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Home My WebLink About14 - Appointment of a New Finance Committee Member to Fill an Unscheduled VacancyPO CITY OF z NEWPORT BEACH Cq G�p� P City Council Staff Report November 10, 2015 Agenda Item No. 14 TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FROM: Leilani I. Brown, City Clerk - 949-644-3005, 1brown@newportbeachca.gov PREPARED BY: Leilani I. Brown, City Clerk TITLE: Appointment of a New Finance Committee Member to Fill an Unscheduled Vacancy ABSTRACT: Due to the resignation of Bill McCullough from the Finance Committee, the City Council is being asked to confirm Council Member Scott Peotter's appointment to fill the unscheduled vacancy, pursuant to Resolution No. 2015-5. RECOMMENDATION: Confirm Council Member Scott Peotter's appointment of Patti Gorczyca to fill the unexpired balance of Bill McCullough's term on the Finance Committee. FUNDING REQUIREMENTS: There is no fiscal impact related to this item. DISCUSSION: On January 13, 2015, the City Council adopted Resolution No. 2015-5 which, among other changes, amended the membership of the Finance Committee as follows: • The Finance Committee consists of seven members. • Three Council Members are appointed by the Mayor, subject to approval by the full City Council. The terms of the Council Members would be indefinite, pending specific City Council action to replace them. • Four "Citizen Advisors" would be recommended by the four Council Members not on the Finance Committee, and these four Citizen Advisors would be subject to approval by the full City Council. Each Citizen Advisor term would last one-year, but reappointments could be made annually. • The Citizen Advisors would have equal voting status. • The Mayor appoints the Finance Committee chair, subject to confirmation of the full City Council. 14-1 Appointment to the Finance Committee November 10, 2015 Page 2 On September 23, 2015, the City Clerk received Finance Committee Member Bill McCullough's resignation from his seat on the Finance Committee. His term was scheduled to expire on January 27, 2016. Pursuant to City Council Policy A-2 (Board, Commission and Committee Appointments), Council Member Peotter's appointee will serve Mr. McCullough's unexpired term. Pursuant to the Maddy Act and City Council Policy A-2, the City Clerk prepared and posted a Special Notice of Unscheduled Vacancy on Thursday, September 24, 2015, in the City Clerk's Office, at the Central Library, on the bulletin board in the City Council Chambers, and on the City's webpage, and published the Special Notice in the Daily Pilot on Saturday, September 26, 2015. As provided in the Special Notice, applications were accepted by the City Clerk's Office until 12 p.m. on Thursday, October 1, 2015. At the October 13, 2015, City Council meeting, Council Member Peotter's appointment of Jim Mosher was not confirmed by the City Council. The City Clerk was directed to repost and re -publish the Special Notice of Unscheduled Vacancy. The Special Notice was reposted on Thursday, October 15, 2015, in the City Clerk's Office, at the Central Library, on the bulletin board in the City Council Chambers, and on the City's webpage, and re -published the Special Notice in the Daily Pilot on Saturday, October 17, 2015. As provided in the Special Notice, applications were accepted by the City Clerk's Office until 12 p.m. on Thursday, October 30, 2015. Three applications were received by the City and considered by Council Member Peotter. Patti Gorczyca's application is attached as Attachment A and the other two applications are attached as Attachment B. ENVIRONMENTAL REVIEW: Staff recommends the City Council find this action is not subject to the California Environmental Quality Act (CEQA) pursuant to Sections 15060(c)(2) (the activity will not result in a direct or reasonably foreseeable indirect physical change in the environment) and 15060(c)(3) (the activity is not a project as defined in Section 15378) of the CEQA Guidelines, California Code of Regulations, Title 14, Chapter 3, because it has no potential for resulting in physical change to the environment, directly or indirectly. NOTICING: The agenda item has been noticed according to the Brown Act (72 hours in advance of the meeting at which the City Council considers the item). ATTACHMENTS: Attachment A - Patti Gorczyca's Application Attachment B - Additional VNB Applications 14-2 LrifATS]!IAI=1ki11rA APPLICATION FOR APPOINTIVE POSITION CITY OF NEWPORT BEACH 100 Civic Center Drive Newport Beach, CA 92660 City Clerk (949) 644-3005 Fax (949) 644-3039 DIRECTIONS: One application can be used for all the appointive positions you are applying for. Applications should be filled out completely so that the City Council may fully evaluate your qualifications. It is the responsibility of the applicant to familiarize themselves with the duties and responsibilities of the position(s) applied for. Detailed information outlining the responsibilities of the positions can be obtained from the City Clerk's Office or on the City's website: www.newportbeachca.gov (City Government/Boards, Commissions and Committees). Applications will be kept on file for two years for the position(s) applied for. If you are not selected for appointment during that period of time, it will be necessary for you to re -submit an application if you are still interested in being considered. NOTICE: Section 702 of the City Charter requires that members of Boards or Commissions appointed by the City Council shall be from the qualified electors of the City. This document is a public record and may be posted on the internet. NAME OF BOARD, COMMISSION OR COMMITTEE: Finance Name: Gorczyca Patricia Marie (Last) (First) (Middle) Residence Address (required): Zip Code: OM 7-71 How long have you lived in Newport Beach? 5 1/2 years Business Address: retired Home/Cell #: Business Phone: Email Address: Have you ever been convicted of any crime or violation of any law or statute other than minor traffic violations? [X NO R YES (If yes, attach separate sheet with explanation) NOTICE: Pursuant to Section 702 of the City Charter, no members of boards or commissions shall hold any paid office or employment in the City government. Do you currently hold any paid office or employment with the City of Newport Beach, including but not limited to contracted services? ❑X NO ❑ YES (If yes, attach separate sheet with explanation) If applying for a position on the Finance Committee, have you declared bankruptcy in the last 10 years? FX-] NO ❑ YES Please state any past, current or foreseeable future financial interests of any kind that may conflict with the Board, Commission or Committee you are applying for. none 14-3 Name and Location of Colleges/ Universities Attended Major degree Last Year Attended UCLA Economics BA 1975 UCI Planning/Public Policy MA 1976 Prior or Current Civic Experience (include membership in professional, charity or community organization) Office Held (if any) Dates of Membership Adoption Guild 2015 Newport Beach Library Literacy Tutoring 2012-2014 occupational History. Begin with your present or most recent position. List all positions separately held for the last five years. Firm or Organization Type of Business Title Dates of Employment resume attached References. Include names of at least two residents of Newport Beach who are not officially connected with the City. i. Name Dr. Lawrence Sherwin Address Phone No. 2. Name Elizabeth Young Address Phone No. Summarize why you wish to serve the City of Newport Beach on a board, commission or committee. Include any special qualifications you have which are particularly appropriate to the position for which you are applying. Having 35 years of public finance and management experience serving as a policy maker, public executive and financial advisor to governments, I would like to support the City's finance and budgetary efforts. I certify that all statements made on this application are true and correct to the best of my knowledge. I have read and understand the duties and responsibilities of the particular position(s) that I am applying for and authorize the release of this information on the internet. �s ® Signature Date 14-4 PATT I G O RCZYCA Cell Phone Email Patti Gorczyca is retired following thirty-five years of public finance and management experience, serving as a policy maker, public executive and financial advisor to governments. Pre -Retirement Employment Summary April 2007 to January 2008 Admin Manager III County of Orange CEO Served as Administrative Manager III for the County of Orange CEO/Office of Finance, where she managed the County's Strategic Focus Program and Special assignments for the County CEO and CFO. She also coordinated the County's efforts to address its pension and retiree medical liabilities, including the creation of a County Pension Prepayment Program and the restructuring of the County's Retiree Medical Program (OPEB). She also managed the implementation of the County Facilities Master Plan and prepared the CEO's annual goals and status reports. Patti retired from the County of Orange in January 2008. January 2007 to April 2007 Chief of Staff Supervisor Pat Bates Employed as Chief of Staff to Supervisor Pat Bates, she established the Supervisor's office operations, staffing, assignments and processes. In addition to staff management duties, she covered all policy matters pertaining to finance, County administration and transportation. She also served as alternate Board member to the Transportation Corridor Agencies. 2005 January 2007 Admin Manager II County of Orange CEO Employed as Administrative Manager II for the County of Orange CEO/Office of Finance, she managed special assignments for the County CEO. She led the County's first Strategic Focus planning efforts and steering committees, implemented the County's first employee survey and recommendations, established the County's Balanced Scorecard Program, developed the County's pension pre -payments program and managed efforts to address the County's retiree medical liabilities. She also developed the County's twenty-year cash flow model, managed the development of a Master Plan of County Facilities and coordinated the IT Working Group Committee meetings. 2003 to 2005 Policy Advisor Supervisor Bill Campbell Served as a Policy Advisor to County Supervisor Bill Campbell covering budget, finance, county administration, employee benefits and transportation. She provided advisory support on transportation matters such as the proposed $413 acquisition financing of the San Joaquin Hills and Foothill Eastern Transportation Corridor Agencies, planning efforts to extend the measure M sales tax, the 91 Toll Road major investment study and other OCTA and TCA transportation 14-5 concerns. She crafted solutions to pressing regional issues for the Supervisor including the Master Plan of County facilities, the assessment of the County's Procurement Operations, affordable housing projects and bond financings. 2002 to 2003 Financial Manager CEO/HR Employee Benefits Employed as Financial Manager to the County of Orange CEO/HR Employee Benefits Program. Returning to County employment after 15 years, she pursued an employee benefits assignment to broaden her public finance experience by gaining health benefits, deferred compensation and pension and retiree medical expertise. In this capacity, she also served as Fiscal Manger to HR providing financial analysis to pension and retiree medical issues, employee compensation negotiations and early retirement incentives. 1998 to 2002 Principal PMG Financial Consulting Formed PMG Financial Consulting and served as its principal consultant for four years. Her clients included the County of Orange, the Orange County Transportation Authority, the cities of Santa Ana, Tustin, Mission Viejo, Seal Beach, Huntington Beach, Westminster and Santee; the Orange County Housing and Community Development and Social Services Agency, the Orange County Fire Authority, the Orange, Newport Mesa and Santa Ana Unified School Districts; the Western Riverside County Regional Wastewater Authority and the Countywide Public Facilities Financing Authority. She also co -drafted the County of Orange Affordable Housing Strategy and the Orange County Housing Plan for Emancipated Foster Youth. 1993 to 1998 Sr. Managing Consultant Public Financial Management Served as a Senior Managing Consultant for Public Financial Management, Inc. (PFM), in Newport Beach. While at PFM, she provided financial advisory services to the County Sanitation Districts of Orange County, the County of Orange, the Orange County Sheriff and the Orange County Fire Authority; the cities of Mission Viejo, Santa Ana, Placentia, Yorba Linda, Tustin, Riverside, Irvine, Corona and Hemet; the Western Riverside County Regional Wastewater Authority, the Countywide Public Financing Authority (in Orange County), the Sacramento County Water Resources Authority and Orange Unified School District. 1990 to 1993 Financial Manager Orange County Sanitation Districts Employed as Financial Manager to the County Sanitation Districts of Orange County, she developed a capital financing program including over $600 million of short and long-term debt and investments. She developed a Long Range Financial Plan that included ten-year cash flows, financial goals and objectives, policy parameters receiving recognition from the rating agencies and the financial community. Ms. Gorczyca also served as the District's Risk Manager, managing the full range of insurance programs and coordinating employee benefits in cooperation with Human Resources. 14-6 1988 to 1990 Vice President Evenson Dodge Served as Vice President for Evensen Dodge, a financial advisory firm to governments located in Costa Mesa. She was responsible for serving numerous California clients including the County of Orange, Orange County Flood Control District, Orange Unified School District, City of Riverside, County of Riverside, County of Sacramento, City of San Diego, County of San Diego, County of Inyo, Sacramento Flood Control Planning Office, City of Beverly Hills, City of Santa Monica, and Cathedral City. 1974 to 1988 Planner 1, II, II, IV; Sr. Staff Analyst, Analyst IV, V County of Orange Employed for fifteen years, she served seven years in the CEO Public Finance Division managing numerous debt offerings and capital financial planning efforts including the Santa Ana Heights Redevelopment Plan, Santa Ana River Flood Project Financial Plan, John Wayne Airport financing, County's Multi -Modal Transportation Financing Plan, and numerous Mello -Roos and assessment financings, Certificates of Participation, and single-family and multi- family housing bonds. She served as Assistant Director of the Orange County Development Agency and Senior Staff Analyst in the Office of Management and Budget. She served as a planner in the County's Environmental Management Agency for nearly six years and began as a management intern in the CEO Office of Economic development and Forecast and Analysis Center. Post -Retirement Employment Summary 2010 to 2011 Consultant to Public Financial Advisory Firms and CalBEN Served as a part-time consultant to public financial advisory firms and established a non-profit website, CalBEN, designed to permit California governments to share information, educate and problem solve. September 2008 to March 2009 Assistant to City Manager Los Alamitos Served as Assistant to City Manager for the City of Los Alamitos. She left full-time employment to devote more time to her duties as Trustee of the Orange County Employees Retirement System. August 2008 to August 2011 Trustee Orange County Employees Retirement System Appointed to serve as a Trustee for the Orange County Employees Retirement System (OCERS) by the Orange County Board of Supervisors. Over a three-year period, she served as Chair of the Private Markets Committee, Chair of the Ad Hoc Committee, Vice Chair and Chairman of the Board. January to September 2008 Sr. Vice President Kinsell Newcomb & DeDios Employed as a Senior Vice President for Kinsell, Newcomb & DeDios (KND), an investment banking firm serving governments, located in Santa Ana. 14-7 Professional and Personal Patti is a past member of the Government Finance Officers (GFOA) and served as a technical advisor to and Vice Chair of the GFOA Debt and Fiscal Policy Committee and Chair of its Subcommittee on Tax Policy and Disclosure. She was a member of the California Society of Municipal Finance Officers (CSMFO). Ms. Gorczyca holds a B.A. Degree in Economics from the University of California at Los Angeles and an M.A. Degree in Planning and Public Policy from the University of California at Irvine. She has been married for 39 years and has two married sons and one grandchild. ATTACHMENT B APPLICATION FORA, ]PCS► 'IVE POSITION CITY OF NEWPORT BEACH L JUL 6 l0 100 Civic Center Drive Newport Beach, CA 92660 City Clerk (949) 644-3005 Fax (949) 644-3039 W t.s ° DIRECTIONS: One application can be used for all the appointive positions you are applying for. Applications should be filled out completely so that the City Council may fully evaluate your qualifications. It is the responsibility of the applicant to familiarize themselves with the duties and responsibilities of the position(s) applied for. Detailed information outlining the responsibilities of the positions can be obtained from the City Clerk's Office or on the City's website: www.newportbeachca.gov (City Government/Boards, Commissions and Committees). Applications will be kept on file for two years for the position(s) applied for. If you are not selected for appointment during that period of time, it will be necessary for you to re -submit an application if you are still interested in being considered. NOTICE: Section 702 of the City Charter requires that members of Boards or Commissions appointed by the City Council shall be from the qualified electors of the City. This document is a public record and may be posted on the internet. NAME OF BOARD, COMMISSION OR COMMITTEE: Finance Committee Name: Mosher James ("Jim") I M. (Last) (First) Residence Address (required): Zip Code: E How long have you lived in Newport Beach? since 1981 Home/Cell #: Business Address: Business Phone: Email Address: Have you ever been convicted of any crime or violation of any law or statute other than minor traffic violations? X❑ NO ❑ YES (If yes, attach separate sheet with explanation) (Middle) NOTICE: Pursuant to Section 702 of the City Charter, no members of boards or commissions shall hold any paid office or employment in the City government. Do you currently hold any paid office or employment with the City of Newport Beach, including but not limited to contracted services? ❑X NO ❑ YES (If yes, attach separate sheet with explanation) If applying for a position on the Finance Committee, have you declared bankruptcy in the last 10 years? ❑X NO ❑ YES Please state any past, current or foreseeable future financial interests of any kind that may conflict with the Board, Commission or Committee you are applying for. Discussion of projects close to my residence CONTINUE TO PAGE TWO 14-9 .:� h: tiYL •: F �'l 5 S 11 �; rsx� !/ �.. ,\: 3 i ,./ ;..V/ev U �"�>:ud` � � i';G` sm, ,, � < � ,. e .. u"�'�a'�iS �, ::�...� a., ,. .,.. / r eu. ?'.. �'r .. a.Y r , { � /f✓. R ,.� ... ... 'Y../., ,.« x.60.. 2 .,r., ,. ((/ `•\. ...t, "�;,.. i/., .:�., ,,. 9 1 r. �g....ti /` � , �. �. fS .�,. F, .. L .. ,a., `. , , rc F.. QCT ,. f / n- .. / `G � / -,f� �. . `•�.. - 60,� • .�' ./ 5- \ . ru3 .k:. �. /i/ Wiz, ! F.. � < � ��z, / „t�� l� , � � tea,,,, iU�r �:<� � � .nd ,�✓a;6 �, �,:�i�: i a� < �� / /s / „� ��ar ~� '� :$' .. L � `'�-^ �. � jai• -�i l _ \.,R �3 � /�i>t �,. x�\� / /w�/ _-,, �, ,,�i �� A�� h t '� /�J� / �{, � a,Tr. ; ) / � 'tea. u.""3S�A� E l'/ �3 5 lY } G :S .F^ S✓� pr �%u: ; •a c ' ti �4'f� � �� t ; �� y{ .'�'t'i ,+ �, z � � �' � �, s ,:� � g `� �>a i �I,/ � a�' ;� ✓/i �� mc�j , l n \ �... 4 � 6 P ,a. 3? �X , f� � h. M ),;, fi' ti �.. .�"�:/// � �� it: /� �. ..�..✓ ! k Y ;,;� j .`t„r ,:,.1. / '1 4 � • t� `U 4 �� >\ r..-b;..� . � /�,.� /;,�e�U�L�i YZ' U,. / �" �. tix . ':. i n,;'• i b.'1+i5'//r Lr✓ , � � / f � F � 4✓ � i3' 2 �/ r' / C",, none /FKO.£ �; Y lE h!!r<'� .� /f, i'.a,., ✓ln/vr i /",.: '�.. ',e Y /� /'. .fir ..lrti; r? �' :. .lF'zu.. /x i�E✓rrl :. r .>la Occupational History. Begin with your present or most recent position. List all positions separately held for the last five years. "g''� ~..~;/rs ;.,>✓/. / ,F{>•v'1tt. ~✓- }{nt �z �� /FKO.£ �; Y lE h!!r<'� .� /f, i'.a,., ✓ln/vr i /",.: '�.. ',e Y /� /'. .fir ..lrti; r? �' :. .lF'zu.. /x i�E✓rrl :. r .>la Independent Consultant physics/optical engineering n/a 1986 -retired Rosemount Analytical/Uniloc Division instrument development Senior Scientist 1982-1986 DiscoVision Associates (IBM/MCA partnership) video disk development Staff Engineer 1981-1982 Lockheed Palo Alto Research Lab solar astronomy research Research Scientist 1976-1981 References. Include names of at least two residents of Newport Beach who are not officially connected with the City. 1. Name Robert C. Hawkins I Address Phone No. 2. Name Novell Hendrickson Address Phone No. Summarize why you wish to serve the City of Newport Beach on a board, commission or committee. Include any special qualifications you have which are particularly appropriate to the position for which you are applying. Although I lack the recommended "CPA, CFA or Business/Finance major" background, and have no training in finance, I have followed the City budget process for a number of years and believe I could ask pertinent questions of interest to the public in general. I certify that all statements made on this application are true and correct to the best of my knowledge. I have read and understand the duties and responsibilities of the particular position(s) that I am applying for and authorize the release of this information on the internet. [BOX MUST BE CHECKED IF SUBMITTING ELECTRONICALLY] W1Signature Date Jul 6, 2015 14-10 APPLICATION PINTIVE POSITION It 5 ANNI 12 RM : 09 CITY OF NEWPORT BEACH 100 Civic Center Drive *"OWN lam# we_ Newport Beach, CA 92660 City Clerk (949) 644-3005 `f Fax (949) 644-3039 A U DIRECTIONS: One application can be used for all the appointive positions you are applying for. Applications should be filled out completely so that the City Council may fully evaluate your qualifications. It is the responsibility of the applicant to familiarize themselves with the duties and responsibilities of the position(s) applied for. Detailed information outlining the responsibilities of the positions can be obtained from the City Clerk's Office or on the City's website: www.newportbeachca.gov (City Government/Boards, Commissions and Committees). Applications will be kept on file for two years for the position(s) applied for. If you are not selected for appointment during that period of time, it will be necessary for you to re -submit an application if you are still interested in being considered. NOTICE: Section 702 of the City Charter requires that members of Boards or Commissions appointed by the City Council shall be from the qualified electors of the City. This document is a public record and may be posted on the internet. NAME OF BOARD, COMMISSION OR COMMITTEE: Name: I Bk�-E(t I [ 1 LLAdel I /+f%i-� (Last) Cell phone (First) Residence Address (required): Zip Code: (Middle) How long have you lived in Newport Beach? I g g Yj �RgS I Home/Cell #: -U10041 Business Address: Business Phone:IfYIAI FTTT1-III I�I tv A Email Address: Have you ever been convicted of any crime or violation of any law or statute otherthan minortraffic violations? NO F� YES (if yes, attach separate sheet with explanation) NOTICE: Pursuant to Section 702 of the City Charter, no members of boards or commissions shall hold any paid office or employment in the City government. Do you currently hold any paid office or employment with the City of Newport Beach, including but not limited to contracted services? ZNO [:] YES (If yes, attach separate sheet with explanation) Please state any past, current or foreseeable future financial interests of any kind that may conflict with the Board, Commission or Committee you are applying for. ONE TfffFZp OUI /i;�7Rj 9AL6UA 151-14nrD FFAR!?f 14-11 :.: y E � � C f � 4_ ✓ fit- ':.! s `"� ��g`� �`R 5 ^S"r � N� '£ �i a'_ � }� x,"'t �,4 „ h` fi.. b ➢x .4`vk '�xt"=3, .a i` i 3 ''i `?�' �. ^$-. ^�S�S gk,�ufi,. �v"tm � �# ��., ��°�>'-"� i' F"�.. `'��'` ,•. t' „ ", s`$�"wak�em�� T2 .z4".�a. ;� 3: ,. �""J`i't,�£ .�'.+ ,. �" *€$ s"t"Y''. r �'� �yr�. I\/,5 /P0R7 6EAC-14 PLRnwN iN0- db MM IS510W N A 19 7Y 1 -??l (V61vPoR-1 6EACH FRCL-LE TPR145 t4c)N11 AE 120SFACC-7 CbMF474 RS Ic0l 1475 '4 LAA-troRNift Hft(4 ITIME A-C1919a:M N#FIV16r14TIM SFS, I ?qT L AL r F6991A 10571TL(TE PN �'si if g S8C RETAR Y l9S0 Occupational History. Begin with your present or most recent position. List all positions separately held for the last five years. 1 ''Sy"�rrg } fi.. b ➢x .4`vk '�xt"=3, .a i` i 3 ''i `?�' �. ^$-. ^�S�S gk,�ufi,. �v"tm � �# ��., ��°�>'-"� i' F"�.. `'��'` ,•. t' „ ", s`$�"wak�em�� T2 .z4".�a. ;� 3: ,. �""J`i't,�£ .�'.+ ,. �" *€$ s"t"Y''. r �'� �yr�. I\/,5 /P0R7 6EAC-14 PLRnwN iN0- db MM IS510W N A 19 7Y 1 -??l (V61vPoR-1 6EACH FRCL-LE TPR145 t4c)N11 AE 120SFACC-7 CbMF474 RS Ic0l 1475 M 01e(NE-(Z5 (OMMAV R T Y A 53 6CrA T ION PgL-51DENT I qui — C tsT Bc5ACrrn1 Bk' e0Wfu1v17Y A55c)CIP' ION W ASL, 9eP\ i467 .- (472 Occupational History. Begin with your present or most recent position. List all positions separately held for the last five years. 1 ''Sy"�rrg } fi.. b ➢x .4`vk '�xt"=3, .a i` i 3 ''i `?�' , f%.. �+''.��+''sa 7vnLJ;P.. '�. civ^a.+� S""4` t"" �b ti % 9,97'1 R, i .D NA N A PRE-5471VT 9Oe/(IA/L AE 120SFACC-7 CbMF474 RS MQ18 7&01, STAFFV7 (f62 - l?3 5 Pr,>N V®I.GRNTb;L=2 c'(T17-,Lc-tVS S8C RETAR Y St7- PRc 5 -WT References. Include names of at least two residents of Newport Beach who are not officially connected with the City. 1. Name J &PrN WA -7 T Address Phone No. 2. Name JACK S K(ffNL7g Address Phone No. As" Summarize why you wish to serve the City of Newport Beach on a board, commission or committee. include any special qualifications you have which are particularly appropriate to the position for which you are applying. I 1f AVE- eOMPLL-TeP A- C06(956� (N A((COt(V I OVC, fflwe-37UD1E�D TH,9 (I-ALPiwR5 1,7,9PoP / O fes( r1ft�4mj UW'PE7P 1.1d}614(7Y, f'o2 Tr+ E Y'EA25 f W'15 'rP'hE-7 46 -ha e of= VueDfifche VoTE-Rs 66sE'i vV&k AT 7( - orF-jeS ®p °T1t,!F o,�ANf& CcUN'TY "L4-0 HEt-P UJ 17ly C�I�uN�1L - 7®— vr�%� �t Jvv �s`i�/ N��N� (,c A C'171�E><r (S T® 136- rgPPOIA/767a io TlfiE- F1NRNC16= CO 7N�1?TT��o I certify that all statements made on this application are true and correct to the best of my knowledge. I have read and understand the duties and responsibilities of the particular position(s) that I am applying for and authorize the release of this information on the internet. [BOX MUST BE CHECKED IF SUBMITTING ELECTRONICALLY] ❑ Signature Date C� J 2 2D 1 T 14-12