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Home My Public Portal About8-IRS Form 8038-G and evidence of filingWEISS SEROTA HELFMAN COLE & BIERMA.N A rHE CROSSROADS Of BUSINESS, GOVERNMENT NT & THE: LAW Internal Revenue Service Center Ogden, UT 84201 April 27, 2017 Certified Mail Return Receipt Reauested 7012 0470 0001 2402 8283 Re: $1,001,001.20 Village of Key Biscayne, Florida Lease Purchase Financing Dear Sir or Madam: Enclosed please find Form 8038-C, Information Return for Tax -Exempt Governmental Obligations, for the above referenced matter. If you have any questions regarding the foregoing, please do not hesitate to contact Us. Sincerely, :;ic�cli��l'?iEiiklcl,erger, Paralegal Jed K \DOCS\O1n3\1O2 ;3E8R9 23 DOCX Enclosure as noted, cc: Jeff DeCarlo, Esq. 2525 Ponce de Leon Blvd., Suite 700, Coral Gables, FL 33134 1305-854-0800 Lvww.wSh-law.ro111 m £t7 ru rU D m r9 D D D a N D N r9 D U.S. Postal Service. - `CERTIFIED MAIL RECEIPT (Domestic Mall Only; No insurance Coverage Provided) - or delivery: information visit our website at www.usps.coms Postage Certified Fee Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees Sent To 1:12„ H Ol a3, /o,L- Postmark Here Street, Apt. No.; or ! , r �' or PO Box No.. D � U � Y'+l'G City, Slate, Z!P+4 PS Form 3800, August 2006 See Reverse for Instructions SENDER: COMPLETE THIS SECTION ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery Is desired. ■ Print your name and address on the reverse so that we can return the card to you. • Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: COMPLETE THIS SECTION ON DELIVERY A. —Signature _ _ rn a Received by (Printed Name) n° MAYS 1, t. ; Is delivery address dl ent fr errepter delivery addre �t2tle wc SAwi U ❑ Agent ❑ Addressee C. Date of Delivery m1? ❑Yes ow: 0 No 3. Service Type Certified Mall® 0 Priority Mail Express'" ❑ Registered Return Receipt for Merchandise ❑ Insured Mail Collect on Delivery 4. Restricted Delivery? (Extra Fee) 0 Yes 2. Article Number (Transfer from service label) 70/02 o4 90 ace)! t/o XelT3 PS Form 3811, July 2013 Domestic Return Receipt F Form -G Info[ruuoatkm Rota g` v Tax-Exempt. Governmental Obligations (Rev. September 2011) Department of the Treasury Internal Revenue Service D Under Internal Revenue Code section 149(e) 12> See separate instructions. Caution: If the issue price is under $900,000, use Form 8038 -GC, OMB No, 1545-0720 Part Reporting Authority If Amended Return, check here - ❑ 9 Issuer's name Village of Key Biscayne, Florida 2 Issuer's employer identification number (SIN) 65-0291811 3a Name of person (other than issuer) with whom the IRS may communicate about this return (see instructions) 3b Telephone number of other parson shown on 3a 4 Number and street (or P.O. box If mall Is not delivered to street address) 88 W. McIntyre Street Room/suite 5 Report number (For IRS Use Only) 3 1 6 City, town, or post office, state, and ZIP code Key Biscayne, FL 33149 7 Date of Issue 04/21/2017 8 Name of Issue Master Lease Purchase Agreement, Lease Schedule No. 3 and Lease Schedule No. 4 9 CUSIP number none 10a Name and title of officer or other employee of the issuer whom the IRS may call for more information (see instructions) John Gilbert, Village Manager 10b Telephone number of officer or other employee shown on 10a 305-365-5514 Part II Tvne of Issue (enter the issue orice). See the instructions and attach schedule. 11 Education 12 Health and hospital 13 Transportation 14 Public safety 15 Environment (including sewage bonds) 16 Housing 17 Utilities 18 Other. Describe II* general government vehicles 11 12 13 14 956, 993 00 15 16 17 18 44,008 20 19 If obligations are TANs or RANs, check only box 19a I ■ If obligations are SANS, check only box 19b 113. ❑ 20 If obligations are in the form of a lease or installment sale, check box lP ❑ Part iii Description of Obligations. Complete for the entire issue for which this form is being filed. 21 (a) Final maturity date (b) Issue price (c) Stated redemption price at maturity (d) Weighted average maturity (e) Yield 04/1212021 $ 1,001,001.20 $ N/A 4 years 1.53 % Part IV Uses of Proceeds of Bond Issue (including underwriters' discount) 22 Proceeds used for accrued interest 23 issue price of entire issue (enter amount from line 21, column (b)) 24 Proceeds used for bond issuance costs (including underwriters' discount) . . 24 5,000 00 22 23 1,001,001 20 29 5,000 00 25 Proceeds used for credit enhancement 25 26 Proceeds allocated to reasonably required reserve or replacement fund 26 27 Proceeds used to currently refund prior issues 27 28 Proceeds used to advance refund prior issues 28 29 Total (add lines 24 through 28) 30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) . . 30 996,001 20 Part V Description of Refunded Bonds. Complete this part only for refunding bonds. 31 Enter the remaining weighted average maturity of the bonds to be currently refunded . . . . 32 Enter the remaining weighted average maturity of the bonds to be advance refunded . . 33 Enter the last date on which the refunded bonds will be called (MM/DD/YYYY) 11> 34 Enter the date(s) the refunded bonds were issued ® (MM/DD/YYYY) For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 637735 years years Form 8038-G (Rev. 9-2011) Form 8038-G,(P.ev.9-2011) Page 2 Miscellaneous Part VI 35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) . . 36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (GIC) (see instructions) b Enter the final maturity date of the GIC ► c Enter the name of the GIC provider* 37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans to other governmental units 38a If this issue is a loan made from the proceeds of another tax-exempt issue, check box ► 0 and enter the following information: b Enter the date of the master pool obligation ► c Enter the EIN of the issuer of the master pool obligation 10- d Enter the name of the issuer of the master pool obligation ► 39 If the issuer has designated the issue under section 265(b)(3)(B)(1)(lil) (small issuer exception), check box 40 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box 41a If the issuer has identified a hedge, check here ► ❑ and enter the following information: b Name of hedge provider* c Type of hedge ► d Term of hedge ► 42 If the issuer has superintegrated the hedge, check box * ❑ 43 If the issuer has established written procedures to ensure that all nonqualified bonds of this issue are remediated according to the requirements under the Code and Regulations (see instructions), check box ► 111 44 If the issuer has established written procedures to monitor the requirements of section 148, check box ► ❑ 45a If some portion of the proceeds was used to reimburse expenditures, check here ► 0 and enter the amount of reimbursement ► b Enter the date the official intent was adopted ► Signature and Consent under penalties of perjury, t declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they era true, correct. and complete. I further declare that I consent to theIRS's disclosure of the Issuer's return information. as necessary to proces , this return, to the person at I have authorized above. Sign: tuFe of isst eDs authorized re •reseitative Paid Preparer Use Only •rift.Typ: preparer`sname J Frey D Carlo Date Prepart`s 4npurif John Gilbert, Village Manager Type or print name and title Frm,kpam s Weiss Serota Heitman c9f. &Bierman, P.L. Firm's address i 2525 Ponce de Leon Blvd., Suite 700, Coral Gables, FL 33134 Check ❑ if sell -employed Firm's EIN ► Phone no, 305-854-0800 PTIN P01491813 20.8112403 Form 8038-G (Rev, 9-2011i