First Empire Securities / Internet Acct. Access 16FIRST EMPIRE SECURITIES
Member FINRA/SIPC
100 MOTOR PARKWAY, 2nd Floor
HAUPPAUGE, NY 11788
(800) 645-5424
(631) 979-0097
www.1empire.com
Client Authorization for Internet Account Access
Fax or mail the completed form to: First Empire Securities, Inc. 100 Motor Parkway, 2nd Floor, Hauppauge, NY 11788, or fax to 631-
979-0448. Once the above information has been received by FES, it will be entered into Pershing LLC's database, and the account
information should be accessible within 48 hours.
This form is used to authorize First Empire Securities, Inc. ("FES") to set up a User ID and password for viewing account information
through the FES website located at www.lempire.com. Please Print.
1. Account Number(s):
We must have a valid 9 -digit FES account number. If you
have more than one account, in the same name, please list
all account numbers.
(P) 50M -165408
(P) 50M
BY SIGNING BELOW, I HEREBY AUTHORIZE FES TO SET
UP A USER ID AND PASSWORD FOR ACCESSING
ACCOUNT INFORMATION THROUGH THE FES WEBSITE.
Subscriber Signature (required)
Karla Campos
Subscriber Name (please print)
4. E-mail Address: kcampos@Ia-quinta.org
(P) 50M
To issue a User ID, we must have a valid e-mail address,
(P) 50M complete with the @. Example: name@domain.com.
5. Tax identification #: 95-3740431
2. Account Name and Address:
This is the account name or title that corresponds to the
account numbers listed above.
City of La Quinta
Name:
Address:
78495 Calle Tampico
La Quinta, CA 92253
3. Subscriber User ID:
Please provide a personal login (User ID). It can be
alphanumeric, and should be at least one, but no more
than 15 characters. Please note that your user ID cannot
contain any spaces and/or symbols and should not be your
tax ID or social security number and/or your account number.
PLEASE PROVIDE AN ALTERNATIVE.
1 st Choice: LQ 1500693
Alternate: GEM 1500693
Please enter the tax identification or social security number
on the account.
6. Other Verifying Information:
For identification purposes, you are required to provide the
date of birth for the User ID.
Date of Birth: 11-27-79
The LOGIN NAME will be the User ID specified, and the
PASSWORD will be automatically set as FE followed by
mm/dd/yy of user's d.o.b. You will be required to change
the password after the first time you log in. The password
must be 8 alphanumeric characters.
FES RECOMMENDS THAT YOU USE A SECURE WEB
BROWSER FOR VIEWING ACCOUNT INFORMATION
ON THE WEBSITE AND TO MAINTAIN YOUR PASSWORD
IN CONFIDENCE.
If this is a Corporate or Business account, an authorized
officer must also sign authorizing access. This must be
signed by an individual in a.dition to the individual
re•u-sting the User
Additional
Officer Signature, Ti le
Corporate Resolution
"Resolved, that each and any of the following individuals:
Name(s) of authorized person(s)
Frank J. Spevacek
Title
City Manager
Karla Campos
Finance Director/City Treasurer
each of whom holds the office indicated, is authorized to act on behalf of the corporation to buy, sell, assign, loan,
borrow, endorse for transfer, transfer and receive stocks, bonds, securities, money and other assets now or hereafter
registered in the name of or held by or for the corporation."
I, the undersigned officer of the corporation identified below, hereby certify that the corporation is a corporation in
good standing, incorporated in the state indicated below, and that the above -quoted resolution is a true and complete
copy of a resolution duly adopted by its board of directors on the date indicated below, in full compliance with all the
requirements of applicable law, articles of incorporation, bylaws and any other governing documents, and that the
resolution has not been repealed or amended and remains in full force and effect.
Name of Corporation:
City of La Quinta
State of Corporation:
California
Signature of Corporate or ot''er Officer
Required
Susan Maysels, City Clerk
Printed Name of Corporate Secretary
or other Officer
Corporate Seal:
None
(If no seal, please write"NONE")
07/07/16
Date
Must be signed by the Corporate Secretary or
other officer. Person who signs here should not
be one of those given authority by the resolution.
Institutional Suitability and Sophisticated Municipal
Market Professional (SMMP) Certificate
In connection with any recommended transaction of investment strategy by First Empire Securities, Inc. ("FESI'), the undersigned acknowledges on
behalf of the Institution named below that:
It is an Institutional Account as defined in FINRA Rule 4512(c)1
II. It is capable of evaluating investment risks independently, both in general and with regard to all transactions and
investment strategies involving a security or securities; and will exercise independent judgment in evaluating
the recommendations of FESI or its associated persons, unless it has otherwise notified FESI in writing;
Do you engage in municipal securities transactions? Yes X No
If yes, the undersigned acknowledges on behalf of the Institutional Account named below that:
It is a customer of the nature defined in MSRB Rule D -15(a)2 ;
II. It is capable of evaluating investment risks and market value independently, both in general and with regard to all
transactions and investment strategies in municipal securities;
III. It (1) is exercising independent judgment in evaluating:
(A) the recommendations of FESI or its associated persons;
(B) the quality of execution of the customer's transactions by FESI; and
(C) the transaction price for non -recommended secondary market agency transactions as to which (i)
FESI services have been explicitly limited to providing anonymity, communication, order matching
and/or clearance functions and (ii) FESI does not exercise discretion as to how or when the
transactions are executed; and
(2) has timely access to material information that is available publicly through established industry sources as
defined in MSRB Rule G-473;
It will notify FESI if anything in this Certificate ceases to be true; and he or she is authorized to sign on behalf of the Institutional Account
named below.
By signing this Certificate, the undersigned affirms that the above statements are accurate but does not waive any rights afforded under U.S. federal
or state securities laws, including without limitation, any rights under Section 10(b) of the Securities Exchange Act of 1934, as amended, and the
rules and regulations promulgated thereunder.
NOTE: This Certificate shall apply with respect to all recommended transactions and investment strategies involving securities that are entered into
by the 'Institutional Account" named in this Certificate, whether for the account of such Institutional Account or for the account of any beneficial owner
that has delegated decision making authority to such Institutional Account.
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100 Motor Parkway 1 Hauppauge 1 NY 1 11788 1 Toll Free: 800.645.5424 1 Tel: 631.979.0097 1 Fax: 631.979.0448
wwwlempire.com 1 operations@lempire.com
Institutional Suitability and Sophisticated Municipal
Market Professional (SMMP) Certificate
NOTE: This Certificate shall apply with respect to all recommended transactions and investment strategies involving securities that
are entered into by the `Institutional Account" named in this Certificate, whether for the account of such Institutional Account or for the
account of any beneficial owner that has delegated decision making authority to such Institutional Account.
Institutional Account Name: City of La Quinta
Address, City, State, Zip78495 Calle Tampico
Telephone (760) 777-7150
Email Address. kcampos@Ia-quinta.org
95-3740431
U.S. Tax ID/EIN (if applicable):
Name of Authorized Signatory.
Title of Authorized Signatory.
Signature of Authorized Signatory.
Karla Campos
Finance Director
Date 07/07/16
1The term "Institutional Account" means the account of: (1) a bank, savings and loan association, insurance company or registered investment company; (2) an
investment adviser registered either with the SEC under Section 203 of the Investment Advisers Act or with a state securities commission (or any agency or office
preforming like functions); or (3) any other person, corporation, partnership, trust or otherwise) with total assets of at least $50 million as of the date of this Certificate
(whether such assets are invested for such person's own account or under management of the account of others).
2Pursuant to MSRB Rule D-15, the term "sophisticated municipal marketing professional" or "SMMP" is defined by three essential requirements: the nature of the
customer; a determination of sophistication by the broker, dealer, or municipal securities dealer ("Dealer"); and an affirmation by the customer. The customer must be:
(1) a bank, savings and loan association, insurance company or registered investment company; (2) an investment adviser registered either with the SEC under Section
203 of the Investment Advisers Act of 1940 or with a state securities commission (or any agency or office performing like functions); or (3) any other person or entity
with total assets of at least $50 million as of the date of this Certificate.
3Pursuant to MSRB Rule G-47(b)(i), established industry sources shall include the MSRB's Electronic Municipal Market Access ("EMMA"®) system, rating agency
reports, and other sources of information relating to municipal securities transactions generally used by brokers, dealers, and municipal securities dealers that effect
transactions in the type of municipal securities at issue. Pursuant to MSRB Rule G-47 (b)(ii), information is considered to be material if there is a substantial likelihood
that the information would be considered important or significant by a reasonable investor in making an investment decision.
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100 Motor Parkway 1 Hauppauge 1 NY 1 11788 1 Toll Free: 800.645.5424 1 Tel: 631.979.0097 1 Fax: 631.979,0448
www.lempire.com 1 operations@lempire.com