Resolution 2015-227 RESOLUTION NO. 15- 2 2 7
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, this �µy N�U�
Iv day of September, 2015.
AT'T'EST:+ ',' BOARD OF COUNTY COMMISSIONERS
DWIPI1 T E t K CLERK COLLIER CO TY, F ORIDA
,� .. By: Gc
,.t as to thaitOaft) ry9 " TIM 4NCE, CHAIRMAN
siqnature o1Y to�
pprove Is form an
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'olleen M. Greene
Assistant County Attorney
[15-LIB-00118/1204661/1]
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 \ \ 1\° 015,-
-, c x� yC
D. IS T E,SR , �� :Signature•I, ' +_, TIM NANCE
By:
Attest as t0 Chairman' }
s Printed Signature
signature'aftly. ''
CHAIRMAN
Approved as to form an, legality Title BOARD OF COUNTY COMMISSIONERS
/I/ /
ti i , COLLIER COUNTY, FLORIDA
Assistant County
6e/ uome:
NTAC:2SE-18
0
Form #9 Request for Taxpayer Give Form to the
(Rev.December 2014) requester. Do not
Depertmera a the ,y identification Number and Certification send to the IRS.
Internal 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 imissioners
�} 2 business name/dlsregarc)d entity name,if fifferent from above
1 3 Check appropriate box fo'federal tax class option;check only one of the following seven boxes: 4 Exemptions(codes apply only to
❑individual/sole proprlet�v or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate instructions tions on pa Individuals;see
single-member LLC
❑Limited liability camper 1,Enter the tax cli tssificatlon C C co partnership} Exempt payee code(if any)
Y P ( = corporation,5=5 corporation,P= ►
Note.For a single-men bar LLC that Is di regarded,do not check U..C;check the appropriate box in the line above for Exemption from FATCA reporting
the tax classification of'he single-membe r owner. code(if any)
a. o MI Other(see instructions) • Government Nppato accounts m•intak,•doneeem.US.)
5 Address(number,street,1 Xi apt,or suite rx.) Requester's name and address(optional
3299 Tamami Tr E Ste 700
8 City,state,and ZIP code
Naples, FL 34112-574t I
7 List account number(s)her i(optional)
Part I Taxpayer ide itification Number(TIN)
Enter your TIN In the appropriate box.The TIN provided must match the name given on line 1 to avoid [Social security number
backup withholding. For individus Is,this is gener illy your social security number(SSN).However,for a
resident alien,sole proprietor,or iisregarded ent ty,see the Part I instructions on page 3.For other
entitles,It is your employer identi cation number(EIN).If you do not have a number,see How to get a
TIN on page 3. or r
Note.If the account is in more th.in one name,Sc e the Instructions for line 1 and the chart on page 4 for I Employer Identification number I
guidelines on whose number to e iter.
5 9 - 6 0 0 0 5 5 8
Part II Certification -
Under penalties of perjury, I certif' that:
1. The number shown on this Corr i 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 wltl holding becaut e:(a)I am exempt from backup withholding,or(b)t have not been notified by the Internal Revenue
Service(IRS)that I am subject o backup withh,iding 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(define(s 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 m,ist cross out ite n 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report s 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 ad property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than int(rest and divides 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.person • ;6 ri t-E_. C . ----i\tsj,ILA Date► ( i q )(
General Instructions •Form 1 8 ore mortgage interest),1098-E(student loan interest),1098-T
(tuition) i...r
Section references are to the Internal Re renue Code unles 3 otherwise noted. •Form 1099-C(canceled debt)
Future developments.Information abot t developments a fecting Form W-9(such •Form 1099-A(acquisftion or abandonment of secured property)
as legislation enacted after we release if is at www.irs.gov'tw9.
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 sr)who is requires i 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 corn ict taxpayer+dent fication number(TIN) to backup withholding.See Whet is backup withholding?on page 2.
which may be your social security numb(r(SSN),individue taxpayer identification By signing the filled-out form,you:
number(ITIN),adoption taxpayer identifk at/on number(AT N),or employer i,Certify that the TIN
identification number(EIN),to report on 11 information retu n the amount paid to you are giving is correct(or you are wafting for a number
you,or other amount reportable on an int)rmation return.E temples 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 paid) 3,Claim exemption from backup withholding if you are a U.S.exempt payee.if
•Form 1099-DIV(dividends,including thr se from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
any partnership income from a U.S.trade or business is not subject to the
•Form 1099-MISC(various types of Inco,ie,prizes,award,,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-8(stock or mutual fund sale i and certain othe•transactions by 4,Certify that FATCA code(s)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-$(proceeds from real estate transactions) page 2 for further information,
•Form 1099-K(merchant card and third F arty network tram actions)
Cat.No.10231X Form W-9(Rev.122014)
0600036 09/01/12
IConsumer's Certificate of Exemption I R D 11
DEPARTMENT Issued Pursuant to Chapter 212,Florida Statutes
Of REVENUE
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 DR-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.
The Northern Trust Company
4001 Tamiami Trail North
Naples,Florida 34103
(239)262-8800
(411) 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.
Ft
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NTAC:2SE-18
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 Ill of the Declaration and substitute therefor a new
Article III to be and read as follows:
"ARTICLE HI.
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
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.
IN WITNESS WHEREOF, I have executed this instrument this 'jay of January,
2014. -}//
VIR INIA M. HENDRICKSON,as Settler
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 ,#"of January,2014.
(Witness
fr. (S 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.
Notary ublic, St� �
t f lorida
Name: Zaks
(Print Name)
My Commissiopi1uc•sTATE OF�.oRIDA
' Joan C. zaks
,)Commi39io4#.EE065637
\;�r•I Expires, FE13.17,2015
-2- THRU ATLANTIC BONDING CQ,U C.
WILLIAM G. HENDRICKSON
SIXTH AMENDED AND RESTATED
DECLARATION OF TRUST
I
I, WILLIAM G. 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
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• I D P. HENDRICKSON and JULIE
ANN HENDRICKSON. In determining whether any person i. 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 11.
DISTRIBUTIONS DURING MY IFETIME
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
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-
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 /'"day
of October, 2008.
av� 1 Vt.
WILLIAM G. HENDRICKSON, as Senior
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 °day of October,2008.
1 residing at .7Z2‘ ,1/ (0 r,
ivr/e 5 r/0
]1AIL E.�!' d residing at gS-7. V1Di`Ga►' yikr e, . #t3ott
41\06)1A Eskre P& 33428
STATE OF FLORIDA )
) SS:
COUNTY OF COLLIER )
On this ae day of October, 2008, before me personally came WILLIAM G.
HENDRICKSON, who is personally known to me (no) or who has produced
as identification to me, and who acknowledged execution of the
foregoing instrument.
t
•t / ��, e `.i1.5 IJ
n " KATHRYN E BEACH No• • P •lie, State of Florida
_.: NY COMMISSION,005,361822 IRES: s,zone Name: ►1 • 1.4-c •
-4,4;:,t eaw nru M ak,'Yubk undersign
(Prier!Name)
My Commission Expires:
n (planning e-hlhendrickconih trust Sep 08.doc
-32-
jk! , Northern must
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,
A, / / *--)Ci2<:
Kimberly A. Spiker
CC: Julie Hendrickson, Thomas Hendrickson and Donald Hendrickson, Co-Trustees
Daniel Capes, Esq.
NTAC:2SE-I8