--- OCR page 1 of 21 ---
‘
EMERGENCY MEDICAL SERVICE BOARD
2014-2015
es ESTIMATE OF NEEDS
AND FINANCIAL STATEMENT OF THE
FISCAL YEAR 2013-2014
EMERGENCY MEDICAL SERVICE BOARD
THE COUNTY OF OTTAWA
| | STATE OF OKLAHOMA
gE Two copies of this Financial Statement and Estimate of Needs should be filed with the County Clerk not later than August 17
for all Counties, After approval by the Excise Board and the levies are made, both statements should be signed by the
appropriate Board Members. One complete signed copy must be sent to the State Auditor and Inspector, Suite 106, 4200 N.
a Lincoln Blvd., Oklahoma City, OK 73105-3453. If publication may not be had by date required for filing, affidavit and proof
of publication are required to be attached within five days after date of filing.
‘THE 2014-2015 ESTIMATE OF NEEDS AND FINANCIAL
STATEMENT OF THE FISCAL YEAR 2013-2014
PREPARED BY Turner & Associates, PLC
SUBMITTED|TO THE OTTAWA COUNTY,
E EXCISE BOARD THISQS<° DAY OF 2014
EMERGENCY MEDICAL SERVICE BOARD
= n >
Chairman Yo nbaL Member Za a Z Docu iit
r Member o Member 2)
Dy
- Member __* ( 5 : Member
Clerk
S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014


--- OCR page 2 of 21 ---
é
af = -”
™
EMERGENCY MEDICAL SERVICE BOARD $
OF
OTTAWA COUNTY 4
2014-2015 |
ESTIMATE OF NEEDS
AND FINANCIAL STATEMENT OF THE 4
FISCAL YEAR 2013-2014
"|
INDEX
|Letters and Certifications: Page 7
Letter To Excise Board sstotenttanaurnut enti erineeeetimennnasennnnnnttntiinnnneenemnnentienmmenannnnaanianuasnnn  ! 7
Affidavit of Publication, mumsaanannininuninnnntnnsnnniniinananmnnnnmmnnnunnnn — 2

Certificate of Excise Board mitten  EXbibit "Y" - Page 1
Exhibits: Filed 7
Exhibit "E" Emergency Medical Fund i mantinnininannnnnnnnnnnee XC 7
Exhibit "J" Capital Project Funds atennmnnimanuinnsintenninmamnnaninmemnnanmnnenannnn NO 7
Exhibit "Y" Certificate of Excise Board Estimate of Needs i mnmsneninnunnananannennannnannn YS 7
Publication Sheet Filed With County Budget eannnennnnnesnnmnnnnnininennunnnnannmmenenmenmnnanen NO
4
|
7
we S.A.&I1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014 7
7


--- OCR page 3 of 21 ---
- Page 1
a
EMERGENCY MEDICAL SERVICE BOARD
OF
OTTAWA COUNTY
4 2014-2015
ESTIMATE OF NEEDS
AND FINANCIAL STATEMENT OF THE
al FISCAL YEAR 2013-2014
OTTAWA COUNTY, EMERGENCY MEDICAL SERVICE BOARD
STATE OF OKLAHOMA, COUNTY OF OTTAWA, ss:
To the County Excise Board of said County and State, Greeting:~
Pursuant to the requirements of 68 O.S. 1991 Section 3002, we submit herewith for your consideration, the within statement of the
- fiscal condition of the Emergency Medical Service Board, County of Ottawa , State of Oklahoma, for the fiscal year beginning July
1, 2013 and ending June 30, 2014, together with an itemized statement of the estimated needs thereof for the fiscal year beginning
July 1, 2014 and ending June 30, 2015. The same have been prepared in conformity to Statute, in relation to which be it further
noted that:
1. We, the members of the Emergency Medical Service Board of said County and State, do hereby certify that the statements herein
submitted show the true and correct conditions of the fiscal affairs of said Emergency Medical Service Board for the fiscal year
ending June 30, 2014, that said statements comprise a "full and accurate statement of the assessments, receipts and expenditures of
a] the preceding year, made out in detail under separate heads" as required by 19 O.S. 1991 Section 345; that said preparation was had
at an official session of said Board, begun on the first Monday in July, 2014 pursuant to the provisions of 68 O.S. 1991 Section 3002.
2, And we further certify that the estimates of the several amounts necessary for current expenses for the fiscal year beginning July 1,
= 2014 and ending June 30, 2015 as shown under "Schedule 8" were prepared and filed with the Emergency Medical Service Board as
of the first Monday in July 2014, that the same have been correctly entered, and that all estimates made are entered as certified by
Department Heads for the respective purposes herein set out. We further certify that the sums requested for salaries of county
‘ officers and the deputies are calculated and based upon authority of salary statutes currently effective and applicable in this county.
3. We further certify that the estimated income from sources other than ad valorem tax, shown on "Schedule 4", may reasonably be
expected to be collected as a revenue during the ensuing fiscal year, and is not in excess of the 90% of the amounts collected for the
_ same sources during the fiscal year ending June 30, 2014.
Dated at the office of the County Clerk, at Miami, Oklahoma, this___dayof__— 2014.
1. 7 >
ia Dy 2 Lambe l Z PAMEL
Chairman Member
od x Bos
Membi Member
> Yad
mber Member
Clerk
: Filed this day of. , 2014 Secretary and Clerk of Excise Board, Ottawa County, Oklahoma.
S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014


--- OCR page 4 of 21 ---
“
Page 2 5
a |
ae al
Independent Accountant's Compilation Report |
Honorable Emergency Medical Service Board 7
Ottawa County
We have compiled the 2013-2014 financial statements as of and for the fiscal year ended June 30, 2014 and the 2014-
2015 Estimate of Needs (SA&I Form 2631R97) and Publication Sheet (SA&I Form 2631R97, Exhibit "Z") for Ottawa "|
County, included in the accompanying prescribed forms. We have not audited or reviewed the financial statements, ‘
estimate of needs and publication sheet forms referred to above and, accordingly do not express an opinion or provide
any assurance about whether the financial statements, estimate of needs and publication sheet forms are in accordance =
with the basis of accounting prescribed by the Office of the Oklahoma State Auditor and Inpector per 19 OS § 1722 |
a as promulgated by 19 OS § 1708-1721.
7
Management is responsible for the preparation and fair presentation of the financial statements, estimate of needs and {
publication sheet in accordance with the requirements prescribed by the Office of the Oklahoma State Auditor and
Inspector, per 19 OS § 1722 as promulgated by 19 § 1708-1721 and for designing, implementing, and maintaining =
internal control revelvant to the preparation and fair presentation of the financial statements, estimate of needs and |
publication sheet. I
Our responsibility is to conduct the compilation in accordance with Statements on Standards for Accounting and 4
= Review Services issued by the American Institute of Certified Public Accountants. The objective of a compilation is
to assist management in presenting financial information in the form of financial statements without undertaking to
obtain or provide any assurance that there are no material modifications that should be made to the financial =
statements. |
The financial statements, estimate of needs and publicaton sheet included in the accompanying prescribed forms are om
presented in accordance with the requirements of the Office of the Oklahoma State Auditor and Inspector per 19 OS § |
1722 as promulgated by OS 19 § 1708-1721 and are not intended to be a complete presentation of the assets and
liabilities of the Ottawa County Emergency Medical Service District. 7
This report is intended solely for the information and use of management of the Ottawa County Emergency Medical
Service District, the Ottawa County Excise Board, management of Ottawa County, and for filing with the State
Auditor and Inspector and is not intended to be and should not be used by anyone other than these specified parties. 7
Turner & Associates, PLC "|
Thver> Aseociates, PLE
- October 20, 2014 ”
!
S.A. Form 268BR98 Entity: Ottawa EMS Board, 58 ~ ‘Monday, October 20, 2014 “|
|
- 7
i


--- OCR page 5 of 21 ---
Proof of Publication
Ottawa County, State of Oklahoma
FIN. STMT FY 2014
. EST. OF NEEDS FY 2015
“ Affidavit of Publication
STATE OF OKLAHOMA, OTTAWA COUNTY OF
OKLAHOMA:
|, Cheryl Franklin, of lawful age, being duly sworn, upon oath
deposes and says that she is the Authorized Agent of The
Miami News Record of Miami, Oklahoma, located at 14 1*
Ave. N.W, Miami, Oklahoma 74354, a daily newspaper of
general circulation in Ottawa County, printed in the English
language, and published continuously and uninterruptedly
published in said county for a period of one hundred and four
(104) weeks consecutively prior to the first publication of the
said notice.
That said newspaper is in the city of Miami, Ottawa County,
Oklahoma, a Daily newspaper qualified to publish legal
notices, advertisements and publications as provided in
Section 106 of Title 25, Oklahoma Statutes 1971, as
amended, and complies with all other requirements of the
laws of Oklahoma with reference to legal publications.
That the attached notice is a true copy thereof and was
published in the regular edition of said newspaper for 1
time(s), the first publication thereof being made as aforesaid
' on the November 23, 2014.
[y Unt. ds “th —
Cheryl Franklin ” Publisher
Subscribed and sworn to before me this November 27, 2014
y es
Kathléen F. Merrill Notary Public
My commission expires: 08-25-2016
Publication Cost: $226.80
Acct #: 20900195
- jy
se. ME;
ee Remittance Address:
SE geste: Miami News Record
S som Si clo GHM Billing Department
pak PO Box 940
Si. PUR AS, —
Zaz EON Miami, OK. 74355


--- OCR page 6 of 21 ---
[FINANCIAL STATEMENT OF THE VARIUS FUNDS FOR THE FISCAL YEAR ENDING JUNE 30, 2014, AND ESTIMATE OF NEEDS q
‘FOR THE FISCAL YEAR ENDING JUNE 30,2015, OP THE EMERGENCY MEDICAL SERVICE BOARD OF fq :
‘OTTAWA COUNTY. OKLAHOMA
2 a
iff ERERT OF FINARICAL CONDITION
—————= pe AS OF JUNE 30, 20M tet} |
|ASSETS: |
ea POA |
ICIASILTTIES AND RESERVES? =|
es
Reserve ir latest on Wea
[Beene From Schedule
(Fear RN ARS bere rr
— ESTIMATED NEEDS FOR FISCAL YEAR ENDING IONE S,T01s
TERRA FORD SION TORD ANCESTOR]
Siren peg sre neon ed od
Reserve for fn. on Wares & Revaawion [$8,556.70 Lega ivesments Propel Matuog —[§_]
Fi: Fudgemens Pad to Reeoverby Tacky [3]
ee eS ec a eS |
» | |B we ea a aa ts 8 sort fe rasa" § ——] | .
[ESTIMATED MISCECLANEOUSREVENUE: [JJ Inures Threon Afer Lani Coupa [sy ft
a ns | 5
{000 Local Sours of Revenue PS Jugend fi eve frais = |
[Boe Sta: SoaressofReyeawe IS Tol emsa Tigh |
$00 Mibetnenus Revenue IS feted Reserve f Ane Sta | =} },
[ett ourestons fom Omer Fans Sap eared Uamanred nest 3} |,
I igs Lasden Vase boat [s——] |i
fs teallenes Taoieht_——ts d,
Hz Accrual on Unmanired Bonds. ¢- |
[Annual Acowa on “Prepaid Jeigemens——|[$]
fs Aanual Aczrunon “Ungald"Tudgements [3]
[Stneteston UnpsidTudeemeas I's
| jf-Assoo Acer From Exmbie RK
{or
{or
— oF:
ee
i Hi
a eT | 11
oo
eT
[Bete I
| —— .
| a
ee 295 a es |
Fara SATS ny Coen NG Boa Fico Ona
5 EMERGENCY MEDICAL SERVICE BOARD PUBLICATION SHEET - OTTAWA COUNTY, OKLAKOMA
5 FINANCIAL STATEMENT OF THE VARIUS FUNDS FOR THE FISCAL YEAR ENDING IUNE 30,201, AND ESTIMATE OF NEEDS
FOR THEFISCAL YEAR ENDING TUNE 30,203, 0 THE EMERGENCY MEDICAL SERVICE BOARD OF
(OTTAWA COUNTY, OKLAHOMA B . B
pom _
fF rte 1 arta tan ne To ai oaatng W" Teves TE aR]
eer rr lad [Soo _| .
a :
Hi4d. k. Unenatured Bends So Due {|
| [ites Cash Reuter fox Coet Fazal Vera Bese of Cut on Hand Grom Une 164 Abo) ;——]
re |
CERTIFICATE - GOVERNING BOARD .
STATE OF OKLAHOMA, COUNTY OF OTTAWA, ss A
We te endegoed Enexgecy Metical Service Bow of Gta Couny Obebams, do bec ctf ata metngot be Emergency Medical
Servic Board f the sd Cun, begun atthe ine provided by aw fer Coun apa othe provisions of 6 OS. 1991 Sex 3002 be
‘foregoing statement! was prepared and isa true and comea condition of the Financial Affairs of sid Emergency Medical Board as reflected by the
retro Clean Treas. We eer ey hat the forgeag exinae cure xpees forthe fe yeti uly 1, 2014 ard
‘ding Ke 30,2015, aso ae esosby necessary forthe propecondel ofthe afc fhe sid Emergeney MetielSrvie Bow ht he :
Einttd lca tbe derived fom sores chert valorem tandses no exe the lnwfly tori alin of te eveaue deed fm ’
the same sourees during the preceding fiscal year. 4
_ F
4 nb de f Cunt % i
Timi ofBoad Be ras ;
f 2 Ll —
Member Veta .
REBA G. Sin.cifiiah. -
nen AG. Sing Jon d
Goal Oe BL Tis NY sel H
ARMS NN i
«cots Coun i
— Re Sea }
GR, ‘OFFICAL SENL Wi Wy
AM BEWUS ae i
PRE rrouirrtcom anos
Rey otiawcouy
1 Stowe. anon x aro .
i Ney :
‘Subserbed and sort be is yf 2,
a 2 (Nowy Polis :
kedo Ye bled in ply. qulfedawnpaper rate inthe County, oan se publahed ino legly-qusiied newspaper of eer cretion 3
‘nhs Cou, i
[Published in the Miami News-Record — November 23, 2014] ‘


--- OCR page 7 of 21 ---
r a Page 3
‘ AFFIDAVIT OF PUBLICATION
L STATE OF OKLAHOMA, COUNTY OF OTTAWA
r Personally appeared before me, the undersigned Notary Public, County Clerk of the

County and State aforesaid, who being first duly sworn according to law, deposes and says: That he/she complied with the law by

having the financial statement for the fiscal year ending June 30, 2014, and the estimated needs and the estimated income from

sources other than ad valorem taxes, for the fiscal year beginning July 1, 2014 and ending June 30, 2015 published in one issue of
r the Miami News Record a legally-qualified newspaper published - of general circulation, in said county (strike inapplicable phrase)

a copy of which together with proof of publication is herewith attached marked Exhibit "Z" and made a part of hereof.
r County Clerk

Subscribed and sworn to before me this___dayof___ i 2014.

r Notary Public My Commission Expires
r es
(
r S.A.&1. Form 268BR98 Entity: EMS Board, 58 See Accountant's Report ‘Monday, October 20, 2014
fi
L


--- OCR page 8 of 21 ---
r EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
P EXHIBIT "E" PAGE 1
r
Arnot J
ASSETS:
r
| Investments Cid
3 [TOTALASSETS COC™~—CCN#CO(‘#dz
r [CIABILITIES AND RESERVES:
ls |
[ss
Pr [s
[sd
r
CEE Se
. REVENUE:
 feshbumenesnns gs cassia
Pr {|
{Cd
[
r Lo
| =
Iclaims Paid by Warrants Issued $ 244,080.25
[so
r rs es
es ee
es
r
r"
{
i is
c
[so -
m
Pr
:
a fn
r [s_-
[s
fs—__——
r
{|
is
cr S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014
c


--- OCR page 9 of 21 ---
=
EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
- ESTIMATE OF NEEDS FOR 2014-2015
EXHIBIT "E” da)
‘Schedule 4, Miscellaneous Revenue !
2013-2014 ACCOUNT
SOURCE ACTUALLY _]) =}
ESTIMATED COLLECTED. {
1000 CHARGES FOR SERVICES rs |
IIL Service Fees CS Ce
[112 ServiceFees ST
— au training Fees gg
[1114 Other fs
a |
[2116 Others
1117 Other - [ss
1118 Other - ee al
[1119 Otter
1120 Other ~ [ss
[1121 Other Ss 5
1122 Other - [sos
cs [11123 Other ss
1124 Other - [ss =
[1125 Other ss
Total Charges For Services [ss
INTERGOVERNMENTAL REVENUE, es
2000 INTERGOVERNMENTAL REVENUE - LOCAL SOURCES: ee | ee | a
2111 Local Contributions js es
2112 Local Governmental Reimbursements [ss
2113 Local Payments in Lieu of Tax Revenue Is | al
2114 Other - Protest Tax a
“ 2115 Other - [ss
re Ce
[2116 Other =
2118 Other ~ [ss
2124 Other- [s______- |s____—_--]} _,
Total - Local Sources es
3000 INTERGOVERNMENTAL REVENUES - STATE SOURCES: es |
3111 County Sales Tax - OTC js
3112 Other - OTC. [ss "]
_ Sub-Total - OTC [ss
[3211 State Grants
3212 State Payments in Lieu of Tax Revenue [ss
3213 Homestead Exemption Reimbursement aS ee
3214 Additional Homestead Exemption Reimbursement [is UWdSC~“*=‘“S*S*CS*=C*@Yd
3215 Other - 5 year exempt rs es
3216 Other - ee |
3217 Other - es
3218 Other Es Ce
3219 Other - [fs is
~ [3220 Others
[3221 Other Sf
js
3223 Other - [ss
[32240ther- CdS Cd Cd
3225 Other - es ee
Total - State Sources a ee
Continued on page 2b See Accountant's Report Monday, October 20, 2014
S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 =
|


--- OCR page 10 of 21 ---
r EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
r Page 2a
{ |
’ BASIS AND
oe | icrornsine | “aaanaE [sassy | — maa
r [____(UNDER)_| ESTIMATE
| | |
|
r [s_ 90.0006 gs
[ss 90.00% sg
[sO s0.00%f's gs
r [so 90.00% ss
[ss 00 $s
[soos see
() GG! EE ON LS]
c [ss 90.008 s sg
[0.008 pr
LL
Cones oh oh
[ss g0.000qf ss ig
7 a |): Ea | |S
r [s socom sg
ES | OR | | |
eS | | | | ON |
eS | | | SO
[ [ss s0.000gf ss gs
[se 90.000 sg
js g0.000f' ss
c [gs  90.00nf'¢ ss
[so g0.00%f's sg
[sO — 80.0028 $s
r [se 9000's sg
[sn 90.0024 $s
0.009 § Ss
r [SS Sd
| | |S |
[se 90.0004 ¢ ss
[is 90.00nf ss tg
r ST 7 | | |
a |X | | |
ee 7) SN | |S
PR nt 0. fs
a CL
[scons ss
r a | a | |
[se 90.00% gs gs
a TE
r [so 0.000 ss
[se 90.00% s
[s— 90.0094 § fs
[0.0008 $s fs
c [se 000s ss
[so g0.c0rf's sg
r a |S |S |
is SS
S.A.&l. Form 268BR96 Entity: Ottawa EMS Board, 5B ‘See Accountant's Report Monday, October 20, 2014


--- OCR page 11 of 21 ---
"
|
EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
EXHIBIT "E" 2v *)
° }
SOURCE :
ee
| 4000 INTERGOVERNMENTAL REVENUES -FEDERAL SOURCES. SdSCS*d
[atti Federal Grants CdS CCS CSS 4
[4112Reimbursement-Federal CdS CdS CC~*d SC?
| 4113 Federal Payments in Lieu of TaxRevenue CdS CS C—~*
[414 Other ss =
EL | | i
[4116 Others ss
[4117 Other = ss
OL S| "|
[4119 Other = Ss
[4120 Other
[4121 Other= SYS SY |
[4122 Other SS SC
[4123 Other dS dS CS
[412s Omer dS
[41260ther- TT CCSC*ddS TCC CdS OCOC~SSY
[4127 Other = ss
[4128 Other OS al
[____Total Federal Sourees dS TTCCCSCC*dS CCOC~CS~*
[Grand TovalIntergovernmental Revenues SY
[5000 MISCELLANEOUS REVENUE: Pd
[Sit intereston Investments CdS SSCS SdiS a0 |
[5112 Rental or Lease of Property SC CdS CS =C*d
[5113 Sale ofPropety CdS CCS C~*Y =
* | 5114 Subscription Sales Memberships) SC dS CC ~*d
[5115 Insurance Recoveries CdS CCC CdS CSS~*Y
| 5116 insurance Reimbursement OS OS Cd
[5117 Retum Check Charges SCC CO SCCC*dSCSY
[S118 Usilty Reimbursements CdS COS CS~*
[5119 Vending Machine Commissions CdS CCC CdS CS~*
| $120 Other Concessions dS CCC*dS CSCS “|
[5121 Other dS SC
[5122 Other ss
- |f9123 Other ss
[5126 Other = ss
[5125 Other = ss
| $126 Other = ss "
[$128 Other CdS CdS CSS
| $129 Other ss
| $131 Other ss
[5132 Other dS
- [_____ Total Miscellaneous Revenue CdS SSCS—~*dS Se
[S000 NON-REVENUE RECEIPTS! Or Cd”
[6111 Contributions from Other Funds dS CCCC«C*dS SSCS
a | |
[___ Grand Total Emergency Medical Fund Sid ~«*idS ——S—~sr Or | 7
S.A.&1 Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014 :
7


--- OCR page 12 of 21 ---
r EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
Pr Page 2b
oY
BASIS AND
= LIMIT OF ENSUING
Po [=o ESTIMATE
a |
ones oh FJ
a a 7 a
[snc 09 ss
[sf 0 ctf § 3 rs
ee CC eS
[S| s.o0ed $s
fs 0008 $s
rs ee es
[sf 9.002ff §
Ss 009s 5 i
= fs ps i
0 008 ht
[sf 0.00 § 3
m= fs 90.000
A TC
[sO 9009f ss
[sf 0008 §
ee EC |
a ne | STO |S |
ee LE FE Eee SEE
Pp a a | | ||
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Po 00's fs Ys
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rts
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CS 0.098 ss
c— 0 0's ss
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PR so 09 $s ts
ba 009 is
a CN
r A TK | | |
a | | | ||
a CT a
a
Pr ES (502 | | |S |
. S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014
f
|


--- OCR page 13 of 21 ---
7
EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
EXHIBIT “E" 3 “|
[so
es
4
7
[s_ 191.04
[sd 4
, y
|
[so
|
rs
[s =
[sg
™
|
[s
:
[TOTAL C—*zd
4
Ge es
[ss
is
1
[BALANCE WARRANTS OUTSTANDING JUNE 30,201 [S|
=
|
=|
es
js
7
[ss
7
[s_
|
. S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 ‘See Accountant's Report Monday, October 20,2014“


--- OCR page 14 of 21 ---
r EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
Page 3
r Schedule 5, (Continued)
2012-2013 2011-2012 2010-2011 2009-2010 2008-2009 2007-2008 TOTAL
S$ i2g3si28f[s = ss
r [s—zeasize's ss YS dS “i ___-_] 8 128 35128]
es
[ss sss
i $ 4asg76$ sss
SS Fe ee |
r [ss sss
SS ES | | |
ps ss gs sans 81056
gs aaso7eiis Ss gs
r Js ss sss 244,080.25 |
[ss ss ss
a SC |
r $ 44g9.76|[$_ iS SS is CS 291,081.59
ES | | | S|
[ss sss
= ES (ES | | |
r SS | Se | |
| |S || |
$ 4.499.76[s___ = dS CS dS dS
c
2013-2014 2012-2013 2011-2012 2010-2011 2009-2010 2008-2009 2007-2008
[so ss is ss
c a | ES | ek
[ss s- S
r $s 244,08025[ Ts ss
[ss ss ss
| ES ES | | |
7 ES |S | |
r [sits ds dS dS Sd
a ES ES | | | | |
r Schedule 9, Emergency Medical Fund Investments
Tavestments LIQUIDATIONS Barred Tavestments
P INVESTED IN on Hand Since by on Hand
June 30, 2013 Purchased of Cost Premium Court Order_||__June 30, 2014
a |S | | | |
p a | |S |S |S |
r a | ES | SO | SE | S| SO |
a | ES (S| Se
E a | SS |S |
r ss ss gs
a ES Sn | SO | S| |
SE CS CS CC |
i | ES |
[OTALINVESTMENT/S = SS TS
r S.A.&L. Form 268BR98 Entity: Ottawa EMS Board, 58 ‘See Accountant's Report Monday, October 20, 2014


--- OCR page 15 of 21 ---
x
EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
EXHIBIT "E” 4 "|
Po FISCAL YEAR ENDING JUNE 30,2013
7
|
pT issn Tarpropriations[ |
a ee SY
2 EMERGENCY MEDICAL BUDGET ACCOUNT: [| 7
[p2aPersonal Services 0 gs 1,050.00]
fabParTimeHelp ss ss
Peeve gs sss
2d Maintenance and Operation t's sss arz.0498
B2e Capital Outlay gs ss
eat intergovernmental sss
2g Revaluation 0g ss sara
Jp2h Other sss
fea} Other gs ss
[92 Total Ss 995357370)
cS (ce A (S|
Jp3aPersonal Services sss eg
pabPartTimeHelp sss
Se | | | | |
[p3d Maintenance and Operation ss ss
Jp3e Capital Qutlay sss
p3fintergovernmental ss ss
3g. Other ss ss
3h Other ss ss
[93Total SS ss 7
[95 EMERGENCY MEDICAL AUDITBUDGET ACCOUNT: [J
Sa Salaries and Expense of AuditandRepot S$ Ss Ws 4 25559]
[pSb Intergovemmental sss 7
Se Other = gs gs
2 ee Fn | |
Se Other= gs ss a
st Other= ss ss
Sg Other= ss ss
5h Orer = sss
[9S Total Ss 25559] 7
PSOTHERUSES; eee 2
Jp8a Other Deductions Ss ss a
. | | SN |F ES| S
Po rs
oe
——————
[s_ =| [s_-|
[GRAND TOTAL GENERAL FUND SS S516, 62979] 7
es
[Current Expense eee
TT 7
S.A.&I. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014 7


--- OCR page 16 of 21 ---
r EMERGENCY MEDICAL FUND ACCOUNTS COVERING THE PERIOD JULY 1, 2013, to JUNE 30, 2014
ESTIMATE OF NEEDS FOR 2014-2015
r Page 4
-~ [oT Neramount [ WARRANTS | RESERVES [LAPSED | NEEDS AS [APPROVED BY|
r | SUPPLEMENTAL [or [| issuep [BALANCE [ESTIMATED BY} COUNTY _|
| _ ADJUSTMENTS _| appropriations [|| KNOWNTO BE| GOVERNING | EXCISE BOARD|
|__ADDED [CANCELLED] Td C*dUNENCUMBERED! BOARD |
Pr a | S|
‘ is fs ts ,050.00[$_ 044.00 [ss e008 1, s00.00|[s 1,500.00]
a | | | |
r [ss sss
[s_- [s = Ts 472,049.68 |[$ 237,722.40|/$ = T'S 234,327.28 || $  649,550.00|| $642,296.43 |
SE ES
r SR ES | | |
[sss 2.27402 [s2.27402[s ss 10,000.00 s8,636:70
[sss sg ss
m fs. fs ss ss gs
r [sts = _ 475,373.70] $241,040.42 [sd Ss 234,333.28 $661,050.00] $ _ 652,433.13 |
a | (| | ||
- fs - is. ss ss ss
r Is - Is - is ts ss ss
[Is - fis = is ss sss
ey | EE S| | |
r [Is - Is - Iss ss ss
[Is - Is - Is fs ts is ss
fs. |s - is ss sss
r [s- Is - ss ss ss
Is_- Is - ls - ‘Is is SS
| | | | | |
r [s- |s _- I[s 412sssol[s 3,039.83 |[s Ws 38,215.76 |/'s_ 55,000.00] $__ 35,873.53]
[s_- lls - Js - sss is ts ts
[s_-|s - ls —- ‘is fs ts is is
, |s -|s - ss ss ss
r [s- Is - [ss ts Ss ss
[fs -|s - Is - (is - is ts is is
[s- |s - Is - is ss ss
[P= 5 ag ae | —— Ff)
[is _- [s_- Ws 44.25s59|[s 3,039.83 |[s = [S__ 38,215.76 |['s 55,000.00 |[ $35,873.53
a | RR | |(|
fs - Is -|s - [fs fs ss is
r [s-s_-|s - ‘is - is = ss
[fs — aa pas ——— rs re
[S____- |S _516,62929|[S_244,08025][S = ‘| S_ 272,549.04] $_716,050.00][ $ 688,306.66
————————— —— ———
a [si [s-|
r [s__- IS _- I$ sie0529|[S 244,080.25] $= (|S 272,549.04 | $ _716,050.00][ $688,306.66]
DT estimate of “TT Approved by |
r (Governing Board] Excise Board]
P8706, 050.00 TS 679,669.96 |
em |[oT810,000:00 8,636.70
a
r CL S716, 050,00 [SF _ 688,306.66
r 'S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report Monday, October 20, 2014


--- OCR page 17 of 21 ---
Exhibit “Y” Page 1

r CERTIFICATE OF EXCISE BOARD

{ ESTIMATE OF NEEDS FOR 2014-2015

r COUNTY OF OTTAWA, STATE OF OKLAHOMA,

‘We, the members of the Excise Board of said County and State, do hereby certify that we have examined the foregoing estimates of
proposed current expenses for the ensuing fiscal year as filed with the Emergency Medical Service Board, and those directly under, or in

Pr contractual relationship with, the Emergency Medical Service Board; we have ascertained from the Financial Statements submitted
therewith the amount of Surplus Balances of Cash on Hand; we have considered the uncollected ad valorem taxes of the previous year or
years; and we have ascertained that the probable Income estimated to be collected from all sources other than ad valorem taxation may

cr reasonably be expected as a revenue for the ensuing fiscal year, and that the same does not exceed 90% of the actual collection from such
sources for the previous fiscal year.

r Inso doing, we have diligently performed the duties imposed upon the Excise Board by 68 O.S. 1991 Section 3007, (1) ascertaining that
the financial statements, as to statistics therein contained reflect the true fiscal condition at the close of the fiscal year, or caused the same to
be corrected so to show; (2) struck from the estimate of needs so submitted any items not authorized by law and reduced to the sum
authorized by law any items restricted by statute as to the amount lawfully expendable therefore; (3) supplemented such estimate, after

cr proper publication, by an estimate of needs prepared by this Excise Board to make provision for mandatory governmental functions where
the estimate submitted wholly failed or was deemed inadequate to fulfill the mandate of the Constitutions or of the Legislature; (4)
computed the total means available to each fund in the manner provided; and (5) then and only thereafter. -

[ Accordingly, we have and do hereby appropriate the Surplus Balances of Cash on Hand, and the Revenues and Levies hereinafter set forth
for each Fund to the several and specific purposes named in such estimates, by each, to the intent and purpose that CONSTITUTIONAL

ie GOVERNMENTAL FUNCTIONS shall be first assured and provided for, and subsequently to provide for Legislative Governmental
Functions insofar as to the available Surpluses, Revenues and Levies will permit; and we have provided also that the Levies are in excess of
the amount appropriated to needs after deducting the surplus cash balance on hand, and Estimated Revenues other than tax, by the

r percentage and amount or reserve for delinquent tax as hereinafter set forth, which we have determined in the manner provided by law.

We further certify that we have examined the within statements of account and estimated needs or requirements of the Governing Board of

r 2013 County, in relation to the Sinking Fund or Funds thereof, and after finding the same correct or having caused the same to be corrected
pursuant to 68 O. S. 1991 Section 3009, have approved the requirements therefor to fulfill the conditions of Section 26 and 28 of Article
10, Oklahoma Constitution, and have made and certified a tax levy therefor to the extent of the excess of said total requirements over the

r total of items 2, 3, 6, and 12 of Exhibit "Y" (Page 2) and any other legal deduction, including a reserve of 10% for delinquent taxes.

r See Accountant's Report

S.A.&I. Form 268BR98 Entity: Ottawa EMS Board, 58 Monday, October 20, 2014


--- OCR page 18 of 21 ---
CERTIFICATE OF EXCISE BOARD -
ESTIMATE OF NEEDS FOR 2014-2015
Page 2
(County Excise Board's Appropriation EMS Sinking Fund ||"
lof Income and Revenue Fund (Exc. Homesteads)
[Appropriation Approved & Provision Made $688,306.66 |S =
7
lExcess of Assets Over Liabilities $286,591.83
[Unclaimed Protest Tax Refunds [st
iscellaneous Estimated Revenues [ss
IEst. Value of Surplus Tax in Process "
Sinking Fund Contributions [s_
Surplus Builing Fund Cash [ss
[Total Other Than 2013 Tax S$ 286,591.83 7S =
[Balance Required. $ 401,714.83$ |
|Add 10% for Delinquene [S___ 40,171.48 [$= T
otal Required for 2013 Tax 741,886.31
pie ot Levy Required end Cortiied (00 Mig) 0
We further certify that the net assessed valuation of the Property, subject to ad valorem taxes, after the amount of all Homestead Exemptions have been
deducted in the said County as finally equalized and certified by the State Board of Equalization for the current year 2014-2015 is as follows:
[VALUATION AND LEVIES EXCLUDING HOMESTEADS
$_99,541,655.00][ $ _25,346,182.00 [8 _19,049,072.00]| S_143,936,909.00]|
and that the assessed valuations herein certified have been used in computing the rates of mill levies and the proceeds thereof appropriated as aforesaid;
and that having ascertained as aforesaid, the aggregate amount to be raised by ad valorem taxation, we thereupon made the levies therefor as provided by
Jaw as follows: .
EMS Fund 3.07 Mills; Building Fund 0.00 Mills; Sinking Fund 0.00 Mills; Sub-Total 3.07 Mills;
——— l_D
Free Fair Budget Account (Levy Per Applicable Statute) 0.00 Mills;
Free Fair Improvement Budget Account (Net Proceeds of 1.00 Mill) 0.00 Mills;
Free Fair Additional Improvement Budget Account (Net Proceeds of 1.00 Mill) 0.00 Mills;
Library Budget Account (Net Proceeds of 1/2 of 1.00 Mill) 0.00 Mills;
Cooperative County/City-County Library Budget Account (1.00 to 4.00 Mills) 0.00 Mills;
County Cemetery (Prior To Aug. 15, 1933) Budget Account (Net Proceeds of 1/5 of 1.00 Mill) 0.00 Mills;
Public Buildings Budget Account (Not To Exceed 5.00 Mills) 0.00 Mills; =
County Health Fund (Not To Exceed 2.50 Mills) 0.00 Mills;
Emergency Medical Service ( Not To Exceed 3.00 Mills) 0.00 Mills;
Total County Levies 3.07 Mills;
County Wide Levy For Schools (4.00 Mills) 0.00 Mills;
Total County Wide Levy 3.07 Mills;
Ss
and we do hereby order the above levies to be certified forthwith by the Secretary of this Board to the County Assessor of said County, in order that the
Assessor may immediately extend said levies upon the Tax Rolls for the year 2015 without regard to any protest that may be filed against
any levies, as required by 68 O. S. 1991, Segtion 2869
Dated at “\ ome , Oklahoma, thistX™ day of. Ys conbs/ » 2014.
a Excise Board Chairman mR
a LEN
‘Excise Board Member Se Board Seoretary/# Ese FouNiN\e
y « /1907\ * B) 7
S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 See Accountant's Report SoC Minds Detober 20, 2014


--- OCR page 19 of 21 ---
r OTTAWA COUNTY, 58
STATISTICAL DATA

r FISCAL YEAR 2013-2014
Total Valuation

r Total Gross Valuation Real Property $ 107,578,923.00
Total Homestead Exemption $ 8,037,268.00

[ Total Real Property $ 99,541,655.00

[ Total Personal Property $ 25,346,182.00
Total Public Service Property $ 19,049,072.00

[ Total Valuation of Property $ 143,936,909.00

l

See Accountant's Report


--- OCR page 20 of 21 ---
S
EMERGENCY MEDICAL SERVICE BOARD PUBLICATION SHEET - OTTAWA COUNTY, OKLAHOMA
FINANCIAL STATEMENT OF THE VARIUS FUNDS FOR THE FISCAL YEAR ENDING JUNE 30, 2014, AND ESTIMATE OF NEEDS "|
FOR THE FISCAL YEAR ENDING JUNE 30, 2015, OF THE EMERGENCY MEDICAL SERVICE BOARD OF :
OTTAWA COUNTY, OKLAHOMA
EXHIBIT "Z" Page | 4
ATEMENT OF FINANICAL CONDITION |
ASSETS:
4
[/ tavesiments
[LIABILITIES AND RESER a
er Pe
Reserve for Intereston Wananis
[Reserves From Schedule 8S
[TOTAL LIABILITIES AND RESERVES es
[CASH FUND BALANCE (Defic) JUNE W020 OTS] |
ESTIMATED NEEDS FOR FISCAL YEAR ENDING JUNE 30, 2014 H
[GENERAL FOND [GENERAL FOND] SINKING FUND BALANCE SHEET]. SINKING FUND]
[Curent Expense [$679,669.96 I. Cash Balance on Hand June 30,2014 [$= |
[Reserve forint. on Waranis & Revaluation | $8,636.70 2. Legal Investments Properly Maturing |[$_- | |
[TotalRequired I $688,306.66 J. Judgements Paid to Recover by TaxLewy || S$ - |
JFINANCED Tota Liquid Assets dS
[CashFund Balance |S 986591, 85 [Deduct Marured Indebtedness JD]
[Estimated Miscellaneous Revenue ——[$___-_|f5.a PastDue Coupons Sid dC
[Tol Deductons dS 286,551.85 6. Interest Accrued Thereon dS
[Balance to Rase from Ad Valorem Tax $401,714.83 ]7-c. PastDue Bonds | s_-_]
[ESTIMATED MISCELLANEOUS REVENUE, [8 d.JneretThereon Afra Caupon——_l[$
[1000 Charges forServices iS = J. Fiscal Agency Commissions on Above | S$ -]
[2000 Local Sources of Revenue [8 -]f0. Judgements and In. Leviedfor/Unpaid | $_-_|
[5000 Stale Sources of Revenue [$__- ll. Toualltemsa Through +S -_|
[000 Federal Sources ofRevenve | $__- 12. Balance of Asses Subject to Acoma [S| "
15000 Miscellaneous Revenue | $ Deduct Acorual Reserve If Assets Sufficienty [|]
[5111 Contributions from Other Funds 8 -ll3.g.Bamed UnmaturedIntrest [S$ -_|
[_ Total Estimated Revenue $=] Accrual on Final Coupons | $___]
15.1 Acerued on Unmatued Bonds [§-] "|
[i6. —Totalftemsg. Throughi, ]|s_-] |
[7 Exoess of Asseis Over Accrual Reserves == || $
[J.Interest EarningsonBonds TS 7
B.-Accrual on Unmatured Bonds | $s -_]
By Annual Accrual on "Prepaid Judgements | $____- |
[s-Annual Accrual on “Unpaid” Judgements | $= |
Choctortmd ea ts] |
[5-Annual Accrual From ExhibtKK —__[$_- _|
a
a |
a |
a |
a
a
ae
[Toa Sinking Fund Requienens | s———
[emer |
[LExces of Asses Over Linbiiies | $__-]
[2 Surplus Building Fund Cash JJ? __]
[Balance to Raise ByTaxLevy OS Cid
S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 Monday, October 20, 2014 4
4
|


--- OCR page 21 of 21 ---
7 EMERGENCY MEDICAL SERVICE BOARD PUBLICATION SHEET - OTTAWA COUNTY, OKLAHOMA.
FINANCIAL STATEMENT OF THE VARIUS FUNDS FOR THE FISCAL YEAR ENDING JUNE 30, 2014, AND ESTIMATE OF NEEDS
FOR THE FISCAL YEAR ENDING JUNE 30, 2015, OF THE EMERGENCY MEDICAL SERVICE BOARD OF
OTTAWA COUNTY, OKLAHOMA
_ EXHIBIT "Z"
[F* If line Tis less than line 16 after omitting "h” deduct the following NEI
each in turn from line 4, "Total Liquid Assets".
Tad. j. Unmatured Coupons Due 4-1-2015 [so
me _ |[i4a.k. Unmatured Bonds So Due [|
5d. |. Whatever Remains is for Exhibit KK Line E,
S|
17d. Less Cash Requirements for Current Fiscal Year in Excess of Cash on Hand (From Line 15d Above). st
pm |[08d. Remaining Deficit is for Exhibit KK Line F.
CERTIFICATE - GOVERNING BOARD
= STATE OF OKLAHOMA, COUNTY OF OTTAWA, ss:
We, the undersigned Emergency Medical Service Board of Ottawa County Oklahoma, do hereby certifythat at a meetingof the Emergency Medical
ne Service Board of the said County, begun at the time provided by law for Counties and pursuant to the provisions of 68 O. S. 1991 Sec. 3002, the
foregoing statement was prepared and is a true and correct condition of the Financial Affairs of said Emergency Medical Board as reflected by the
record of the Clerk and Treasurer. We further certify that the forgoing estimate for current expenses for the fiscal year beginning July 1, 2014, and
ending June 30, 2015, as shown are reasonably necessary for the properconduct of the affairs of the said Emergency Medical Service Board, that the
F Estimated Income to be derived from sources other than ad valorem taxationdoes not exceed the lawfully authorized ration of the revenue derived from
the same sources during the preceding fiscal year.
S [ ~ 7 HS * _
Chairman of Board Wether Member
7 ; eA ,
Membey Membs Member
Attest
County Lp Seal
= Som
Ee aN
Tow, OFFICIAL SEAL i OTTAW. H
ro] Se B. ELLIS Bh /1907\ *
2a UN be NOTARY PUBLICOKLAHOMA = j aL &
a AV ‘OTTAWA COUNTY Sa
IB Nev } iGo, NC 02020494 EXP. 01-13-2015} ome
{Subscribed and swom to before me this 2 day of Ing, 2014. ~
oe Zz
A VOoLKGE Notary Public
1 Regéfred to be published in a legally-qualified newspaper printed in the County, or one issue published in a legally-qualified newspaper of general circulation
in the County.
S.A.&1. Form 268BR98 Entity: Ottawa EMS Board, 58 Monday, October 20, 2014