenced bequest was made to the Collier County Public Library under
Article VI of the Trust.
"Ten Thousand Dollars ($10,000.00) to the Collier County Public Library, Naples, FL to
be used for youth education programs."
Sequence of Events. I will sign and deliver this Receipt to Northern Trust, and then
Northern Trust will distribute the aforementioned trust property to Collier County Public
Library; provided, however, that this Receipt shall not become effective until Northern
Trust has in fact distributed the trust property to Collier County Public Library.
I hereby acknowledge receipt of the sum of$10,000 in full satisfaction of all the amounts
to which the Collier County Public Library is entitled under Article VI of the Trust.
Signed on \ `� ouninii ,015,-
Ark-EST: , Qom, CI '� :Signature
��^ , =• -��:-• TIM NANCE
Attest as to Chairman's ` Printed Signature
signature anis;
CHAIRMAN
Approved as to form an. legality TitleBOARD OF COUNTY COMMiISSIONERS
• /!/b 141
14 , COLLIER COUNTY, FLORIDA
z
Assistant County • ttorney
NTAC:2SE-18
16015
Form W-9 Request for Taxpayer
(Rev.December 2014) Give Form to the
' identification Number and Certification requester. Do not
Internee a or erre Service
send to the IRS.
lmemaf Revenue Service
1 Name(as shown on your income tax return,Name is required on this line;do not leave this line blank.
Board of County Cor tmissioners
N 2 Business name/disregarc xi entity name,if iitferent from above
c3 Check appropriate box fo federal tax class tication;check only one of the following seven boxes: 4 Exemptions(codes apply only to
Individuatlsole certain entities,not individuals;see
propriet r or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust estate instructions on page 3):
i= ❑ single-member LLC Exempt payee code(if any)
Limited liability compar/.Enter the tax ci:issificatlon(C=C corporation,S=$corporation,P=partnership)►
Exemption from FATCA reporting
Note.For a single-men bet LLC that Is di;regarded,do not check U_C;check the riate box in the line above for
approp
the tax classification of he single-member owner code(if any)
a ❑✓ Other(see instructions) • Government
tsP•••r0•CCOWIN m.hnrn.d Wrs.d.rry VS,)
E5 Address(number,street,t le apt.or suite nt.) Requester's name and address(optional)
3299 Tamami Tr E Ste 700
6 Ctty,state,and ZIP code
Naples, FL 34112-574t1
7 test account number(s)her (optional)
Part I Tax•a er Ide itification Number(TIN)
Enter your TIN In the appropriate box.The TIN provided must match the name given on line 1 to avoid f social securtty number
backup withholding. For individus Is,this is gener illy your social security number(SSN). However,for a I
resident alien,sole proprietor,or iisregarded ent ty,see the Part I instructions on page 3.For other - -
entities, It is your employer Identi ication number;EIN).if you do not have a number,see How to get a
TIN on page 3. or
Note.If the account is in more thin one name,see the instructions for line 1 and the chart on page 4 for Employer IdenNficetlon number -�
guidelines on whose number to e iter.
5 9 - 6 0 0 0 5 5 8
Part II Certification
Under penalties of penury, I certif! that:
1. The number shown on this forr t is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2. I am not subject to backup wit!holding becaut e;(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject o backup withhplding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup wi hholding;and
3. I am a U.S.citizen or other U.S person(defined below);and
4.The FATCA code(s)entered on I its form(if any)Indicating that i am exempt from FATCA reporting is correct,
Certification instructions.You mist cross out ire a 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have fated to report:II interest and c Ividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage
interest paid,acquisition or abandi nment of secur td property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than inti rest and divider ids,you are not required to sign the certification,but you must provide your correct TIN,See the
instructions on page 3.
Sign Signature of }
Here U.S.Pomo► 11-k C • -- 1..A.A Data► 1 q )i
General Instructions •Form 1 8 ome mortgage Interest),1098•E(student loan Interest),1098-T
(tuition) U
Section references are to the Internal Re/enue Code unless otherwise noted. •Form 1099-C(canceled debt)
Future developments.Information abet t developments a fecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release It;is at www.irs.gov'f 9.
Use Form W-9 only if you are a U.S.person(Including a resident alien),to
Purpose of Form provide your correct TIN.
An individual or entity(Form W-9 request)0 who is requires'to file an information If you do not return Form W-9 to the requester with a 77N,you might be subject
return with the IRS must obtain your con rct taxpayer(dent flcation number(T1N) to backup withholding.See Whet is backup withholding?on page 2.
which may be your social security numbs r(SSN),Individue taxpayer identification By signing the filled-out form,you:
number(ITN),adoption taxpayer Identlfk aeon number(AT N),or employer 1.Certthat the TINyou giving (oryou are wafting for a number
Identif�cation number(EIN),to report on s 1 information retu n the amount paid to are ivi s correct ng
you,or other amount reportable on an inl>rotation return.E samples of information to be issued)'
returns Include,but are not limited to,the following 2.Certify that you are not subject to backup withholding,or
•Form 1099-INT(interest earned or pato) 3,Claim exemption front backup withholding if you are a U.S.exempt payee.tf
•Form 1099-DIV(dividends,including tilt se from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
MISC(various typesany partnership income from a U.S.trade or business is not subject to the
•Form f p99-
of ince te,Prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-B(stock or mutual fund sale;and certain°the.transactions by 4,Certify that FATCA codes)entered on this form(if any)indicating that you are
brokers) exempt from the FATCA reporting,Is correct.See What is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further information,
•Form 1099-K(mercnant card and third f arty network trans actions)
Cat.No. 10231X Form W-9(Rev.12-2014)
1 6 0 1 5
O600O35 08,01112
Consumer's Certificate of Exemption R 04;11
DE PARTMF'f� Issued Pursuant to Chapter 212,Florida Statutes
OF REVENUE
1 85-8015966531C-1 10/31/2012 10/31/2017 COUNTY GOVERNMENT
Certificate Number Effective Date Expiration Date Exemption Category
This certifies that
COLLIER COUNTY BOCC
3301 TAMIAMI TRL E
NAPLES FL 34112-4961
is exempt from the payment of Florida sales and use tax on real property rented,transient rental property rented,tangible
personal property purchased or rented,or services purchased.
Important Information for Exempt Organizations °R-14
R.04/11
DEPARTMENT
OF REVENUE
1. You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases.
See Rule 12A-1.038, Florida Administrative Code(F.A.C.).
2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's
customary nonprofit activities.
3. Purchases made by an individual on behalf of the organization are taxable,even if the individual will be
reimbursed by the organization.
4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible
personal property,sleeping accommodations,or other real property is taxable. Your organization must register,
and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this
requirement except when they are the lessor of real property(Rule 12A-1.070, F.A.C.).
5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no
circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for
payment of the sales tax plus a penalty of 200%of the tax, and may be subject to conviction of a third-degree
felony. Any violation will require the revocation of this certificate.
6. If you have questions regarding your exemption certificate,please contact the Exemption Unit of Account
Management at 800-352-3671. From the available options,select"Registration of Taxes,"then"Registration
Information,"and finally"Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480,
Tallahassee, FL 32314-6480.
16015 5
The Northern Trust Company
4001 Tamiami Trail North
Naples,Honda 34103
(239)262-8800
et) Northern Trust
Kimberly A.Spiker
Vice President
July 31, 2015
Collier County Public Library
2385 Orange Blossom Drive
Naples, FL 34108
Re: William G. and Virginia M. Hendrickson Trust
Dear Sir or Madam:
William G. Hendrickson of Naples, Florida died on December 4, 2009. William's wife,
Virginia M. Hendrickson, also of Naples, FL passed away on January 23, 2015. The
Northern Trust Company,Julie Hendrickson and Thomas Hendrickson are Co-Trustees of
the Virginia M. Hendrickson Trust under agreement dated April 18, 1990 which was
amended and restated in full on March 29, 2013 (the "Trust"). Mrs. Hendrickson's Trust
directs that her Trust be distributed to the William G. Hendrickson Trust pursuant to
Article VI of that Trust. Northern Trust, Julie Hendrickson and Donald Hendrickson are
Co-Trustees of the William G. Hendrickson Trust. Article VI of the William G.
Hendrickson Trust provides for the below referenced bequest to be paid at Mrs.
Hendrickson's death.
"Ten Thousand Dollars($10,000.00)to the Collier County Public Library.Naples,
FL to be used for youth education programs."
In addition, as Mr. Hendrickson's trust provides that the gift to the Collier County Public
Library to be used specifically for the youth education programs we would like a
resolution by the board of the Collier County Public Library that it will abide by the gift
provisions set forth in the William G. Hendrickson Trust. Please forward a copy of the
resolution to me at your earliest convenience. If you would like us to review the proposed
resolution ahead of time to ensure it will be sufficient for our purposes, please forward a
copy to me and I will be happy to have it reviewed. Y
125,:i..,-,iy,), EAR()
-,:-,i,,.-
- 1.T. LI l a;;' ` i!; !`1 i.,
NTAC:2SE-18
1 6131
AMENDMENT TO THE
VIRGINIA M. HENDRICKSON
FOURTH AMENDED AND RESTATED
DECLARATION OF TRUST
WHEREAS, I, VIRGINIA M. HENDRICKSON, as Settlor and Trustee, executed a
Declaration of Trust dated April 18, 1990, as amended and restated on December 12, 1996, on
December 19, 2003, on December 19, 2007 and most recently on March 29, 2013, under which
Julie Ann Hendrickson currently serves with me as a Co-Trustee(the"Declaration"); and
WHEREAS, under Article XII of the Declaration, I retained the right to amend or revoke
the Declaration in whole or in part at any time;and
WHEREAS,I desire to amend the Declaration as provided below.
NOW,THEREFORE,I do hereby amend the Declaration as follows:
FIRST: I hereby delete Section 2.1 of the Declaration and substitute therefor a new
Section 2.1 to be and read as follows:
"2.1. Income and Principal. The Trustee shall pay so much or all of the
net income and principal of the trust estate to me or for my benefit as I direct.
Any income not so paid shall be added to principal. Further, the Trustee shall
administer the trust estate in such manner as I may from time to time direct."
SECOND: I hereby delete Article III of the Declaration and substitute therefor a new
Article III to be and read as follows:
"ARTICLE III.
DISTRIBUTIONS AT MY DEATH
The Trustee, as of my death, and after first paying from the balance of the
trust estate (the"residuary trust estate") all expenses, debts, costs and death taxes
as provided in Article IV below, shall distribute the balance of the residuary trust
estate to the then acting trustee of the WILLIAM G. HENDRICKSON
DECLARATION OF TRUST executed by my deceased spouse on April 18,
1990, as most recently amended and restated in its entirety on October 31, 2008,
as further amended on July 16, 2009 ("my spouse's revocable trust"), to be
administered as provided in Article VI therein for the distribution of assets upon
my death (as modified to the extent I have exercised in my Will the limited
powers of appointments granted to me under my spouse's revocable trust).
Notwithstanding the foregoing, if the trust estate includes a promissory note
payable from a child of mine to me, my estate or the Trustee under this
1 6 D 1 5
Declaration, I hereby forgive, as of the date of my death, in full any and all
amounts outstanding under such promissory note and the amount forgiven shall
be taken into account by the Trustee of my spouse's revocable trust in
determining the amount to be distributed as part of the child's distribution
(whether or not the child survives me) under my spouse's revocable trust, as
modified by my exercise of powers of appointment over the trusts created under
my spouse's revocable trust."
THIRD: As hereby changed and amended, I do hereby ratify and confirm the
Declaration, reserving the right to further alter, amend, modify, or revoke the Declaration and
this Amendment.
cett
IN WITNESS WHEREOF, I have executed this instrument this 0 day of January,
2014.
VIR INIA M.HENDRIC {ON,as Settlor
and as Trustee
The foregoing instrument was signed, sealed, and declared by VIRGINIA M.
HENDRICKSON as and for an Amendment to her Fourth Amended and Restated Declaration of
Trust, in the presence of us, the undersigned,who,at her special instance and request,do attest as
witnesses, immediately after VIRGINIA M. HENDRICKSON has signed her name thereto, in
her presence and in the presence of each other, this g\#"of January,2014.
(Witness
(% itness)
STATE OF FLORIDA )
) SS:
COUNTY OF COLLIER )
On this o day of January, 2014, before me personally came VIRGINIA M.
HENDRICKSON, who is personally known to m (yes)`' no) or who has produced
as identification to me, and who acknowledged execution of
the foregoing instrument.
(dia-
Notary ublic,Stat nfF1or s
Name: C
(Print Name)
My Commissiop �p irc tJc.STATEOFFLORIDA
Jan C. Zaks
1' Commoissio4+ .EE065637
,nExpire9a FEB.17,2015
-2- soimD mu ATLANTIC eo mi ca,oic.
1 6 0 1 5
.. .
r.
WILLIAM G. HENDRICKSON
SIXTH AMENDED AND RESTATED
DECLARATION OF TRUST
I, WILLIAM C. HENDRICKSON, of Collier County, Florida, do hereby amend and
restate in its entirety, as set forth below, that certain instrument signed by me as Settlor and Trustee
and dated April 18, 1990, establishing the William G. Hendrickson Declaration of Trust, which was
most recently amended and restated in its entirety on December 19, 2007 (the "Declaration"). The
property transferred to the Trustee under the Declaration shall be held as part of the trust estate
which shall be administered in accordance with this Fifth ended and Restated Declaration as
follows:
ARTICLE I.
FAMILY
i
The name of my spouse is VIRGINIA M. HENDRIC SON ("my spouse"). My spouse is a
citizen of the United States. I have four children, each of who is now living, namely: ROBERT J.
HENDRICKSON, THOMAS J. HENDRICKSON, DON D P. HENDRICKSON and JULIE
ANN HENDRICKSON. In determining whether any person iS a child or descendant for purposes of
this instrument, only children and descendants by birth shall be included, except that my adopted
grandchild, WILLIAM HAROLD HENDRICKSON, and his'descendants by birth, shall be treated
as my descendants for purposes of this instrument.
ARTICLE II.
DISTRIBUTIONS DURING MY LIFETIME
During my lifetime, the Trustee shall administer the trust estate as follows:
2.1. Income and Principal. The Trustee shall pay so much or all of the net income and
principal of the trust estate to me or for my benefit as I direct. Any income not so paid shall be
added to principal.
2.2. Disability. If at any time or times I am under a legal disability or am unable to
manage my affairs, the Trustee may use such sums from the net income and principal of the trust
estate as the Trustee deems necessary or advisable for the health, education, support or maintenance
of myself and my spouse, or for any other purpose the Trustee considers to be for my best interests,
adding to principal any income not so paid. It is my desire that, during any time or times I am
unable to manage my affairs, the Trustee maintain me in my home for as long as the Trustee deems
it to be in my best interest. During such time, the Trustee may pay expenses for twenty-four hour
1
1 6 n15
3.2.2.1. The Heritage Foundation. The Trustee shall
distribute the sum of Twenty Five Thousand Dollars ($25,000) to
THE HERITAGE FOUNDATION, Washington, D.C.
3.2.2.2. The Conservancy of Southwest Florida, Inc. The
Trustee shall distribute the sum of Ten Thousand Dollars ($10,000) to
THE CONSERVANCY OF SOUTHWEST FLORIDA, INC., Naples,
Florida.
3,2.2.3. Philharmonic Center for the Arts, Inc. The Trustee
shall distribute the sum of Ten Thousand Dollars ($10,000) to the
PHILHARMONIC CENTER FOR THE ARTS, INC., Naples,
Florida,to be used for education programs.
3.2.2.4. Moore Regional Hospital. The Trustee shall
distribute the sum of Five Thousand Dollars ($5,000) to MOORE
REGIONAL HOSPITAL, Pinehurst, North Carolina, to be used for
the Radiation Oncology Department.
3.2.2.5. Collier County Public Library. The Trustee shall
distribute the sum of Ten Thousand Dollars ($10,000) to the
COLLIER COUNTY PUBLIC LIBRARY,Naples, Florida, to be used
for youth education programs.
3.2.2.6. Youth Haven, Inc. The Trustee shall distribute the
sum of Ten Thousand Dollars ($10,000) to YOUTH HAVEN, INC.,
Naples,Florida.
3.2.2.7. St. William Catholic Church. The Trustee shall
distribute the sum of Ten Thousand Dollars ($10,000) to
ST. WILLIAM CATHOLIC CHURCH,Naples, Florida.
3.2.2.8. Abatement, If there are insufficient assets to fully
fund the distributions under Section 3.2.2, then the distributions shall
be abated pro rata.
3.2.3. Abatement. If there are insufficient assets to fully fund the
distributions under both Sections 3.2.1 and 3.2.2 above, then (i) the distributions
under Section 3.2.2 shall be abated (as provided above)first, and(ii) the distributions
under Section 3.2.1 shall be abated (as provided above) last.
-5-
1 6 015
IN WITNESS WHEREOF, I have executed this instrument, in the presence of the
witnesses who shall hereafter subscribe their names hereto as attesting witnesses, this the -?/1day
of October, 2008.
'W`:\ 1` . �•
WILLIAM G. HENDRICKSON, as Settlor
and as Trustee
The foregoing instrument was signed, sealed, and declared by WILLIAM G.
HENDRICKSON, as and for his Sixth Amended and Restated Declaration of Trust in the presence
of us, the undersigned, who, at his special instance and request, do attest as witnesses, immediately
after WILLIAM G. HENDRICKSON has signed his name thereto, and in his presence and in the
presence of each other, this the l srday of October,2008.
1 residing at .722 r I // G'0 ti el Cr .e
iv 4 les rice Wet._
II ha r. • {� � residing at gS 7J' \4o Go.rkhlei eQ_ t3ov
:s}ud , F4_ 33425
STATE OF FLORIDA )
) SS:
COUNTY OF COLLIER )
On this 3je day of October, 2008, before me personally came WILLIAM G.
HENDRICKSON, who is personally known to me e (no) or who has produced
as identification to me, and who acknowledged execution of the
foregoing instrument.
,i" ^`E KATHRYN E BEACH No a P •lie, State of Florida
MY COMMISSION/DO 361622
r EXPIRES:December 5,2008 Name;
'2 a Bonded �,Nati/Pubic UtdrnelYn
(Print Name)
My Commission Expires:
n:Iplanning e-hlhendricksonlh trust Sep 08.doc
-32-
16015
Northern Trust
Please provide a copy of the Collier County Public Library's federal tax-exempt
determination letter [501(C)(3) letter] and organizational documents indicating who has
the authority to sign on behalf of the organization.
A check for $10,000 in payment of that bequest will be forwarded when the enclosed
documents(IRS W-9 and receipt)and requested documents are returned.
If you have any questions, please do not hesitate to contact me directly at(239)213-6221.
Sincerely,
Kimberly A. Spiker
CC: Julie Hendrickson, Thomas Hendrickson and Donald Hendrickson, Co-Trustees
Daniel Capes, Esq.
NTAC:2SE-I8