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2017-05-16 Appointment
NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: AIRPORT COMMISSION One Vacancy — Four Year Term July 1, 2017—July 1, 2021 • Duties: To exercise all the powers granted to cities and towns under Chapter 330 of the Code of Iowa, except the power to sell said airport. • To annually certify the amount of taxes within the limitations of the Statutes of the State of Iowa to be levied for Airport purposes. All funds derived from taxation or otherwise for airport purposes shall be under the full and absolute control of the Airport Commission, deposited with the City Treasurer, and disbursed only on the written warrants or order of the Airport Commission. The Airport Commission meets the third Thursday of each month at 6:00 p.m. Iowa City appointed members of the boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Airport Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Commission One Vacancy, Four year term 7/1/2017 - 7/1/2021 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/1917 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: None Female:2 Male:2 Gender Name and Address NO APPLICATIONS NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING One vacancy to fill an unexpired term Upon appointment - December 31, 2021 Duties of the Airport Zoning Commission are: To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. To recommend the adoption of new Airport Zoning regulations. The Board meets as required Iowa City -appointed members of boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Commission One Vacancy, to fill an unexpired term Upon appointment -12/31/2021 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 4/18/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: None Female: Male: Gender Name and Address NO APPLICATIONS NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy to fill an unexpired term Upon appointment - December 31, 2020 • The powers and duties of the Airport Zoning Board of Adjustment are to hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. • To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. • To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. The Board meets at the call of the Chairperson. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Board of Adjustment One Vacancy, to fill an unexpired term Upon appointment - 12/31/2020 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 4/18/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement Current Gender Balance: None Female: Male: Gender Name and Address NO APPLICATIONS I.fsllfazi THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy to fill an unexpired term Upon appointment - December 31, 2018 • The powers and duties of the Airport Zoning Board of Adjustment are to hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. • To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. • To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. The Board meets at the call of the Chairperson. • Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Board of Adjustment One Vacancy, to fill an unexpired term Upon appointment - 12/31/2018 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 4/18/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: None Female: Male: Gender Name and Address NO APPLICATIONS r7rm- 77 18e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: COMMUNITY POLICE REVIEW BOARD Two Vacancies — 4 year terms July 1, 2017 —July 1, 2021 reviews police policies, procedures, and practices, and may recommend modifications to them. The board shall hold at least one community forum each year for the purpose of hearing views on the policies, practices and procedures of the Iowa City police department. • has only limited civil administrative review powers and has no power or authority over criminal matters or police discipline. It is not a court of law and is not intended to substitute for any form of legal action against the Police Department or the City. • reviews Police Department policies and practices and recommends changes to the City Council Iowa City -appointed members of boards and commissions must be 18 years of age and reside in the City of Iowa City. However, the City Council reserves the right to waive the residency requirement for good cause shown. The City Council also reserves the right, for good cause shown, to waive the requirement that the Board include one current or former "peace officer' as that term is defined by State law. The City of Iowa City encourages diversity in the appointment of people to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Community Police Review Board should be directed to Kellie Tuttle at 356-5043. 5/4/2017 Board/Commission Application Cover Board/Commission: Community Police Review Board (CPRB) ** Appointments to the Board shall include one current or former "peace officer" as that term is defined by State law. The City Council reserves the right, for good cause shown, to waive the requirement that the Board include one current or former peace officer. ** The City Council also reserves the right to waive the residency requirement for good cause shown. Two vacancies, four year term 7/1/2017 - 7/1/2021 Joseph Treloar and Mazahir Salih It is hereby established, as a formal polity of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 Female, 1 None Current Gender Balance: Female: 1 Male: 2 Gender Name and Address Male Ahmed, Ali 1520 McKinley Place Male Eastham, Charles 953 Canton St. Female Johnson, Kristin 415 S. Van Buren St., Apt.1 Female McDonald, Sharon 1216 Jensen St Female Rose, Clare 928 E Bloomington St Female Salih, Mazahir 1 full term 2355 Jessup Cir Male Selmer, David 403 Boyd Ct. P 1 _ L Advisory Board/Commission/Committee CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. Advisory Board/Commission/Committee Name Date Nam Home Address 6P)114 p Contact phonenumbersigq�*)) v Email Address Q(i tvvt�Fvl i7,II/w1Gu/-CGvVt Your home address must be within the corporate limits of Iowa City? \#0 ^� ! »0j KOSS �/ P U. Rax �13z How long have you /ln�ived in Iowa Ciity? _�( ,1 C -e <96 DZ) 0 �wC Cty to %2yq Occupation: Gender: Male Female Experiences and/or activities which you feel qualify you for this position: G)boorJ ,vlewther vvifh TYIe Suelavtese A rn2rieaK A SS05iA&-47 051ACe U D @BorAJ Mewl1)2 r with 4.er 4/>„/or%vravw us,+I Ge • 51Ace ]012 0,, &ard ry%ember wi+h %4Unrnao Rio ComwiiSSlOnSt5Lvei6Fy DOW Ol3GarG� McMber w/+hwoC'l�ba vu ��uy Pir6,ec:� — O>nIce, t,SL o�--T What is your present knowledge of this advisory board? My e meKA}2er L,,/ h 67mrALA";4-yPc) ,,c4 Revit j /3aaM-A Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision—making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally—assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shall not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children, step children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt,uncle, niece, nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and persons whom the employee is in an intimate relationship. Res. #15-300 states that each application for reappointment to a City Board or Commission will be congidered:without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Couhcil policy is not to permit an individual to serve on two Boards or Commissions at the same time' You will be asked to resign from one if appointed to another. Do you currently have a conflict of interest? YES_ NO List potential conflicts of interest (See last page for information regarding conflict of interest) Please indicate if there are none. Do you currently serve on another Iowa City board or commission? YES_ NO_X_ If so which one do you prefer? The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age -4a yeo rs Countryof Origin SLA66 V\ — Sexual Orientation Religion -1s�o,�n Do you have a disability? YES_ NO x Race, Color or Ethnic Group u t(l, c _ k *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise finance and one person who receives rental assistance. (Resolution) Signature of Applicant* �—�/�� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. Advisory Board/Commission Application Form M-11, s iiWill This application is a public document and as such can be reproduced and distributed for ��1i the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. uHrsco an or LUE"W u NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 5/8/2017 First Name Charles Last Name Eastham Home Address* 953 Canton St. City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 541-3972 Email Address* eastham@outlook.com Boards & Commissions Select a Board or Commission you are interested in:* Community Police Review Board (CPRE) 2. How long have you been a resident of Iowa City?* 45 years 3. Occupation:* Retired 4. Gender:* Male 5. Experience andlor activities which you feel qualify you for this position:* I am currently actively participating in the following organizations and groups. My involvement with these groups requires analyzing racial and ethnic disparities in numerous outcomes and developing strategies for reducing those disparities. Iowa City Community School District Equity Advisory Conrrvtlee Center for Worker Justice Board of Directors Black Voices Project Coalition for Racial Justice 6. What is your present knowledge of each advisory board you are interested in?* Currently, the Iowa City Community Police Review Board (CPRB) may review police policies, procedures, and practices, and recommend moderations to them as appropriate. The CPRB also provides a complaint process for claims of Misconduct by individual police officers. At its April 18, 2017 Work Session the Council supported proposals by Police Chief Jody Matherly to aggressively address the Iowa City Police Department's disproportionate minority contact issues over the next five years by, among other measures, increasing the role of the CPRB in reviewing police policies. At the April 18, Work Session the Council also discussed a number of strategies proposed by Council Member Kingsley Bolchway to address racial disparities in ICPD policing outcomes. Those strategies include restructuring the CPRB so that the Board: • Focuses on policies and procedures and whether these policies and procedures align wth community expectations • Focuses on use of force data and whether patterns align with community expectations • Reviews key areas of disproportionality and reports improvement • Requires independent investigation of any police misconduct as determined by the CPRB R appointed, I am looking forward to working with other members of the CPRB, the police department and the Council to substantially reduce disproportionate minority contact by the ICPD and to conducting fair, thorough, and accurate investigations of misconduct complaints brought against individual officers. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of bwageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that ft following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, sort -in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-irHaw, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 75 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion IJone 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* &A"Ar fzk r -Zw Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down t Advisory Board/Comnission Application Form _A Rt This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and autornatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LREMIUM NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 4/5/2017 First Name Kristin Last Nam* Johnson Home Address* 415 S. Van Buren St., Apt.1 City IOWA CITY State A Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number* 319-594-1032 Email Address sunshineariel99@gmaii.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are Interested In:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 22 years 3. Occupation:* volunteer 4. Gender:* Ferrele 5. Experience and/or activities which you feel quality you for this position:* I am active in some support groups which help me stay connected to the community and help me to take good care of myself, and interact with an interesting and diverse population in this city. S. What Is your present knowledge of each advisory board you are interested In?* I am aware that the library board term is a period of 6 years and helps determine policies and practices. I am aware that the Community Police Review Board is designed to help those concerned with criminal justice in this community. And I am aware that the Human Rights Commission is designed to help protect people with disabilities to be heated fairly in this community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilifies with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract CityCouncil Resolution # 15-300 established a policy that the following persons shall rot be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-irHaw, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* 0 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion Episcopal 13. Do you have a disability? Yes Please explain: I have a mental health condition which I manage with medication and social activities and healthful activities. For example, 1 volunteer at a local peer support recovery center, volunteer for New Pioneer Co-op,8 garden in the city garden. I also advocate with letters and phone calls to our elected representatives for a combination of issues I am concerned about, such as mental health parity, the environment and social justice.) also receive rental assistance. 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 0(p W* 01& r Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down ft Advisory Board/Commission Application Form N M�®yi This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO OT Or nrEMWRE NOTE: Must he 18 years of age and live within city limits of Iowa City to apply Date of Application 3/31/2017 First Name Sharon Last Name McDonald Home Address* 1216 Jensen St City IOWA CITY State IA Zip Code 52246 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number* 3196318270 Email Address* srrr-donald2l28@gmaii.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 29 years 3. Occupation:* child care center director 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have been interested in this topic for a long time. I live quite Gose to the Pheasant Ridge complex I worked at the Fareway store on Mormon Trek for 14 years and got to know many of the residents of PR. I also used to live in the yellow townhouses behind the Kwik Trip on MT. I was the 2016 precinct captain for these two neighborhoods and canvassed them personally and by phone quite often. I know that getting into these units is difficult and I also know there are significant challenges for those that do. 6. What is your present knowledge of each advisory board you are interested in? I follow what's reported in the newspaper. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-inlaw, sister-inaaw, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* W Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin United States 11. Sexual Orientation nits 12. Religion unitarian 13. Do you have a disability? Yes Please explain: I have a bad back but I can walk fairly well with a walker. 14. Ethnicity caucasion 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down _ ; 50 Advisory Board/Commission Application Form }�l,llf t This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNE WO CITY OF Lm MMU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/4/2017 First Name Clare Last Name Rose Home Address* 928 E Bloomington $t city IOWA CRY State IA Zip Code" 52245 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number* 3192130477 Email Address* cmartin204@grriail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* North Side 2. How long have you been a resident of Iowa City?` 26 years 3. Occupation:* Technical Project Manager 4. Gender:* Female S. Experience and/or activities which you feel qualifyyou for this position:* I have been a project manager for five years at Pearson Education. My skills as a project manager, including gathering information from stakeholders, planning processes and documenting decisions I feel would be applicable to these commissions. Previously I was a research intern at a small think tank in Washington DC called SpirhHDuse, where I was tasked with gathering large amounts of research and distilling it down into easily understandable pieces for press releases. In college I worked for a development firm who built low- income assisted living facilities In Iowa City, I was tasked Mh reviewing potential resident applications and approving income requirements. Finally, I have lived in Iowa City for 26 years, a)periencing it as a child, a college student and finally an adult. I have the good fortune to be able to call on the perspectives of these multiple roles in considering issues that might come to the attention of these commissions. 6. What Is your present knowledge of each advisory board you are Interested In?* I have limited knowledge of the specifics of each of these advisory boards. I have lived in the Northside neighborhood most of my fife and from a citizen observer perspective I am familiar with some of the duties of the Hstoric Preservation Commission. Regarding the Housing and Community Development Commission, I have reviewed the agendas and notes from the last few meetings. I recognize the role this commission plays in programs such as UniverClty and it work in providing assistance in allocating funds towards affordable house in Iowa City. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* iJ�U�lC[� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 5/2/2017 First Name' Mazahir Last Name* Salih Home Address* 2355 Jessup Cir City IOWA CITY State A 21p Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5712825188 Email Address* salihniazahir@grriail.com Boards & Commissions Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 5years 3. Occupation:* Community organizer at CWJ 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* Working and dealing with low wage workers, immigrant and people of color. Plus rm a current member. Advisory Board/Commission Application Form Mt This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. unrsm an or urrnwruu NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 5/2/2017 First Name' Mazahir Last Name* Salih Home Address* 2355 Jessup Cir City IOWA CITY State A 21p Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5712825188 Email Address* salihniazahir@grriail.com Boards & Commissions Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 5years 3. Occupation:* Community organizer at CWJ 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* Working and dealing with low wage workers, immigrant and people of color. Plus rm a current member. 6. What Is your present knowledge of each advisory board you are Interested In?* rm a current member. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decisiorrmaking process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federall"ssisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at ft same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 44 10. Country of Origin Sudan 11. Sexual Orientation 12. Religion Muslim 13. Do you have a disability? W 14. Ethnicity NH "NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 18 years of age and live within city lir its of Iowa City to apply Date of Application 2/16/2017 First Name David Last Name Selmer Home Address* 403 Boyd Cf. City IOWA CTY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-331-9956 Email Address* dselmer@hmsblaw.com Boards & Commissions Select a Board or Commission you are Interested in:* Community Police Review Board (CPRE) 2. How long have you been a resident of Iowa City?* Four years 3. Occupation:* Lawyer 4. Gender:* Male S. Experience and/or activities which you feel qualify you for this position:* Advisory Board/Commission Application Form y w-10C2%rei�t ne®�� This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCCICITY Or UNUNgE NOTE: Must be 18 years of age and live within city lir its of Iowa City to apply Date of Application 2/16/2017 First Name David Last Name Selmer Home Address* 403 Boyd Cf. City IOWA CTY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-331-9956 Email Address* dselmer@hmsblaw.com Boards & Commissions Select a Board or Commission you are Interested in:* Community Police Review Board (CPRE) 2. How long have you been a resident of Iowa City?* Four years 3. Occupation:* Lawyer 4. Gender:* Male S. Experience and/or activities which you feel qualify you for this position:* I served as Assistant Corporation Counsel for the City of Chicago after graduating law school in 2004. For four years thereafter I defended the City of Chicago police in civil rights complaints wherein police misconduct was alleged. My representation of officers was in both the state and federal lawsuits, internal investigations. My representation also extended, at times when there was no conflict, to defending the City in regards to their policies and practices, including the investigation of its officers In these capacities I worked extensively in analyzing and applying constitutional principles and procedural standards to officer conduct, including applying reasonable force diagrams. I later worked for a few years in the private practice Mere I prosecuted claims of civil rights abuse and police misconduct in both State and Federal court. Since 2014 1 have been employed as an attorney at Hayek, Moreland, Smith 8 Bergus, LLP, doing general practice that has involved defending officers in misconduct matters in the jail or in the field, and defending criminal cases. I have also helped file a recent complaint against a University Heights police officer and continue to represent a client in that capacity. Overall I have a commanding knowledge of the issues that will be presented before the panel for review, a desire to apply my knowledge to ensure that the police and our citizens are being treated fairly and the integrity of our system - that is critical for the police and the community alike - remains intact. 6. What is your present knowledge of each advisory board you are interested in?* 1 have a command of the goals, functions and role of the board as well as a high level of understanding of the procedures for the review. I have reviewed the several decisions of the board in recent years, including the prologue of the decision that describes the recommendations of the board and its duties. I have also discussed the review board with ex city council members to get an understanding of the purpose for its implementation and its effectiveness. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-ir"aw, daughter-in-law, mother-iMaw, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother -int -law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chill, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. H reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* M 8. Do you currently serve on another Iowa City board or comnAssion?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin USA 11. Sexual Orientation Male 12. Religion Unitarian 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down E § E § ] ■ x § k « I I §k! •a& q ' k•�§� �#.■§■/�|k|)|=� 4�2�0 ■;o�x4;a § IKONIS]= THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION COMMISSION Four Vacancies — Three Year Terms July 1, 2017 — July 1, 2020 1 Longfellow Representative 1 Northside Representative 2 At -Large Representatives • Duties of the Historic Preservation and Land Marks Commission include: conducting studies for the identification and designation of Historic Districts; reviewing and acting upon all applications for Certificate of Appropriateness; cooperating with property owners and city agencies regarding remedy of dangerous conditions. • Furthering the efforts of historic preservation in the City by making recommendations on preservation issues, when appropriate, by encouraging the historical, architectural or cultural value, and by encouraging persons and organizations to become involved in preservation activities. • Applicants for district representatives to the Historic Preservation Commission must reside in the district that is specified. • This Commission meets the second Thursday of each month at 5:30 p.m. • City -appointed members of boards and commissions must be at least 18 years old and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Historic Preservation Commission should be directed to Bob Miklo, Sr Planner at 356-5240. 5/4/2017 Board/Commission Application Cover Board/Commission: Historic Preservation Commission - Longfellow One vacancy, three year term 7/1/2017 - 7/1/2020 Gosia Clore It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 Gender Balance Requirement: Current Gender Balance: Gender Female After date above Council may appoint without regard to gender 3 Male, 1 None Female:5 Male:2 Name and Address Clore, Gosia 1 full term 1133 a court st d r � O� CITY Of IOWA CITY UNESCOOT OFUMMIUK Date of Application 5/7/2017 First Name Gosia Last Name Clore Horne Address* 1133 a court st City IOWA CITY State IA Zip Code 52240 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application Wil be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 9733425599 Email Address* gosiaclore@gniail.com Boards & Commissions Select a Board or Commission you are interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* Longfellow 2. How long have you been a resident of Iowa City?* 5 3. Occupation:* Research Scientist 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* - a oomrrrssioner with the HPS - experience with preserving and restoring historical homes 6. What Is your present knowledge of each advisory board you are Interested in?* rm a commissioner with the HPS Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-ir-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-ir-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is rat to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 10. Country of Origin 11. Sexual Orientation 12. Religion 13. Do you have a disability? 14. Ethnicity 'NOTE: The Hunan Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* fKaO Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Board/Commission Application Cover Board/Commission: Historic Preservation Commission - North Side One vacancy, three year term 7/1/2017 - 7/1/2020 Thomas Agran It is hereby established, as a formal polity of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: 3 Male, 1 None Current Gender Balance: Female: 5 Male: 2 Gender Name and Address Male Agran, Thomas 1 unexpired term, plus 1 full term 512 N. Van Buren St. i Advisory Board/Commission Application Form - ' rY =a� y��Ptt'f� t This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCOCIT OF MEN.QUH NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/27/2017 First Name Thomas Last Name Agran Home Address* 512 N. Van Buren St. city IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 541 4554 Emall Address* thomasagra n@g mail. corn Boards & Commissions Select a Board or Commission you are interested In:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* North Side 2. How long have you been a resident of Iowa City?* 8 years 3. Occupation:* Artist / Self employed 4. Gender:* Male 5. Experience andlor activities which you feel qualify you for this position:* I have had the pleasure to serve on the HPC over the last 3 years, and have learned a lot about the commission's role and responsibility in our community. Since moving to the Northside in 2011, 1 have had growing interest in how we preserve the existing assets of our older neighborhoods, as well as how we encourage the overall vitality of the neighborhoods and appropriately invest in their future. In terms of the meeting -to -meeting responsibilities, I think my experience working for a number of years in carpentry on older homes and buildings, as well as the experiences living and maintaining in a 100 year old home and maintaining a few other century old properties in town is useful perspective and knowledge to draw on. 6. What is your present knowledge of each advisory board you are interested in? I have sal on the HPC representing the Northside area for the last 3 years. I feel I have a strong understanding of the important role the commission holds. Our motions and recommendations form valuable precedents, and I try and think critically and objectively about the rases that come before the commission. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted acfivity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full tern in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 30 10. Country of Origin United States 11. Sexual Orientation Straight 12. Religion n/a 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Hunan Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* .A ori Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Board/Commission Application Cover Board/Commission: Historic Preservation Commission - At -Large Enter text specific to board/commission Two vacancies, three year terms 7/1/2017 - 7/1/2020 Andy Litton and Kevin Boyd It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender Female Male Male Female Female 3 Male, 1 None Female:5 Male:2 Name and Address Bergstrom, Annika 1125 Sandusky Drive Boyd, Kevin 1 unexpired term 622 N Van Buren St Karr. GT #2 Ashwood Drive Simpson, Michelle 1213 Friendly Ave Rose, Clare 928 E. Bloomington St. 10215711, w� r CITY OF IOWA CITY UNEXOCITY Or UTFMN0.F Date of Application 2/16/2017 First Name* Annika Last Name Bergstrom Home Address* 1125 Sandusky Drive City IOWA CITY State IA Zip Code 52240 Advisory Board/Comrnission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196212998 Emal I Address* ann ika.bischoff.bergstrom@g mail. com Boards & Commissions Select a Board or Commission you are Interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* At -Large 2. How long have you been a resident of Iowa City?* 22 years 3. Occupation:* Student 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* Part-time job in 2013 as an assistant in the University of Iowa Main Library's preservation department 6. What is your present knowledge of each advisory board you are interested in?* Minimal knowledge of HPC - however, I am passionate about ensuring the preservation of old buildings and documents Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* W S. Do you currently serve on another Iowa City board or commission?* W Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the communityand the groups(s) which it serves, please provide your information for the following: 9. Age 22 10. Country of Origin United States 11. Sexual Orientation Bisexual 12. Religion Non religious 13. Do you have a disability? Yes Please explain: Mental health diagnosis 14. Ethnicity While 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefor:, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* OKWAVAT ,14-cyar-r~ Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form ry _ ' This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY Of UTE TUU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4126/2017 First Name Kevin Last Name Boyd Horne Address* 622 N Van Buren St City IOWA CITY State LA Zip Code 52245 1. Is your home address Misted above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-400-2051 Emall Address* kevinmboyd@gmail.com Boards & Commissions Select a Board or Commission you are interested In:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* At -Large 2. How long have you been a resident of Iowa City?* 25 total; 2 since returning 3. Occupation:* National Political Director 4. Gender:* Male S. Experience and/or activities which you feel qualify you for this position:* I was appointed to fill an unexpired at -large term last summer, and would like to continue that work and serve a full term. Before 1 applied, I had taken some tistoric Preservation Gasses through Kirkwood Community College. I have since continued that education on historic preservation methods, including a recent class conducted by Friends of Hstoric Preservation. My home is in a historic district and across the street from a conservation district - I've seen the benefits of preservation on the neighborhood. 6. What is your present knowledge of each advisory board you are Interested in?* Since my appointment last summer, I have worked hard to become an active member of the commission. rve volunteered to help with the HPC annual awards ceremony. I have offered assistance to the staff and chair as the commission works to achieve our 2017 Priorities. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federaly-assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in4aw, step-parent, brother, sister, step -siblings and half -siblings, brofher-inaw, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency ff reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 37 10. Country of Origin United States 11. Sexual Orientation LGBT 12. Religion not practicing 13. Do you have a disability? Pio 14. Ethnicity white "NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Kau, Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down 'l d �;i�lil~tt war y CITY OF IOWA CITY rmrscoarr of urauniu Date of Application 5/4/2017 First Name' GT Last Name Karr Home Address* #2 Ashwood Drive City IOWA CITY State IA Zip Code 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of lova City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number"' 319-831-4342 Email Address* gtkarr4@gmail.com Boards & Commissions Select a Board or Commission you are Interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* At -Large 2. How long have you been a resident of Iowa City?* 38 3. Occupation:* Business Owner-Sueppel's Siding & Remodeling 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* Own and manage Supppel's Siding and Remodeling for 15 years. Over 20 years of remodeling experience. Construction Management Degree 11Nl. Have worked on projects in Historic and Conservation Districts. Serve as current Iowa City Homebuilders Remodelers Council Chair. Serve as 2nd Vice President for the Iowa City Homebuilders Association. Currently serve on the Johnson County Senior Action Housing Team and starting to work with the Iowa City Climate Action Steering Committee as an HBA Representative. Currently serve on the Iowa City Homebuilders Parade of Homes Committee. Received the Historic Preservation Commercial Rehabilitation Award in 2013. 6. What is your present knowledge of each advisory board you are interested in?* I have worked with the Historic Preservation Commission in the past and found it somewhat difficult to navigate and understand. I would like to use mry construction experience as well as the knowledge I have gained working with the Commission and the City to help create an easier way for homeowners and contractors to remodel and improve homes while still complying with the guidelines outlined in the Historic Preservation Handbook. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted acfivity, or with respect to the proceeds of the federaly-assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 6. Do you currently some on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin USA 11. Sexual Orientation Hetrosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* q T. Karr Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down i e ,I Advisory Board/Commission Application Form -vgrrtt This application is a public document and as such can be reproduced and distributed for w� ' the public. This application Hill be considered for twelve months only and automatically CRY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LKERGTURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Michelle Last Name Simpson Home Address* 1213 Friendly Ave City IOWA CRY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 2106274694 Email Address* rnsirnpson'! 15@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* At -Large 2. How long have you been a resident of Iowa City?* 5 Years 3. Occupation:* Business 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* Worked in FEMA Public Assistance for nine years managing grants for various disasters across the country. Part of that process is ensuring grants are in compliance with all federal laws, including the National Historic Preservation Act. Familiar with secretary of the Interior guidelines for historical restorations. Also familiar with mitigating adverse affects for historic sites. Coordinated with FEMA Historic preservation specialists and various SHPOs during these nine years. I love the research and history that goes into reviewing historic sites and feel I would be a great asset to this commission. 6. What is your present knowledge of each advisory board you are Interested in?* Information posted on website about functions of the comrrrssion plus experience working with municipal boards while working with FEMA. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an irxiividual would be limited to one reappointment to a full tens in order to increase the opportunities for new applicants to serve. Council policy is rat to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 40 10. Country of Origin us 11. Sexual Orientation Gay 12. Religion n/a 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down It Advisory Board/Commission Application Form �,4 i zo b A This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCOCHN OF UTENATUM NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 41412017 First Name Clare Last Name'" Rose Home Address* 928 E Bloomington St City IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3192130477 Emall Address* cmrtin204@grnaii.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested In:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* 2. How long have you been a resident of Iowa City?* 26 years 3. Occupation:* Technical Project Manager 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have been a project manager for five years at Pearson Education. My skills as a project manager, including gathering information from stakeholders, planning processes and documenting decisions I feel would be applicable to these co rNssions. Previously I was a research intern at a small think tank in Washington DC called SpiritHouse, where I was tasked with gathering large amounts of research and distilling it down into easily understandable pieces for press releases. In college I worked for a development firm who built low income assisted living facilities in Iowa City, I was tasked with reviewing potential resident applications and approving income requirements. Finally, I have lived in lows City for 26 years, experiencing it as a child, a college student and finally an adult. 1 have the good fortune to be able to call on the perspectives of these multiple roles in considering issues that might come to the attention of these cornnisslons. 6. What is your present knowledge of each advisory board you are Interested In?* I have limited knowledge of the specifics of each of these advisory boards. I have lived in the Northside neighborhood most of my life and from a citizen observer perspective I am familiar with some of the duties of the Historic Preservation Commission. Regarding the Housing and Community Development Commission, I have reviewed the agendas and notes from the last few meetings. I recognize the role this commission plays in programs such as UniverCity and It work in providing assistance in allocating funds towards affordable house in Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federaly-assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract CityCouncil Resolution # 15-300 established a policythat the following persons shall rot be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Gola�,x'k Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. HISTORIC PRESERVATION COMMISSION ATTENDANCE RECORD 2016-2017 NAME TERM Exp, 2125 3112 4114 5112 6/9 7114 8111 918 10113 11/10 12/8 1/12 219 AGRAN, THOMAS 3129117 X X 0/E X X 0/E 0/E x X X X X X BAKER, ESTHER 329/18 X X X X X X X X X 0/E X X X BOYD, KEVIN 329117 — — — — — — — X X X 01E X X BUILTA, ZACH 329/19 — — X X X X X X x X X I O/E X CLORE, GOSIA 329117 01E X X X O/E X X X O/E X X X 01E DEGRAW, SHARON 329/19 — — X X X X O/E X O/E x X X X KUENZLI, CECILE 3/29119 - - 01E O/E x X X X X X X 01E X LITTON, ANDREW 329117 X X X O/E 01E X O/E X x 01E O/E X X MICHAUD, PAM 329/18 X X X X X X O/E X X X X X X SANDELL, BEN 329/17 X X X X X X — — — — — — SWAIM, GINALIE 3129118 X X X X X X X X X O/E 01EWAGNER, tx FRANK 329/18 X X X X X X X X O/E X X X KEY: X = Present 0 = Absent O/E = Absent/Excused — = Not a Member NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION COMMISSION One Vacancy to fill an unexpired term Upon appointment — July 1, 2019 (1) Jefferson St Representative Duties of the Historic Preservation Commission include: conducting studies for the identification and designation of Historic Districts; reviewing and acting upon all applications for Certificate of Appropriateness; cooperating with property owners and city agencies regarding remedy of dangerous conditions. Furthering the efforts of historic preservation in the City by making recommendations on preservation issues, when appropriate, by encouraging the historical, architectural or cultural value, and by encouraging persons and organizations to become involved in preservation activities. • Applicants for district representatives to the Historic Preservation Commission must reside in the district that is specified. City -appointed members of boards and commissions must be at least 18 years old and reside in the City of Iowa City, The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Historic Preservation Commission should be directed to Bob Miklo, Sr Planner at 356-5240. 5/4/2017 Board/Commission Application Cover Board/Commission: Historic Preservation Commission Jefferson Street Representative One Vacancy, to fill on unexpired term Upon appointment — 7/1/2019 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 4/18/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: None Female: Male: Gender Name and Address NO APPLICATIONS O5-16-17 18h m� NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HOUSING $ COMMUNITY DEVELOPMENT COMMISSION Three Vacancies — Three Year Terms July 1, 2017 —July 1, 2020 Duties of the Housing and Community Development Commission include assessing and reviewing policies and planning documents related to the provision of housing, jobs, and services for low- and moderate -income residents; reviewing policies and programs of the Public Housing Authority and Community Development Division and make recommendations regarding the same to the City Council; reviewing and making recommendations to the City Council regarding the use of public funds to meet the needs of low- and moderate -income residents; housing policies and programs, and seeking public participation in assessing needs and identifying strategies to meet these needs; recommending to the City Council from time -to -time amendments, supplements, changes, and modifications to the Iowa City Housing Code. The Housing and Community Development Commission will have monthly meetings. Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. When possible, Council will appoint persons with expertise in construction and/or finance, a person receiving rental assistance, and a member of the Local Homeless Coordinating Board. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org.or by contacting the Clerk's office. Questions about the Iowa City Housing and Community Development Commission should be directed to Kris Ackerson, Community Development Planner at 356-5247. Board/Commission Application Cover Board/Commission: Housing and Community Development Commission(HCDC) Three vacancies, three year terms 7/1/2017 - 7/1/2020 John McKinstry, Peter Byler, and Dorothy Persson It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: 2 Male, 1 None Current Gender Balance: Female: 4 Male: 2 Gender Name and Address Female Dietrich, Johanna 637 S. Johnson Street Male Eastham, Charles 953 Canton St. Female Fixmer-Oraiz, Vanessa 437 S. Governor St. Female Johnson, Kristin 415 S. Van Buren St., Apt.1 Female Lambertz, Angela 1710 Hollywood Blvd. Male Maggos, Nikolaos 320 E. Burlington St., Apt. 6 Female McDonald, Sharon 1216 Jensen St Male McKinstry, John 1 unexpired term 308 Ronalds Street Female Rose, Clare 928 E Bloomington St Female Wall, Rachel 321 S. Linn Street Apt. 123 Female Young, Heather 502 3rd Ave. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Johanna Last Name Dietrich Horne Address* 637 S. Johnson Street City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5077794207 Email Address* johanna-dietrich@uiowa.edu Boards & Commissions Select a Board or Commission you are interested In:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* A year and a half 3. Occupation:* Student and Camubs Driver 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* Advisory Board/Commission Application Form ,L 7: 1 This application is a public document and as such can be reproduced and distributed for w� ' the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNES 00OF UTE"WR NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/16/2017 First Name Johanna Last Name Dietrich Horne Address* 637 S. Johnson Street City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5077794207 Email Address* johanna-dietrich@uiowa.edu Boards & Commissions Select a Board or Commission you are interested In:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* A year and a half 3. Occupation:* Student and Camubs Driver 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I was active in my high school apart of the student council and Vice President of my senior class. I was introduced to this position from my human rights class. I want to bring positive change to the community and be actively engaged with the Iowa city citizens. I am a student at the University of Iowa studying enterprise leadership, minor in human relations and certification in human rights. My goal is to become a social entrepreneur. I think being apart of the board will help me understand more about the community needs. 6. What Is your present knowledge of each advisory board you are Interested In?* I understand that the commission works to make affordable and sustainable housing across Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of bwagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall rat be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-ir-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency if reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No S. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the commtrityand the groups(s) which it serves, please provide your information for the following: 9. Age 19 10. Country of Origin USA 11. Sexual Orientation straight 12. Religion NA 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to Have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down ME City of Iowa City I r Advisory Board/Commission/Committee AD.;m1i4p� Application Form CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENI WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Housing and Community Development Comm.Term 3 year NAME Charles Eastham HOME ADDRESS 953 Canton St., Iowa City Is your home address within the corporate limits of Iowa City? © Yes 1-1 No How long have you lived in Iowa City? 45 years _ Gender: Male Female El Contact # (319) 541-3972 Email Address eastham@outlook.com CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FFFI 61101 IFv vnl I Gno rurc ono T na Previous member of The Housing Fellowship Board of Directors for 25 years. Active member of the Affordable Housing Coalition, the Coalition for Racial Justice and ally member of the Black Voices Project. Member of the Center for Worker Justice Board of Directors. Past president of the Consultation of Religious Communities. Former member of the Iowa City Planning and Zoning Commission. •.F s. J 1� I vert rKraery 1 r NUVVLtOGE OF THIS ADVISORY BOARD? The principle responsibility of the HCDC is to make recommendations to Council regarding the use of public funds to meet identified needs of low and moderate income residents. The Commission also reviews various planning documents and policies regarding housing, jobs, and services for low and moderate income residents. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest The only current affiliation I have with organizations that have not but could possibly apply for City funds is as a board member of Pas Trac and New Creations Academy. If appointed to the Commission I will resign from the boards of those organizations if required by City conflict of interest policy. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑X Yes P}o DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 'O Yes Ox No (If yes, please indicate which board would be your first choice to serve on.) N Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 usehold Size 30% Median Income ipoverty Leve11 50°,6 Median Income i6 Median 80% Median Income Median 1 _ $16,700 $27,850 _ Income $33,420 (low income) Income 2 19,100 31,800 38,160 $44,550 $55,700 3 _ 4 _ 21,500 - _ 35,800 - 42,960 50,900 57,250 63,600 5 _ 23,850 39,750 47,700 63,600 71,500 6 25,800 42,950 51,540 68'700 _ 79,500 7 _ 27,700 46,150 55,380 73800 85,900 8 29,600 31,500 49,300 59,160 ' 78900 92,300 98,600 52,500 63,000 84,000 105,000 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES: Lower Income (see table) E:J Receive Rental Housing Assistance N U �T Your response is voluntary, and you may wish instead to elaborate on or indicate areas inrohich you can make a special contribution to the Commission in another section of this form. -o When possible, Council will appoint a person or persons with expertise in construction, finance and/or a person receiving rental assistance. rn If you have expertise in construction or finance, please describe your experience and/or training. I developed the financial plans for several affordable housing projects during the time I was a member of The Housing Fellowship Board of Directors. HCDC Application ebruary 2015 page 4 of 8 t � , BOARD, COMMISSION AND COMMITTEES✓MIr BUSINESS LISTING CITY Of IOWA CITY Name of City Board/Commission/Committee Housing and Community Development Commission Date 7-27-2016 Name Charles Eastham Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7) List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS None NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Misrepresentations on this application will constitute just cause for removal of 2ff appointee. If you fail to answer all the questions. Council may not consider your application. General Application r ; April 2015 Page 3 of 7 Marian Karr From: Harry03 <Harry03@aol.com> Sent: Monday, April 25, 2016 9:10 PM To: Marian Karr Subject: Letter of recommendation, please distribute to City Council Dear Mayor and Iowa City Council members: I am very pleased to recommend for your consideration, Charlie Eastham, to the Housing and Community Development Commission. When Charlie told me of his interest to serve on the Housing and Community Development Commission I encouraged him to apply. I have known Charlie for 6 years and have worked with him on several committees. Whether it be his outstanding work on the Iowa City Zoning Board serving as chair for several years, chairing the Consultation of Religious Communities, on the board of the Center for Worker Justice, and on the Iowa City Community School District Equity Committee, Charlie does the homework, asks thought-provoking questions, is responsible and follows through on committments he takes on. Charlie has relentless energy when it comes to issues of social justice. I see Charlie as an asset to our city and know he will be committed and involved if appointed to the Iowa City Housing and Community Development Commission I highly recommend him and look forward to working with him. Sincerely, Harry Olmstead 1951 Hannah Jo Ct Iowa City, IA 52240 319-338-2931 Sent from my Galaxy Tab® A r Advisory Board/Commission Application Form _ s"N�l'fE�t This application is a public document and as such can be reproduced and distributed for r the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of lova City to apply Date of Application 4/21/2017 First Name* Vanessa Last Name'" Fiwner-Oraiz Home Address* 437 S. Governor St. City 10 WA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 9199236211 Email Address* voraiz@hbkengineering.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 4.5 years 3. Occupation:* Planner 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I am currently a planner with a local engineering firm. I have a Masters degree from the University of Iowa's School of tkban and Regional Planning. I work with communities across Iowa to plan livable and vibrant towns, whether through providing grant writing services, creating Comprehensive Plans/Master Plans, or even completing annexation studies. Our firm also works with local developers and I have assisted with relocation plans, plat development, and various City -related processes, such as Comprehensive Plan amendments, good neighbor meetings, and rezoning applications, that directly apply to housing in Iowa City. 6. What is your present knowledge of each advisory board you are Interested in? I have attended meetings and understand the role that the Housing and Community Development Commission plays in providing recommendations to City Council. I believe that this is a vital and hard working group of people that have a great responsibility to the community to examine various housing aspects in love City. I check the commission agendas and appreciate that they get out into the community and really take a look at housing conditions and examine potential candidates for grant funding opportunities. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagen eraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-ir-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother -in, -law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin USA 11. Sexual Orientation Queer 12. Religion Spiritual 13. Do you have a disability? No 14. Ethnicity Filipino -American 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* VArbdfA-�iYrMsprO�%.4/a Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form L —,=_r5 ry .412=111 `� t This application is a public document and as such can be reproduced and distributed for M®'moi the public. This application will be considered for twelve months only and automatically CIN OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LRERATNRE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/5/2017 First Name* Kristin Last Name Johnson Home Address* 415 S. Van Buren St., AptA City IOWA CRY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-594-1032 Email Address* sunshineariel99@gmil.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 22 years 3. Occupation:* volunteer 4. Gender:* Female 5. Experience and/or activities which you feel qualifyyou for this position:* I am active in some support groups which help me stay connected to the community and help me to take good care of myself, and interact with an interesting and diverse population in this city. 6. What is your present knowledge of each advisory board you are Interested in?* I am aware that the library board term is a period of 6 years and helps determine policies and practices. I am aware that the Community Police Review Board is designed to help those concerned with criminal justice in this community. And I am aware that the Human Rights Commission is designed to help protect people with disabilities to be treated fairly in this community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federaly-assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in--law, mother-in4aw, father-in-law, step-parent, brother, sister, step -siblings and hall -siblings, brother-in--law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chill, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* HD 8. Do you currently serve on another Iowa City board or commission?* NO Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion Episcopal 13. Do you have a disability? Yes Please explain: I have a mental health condition which I manage with medication and social activities and healthful activities. For example, I volunteer at a local peer support recovery center, volunteer for New Pioneer Co-op,& garden in the city garden. I also advocate with letters and phone calls to our elected representatives for a combination of issues I am concerned about, such as mental health parity, the environment and social justice.) also receive rental assistance. 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to safisfy its purpose and intent, when possible to have at least one person with expertise in constriction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* IS!i Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down _ Advisory Board/Commission Application Form ' =_ro rY Z l7it'f/� w� This application is a public document and as such can be reproduced and distributed for w E�the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO C" Of UrERAWRE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 2/22/2017 First Name* Angela Last Name Lambertz Home Address* 1710 Hollywood Blvd. City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196219837 Email Address* cawtee73@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Human Rights Commission 2. How long have you been a resident of Iowa City?* 3 years 3. Occupation:* Content Specialist I, Technical 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* I have lived in various unsafe buildings because of lack of funding for affording safe housing. I am an LGBTQ activist who would like to participate more directly in the government of my community. 6. What is your present knowledge of each advisory board you are Interested in?* I have attended a couple City Council meetings and keep up to date on local news through social media outlets and the local newspaper. I have read through the Duties descriptions of each advisory board on the iowa- city.org website. Please contact the City Attorney at 356-6030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of bwageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-ir-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-ir-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currentlyserve on another Iowa City board or commisslon?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following 9. Age 43 10. Country of Origin United States 11. Sexual Orientation Bisexual 12. Religion Wiccan 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down City of Iowa City Advisory Board/Commission/Committee Application Form THIS APPLICATION 1S A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR TWELVE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. iloars:n5 a,.a i -o r.r.rv.,.,.:.t-y AdvisoryBoard/Commission/Committee Name. tk.n,lofg-uoy 0~%�:-'Term $Oita -Z01`j NAME HOME ADDRESS 3Zo 151'..r(�nr,�zn 1� �- (Q Is your home address within the corporate limits of Iowa City? Yes ) No How long have you lived in Iowa City? --2 vu� Gender: Male% Female Contact#/ W0 -593-9$2 Email Address {'�Sr`^�q�eiC'egra:l.ca'-•v CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS M' .L P1n:l6',1FK./ P�� sFuAtnl' u+c ria=^S en rsS w -S nla.lcF k. S.Y�S,skus- ri�br.4c : (e0d, 7•.aa^^er [5Z. S,.i o1l �P1e. S o-sc Ho./c a w,; rLw- l-; axle -1 lr.s.�+r.4iw M.ca�a.0 S a.r� `eeJ o✓ 5�%, ,F �,+a_ C.4-7 `� tnr3;o.� ;n�crrc.., as awry d (`e+... Y�"r a�o rel2d a1 Imr•s to Puy iPtc b'.il {, L YM.-{ Iro..s, paa^ ru.<awe�,, e. -L I.vsa,— S ;_beresL a,.S uger:,s.c.e. yarttn. 44r. tYa'-tC0'� � ii..b:r, Cafo�d�� ,`!'�-6�ry Y 6e.licvt St1. Sa"y .��e. t�w��s•+�Z. f„Prl c.kio+ <.. i4.g cGcaaa-�iQ4-y ran. OWu� SnN.an e>5"°'l`$` s4 bCu..•-`5�a iE++� r+•nL �Lc c\ct Fc S M1ro.r CCV�.YS r`C�f�-c :a G,.+n.�a �0Y IuS ,tsip rorFaCe_ti.as s.'K" ',Nie. Fa Loma a p..Jn, kkj WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? rcr405 ppparbr; e:.s .^t'rrgp fro L^b,.+L r' er-_L a" ten rrwr+�, :^O��v: du.6r �o-vt aCa�{$ Ro NFor t�to4 Icor.-52� { e -S irre,ll n.s �, Pw,e or^5 LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest N C7 DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? LYes LNo (If yes, please indicate which board would be your first choice to serve on.) c ry .y vb Misrepresentations on this application will constitute just cause for removal of an appointee. ItTou fail to answer all the questions, Council may not consider your application. - - ns dune LUAU t'ageZ of 7 �7 1�r T c11a ct/,r•� M Tawo- 9r�ok sk�r-Lr.1 ,�., cwt-zs� •5 Qe1�,al fkrkio� ptt&ws- r �cCFa:•a:. �. a,a$no� Ar•.��"1 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 15, 2013 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 1 27,700 1 46,150 55,380 1 73,800 1 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 ' ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, PLEASE INDICATE IF YOU ARE A MEMBER OF EITHER OF THE FOLLOWING CATEGORIES: 1KLower Income (see table) < So> M'a.o,. •,nco-L Receive Rental Housing Assistance Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in construction, finance and/or a person receiving rental assistance. If you have expertise in construction or finance, please describe your experience and/or training. :r Str..cd n5 .Lvr 1 -Y�11f-{caT+S � C.¢�irrs' M ILJ.�(. ���� lli5� lw�•'�Q pr(s4n-�a'f1cn Tn Vs+�l i"ic� 4- Pib �s:l (2e1 G54eL-e cieve(apuw�:- loans - we- rU ..,dzb h-r``Z'�a""�- 46 AA"-0aptSS Swi^ uj �.��o:,d. T �.e..ic F,ti..:-I:.,i •`� ,1.i{^ tl.� 1.ww pgt'een^''^4t tML �`S�recf .,lws ;.voc.xr. v HCDC Application February 2015 page 4 of 8 r BOARD, COMMISSION A14D COfl NUTTEES Nt-�.7"'1° BUSINESS LISTING CITY OF IOWA CITY Name of City Board/Commission/Committee µ�sn �c � ,4 �r �IopM.nG (<r Mrrsro� Date -7�25(a Name Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional busjpess., Applicant Signatu N Misrepresentations on this application will constitute just cause for removal of an -appointee. if you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 Marian Karr From: Maggos, Nikolaos S <nikolaos-maggos@uiowa.edu> Sent: Wednesday, July 27, 2018 11:38 AM To: Council Subject: Housing and Community Development Commission Hello City Council members, My name is Nik Maggos and I am applying for a position on the Housing and Community Development Commission. I wanted to send an email introducing myself to all of you with the hope that we will soon be working together towards improving access to employment opportunities and affordable housing for Iowa City's at -risk citizens. To give a little information about myself, I am entering my third year in the Philosophy Ph.D. program at UI and serve as the Political Action Chair for COGS (UI's graduate student union). Academically, I'm most interested in philosophical issues surrounding human rights. Non -academically, I love playing sports (especially basketball, soccer, and tennis), hiking, camping, and spending time with my girlfriend and friends. I also love thinking about spending time with a puppy, because I can't actually spend time with one until I move to a new apartment that allows pets. I look forward to meeting all of you and hearing about your interests as well. I hope to be seeing you all soon! Best, Nik Nikolaos S. Maggos Philosophy Ph.D. Candidate University of Iowa EPB 252 l ' = I Advisory BoardifCommission Application Form rY _ a Iat w.sr� This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. VNEKOCIT OFIITERATVRE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 3/3112017 First Name Sharon Last Name* McDonald Home Address* 1216 Jensen St City IOWA CITY State IA Zip Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196318270 Email Address* snicdonald2l28@gmil.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 29 years 3. Occupation:* child care center director 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have been interested in this topic for a long time. I live quite dose to the Pheasant Ridge complex I worked at the Faraway store on Mormon Trek for 14 years and got to know many of the residents of PR. I also used to live in the yellow townhouses behind the Kwik Trip on MT. I was the 2016 precinct captain for these two neighborhoods and canvassed them personally and by phone quite often. I know that getting into these units is difficult and I also know there are significant challenges for those that do. 6. What is your present knowledge of each advisory board you are interested in?* 1 follow what's reported in the newspaper. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowagenerelly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chili, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will bs considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* Klo Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin United States 11. Sexual Orientation n/a 12. Religion unitarian 13. Do you have a disability? Yes Please explain: I have a bad back but I can walk fairly well with a walker. 14. Ethnicity caucasion *NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ,�mtcw ,�r�aral�f Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for warms r the public. This application will be considered for twelve months only and automatically CITY OF IOWA CIN considered for any vacancy during that time. UNESCO CITY OF LFTERATURE NOTE: Must be 18 years of age and live within city linuts of Iowa City to apply Date of Application 3/8/2017 First Name John Last Name McKinstry Home Address* 308 Ronalds Street city IOWA CRY State IA Zip Code 52245-1942 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-354-0040 Email Address* adiscipleOG40@msn.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 24 years 3. Occupation:* retired pastor 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* previous service on the same conrrrssion, volunteers experience with Shelter House, Habitat, Hosing Fellowship, Board member of Jo. Co. Affordable Hsg. Coalition, disaster recovery, historic preservation, etc. 6. What is your present knowledge of each advisory board you are interested in? Served on the Commission 2016-7 Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-irt-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and hag -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency it reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* W 8. Do you currently serve on another Iowa City board or commission?* W Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 66 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion mainline Protestant 13. Do you have a disability? No 14. Ethnicity midwestern caucasian "NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* o%.e. ov r%W'G'4�0—day Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 414/2017 First Name Clare Last Name Rose Horne Address* 928 E Bloonnngton St city IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3192130477 Email Address* cmartin204@gmail.com Boards & Commissions Select a Board or Commission you are interested In:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are Interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* North Side Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNEsroaTY OF tff P TUU NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 414/2017 First Name Clare Last Name Rose Horne Address* 928 E Bloonnngton St city IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3192130477 Email Address* cmartin204@gmail.com Boards & Commissions Select a Board or Commission you are interested In:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are Interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* North Side 2. How long have you been a resident of Iowa City?* 26 years 3. Occupation:; Technical Project Manager 4. Gender:} Female S. Experience and/or activities which you feel qualify you for this position:* I have been a project manager for five years at Pearson Education. My skills as a project manager, including gathering information from stakeholders, planning processes and documenting decisions I feel would be applicable to these commissions. Previously I was a research intern at a small think tank in Washington DC called SpiritH use, where I was tasked with gathering large amounts of research and distilling it down into easily understandable pieces for press releases. In college I worked for a development firm who built low- income assisted living facilities in Iowa City, I was tasked with reviewing potential resident applications and approving income requirements. Finally, I have lived in Iowa City for 26 years, experiencing it as a child, a college student and finally an adult. I have the good fortune to be able to call on the perspectives of these multiple roles in considering issues that might come to the attention of these commissions. 6. What Is your present knowledge of each advisory board you are Interested In?* I have limited knowledge of the specifics of each of these advisory boards. I have lived in the Northside neighborhood most of my fife and from a citizen observer perspective I am familiar with some of the duties of the Historic Preservation Commission. Regarding the Housing and Community Development Corrrrussion, 1 have reviewed the agendas and notes from the last few meetings. I recognize the role this commission plays in programs such as UniverCity and it work in providing assistance in allocating funds towards affordable house in Iowa City. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside informabon with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-itHaw, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin United States 11. Sexual Orientation Fleterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Advisory Board/Commission Application Form ; .r<E: N This application is a public document and as such can be reproduced and distributed for r the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CRY OF U'll"M E NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/14/2016 First Name It Rachel Last Name Wall Home Address* 321 S. Linn Street Apt. 123 City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 309-646-2354 Ernall Address* rachel.mil@fbfs.com Boards & Commissions Select a Board or Commission you are Interested in:* Housing and Community Development Commission(HICDC) 2. How long have you been a resident of Iowa City? 6 3. Occupation:* Insurance Agent 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* - Treasurer Ubwa Student Disability Organization 2014-2016 - budgeted fiscal year expenses and revenue - licensed to sell life, health, property and casualty insurance -Iowa producer - employed with Farm Bureau Financial Services as an insurance agent - volunteer at the VA Fbspital in Iowa City - advocate for making my community a more inclusive environment for disabled individuals - Hawkeye Accessibility Ambassador Trained 6. What is your present knowledge of each advisory board you are interested in? As a board member, you are obligated to serve your community in their best interest. You are also obligated to provide service and add value to your community. You are representing your community. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 6. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 23 10. Country of Origin Us 11. Sexual Orientation Female 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity White/ Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* � lU�� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. -- - --..- Advisory Board/Commission/Committee Application Form 7V THIS APPLICATION IS A PUBLIC DOCUMENT WII H THE EXCEPTION OF THF LAST PAGE MARKED `CONFIDENTIAL." THIS APPLICATION WILL 13E CONSIDERED FOR TWEI,vE MONTHS AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING TIIAT TIME Advisory+ Bnard/Commission/Commilice Namc ! t e1" tJ ` [J Yt/I 7 erm 3 _ NAME 1-Qu�C' HOME ADDRESS _,SO a Is your home address within the corporate limits of Iowa City'? Yes K No How long have you lived in Iowa City?_,5 V, Gender: Male ___ Female x Contact# J 7 - 35$ 1 a Email Address Y -h V c_27,) 6 © 1j n r°f% /r tJ [4- rl cT CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL )(QUALIFY YOU FOR THIS oncrrr�ne_ T U-) Cw /i aA-o,[LJ L' / t5 CLLLi J-� J-kh bcavX c� o trna *0�,v-0 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? _Yes ,�lo (If yes, please indicate which board would be your fust choice to serve on. Misrepresentations on this application will constitute just cause for removal of no appointee. If you fail to answer all the questions, Council may not consider your application. .tune 2016 Paget of 7 N O r , BOARD, COMMISSION ARID COMMITTEES BUSINESS LISTING NZ-4-ft,�`®1i®� CITY Of IOWA CITY Name of City Board/Commission/Committee HCFL.4" Date Name n, o .,^ Section 362.5 of the Cod of Iowa gVnerally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. NOTE: A new form must be completed if the above information changes or an ownershi� interest is acquired in an additional business. Applicant �n t - Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. ( General Application April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income (Poverty Level) 60% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,700 $27 850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various racial, religious, cultural, social and economic groups in the city," (Ord. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. ® Age Gender t6" Income (see table) Sexual Orientation Other (Please explain below) P I Religion I Disability Race, color or ethnic group u S National origin c- ( Iman Rights Commission Application rebruary 2015 page 4 of 8 HOUSING AND COMMUNITY DEVELOPMENT COMMISSION ATTENDANCE RECORD 2016-2017 Name Terms Exp. 9/10 4/21 5119 6/16 8/18 9/15 10120 11/17 12/15 1/19 219 2/16 Byler, Peter 7/1/17 X X X X X X X X X X O/E X Conger, Syndy 7/1118 0/E X 0/E O/E X X O/E X X X O/E X Harms, Christine 7/1119 -- --- X X X X X X X X X X Lamkins, Bob 7/1/19 X 0/E X O/E 01E X O/E X O/E X O/E X McKinstry, John 711/17 -- X X O/E 0/E X X X X X X Olmstead, Harry 7/1118 X X X X X X O/E X X X X X Persson, Dottie 7/1117 X 0/E X X X X X X X X X X Seiple, Emily 7/1118 X X X X X X X X X X X X Vaughan, Paula 7/1/19 --- --- --- --- X X 0/E X X X X X Kev: X = Present 0 =Absent O/E = Absent/Excused --- = Vacant From: Richard Beebe <richard.beebe@gmail.com> LAM- i"W"Jullb LIS[t1t)Utet Sent: Friday, May 12, 2017 9:27 AM To: Wendy Mayer Subject: Withdrawal of Application for Library Board of Trustees: Richard Beebe �6 % J 5/1-7 (Date) I am hereby withdrawing my Library Board of Trustees Application, dated May 9, 2017. Please convey the withdrawal of my application to the City Council before its deliberation on the applications. Thank you. Richard J. Beebe 171 Stanwyck Drive Iowa City, IA 52240 213-308-4829 m7rTrrfi 18i NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF LIBRARY TRUSTEES Two vacancies — Six year terms July 1, 2017 — June 30, 2023 • The Board of Library Trustees is a semi -autonomous body of nine persons empowered by State Law to plan, direct, and control all affairs of the Public Library. This includes having control of funds allocated or given to the library, determining long-range goals of Library service, adopting written policies to govern operation of the Library, and employing a competent staff to help plan and implement the Board's service goals. • Iowa City appointed members of boards and commissions must be 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. The Library Board meets the fourth Thursday of each month at 5:00 p.m. Iowa City -appointed members of boards and commissions must be at least 18 years of age and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Board of Library Trustees should be directed to Susan Craig, Library Director at 356-5200. 5/4/2017 Board/Commission Application Cover Board/Commission: Library, Board of Trustees Two vacancies, six year terms 7/1/2017 - 6/30/2023 Meredith Rich -Chappell and Thomas Martin It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: 2 None Current Gender Balance: Female: 3 Male: 3 Gender Name and Address Male Beebe, Richard 171 Stanwyck Dr. Female Donnelly, Margaret 1918 Kathlin Drive Female Farkas, Linda 221 East College Street #1108 Female Forkenbrock, Kellee 168 Arlington Drive Female Johnson, Kristin 415 S. Van Buren St., Apt.1 Female Kirsch, Carol 806 Alpine Dr. Female Lewis, Mary -Ellen 87 Learner Ct. I Female Maxwell Leckband, Sarah 134 Ashford PI Female Maybaum, Lenore 1122 Kirkwood Ct. L _ L Advisory Board/Commission ry Bd/CiiApplication Form #4�f1'f Z.t may._ ' This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF UTEMTUNE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 5/9/2017 First Name* Richard Last Name Beebe Home Address* 171 Stanwyck Dr. City IOWA CRY State IA Zip Code* 52240-5944 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 213-308-4829 Email Address* richard.beebe@gmaii.com Boards & Commissions Select a Board or Commission you are interested In:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 7 years, 11 months 3. Occupation:* Public Librarian (Retired) 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* Before my retirement to bwa City in June 2009, 1 had over 40 years e>perience as a professional librarian and library staff employee for the County of Los Angeles Public Library, Los Angeles, California, and for two independent city libraries in Los Angeles. As background, it may help to explain that the County of Los Angeles Public Library is one of the largest single -jurisdiction public libraries in the nation, serving 3.3 million mukicultural, multilingual residents of the unincorporated areas and smaller cities of Los Angeles County, appro>amately 3,000 square miles, With no central library, its collection and services are distributed among 90 community libraries, varying in size from smell storefronts to medium-size, full service libraries serving 150,000 residents. The County Library thus provides its staff and professional librarians with opportunities to serve in widespread, community -focused libraries of varied sizes serving multicultural, socioeconomically diverse populations. Starting as a library page shelving materials in 1974, 1 became a library assistant, then earned my MLS as a professional librarian in 1982, and in 1992 gained ny most responsible position as administrative staff directly reporting to the County Library's Chief of Public Services, line supervisor for the County's 5 regional areas and 90 library facilities. I believe that the length, anent, and depth of my public library experience prepares me fully for serving as a Library Board Trustee. As a professional librarian, my main emphasis was reference services, beginning as a Government Publications Librarian for the Huntington Park Library, a medium public library, then its Flead of Reference. I continued with more specialized reference and public services: Medical Reference Librarian in charge of the County Library's consumer health reference service, Audiovisual Production Coordinator creating training and public relations slide programs, audio tapes, and videos for the County Library's 1200 staff. I then became Director of the County Library's Community Access Library Line, supervising 8 librarians who provided toll-free telephone reference and community, information to a Southern California service population of over 10 million residents. I served briefly as Branch Manager of the With Torrance Library, then became Regional Collection Coordinator for the County Library's South Region, planning, budgeting and maintaining the adult collections in all formats for the Region's 20 community libraries and African American Resource Center, with a combined budget of appro>amately $2 million. From 1992 to 2005 1 became Special Assistant to the County Library's Chief of Public Services, line supervisor of the County Library's 5 Regions and 90 library facilities. As Special Assistant, I was a professional member of Public Services' top management team, providing information, analysis, and operational support. I developed and wrote policies, procedures, staff instructional materials, proposals to the Board of Supervisors, and public announcements, on library registration, circulation, hours, fines and fee schedules, meeting room use, service to special populations, and library purchasing. I maintained PSMIS, the County Library's database of input, operating, and output statistics for each of the 90 libraries, producing Internal management statistical reports as well as compiling, editing and submitting the County Library's 200 -page official annual statistical report to the California State Library and NOES. Based on the PSMIS, I drafted annual staffing plans, cost reports, and proposed budgets ($20+ million) for all libraries for the Library's top management to present to the Board of Supervisors, cities, and other funding agencies. I developed procedures for the annual Services and Supplies budget, monitored individual library purchases, and worked with vendors and community libraries to purchase and install furniture, computer desks, material security gates, service desks, and special program equipment. As needed, I investigated and resolved concerns from the public and other agency officials regarding the Library's policies, procedures, and operations. I participated in developing the County Library's Strategic Plan and in its long-range planning for e)ipanded facilities in the County Library's newly developing unincorporated areas and cities, for e)panded services to its diverse ethnic and socio-economic communities, and for new technologies and programs. I submit that my experience in direct public service, professional reference work, and management administration and strategic planning prepares me well for the Library Board of Trustees' roles to "plan, direct, and control all functions of the Public Library....having control of funds... determining long-range goals... adopting written policies... and employing a competent staff to help plan and implement the Board's service goals.' 6. What is your present knowledge of each advisory board you are interested in?* As an Iowa City resident, library user, and active community participant for eight years, I believe that my knowledge of Iowa City, its coram pity, and the Iowa City Public Library has prepared me for an active role in the Library Board of Trustees. I have attended the Library Board meeting, read its recent agendas, reviewed the Library's Strategic Plan and reports, and met Library Board current members, including the Library Trustee who recommended that I apply for the Library Board. Here are a few examples of my interest in recent Library Board topics. As a resident and homeowner in the GranMood district, I am especially interested in the Library's planning and provision of services in developing areas of the city beyond Downtown and in its connection with ethnic and low income populations of the city. The Library's newly implemented bookmobile addresses the geographic issue of Library presence beyond the center of the city during the summer months. I would like to see how well it will also serve ethnic populations and low income populations, and what metric the Library will use to determine its effectiveness. Additionally, since it only serves during the summer, what provision eAsts for equivalent service during the school year? If it is fully successful, the bookmobile may need to be expanded or supplemented with additional outreach services. As a former library public service employee and librarian, I support the Board's decision to create an art gallery space for local artists in the Library building, even if it requires retiring the current art rental collection. The decision is in line with ICPL's service philosophy of engaging and enriching the local community because it ably focuses vdde public attention on the community's own cultural activities. Implementation of the gallery service, however, may lead to ongoing discussions, such as, how art is selected for display, what space and staff support will be provided to maintain it, how to determine liability for art displayed in a public place, and what policies may need to be created for potentially controversial materials. During my career, I served as a reference librarian and director of two special reference services, one which answered consumer medical reference questions for the Los Angeles County Library's 90 libraries, the second Mich provided toll-free telephone reference and community information service in multiple languages (English, Spanish, Chinese, and Japanese) to most of Southern California. I also served as a local history reference librarian for a small but historically important city, where I preserved and selected items to be scanned for online use. These technological services connected the library with users who had minimal ability to come to a library facility. I thus support and, as a Library Board member, would encourage the Library in ways to e)rand digitization, creation of online services, and the Virtual Library project. In sum, Iowa City Public Library has an excellent reputation for its progressive services to its residents and for its effective administration and planning. I would be honored to serve as a Library Board Trustee supporting its current programs and assisting in its future development. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of iowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract City Council Resolution # 15-300 established a policy that the following persons shall rot be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the communityand the groups(s) which it serves, please provide your information for the following: 9. Age 70 10. Country of Origin United States 11. Sexual Orientation Fleterosexual Male (Married, 3 Children) 12. Religion Secular 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 1?ehard ,j. 3ee6e Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/6/2017 First Name Margaret Last Name Donnelly Home Address* 1918 Kathlin Drive city IOWA CITY State IA Zip Code* 52246-4618 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 331 3102 Email Address* russcl802@aol.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* since 1964 3. Occupation:* social worker 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* Advisory Board/Corrnission Application Form CiitiAN This application is a public document and as such can be reproduced and distributed for +c ' the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CIT' OF UFFERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/6/2017 First Name Margaret Last Name Donnelly Home Address* 1918 Kathlin Drive city IOWA CITY State IA Zip Code* 52246-4618 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 331 3102 Email Address* russcl802@aol.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* since 1964 3. Occupation:* social worker 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* As a professional social worker, I have an orientation towards service in the community. I see the library as a community gathering place Mich will offer stimulation, friendships, and opportunities for learning and grovAh. I myself am an avid reader and an almost daily consumer of library services. I believe that the library is a treasure. I would like to bring the beauty of reading to every resident 6. What is your present knowledge of each advisory board you are interested in? I am aware of the organization which is involved in providing library services. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDGlHOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-ir-law, mother-ir-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency If reappointed, an individual would be limited to one reappointment to a full tens in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 6. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 71 10. Country of Origin USA 11. Sexual Orientation Hetrosexual 12. Religion Catholic 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4116/2017 First Name' Linda Last Name Farkas Home Address* 221 East College Street #1108 City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3199301164 Email Address* linda.farkas@me.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 2.5 years 3. Occupation:* Retired Banker 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* Advisory Board/Commission Application Form ��'�,► This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CIN OF IOWA CITY Considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4116/2017 First Name' Linda Last Name Farkas Home Address* 221 East College Street #1108 City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3199301164 Email Address* linda.farkas@me.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 2.5 years 3. Occupation:* Retired Banker 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* 1.) 1 managed a national sales division of 90 people at a regional bank for 20 years. I feel that my business and managment background could be of help. 2.) 1 served for 6 years on the Iowa City Library Foundation Board. During rrry term I served in the President and Treasurer role. 3.) 1 have served on local boards to include: Riverside Theatre (President for 2 years), Iowa City Noon Rotary 4.) 1 am currently serving on the Board of Gro -Johnson County, Emma Goldman, Coralville Library Foundations Board 6. What is your present knowledge of each advisory board you are interested in? * When I served on the Iowa City Library Foundation Board, I worked closely and in conjunction with the Iowe City Library Board of Trustees . I am very familiar with personnel and the workings of the Library. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at line same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* Yes List potential conflicts of interest [See next page for information regarding conflict of interest]* Coralville Library Foundation Board. If it is determined that it is a conflict, I would resign from the Coralville Library Foundation Board. Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. List all businesses in which you or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Business list of conflicts of interest Business Nam* NONE Business Address* NONE 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 65 10. Country of Origin USA 11. Sexual Orientation female 12. Religion unitarian 13. Do you have a disability? No 14. Ethnicity Caucasion `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ,erda 1 i2a izd Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I I i Advisory Board/Commission Application Form rY � 1 Cd�j �� ' This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF UTE"WU NOTE: Must be 18 years of age and live vnthin city limits of Iowa City to apply Date of Application 4/5/2017 First Name* Kellee Last Name Forkenbrock Home Address* 168 Arlington Drive City IOWA CITY State IA Zip Code* 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-400-8863 Email Address* elizadavidwites@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 17 years 3. Occupation:* Education 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* In addition to my full-time work with an education firm in iom City, rm also an independent author in my spare time (pen name is Elia David). I have been active in other local creative organizations/events surrounding literacy including being a featured author at the Iowa City Book Festival, serving as a writing group concierge for the Iowa Writers House, and participating on the Iowa Soul Fest's Author Panel. 6. What is your present knowledge of each advisory board you are interested in?* As a local writer and an avid patron of ICPL for the past seventeen years, I feel that my e)rerience within the lowa City literary community gives me a diversity to offer as an advocate for ICPL's needs. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federaly-assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family fies, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-ir-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-ir-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currentlyserve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 38 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Catholic 13. Do you have a disability? No 14. Ethnicity Black 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/5/2017 First Name Kristin Last Name'" Johnson Home Address* 415 S. Van Buren St., Apt.1 City IOWA CRY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-594-1032 Email Address* sunshineariel99@gniaii.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) AdvisoryBoard/Commission Application Form YI This application is a public document and as such can be reproduced and distributed for Y may._ the public. This application Will be considered for [Helve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNEXO CITY Of UTENAMM NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/5/2017 First Name Kristin Last Name'" Johnson Home Address* 415 S. Van Buren St., Apt.1 City IOWA CRY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-594-1032 Email Address* sunshineariel99@gniaii.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 22 years 3. Occupation:* volunteer 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I am active in some support groups which help me stay connected to the community and help me to take good care of myself, and interact with an interesting and diverse population in this city. 6. What Is your present knowledge of each advisory board you are Interested In?* I am aware that the library board term is a period of 6 years and helps determine policies and practices. I am aware that the Community Police Review Board is designed to help those concerned with criminal justice in this community. And I am aware that the Human Rights Conrnission is designed to help protect people with disabilities to be treated fairly in this community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchidren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* 0 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion Episcopal 13. Do you have a disability? Yes Please explain: I have a mental health condition which I manage with medication and social activities and healthful activities. For example, I volunteer at a local peer support recovery center, volunteer for New Pioneer Co-op,& garden in the city garden. I also advocate with letters and phone calls to our elected representatives for a combination of issues I am concerned about, such as mental health parity, the environment and social justice.) also receive rental assistance. 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 046-�d&w<074"IdAr Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down CITY OF IOWA CITY UNESCO CITY OF UTEMNRE Date of Application 5/5/2017 First Name Carol Last Name Kirsch Home Address* 806 Alpine Dr. city IOWA CITY State IA 21p Code* 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-325-2559 Emil Address* ca rolkirsch 52@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 22.5 years 3. Occupation:* Retired librarian 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I worked professionally in libraries for over 30 years, including positions in public libraries in Ohio and Iowa (Cedar Rapids). I have held several administrative positions including assistant director of the Upper Arlington, Ohio Public Library and assistant head of technical services at the Cedar Rapids Public Library. I served for several years as the head of libraries and special collections of the State listorical Society of bora. 1 have also served in various technical services positions in various types and libraries and have done occasional library reference work. Currently I am an avid user of the lova City Public Library and am very proud to pronate it. 6. What is your present knowledge of each advisory board you are interested in?* My knowledge of the Library Board of Trustees primarily comes from the information provided on the city's website. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following descrlbea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same chill, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it series, please provide your information for the following 9. Age 65 10. Country of Origin U.S. 11. Sexual Orientation heterosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant's C`'RTic'�fre�can� Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down _ r Advisory Board/Commission Application Form I = ` rY w�r0�r �%L This application is a public document and as such can be reproduced and distributed for wy� the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY Considered for any vacancy during that time. UNESCO CRY OF mEMTURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/4/2017 First Name* Mary -Ellen Last Name Lewis Home Address* 87 Learner Cf. City IOWA CITY State IA Zip Code* 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 805-703-3150 Email Address* melewsesq@gmail.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 2 1/2 years 3. Occupation:* Attorney/Librarian 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* rm a professional librarian (MA in Library Science from the U of Iowa, 1975) and a licensed attorney (Iowa and California). I have been an academic librarian (community college level) and a research/appellate attorney. rm now a semi -retired attorney, representing clients with immigration cases only on a pro bono basis. I've returned to Iowa City after an absence of some 35 years, and am an avid library user. The Iowa City Public Library is a fantastic resource for our community and I would love to serve on its Board of Trustees. 6. What is your present knowledge of each advisory board you are interested in? Susan Craig, the IC public library director, reports to the Board, which meets monthly. The Board oversees the big picture and the financial resources for the library. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family fies, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the follow ng persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissionsatthe same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 66 10. Country of Origin USA 11. Sexual Orientation Heterosewal 12. Religion Roman Catholic 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative; of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* KIWI�ft-SIOew46;W Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Courril Members to express your interest in serving. Drop-down _ Advisory Board/Conrnission Application Form MANt This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNEXO CNV OF ME"TUU NOTE: Must be 18 years of age and live within city limits of lova City to apply Date of Application 312 812 01 7 First Name Sarah Last Name Maxwell Leckband Home Address* 134 Ashford PI City IOWA CITY State IA 21p Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 5159430352 Emall Address* smaxwe1101@gmail.com Boards & Commissions Select a Board or Commission you are interested In:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 18 years 3. Occupation:* attorney/stay at home mom 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* My children and I are frequent patrons of the library and often come to events there. I served on a library Friends board in Northfield, MN, where I lived previously. 6. What is your present knowledge of each advisory board you are interested in? I have reviewed the current board packets on the City web site. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. CityCouncil Resolution # 15-300 established a policythat the following persons shall rat be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility mother, father, sor-ir-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, faster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. 0 reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? w No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 40 10. Country of Origin United States 11. Sexual Orientation straight 12. Religion presbyterian 13. Do you have a disability? No 14. Ethnicity Mite 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down _ t Advisory Board/Commission Application Form rY �i° �tttr�y This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY Of IOWA CITY considered for any vacancy during that time. UNESCO CITY Or LITEMMU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/9/2017 First Name Lenore Last Name Maybaum Home Address* 1122 Kirkwood Ct. City IOWA CITY State LA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number* 3195948796 Email Address* lenore.rnaybaun)@kirk%%ood.edu Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees 2. How long have you been a resident of Iowa City?* 12 years 3. Occupation:* Professor of English at Kirkwood Community College 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* After finishing my B.A in English at Drake University, I moved to bete City to begin my Ph.D. course work in Language, Literacy, and Culture. Throughout those years of graduate study, I partnered with various neighborhood centers, including the Broadway Neighborhood Center here and the Catherine McAuley Center for adult literacy in Cedar Rapids, to do public engagement projects revolving around literacy, English language learning, and social justice. By the time I finished my Ph.D., I was hired full-time on the tenure -track at Kirkwood Community College, where I have been teaching and tutoring since 2005 in the English department. So in terms of my education, scholarship, community service, and career, I am deeply invested in the mission and work of the Iowa City Public Library and literacy studies more generally. As a tenured professor in Kirkwood's English Department, a Ph.D. from University of Iowa, and public engagement scholar, I am rooted in the lows City community and see the library as a generative space that improves the quality of life for all Iowa City residents. Further, I am raising four boys (Noam, who is 9; Jasper, who is 7; Renn, who is 5, and Willem, who is 3), each of whom has grown up in and been shaped by the ICPL and librarians. I see the library as the heart of the community, and rd love to serve this place that has given so much to me, my sons, and my community. Both personally and professionally, I am invested in this position. 6. What is your present knowledge of each advisory board you are interested In?* My understanding is that every policy the library drafts must get the board's approval, and the board has oversight of anything controversial that the library is involved in (i.e., the security cameras in the bathrooms). I would love the opportunity to learn more about this process and to weigh in with any knowledge, concern, or insight I might offer as a parent, literacy scholar, community member, and long-time and frequent library user. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract CityCouncil Resolution # 15300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, step -children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. H reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same lime. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Into rest?* 7.1 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 37 10. Country of Origin United States 11. sexual Orientation heterosexual 12. Religion Christian--t1CC 13. Do you have a disability? No 14. Ethnicity White/Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Board or Commission: [CPL Board of Trustees ATTENDANCE RECORD 12 Month KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting MeetingData Name Ex� bon 3/24/16 4/28/16 5/26/16 6/23/16 7/28/16 8/25/16 9/22/16 10/27/16 11/17/16 12/15/16 1/26/17 2/23/17 Diane Baker 6/30/7.9 X O X X O/E X X X O/E X X O/E John Beasley 6/30/21 O/E O/E O/E X X O/E O/E X X X X X Janet Freeman 6/30/19 X X X X O/E X X X X O/E 0/E X Adam Ingersoll 6/30/21 X X X X X X O/E O/E X X X X Tom Martin 6/30/17 X X X X X X X X O/E X X X Robin Paetzold 6/30/17 X X X X X X O/E X X X X X Meredith Rich -Chappell 6/30/17 O/E X X X X X X X X X X X Jay Semel 6/30/19 X O/E X X X X X X X X X X Monique Washington 6/30/21 X x X X X X X X X O/E O/E X KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting MTMTT 18j som� NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: PLANNING AND ZONING COMMISSION One Vacancy — Five -Year Term July 1, 2017 — July 1, 2022 • The duties of the Planning and Zoning Commission members include making (or causing to be made) surveys, studies, maps, plans, or charts of the whole or any portion of the municipality and any land outside which --in the opinion of the Commission --bears relation to a comprehensive plan; also include recommending to the City Council from time -to -time amendments, supplements, changes, and modifications to the Zoning Ordinance. This Commission conducts formal meetings the first and third Thursdays of each month at 7:00 p.m. (Informal workshops are held the preceding Mondays at 5:30 p.m. on a as needed basis.) Iowa City -appointed members of boards and commissions must be at least 18 years of age and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.iwov.org. or by contacting the Clerk's office. Questions about the Iowa City Planning and Zoning Commission should be directed to Robert Miklo, Sr Urban Planner at 356-5240. 514/2017 Board/Commission Application Cover Board/Commission: Planning and Zoning Commission (P&Z) One vacancy, five year term 7/1/2017 - 7/1/2022 Phoebe Martin It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/11/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/2017 Gender Balance Requirement: Current Gender Balance: Gender Female After date above Council may appoint without regard to gender 1 None Female:3 Male:3 Name and Address Martin, Phoebe 1 full term 1824 G St. d c Advisory Board/Commission Application Form a ��C2if`r"�t This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNfSCOUTY OF UTaUTUPf NOTE: Must be 18 years of age and live within city lirrits of love City to apply Date of Application 5/3/2017 First Name Phoebe Last Name Martin Home Address* 1824 G St. city IOWA CITY State A 23p Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-541-8695 Email Address* phoebe@skogman.com Boards & Commissions Select a Board or Commission you are interested In: Planning and Zoning Commission (P&Z) 2. How long have you been a resident of Iowa City? 13 years 3. Occupation:* Realtor 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have served on P&Z for the past 5 years. 6. What is your present knowledge of each advisory board you are Interested hi I have a very good understanding of Planning and Zoning. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or With respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contact. City Council Resolution # 15-300 established a policy that the following persons shall rat be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, fattier -in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship Res. #15-300 states that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full tens in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commisslon?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 44 10. Country of Origin United States 11. Sexual Orientation 12. Religion None 13. Do you have a disability? No 14. Ethnicity 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* 0'� Alr Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down PLANNING & ZONING COMMISSION ATTENDANCE RECORD 2016-2017 KEY: X = Present O = Absent O/E = Absent/Excused --= Not a Member 1/21 2119 313 3117 417 4121 515 5119 6/2 717 7121 814 911 1016 10/20 11117101EX 1119 DYER, CAROLYN X X X X X X X X X X X X X X X X X FREERKS, ANN O/E X X X X X X O/E X O/E X X X X X X X HENSCH, MIKE X X X X X X X X X X O/E X X X X X X MARTIN, PHOEBE X X X X X X X X X X O/E X X X O/E X X PARSONS,MAX X X X 01E X X X X X X X X X X X X X SIGNS,MARK—XXXXXXXXOETHEOBALD, JODIE X X X X X X X X X X X X X X X X X KEY: X = Present O = Absent O/E = Absent/Excused --= Not a Member __MrTr� 18k : roll irel 4 THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION Two vacancies — Three -Year Terms July 1, 2017—July 1, 2020 • The duties of the Telecommunications Commission include serving as a review board to resolve disputes between any subscriber or potential subscriber and the Cablevision company • reviewing and auditing reports by the cable company to the City as required by the Cable Television Ordinance; working with the public, the media, the City, and the cablevision company for the purpose of making recommendations on various issues; • monitoring and promoting community programming and the use of the local access channels by a wide range of individuals, institutions, and organizations; • informing and educating citizens on matters related to cable TV and other communications systems; and monitoring and reviewing State and Federal legislative and regulatory action or change • Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Telecommunications Commission meets the fourth Monday of each month at 5:30 p.m. Applications must be received by 5:00 p.m., Tuesday, May 9, 2017. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Telecommunications Commission should be directed to Ty Coleman, Media Production Services Coordinator, at 356-5454. 5/4/2017 Board/Commission Application Cover Board/Commission: Telecommunications Commission Two vacancies, three year terms 7/1/2017 - 7/1/2020 It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. Council Announcement Date: 3/21/2017 Application Deadline: 5/9/2017 Council Appointment Date: 5/16/2017 Date of Non -Gender Appointment: 6/19/1917 Gender Balance Requirement: Current Gender Balance: After date above Council may appoint without regard to gender 1 Female, 1 None Female:1 Male:2 Gender Name and Address NO APPLICATIONS