PLATEAU V Y HOSPIT

FUND B

20L7

LGrD 39039t1

DISTRICT

GET

A LETTER

Plateau Valley Hospital District58t28 Highway 330Collbran, CO 81624

December 6.20L6

Division of Local GovernmentL3L3 Sherman Street, Room 52!Denver, CO 80203

Attached is the 2017 budget for theto Section 29-L-1.L3, C.R.S. This budgetregarding the budget, please contact ShaColorado 81624.

The mill levy certified to the countyBased on an assessed valuation of9787,942. A copy of the certification of

I hereby certify that the enclosed is a truethe Board of County Commissioners.

Signatures of Officers & Titles:

LGrD 39039/1

Member

F BUDGET

Valley Hospital in Mesa County,6,201.6. If thereadopted on

Currier at970487 28 and P.O. Box 3

is 8.00 for all general operati700 the property tax ue subject toill levies sent to the ntv Commissioners

accurate copy of budget and certi

anyColl

levies to

A RESOLUTIO]N SUMMAND ADOPTING A BLIDGET FOR THCOLORADO. FOR THI] CALENDAR Y2017. AND ENDING OlV THE LAST D

WHEREAS. the Board ofCurrier, Certified Public Accountant, tothe proper time, and;

WHEREAS, Shannon L. Currier,to this governing body on September 27,

WHEREAS, upon due and properbudget was open for inspection by the1.5,2016, and interested taxpayers were giproposed budget, and;

WHEREAS. whatever increasesadded to the revenues or planned to be exin balance, as required by law.

NOW, THEREFORE, BE IT RPLATEAU VALLEY HOSPITAL DIST

Section 1. 'Ihat the budget as submitted,adopted as the budget of the Plateau Val

Section 2. That the budget herebyand made a part of the public records of County.

ADOPTED, this Sixth dav of December. . ,20L6.

President

Secretary

I

iI

roN ro ADoPr BlulDGErIi

J EXPENDITURES 4ND REVENUES FON|. EACH FUIIDPLATEAU VALLEY I HOSPITAL DISTRICIT, COLLBP-AN,AR BEGINNING ONIT]FIE FIRST DAY OF'JANIJAR.Y,. oF DECEMBER,2917.

I

; of Plateau Valley Ho$nital District has appointed Shannon L.pare and submit a pro{osed budget to said gcrverning body' at

I

lertified Public A."ou,ftunt, has submitted a proposed budgetJL6, for its considerati{n, and;

inotice, published in acfordance with the law, said proposedic at a designated plac$, public hearing was held on Novemberren the opportunity to flile or register any objections to said

rended, and summariled by fund, hereby is arpproved andHospital District for tfre year stated above.

RESO oN ro ADoPr BlulDGEr

iEXPENDITURES AND REV

iI

and adopted shall belsilgned by the President and Secretary

LGID 39039t7

LGID 39O39IL

IIl

l,

li

ON TO SET MILLiLEVIESIl

RESOL

A RESOLUTION LEVI]NG PRCOSTS OF GOVERNMENT FOR THECOLORADO, FOR THT} 2OT7 BUDGET

WHEREAS, the Board of Diannual budget in accordaLnce with the

of the Plateau Valley lHospital District, has adopted theGovernment Budget paw, on December 6, 2016, arnd:

I

WHEREAS. the amount of mopurposes from property tax revenue is $78

WHEREAS . the 201.6 valuation f assessment for the Pl{teau Valley Hospital District as700. lcertified bv the County l\ssessor is $98.49

NOW, THEREF'ORE, BE IT LVED BY THE BOARD OF DIRECTORS OF THEPLATEAU VALLEY HOSPITAL

Section 1. That for the purpose of meetiDistrict during the 2017 budget year,total valuation for assessment of all ta

Section 2. 'That

the District's AccountantCounty Commissioners of Mesa County,as herein above determined and set basedcounty Assessor.

ADOPTED, this Sixth day of December,

Attest:

D.,20L6.

President

Secretary

necessary to balance,942,and;

tljre budget for general operatingl -

li

BUDGET YEAR.

President

Vice-President

Secretary

APPROPRIA

G SUMS OFAND FOR THE

DISTRICT.

has adopted theL6, and;

has made provisions t[ures as set forth in

law, but alsoto and for the pu

the operations of the

THE BOARD OFCOLORADO:

appropriated from

D.,2016.

F,ESOLUTTON

NOW THEREFORE, BS IT RESOLVEDVALLEY HOSPITAL DISTRICT. COLL

Section 1. That the follciwing sums arefor the purposes stated:

General Furnd Cllnent Operating

Total General Frfnd

ADOPTED, this Sixth dqV of December,

WHEREAS, it i$ not only requiredreserves or fund balanceb provided in the bestablishing a limitation pn expenditures

LGID 39039t1

SUMS OF M

TO THE VARIOURPOSES AS SET

budget, and;

ANDw,

COLORADO, 3017

with IrOCal

in for revenues in

to appropriate the and

RECTORS OF THE

revenue of each fu

TH

equal

2.

3 .

4.

5 .

( )(x)( )( )

LGrD 39039t1

PI.ATEAU V

The attached20LT Budget for Plateau V

The budgetary basis of [ccounting is:

DGET MESSAG

Hospital

vide medical servicesany other known e

1. The budgetpry basis of accou ing used in the budgetme available andaccrual basis of accou

services performedn Mesa in October,

of general, admi

location.ide for the future

Cash basisModified adcrual basisEncumbranbe basisAccrural basis

The District's majolr operation is todoes not exereise o]versight control

HOSPIT, DISTRICT

udes these important

the modifiedle. Expenditures

ng when the related

property taxes col by Mesa Countythe long time locati

Interest Income isnue is primarily tal income fort Fund/Miscella Revenues shown

and operatingyear. No significant anges are expected

during the20t6yea included replacement

of the District.

the Plateau Valleyles.

spacesist of

basis.re gene

Clinicin Col AS

District

County Tax Entity Code

CERTIFICATION OF TAX LEVIES for NOTO: County Commissionersr of

On behalf of the

the

of the

Ilereby officially certifies the following millto be levied against the taxing entity's GROa.ssessed valuation of:Note: Ifthe assessor certified a NET assessed valuati(AV) different than the GROSS AV due to a TaxIncrement Financing (TIF) Arear the tax levies mustcalculated using the NET AV. The taxing entity,sproperty tax revenue will be derived from the mill levvnrultiplied against the NET assessed valuation of:

Submitted:(no later than Dec. 15)

12/6/2016(mnlddlyyyy)

PURPOSE (see end notes for clefinitions and

General Operating ExpensesH

<Minus> Temporary General PropertyTemporary Mill Levy Rate Reductionl

SUBTOTAL FOR GENERAL

,3. General Obligation Bonds and Interestr

4. Contractual ObligationsK

5. Capital Expendituresl

6. Refunds/AbatementsM

7. OtherN (specify):

Contact person:(print)

Signed:

Include one copy of this tax entity's completed form when

r lf the taxing entity's boundaries include more than county, you must certify

, Colorado.

t District

98,492,700

, Line 2 of the Certification of Valuation Form DLG 5

598,492,700Line 4 of the Certification of Valuation Form Dt,G 57)

AL CERTIFICATION OF VALU.{IION PROVIDEDR NO LATER THAN DECEMBHR 10

I year 2017(vvvv)

RHIVENUE2

mills 787,942

) mills $ <

39039/ 1DOLA LGID/SID

-SCHOOL Governments

1 .

2.

mills

mills

mills

mills

mills

mills

mills

787,942

Fbrm DLG57 on the County Assessor,s FINAL certi

1 ezo; 487-3,+28

Certified Pubtic Accountant

by January 31st, per 29-1-113 C.R.S., with the

each county per Articlehe levies to each county. Use a separate form, Section 3 of the Colorado Conrstitution.

nue must be calculated the total NET assessed valuation (Line 4 oI

Shannon L.

for each county and certify the same levies uniformly'Irvies must be rounded to three decimal places and

Plateau Valley Hosp

(taxing entity

Board of Dir

(GROSS.. assessed v

(NET- assessed valual

USE VALUE FROM

for budget/

phone:

Title:

the local government's

Page 1 of 4

ion of valuation).

DLG 70 (Rev.6/16)

2.

CERTIFICA OF TAX LEVI continued

APPLIC.R.S.). Taxing entities that are

Special Districts or Subdistricts of Special Di te mill levies and revenues to theBoard of County Commissioners, one each nts of each debt (32-I-1603, C.R.S.)Use additional pages as necessary. The Spec ict's total levies for generill obligationbonds and total levies for contractual oblieati on Page 1, Lines 3 and 4 respectively.

CERTIFY A SEPARATE MILL LEVY

BONDSJ:

CONTRACT:

1 . Purpose of Issue:Series:Date of Issue:Coupon Rate:Maturity Date:Levy:Revenue:

Purpose of Issue:Series:Date of Issue:Coupon Rate:Maturity Date:Levy:Revenue:

CONTRACTSK:Purpose of Contract:Title:Date:Principal Amount:Maturity Date:Levy:Revenue:

Purpose of Contract:Title:Date:Principal Amount:Maturity Date:Levy:Revenue:

Use multiple copies of this page as necessary to contractual obligations per 32-t-I6A3, C.R.S.

J .

4.

tricts must certify sethe funding requiI District's or Subdi

should be reco

R EACH BOND

Page 2 of 4

ly report all bond

DLG 70 (Rev.6/16)

Notes:

o Taxing Entity-A jurisdiction authorized bylocated within its territorial limits (please seetaxing entity is also a geographic area formerlyassessor certifies a valuation for assessment anfinancial obligations incurred by the taxingarea of excluded property formerly within athe exclusion or the area located within the forobligation debt service is administered by anot

B Governing Body-The board of countydirectors, or the board of any other entity thatFor example: the board of county commissioimprovement district (PID); the board of aof the water subdistrict.

c Local Government - For purposes of this lisubdivision under whose authority and withingovernment is authorized to levy property taxthis form:

1. a municipality is both the local goverjurisdiction;

2. a city is the local government when levtaxing entity which it created and

3. a fire district is the local government ifdistrict levies property taxes.

4. a town isthe local government when itboard serves as the board of a dilevy for the annual debt service on oul

o GROSS Assessed Value - There will be a divaluation reported by the county assessor onlydowntown development authority or an urbanboard of county commissioners certifies eachValue fotnd on Line 2 of Form DLG 57.

E Certification of Valuation by Countysimilar) to provide valuation for assessment infcertification no later than August 25th each yeamust use the FINAL valuation provided by

F TIF Area-A downtown development autareas that use "tax increment financing" to deriForm DLG 57 Line 3) attributed to the activitithe differential revenue of each overlappingassessed value after subtracting the tming enti,assessed value.

" NET Assessed Valu*The total taxablefor its uses. It is found on Line 4 of Formmay be both a taxing entity and have also cDDA's boundaries. As a result DDAs mavcertified NET assessedvalue and also receiveDDA's TIF Area, including the DDA,s own

law to impose ad vaB, C, and H below

within a taxingwhich is responsible

when the area was paial district with o

boundaries of a dilocal governmentc

issioners. the citv couresponsible for the cers is the governing boaand sanitation district

on Page 1of the DLGboundaries the

on behalf of the taxing

and the taxing ent

ing a tax on behalf ofcity council is the BIcreated a subdistrict.

rovides the service forwater district, the I

ing obligations.

nce between srossthere is a "tax incre

newal authoritv. withining entity s total mills

, Form DLG 57 -rmation to a taxingand mav amend it. one

when certifying a

(DDA) or urban renrevenue from inc

ments withinentity's mill levy a

's revenues derived

valuation from wh57. Please Note: A

its own TIF areareceive operatingF revenue generatedrating levy.

Page 3 of 4DLG 70 (Rev,6/16,)

property taxes on taxable propertyFor purposes of the DLG 70 onl'y, ai/y's boundaries for which the county

payment of its share until retirernent ofof thetaxingentity. For exarmpl.e: aning general obligation debt at the time of

lved district whose outstanding general

il, the board of trustees, the board ofication of the tming entity's mill.levy.ex officio of a countv oublic;

tutes ex officio the board of directors

the local government is the politicalentity was created. The lr.tcal

For example, for the purposes of

when levying its own levy firr itrs entire

business improvement district (BID)board:

taxing entity , on whose behalf the fire

dissolved water district and the townentity, for the purpose of cer:tifying a

valuation and net assesseclfinancing" entity (see belorv), such as a

he boundaries of the taxing entit.y. Thepon the tming entity's GrossAsriessed

county assessor(s) uses this. The county assessor must

fonn (or onepro'vide thisEach entityime, prior to December 10'n.

x levy.

al authority (URA), may fonm prlanin assessed valuation (grossr minus net,plan area. The DDA or UIIA receives

ied against the taxing entity"s grossits mill levy applied against the net

h the taxing entity will derive re.yenuestown development authority (DDA)have a URATIF Area withLin the

ue from their levy applied to theirany tax entity levies overlapping the

I Line l)-The levyaggregate, all levies fL ines3throuqhTonpenses, unless the

70 Page 1 Line 2)-39-r-r11.5. c.R.s.Tax Credits (TTCs)

use these levies arets established for

y are certitied as aut

70 Page I Lineion bonds. Per 29-t-amount oI revenue

nts. Title 32, Article 1

4)-If repayment ofI oblieation bond

of revenue levied for thspecified by the provi

S):These revenues and municipalities

6)-The countvrty tax that thethey had paid or

their property valadiusted mill levv if ty, in the subsequent yenerate revenues up to,

ion 3 of the Colorado

H General Operating Expenses (DLG 70Line 1 is for general operations and includes, ipurposes not lawfully exempted and detailed inpension levy is included in general operatinguse Line 7 (Other).

t Temporary Tax Credit for OperationsCredit/ Temporary Mill Irvy Rate Reductiongeneral operations to effect refunds. Tempora(non-general operations) certified on this formthe provisions of any contract or schedule ofthe taxing entie per 29-L-301(L7), C.R.S., or tC.R.S.

J General Obligation Bonds and Interest (pay the annual debt service of all general oblilevied for this purpose cannot be greater than tprovisions of any contract or schedule of paycomplete Page2 of the DLG 70.

K Contractuat Obligation (DLG 70 page Ihas been approved at election and it is not a gethis line. Per 29-I-30I(1.7) C.R.S., the amounamount of revenue required for such purpose apayments.

L Capital Expenditures (DLG 70 page 1revenue limit if they are approved by counties301(1.2) C.R.S. and for special districts1-302(1.5) C.R.S. or for any taxing entity ifbe entered on Line 5.

M Refunds/Abatements (DLG 70 page 1(DLG 57 Line 11) the amount of revenue fromyear because taxpayers were given refunds fororiginally charged to them due to errors made irevenue and would have collected it throueh athe government was due the revenue, it mavrevenue. An abatement/refund mill lew mavamount from Form DLG 57 Line 11.

l. Please Note: Pursuant to Article X.

and certified the same to each count]Llocated in more than one countv. first

reported above. For example: a levy for the pusections 29 -7 -I01, 29-7 -IOZ, and 29-7-105 and

assessor, then divide by the taxing enti 's total net assesseddown to the nearest three decimals to vent levying for moreresults in an abatement/refund mill lev that will be uniformlytaxing entity is located even though the abatement/refund did

N Other (DLG 70 Page I Line Z)-Reporr r levies and revenueof television rela

2-I-1005 (1) (a), C.Rlevy for special purposes such as developme

accompanying revenue reported onand revenues raised by a taxiilg entity for

1 of the DLG 70. For example: a fireis voter-approved, if voter-approved,

he Temporary General Prope,rty llaxbe applied to the taxing entil,ty's levy fornot applicable to other types oI levies

usted from year to year as rspecified bypayment of any obligation incurred by

rized at election per 29-1.-3021(:2Xb),

on this line the total lev'/ required to1(1.7) C.R.S., the amount of revenueired for such purpose as spe,cified by the

ial districts and subdistrir:ts must

contractual obligation with property taxon Line 3), the mill levy is entered on

purpose cannot be greater than rlheof any contract or schedulle ol

not subject to the statutory pnoperty taxings pursuant to 29-1.-

pursuant to 29-es approved by these metlnodsi should

r reports on the Certification af V'aluationI government did not receive in tlhe priory were given abatements for taxes. The local government was due the taxvaluation errors had not occurred,. Since, a mill to collect the refund/abatementt not exceeding, the refund/iltratrement

o calculate the abate ntlrefund levy for a taxing entity that isIthe abatement/refuamounts reported by each count.y

, then multiply by 1,000 and roundenue than was abated/refuncledl. This

rtified to all of the counties in which theoccur in all the counties.

subject to 29-1-301C.R.S. that vrere notor translator facilities as specified in.; a voter-approved fire pension lrevli aetc.

Page 4 of 4

disabilities, open

DLC 70 (Rev.6i16;)

ESTIMATED RESOURCESBeginning Fund BalanceLess Tabor ReservesAdjusted Fund Balance

ESTIMATED REVENUESGeneral Property TaxSpecific Ownership TaxInterest lncomeClinic ServicesDistrict RevenueGrants/M iscellaneous Revenues

Total Available Revenues

ESTIMATED EXPEN DITU RESClinic ServicesGeneral & Administrative:

Maintenance & Environmental ServicesUtilitiesAdministrationInsuranceTreasurer's FeesTotal General & Administrative

Total Operating Expenditures

Capital Expenditures

Total Expenditures

Increase (Decrease) in Reserves

FUND BALANCEPlus Tabor Reserves

ENDING FUND BALANCE

PLATEAU ALLEY HOSPITALFUND BUDG

1, to December 31 ,

ACTUAL201s

3,627,405

1,060,341147,136

5,079420,93622,1231 0 . 5 1 3

1 ,666,128

1 , 0 9 1 , 2 5 1

28,31752,418

105,07726,45921

233,473

1,324,724

1 ,360,167

30s.961

3,892,701 $ +

443

LGrD 39039/1 at Board Meeting 1

BUESTIMATED

ACTUAL20162016

4,095,27 $ 3,933,36640 $ (40,805)

$ 3,892,561

BUDGET2O1Z

$ 4,300,841$ (41,3q9)$ 4,259,541

$D

$$$$

$

$$s$

$$

$$$$

1 ,113 ,167 $ 787 ,9 t12 '143,400 $ 1Ct2,430.

4,400.- $ 4,500458,083 $ 4€i6,370"

23,340 $ 2t4,4-t5.605 $ gg)0.

$ 1 ,777 $ 1 ,742,995 $ 1 ,391,017

475,23,1

1 , 1 5 7

29

$ 237

$ 1

$ 1 ,

g 278

$ 1 ,121 ,300

$ 32,500$ 49,230$ 1 0 2 , 9 1 5$ 26 ,310$ 22,265$ 233,220

$ 1,354,520

$ 21 ,000

$ 1,375,520

$ 367,475

$ 4,260,036$ 40,805

$lpqqf4

$ 1 ,1 t i z ,130 '

$ 33,500.$ $1,8rto$ 1 1 1 , 3 3 5 .$ ,!7"875$ "tq,75e .

$ 24Cr,319 ,

$ 1,3$2r,4,+9

$ r8,ollo .

$ 1,442t,4,49 '

$ (til,4i14..

$ 4,208,1t19$ r[1,3tC0

$_3eE4a9

1 0 1