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HomeMy WebLinkAbout2008-08-26 AppointmentPage 1 of 1 ~~. Marian Karr From: Lin Weeks [weeks89@gmail.com] Sent: Sunday, August 24, 2008 11:00 PM To: Marian Karr Subject: Resignation On August 24, 2008, I hereby resign from the Youth Advisory Commission. I will be attending College at the University of Wisconsin-Madison, and will not be able to continue coming to meetings. As a member for a year and a half, I would like to express my confidence that the Commission will continue its important work serving the best interests of Iowa City and area youth. Lin Weeks 8/25/2008 os-is-os 24a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy -Unexpired + 5-yr Term Ending December 31, 2011 The powers and duties of the Airport Zoning Board of Adjustment are: 1. 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. 2. 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. 3. 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. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets at the call of the Chairperson. Applications must be received by 5:00 p.m., Wednesday, August 20, 2008. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 0 Council Announcement Date: June 13, 2006; August 1, 2006; September 5, 2006; September 19, 2006; November 14, 2006; December 12, 2006; January 9, 2007; February 20, 2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24, 2007; September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008 Application Deadline: Wednesday, S:OOp.m., August 20, 2008 Council Appointment Date: August 26, 2008 AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy -Unexpired + 5-yr Term Ending December 31, 2011 Carl Williams resigned No applications as of Wednesday, 5:OOp.m., August 20, 2008 ODenotes applicant completed the Confidential page of the application. 24b NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy -Six-yr Term January 1, 2006 -December 31, 2011 Duties of the Airport Zoning Commission are: 1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. 2. To recommend the adoption of new Airport Zoning regulations. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets as required. Applications must be received by 5:00 p.m., Wednesday, August 20, 2008. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 0 Council Announcement Date: September 20, 2005; November 1, 2005; December 13, 2005; January 23, 2006; February 28, 2006; March 21, 2006; April 18, 2006; June 13, 2006; August 1, 2006; September 5, 2006; September 19, 2006; November 14, 2006; December 12, 2006; January 9, 2007; February 20, 2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24, 2007; September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008 Application Deadline: Wednesday, S:OOp.m., August 20, 2008 Council Appointment Date: August 26, 2008 AIRPORT ZONING COMMISSION One Vacancy -Six-year Term January 1, 2006 -December 31, 2011 Term expires for Mark Anderson No applications as of Wednesday, 5:OOp.m., August 20, 2008 ~ Denotes applicant completed the Confidential page of the application. i 24c i NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HOUSING & COMMUNITY DEVELOPMENT COMMISSION One Vacancy -Three Year Term September 1, 2008 -September 1, 2011 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. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. 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. The Housing and Community Development Commission will have monthly meetings. Applications must be received by 5:00 p.m., Wednesday, August 20, 2008. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Housing and Community Development Commission should be directed to Tracy Hightshoe, Community Development Planner at 356-5244. Housing 8 Community Development Commission Attendance Record 2008 Name Term Ex fires AM 2/12 PM 2/12 2/20 3/13 3/27 4/17 5/15 Jer Anthon 09/01/08 O/E X X X X X X Steve Crane Marc De France And Dou las 09/01/09 09/01/09 09/01/08 O/E X X X X X X X X X X O/E X X X O/E O/E X X X X Charlie Drum 09/01/10 X X O/E X X X X Holt Jane Hart 09/01/10 X X X X X X X Rebecca McMurra Brian Richman 09/01/08 09/01/10 X O/E X X X O/E X X X X X X X X X Michael Shaw 09/01/09 X X X X X O/E Key: X = Present O = Absent O/E = Absent/Excused NM = No Meeting -- -- = Not a Member Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 5 Females: 3 Council Announcement Date: June 3, 2008; July 15, 2008 Application Deadline: Wednesday, 5:00 p.m., August 20, 2008 Council Appointment Date: August 26, 2008 HOUSING 8~ COMMUNITY DEVELOPMENT COMMISSION One Vacancy -Three-Year Term September 1, 2008 -September 1, 2011 Term expires for Jerry Anthony Jose Assouline ~ 15 Ealing Drive Michael McKay ~ 1105 Keokuk St ~ Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ~ r Adviso Board/Commission/Committee ~' ~`"',~'~~ ~ ~ ,application Form cl-.T o IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews atl applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, 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. BOARD/COMMISSION/COMMITTEE NAME Housing and Community Commission TERM 3 year (starting 08) NAME Jose Assouline HOME ADDRESS 15 Ealing Drive, Iowa City, IA 52246 Is your home address (listed above) within the corporate limits of Iowa City? ~/ Yes How long have you been a resident of Iowa City? OCCUPATION Professor of Engineering rIONE NUMBER: HOME (319) 338-7423 ZIP ~No EMPLOYER Univ. of Iowa/Self BUSINESS (319) 541-2036 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I have lived in Iowa City/Coralville for over 30 years, I am a 2 times alum of the U of I. I have seen the city grow and observed its trials and tribulations of the years. I am very proud of the accomplishments of this area and look forward to the continued efforts of citizens to maintain these high standards. In addition to my training in engineering and health-care, I ha~e been involved in real estate and construction. I own and manage real estate rental properties. I took cours i real @3tate and management/entrepreneurship (at the U of I). I always wanted to participate in city councils and board~~ ne~sr dared~l feel that now I acquired additional knowledge in this field, I might be of some help to the city. ~ .,,. -- ~ ~ tin -< r- - m ~ _~ ~~ o b vi WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? My diverse background has allowed me to understand and solve engineering and health issues. As real estate owner and landlord I think I can provide the most. For the past few years, I had tenants with section 8 and various forms of housing assistance. I have met with housing authority staff and housing inspectors in various circumstances. 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. HCDC Application March 2008 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ror the reasons I cited above, both my academic and professional background can be of some help. I believe that housing issues have been more acute in recent years in our city and needs to be addressed very carefully. I feel that fairness and safety ought to prevail as well as to providing help to those that need it. Because funding and housing availability are less readily available, board members city and staff members need to work closer together and find new solutions for new problems. I might be able to help. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies *hat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. :her types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that 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). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the (`nr~o of In~nm nln~m r`nntar•t tha ('itv Attnrnav'e nffir•o at 35R_Fin~n ....,....., . .., ...,., r,. ........ ........... . ...., ... , r .........., ~ ., ...., ... ...... ...... _ . 1„J ~~~ a~ ~ ~' --1 rte.- C_) -C " N --i c ) f". l11 8"4'1 O ~ ~ C~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? YES ~NO v DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ YES ~ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) 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. HCDC Application March 2008 Page 2 of 8 QOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Housing and Community Commission Name Jose Assouline I r ~~.~~ -~.ai_ CITY OF IOWA CITY Date o7i22i2oos 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 Jose and Susan Assouline, management 15 Ealing drive, Iowa city, IA 52246 ECG Academy, Inc POB 2976, IA 52244 O '~`- ~ !y `+-~~ "'! C3 '~ N -~: f" O~ D to NOTE: Anew form must be completed if the above information changes or an ownership interest is acquired in an additional business. . ~~ J Signature Address 15 Ealing Drive, Iowa CSit 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. HCDC Application March 2008 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 13, 2008 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $15,250 $25,400 $30,480 $40,650 $50,800 2 17,450 29,000 34,800 46,500 58,000 3 19,600 32,650 39,180 52,300 65,300 4 21,800 36,300 43,560 58,100 72,600 5 23,550 39,200 47,040 62,750 78,400 6 25,300 ~ 42,100 50,520 67,400 84,200 7 27,050 45,000 54,000 72,050 90,000 8 28,800 47,900 57,480 76,700 95,800 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) ~ 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. D If you have expertise in construction or finance, please describe your experience and/or training. I have a degree in engineering and I have directed a number of projects. I also have a working know~dge a ~ ious business software and database management. Also as a landlord, I have had a few tenants with ass,~t~ce . ~ ~ ~ rte- ~ C7 - : ~°° --,1 C~ ~~ ~n ~~ ~ c~ ~ O D ~n V HCDC Application March 2008 page 4 of 8 CITY OF IOWA CITY ~ r 1 =.:.®~ Advisory Board/Commission/Committee ~.'"'~ ~~ ®~~; Application Form cln o IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Retum the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, 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. BOARD/COMMISSION/COMMITTEE NAME Housing and Community Development TERM 3 Year NAME Michael L. McKay HOME ADDRESS 1105 Keokuk St., Iowa City ZIP 52240 Is your home address (listed above) within the corporate limits of Iowa City? /0 Yes ~TJo How long have you been a resident of Iowa City? 19 Years OCCUPATION Owner/General Manager PHONE NUMBER: HOME 337-6185 zn D~ c7 -< EMPLOYER Keystone IT, Inc. ~ n ~~ BUSINESS 688-9319 - n7 ~~ c_._ c r-- w ~-- ao EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: D v I was in charge of all administrative functions at Systems Unlimited for 17 years. This included accounting, finance, human resources, risk management, and information technology. I was also responsible for the management of thirteen properties (in four corporations) all with HUD mortgages. We also assisted with Section 8 housing and we were the Representative Payee for about 40 clients. I was a founding member of the Johnson County Consortium on Successful Aging. I assisted in writing the Housing Report and did the final edit for the report before it was published. I was then appointed as a member of the Policy Board, its subsequent organization under the Board of Supervisors. I am now involved as an entrepreneur engaged in growing a technology company in Iowa City. I believe that I have a unique background that could be put to good use on this commission. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I have limited knowledge of this board. I discussed the board and my potential for contributing to it with Amy Correia, with whom I worked closely on the Housing Action Team of the Consortium. She explained the main functions of this commission and enthusiastically supported my applying for membership on it. 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. HCDC Application March 2008 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING? suggested above, I have a working knowledge of housing assistance through my work with the city and the staff of Systems limited to obtain assistance for its clients. I was also in charge of all the properties owned by Systems Unlimited and in that established the rent that was charged to the clients. o write the housing report for the consortium, I did research on the housing assistance available to residents of Iowa City and ie county. I also worked with Dr. Kaskie in interpreting the data in the housing survey for the report and incorporated the ;search on housing that was done by a team of graduate students (Public Health). I also conducted a panel discussion of ccessible housing in the area. Leaders from the real estate, builders, developers and community advocates made up the Correria and I led the Housing Action Team for the Consortium (subsequently the Policy Board). We were able to enlist the tance of the Home Builders Association to support our efforts to increase the amount of accessible housing and to urage universal design features in new homes. The HBA is now requiring all members to attend universal design training. are also supportive of having accessible housing designations of some kind for new or modified homes. I will bring this experience and knowledge to the table, as well as my personal and professional relationships with key people in the community. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that 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). If you are uncertain whether a potential conflict of interest exists or have questions about Section ~2.5 of the r„ao .,f ~,,,.,~ .,ie~~o ..,,,,+".+ +tie r:+., n++,,.re.,~~ .,ff:..e ~+ ~~a_~non ~ V V4li VI 1V 1111 Y, r./IV4Jli VVIIIGUI U1G Vllr FlllV111Gr J V111V4 Ul VVV-VVVV. I have no affiliations that would present a conflict of interest. ~ n -,: ~"" '~. --t t~ w -- r-- ~ O~ ~ ~~ D w v IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? YES ~NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ YES ~ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) 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. HCDC Application March 2008 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Housing and Community Development Name Michael L. McKay ~ r ~~.®~~ "'~ ~ 1 ~®/~~ CITY OF IOWA CITY Date 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 Keystone IT, Inc. 365 E. College Street, Iowa City O c:~ ~. a ~ ~ 'Ti ~' i" ~ r- o~ ~ D w NOTE: Anew form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature `J(,.( ` _ ~~(, G Address 1105 Keokuk St., Iowa City 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. HCDC Application March 2008 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 13, 2008 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $15,250 $25,400 $30,460 $40,650 $50,800 2 17,450 29,000 34,800 46,500 58,000 3 19,600 32,650 39,180 52,300 65,300 4 21,800 36,300 43,560 58,100 72,600 5 23,550 39,200 47,040 62,750 78,400 6 25,300 42,100 50,520 67,400 84,200 7 27,050 45,000 54,000 72,050 90,000 8 28,800 47,900 57,480 76,700 95,800 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) ~ 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. My experience includes running the administrative functions, including finance, at Systems Unlimited. I am also responsible i, for all administrative functions at Keystone IT. I have an MBA from Michigan State University and have been a mfr ber of ,upper management in companies for the past 30 years. p 'I ~ n ~ ~~ ~ ~ ~ ~ ..... w ~- -~G r __.. I~ O ?~ ~ HCDC Application March 2008 page 4 of 8 l 24d '. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: POLICE CITIZENS' REVIEW BOARD Two Vacancies -Four Year Terms September 1, 2008 -September 1, 2012 Duties of the Police Citizens' Review Board include reviewing Police Department investigations into allegations of misconduct lodged against police officers, conducting further investigation of the complaint when the Board deems it necessary, and issuing a public report which explains why and the extent to which the complaint is sustained or not sustained; maintaining a central registry of complaints against sworn police officers and issuing annual reports regarding the disposition of the complaints to the City Council; reviewing police policies and practices from time-to-time and recommending changes to the City Council when the Board deems it appropriate. Iowa City appointed members of boards and commissions must be eligible electors of 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. Applications must be received by 5:00 p.m., Wednesday, August 20, 2008. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Police Citizens' Review Board should be directed to Marian Karr or Kellie Tuttle at 356-5041. ~i~ si2oos ~~O~C n u u ii u zz~~~ o ~~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ "f' fD d a r~ ~~ ~ ~ xr ~~ r~r~ ~~ ~ ~ ~~ ~ ~~ '~ ~ ~ ~ ~ ~ 7 a la a ~ N W -+ O C7 ~ ~ ~ ~ ~ ~i ~ ~ ~ W O ~ ~ ~ 0 ~ ~ ~ ~ ~ x ~ o x ~ y y r~ ~ ~d y~ ~z d o~ °~ 0 b 0 r ~I n r~ 0 Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 0 Council Announcement Date: June 3, 2008; July 15, 2008 Application Deadline: Wednesday, 5:00 p.m., August 20, 2008 Council Appointment Date: August 26, 2008 ** Appointments to the Board shall include one current or former "peace officer" as thaf 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 fo waive the residency requirement for good cause shown. POLICE CITIZENS' REVIEW BOARD Two Vacancies -Four Year Terms September 1, 2008 -September 1, 2012 Term expires for Loren Horton and Elizabeth Engel Paul Retish ~ 66 Penfro Dr Janis (Janie) Braverman ~ 55 Redbud PI Peter Hansen ~ 1203 Cambria Ct Abigail Yoder ~ 1528 McKinley PI D Denotes applicant completed the Confidential page of the application. Jul 16 08 06:02p PRetish 3193515011 p.l City of Iowa City ? ~~ ~'~ _ +dvisory Board/CommissionlCommittee ~.*~,,,~,~,~~~ Application Form ~`-"-- CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION 1S A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. n ~ Q Advisory Board/Commission/Committee Name 1'0 /t G'c I~i ~~~ ~°`~ /~~ Term ~ r.1 Youth Advisory Commission, Age on the date of filing:^ Age 15 to 17 (or) ^ l~e 18 t~21 Signature of parent/guardian if Age 15 to 17: ~ ~ c °~"} i'1 ~/ _~ NAME HOME ADDRESS Is your home address (listed above) within the corporate limits of Iowa City? How long have you OCCUPATION resident of Iowa, City? d f^. EMPLOYER ~~~~ PHONE NUMBER: HOME s~./ 1r ~' ~ -,`y l ~ BUSINESS ~ ~ ~ -i 3 vS -.l~33 % EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~' (jr, ~ 1 s ~ G•c ~ - ~-~- c.(~r~^ ~ ~z S !~t y J t~`~` ~ ~ c !':fi ~e r o~2 c, c' 'j Cam. r ~ s, f,,....~ - (/) /f~//~ o J ~ V 4.-.-~ l~ G:.. ~ ~--e c_,_. ~~s ~ti~f~ ~~7~ ~d~~~~r ~~ ~~-.~ ~~t Misrepresentations on this application will constitute just cause for removal of an appointee. ]f you fail to answer all the questions, Council may not consider your application. ~~ V_ I G r ;°'~°j O~ ~ D ~n ~es ^ Na ~neral Application ~~larch 2008 Page 1 of 7 Jul 16 08 06:02p PRetish 3193515011 p.2 WHAT 1S YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? r~-( ~~_ ~Z~ ~p~,.c~ ~G~ he WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE nrn [~nAI cn~ A~~l VIPI(_17 v r~ QG/ ~rG ~ ""~ 1 ~ `~` -- ~ ~ ~~~ ,~ yy~• ~.,r. is a',~/`' CMG- C 4J ~ ~ - - ~ I /~j G , ~ ~C~.-~ ('~7 ~ ...c' ~ ,~ G IN I ~ G`~1 ~ ~ ~ "~~7 POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations tothe ^ity Council about the allocation of City funds, please list any presen# affiliations you have with agenciesthat aply for funding from the City. "Affiliation° includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthatSection 362.5 ofthe Code of lowagenerally prohibits,with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions at~ut Sec`~on 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ~ C) ~ ~~ -~ ~ ~ ~ _~ ~ ~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes ~lo ", DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ l~es ~No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) 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. "~neral Application _.arch 2008 Page 2 of 7 Jul 16 08 06:03p PRetish 3193515011 BOARD, COMM{SSION AND COMMfTTEES BUSINESS LISTING p.3 ~:~~®f~ .:III~r~r-~ -~.~s~._ CITY OF fOWA CITY Name of City / BoardlCommission/Committee ~,/~ (i c ~ ~ ~ I (z ~l ~'~cc~-~c~ Date / D Name Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS ~~ ~~ ~-- ;f T'i -~ ~ c~ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an a Applicant Signature Signature of parent/guardian if/~e 1 Ito 17: Address (L G f Nir1 d~ r L 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. 'eneral Application ,March 2008 Page 3 of 7 City of Iowa City ~._ ~ r 1 Adviso Board/Commission/Committee ~ 1 ~~~ ~~'~l+~'~~'~~ ~-pplication Form ~~~ ~ ~!~~ -5 ~~` CITY OF IOWA CITY `";` ,.;Li;-=sue Individuals serving on Boards/Commissions/Committees play an impo~tati{t ~o7e in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Police Citizens Review Board Term 4 years Youth Advisory Commission, Age on the date of filing: Age 15 to 17 (or) ~ Age 18 to 21 Signature of parent/guardian if Age 15 to 17: ''AME Janis Ann Breggin ("Janie") Braverman HOME ADDRESS 55 Redbud Place, Iowa City, IA 52246 ZIP 52246 Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you been a resident of Iowa City? 41/2 years OCCUPATION writer and fiber artist -retired attorney EMPLOYER self PHONE NUMBER: HOME (319) 338-4042 BUSINESS (303) 349-8851 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Prior to moving to Iowa City, I practiced real estate and business law in Denver for 24+ years, most of them owning my own law firm. During my law school training and my years of practice, I developed analytical and managerial skills that I could apply to duties on the PCRB. In my role as employer, I developed skills related to training and supervision as well as policy making and enforcement. I also attended the Citizens' Police Academy earlier this year, which has given me a great deal of insight into police policies and practices and into the relationship between the police force and the community. While in Denver, I served two+ years on the Mayor's Women's Advisory Board, moving from vice chair to chair in my last year. That board advised the Mayor on policy matters and legislation. 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 March 2008 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Nhat I know about this board is based on what I have read on the website regarding the board and what I learned in tie Citizens' Police Academy. In my time in Iowa, I have had nothing but positive interactions with the members of arious police departments - I have never had occasion to use the complaint process. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I would like to bring my many years of experience in law, business, policy-making and being an employer to the Police Citizens Review Board. I have long been interested in the relationship between police and community. The Citizens' Police Academy taught me a great deal about that relationship. I am currently serving as a VISTA (Volunteer in Service to America -the domestic Peace Corps) summer associate, helping to coordinate the VISTA flood recovery efforts here in Johnson County. It has been very rewarding work, drawing on my experience, education, skills and abilities. Serving on the PCRB would allow me to bring that same package of experience, education, skills and abilities to continue to serve the community that has become my home. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthatSection 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. none IF YOU ARE NOT SELECTED, DO YOU WANT.TO BE NOTIFIED? ~ Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? n Yes ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the ~me tie.) `.~ --~ ~` G:.~ Misrepresentations on this application will constitute just cause for removal of an appa'ti~tee. If,you f to answer all the questions, Council may not consider your application. 5t7~~ ~ ~'~ - , .~ General Application ,~ March 2008 Page 2 of 7 ~o BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Police Citizens Review Board r j ~r +~~.~®~' ,~- 1:::111 ~ ,~ '"'u®'~~ -n.~ CITY OF IOWA CITY Date 08/02/2008 Name Janis Ann Breggin ("Janie") Braverman Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Braverman Development, Inc. PO Box 1907, IC, IA 52244 Braverman Properties, Inc. PO Box 1430, IC IA 52244 Southgate Holdings, Inc. PO Box 1907, IC, IA 52244 Southgate BP Properties LC PO Box 1907, IC, IA 52244 Reggi Originals LLC (this is my business partner 5335 S. Flanders Way, Centennial CO 80015 in the fiber arts business I own as a sole proprietor) Janie Breggin Braverman, sole proprietor 55 Redbud Place, IC, IA 52246 O ice} '`: ~~ NOTE: A new form must be completed if the above information changes or an ownershi~int~stis acquired in an al busin~~s.--~ ~` ~ ~ _ ~ D E,n Applicant Signature ~ ~ ~ Signature of parent/gua'rdian if ge 15 to Address 55 Redbud Place~lowa itv. IA 52246 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 March 2008 Page 3 of 7 City of Iowa City _ , r 1 ~1.=.®~ Advisory Board/CommissionlCommittee ~',~--"';~'~~ .pplication Form -^~-~-- CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name t-o1 ~Ge ~%~~ ~e~t5 I\eV~~ Qp~vd Term y ~'~- `~ ~2 Youth Advisory Commission, Age on the date of filing: Age 15 to 17 (or) ~ Age 18 to 21 Signature of parent/guardian if Age 15 to 17: ~f~ ~' MME ~c~~r cT._ ~? /1 ~eY1 HOME ADDRESS (~~ J~ ~c~~+L ~'-+"%d ~G3 041 r~ ~i ~J~ T~ ZIP ~Z~ ~~ Is your home address (listed above) within the corporate limits of IowagCity? ~ Yes ~ No How long have youbeen a resident of Iowa City? Sr hG e l ~ < 9 OCCUPATION i-c~l.°V~~ plr'd ~c°-$S~UV PHONE NUMBER: HOME 3~9- 3Jr~ " 3 ~ 75 EMPLOYER '-- BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: y hsv~ serv~~Q oK ~ h~l~r do~-e.jt bo~v~s of ~©~p~o~:Z~ovg3l~~ ~~Z.'o~+s S6 Z c~n~er s~a~ ~o l~pG ; cue ~~G~ s;o~ ni/.~ ~; ~ ~Q ~ c ;r w=~ ~~ 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 March 2008 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I~G~ ~ pvov aQ~s a~ ov~v3-; 1-r-~'~re~l.~~,s~i ~a~ vev~ew~ ~'L e ' ;a 1~.: n-2`~ ~ a; ~t s~ ~ al ~~e., /`t , ~~.I r~ ~ t~ l'~ ~ ~ t s z`o ~ ~. ~~ ~ ~. ~ ~-~ ; ~, ©~~~cGGi;~a~~h ~~~Cci~.~Liv l U~iG~ Qom. ~v~~~, ~tc~ Z~ GO~I~~t WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I ! ~V ~ ~G$ l~ V e ~ ~OV ~~ ~/+~~,Y~ .~ h~ (rte `i. GGG(~~LG~~~~'-c~ eL U~.~'~~ /ZCO ~?,c ~L o~ d~Q~re ~xP~;~;~kce ~ ~-s ~ G~e~,~s~~t.~~~~~~d~- ~~Y s-~~a~l v L ~ r~ ~ e~ l k~~~~' u1 ~ ~~ Go l a.1' y0~es- ~ ~i~t,~ e~cd ~. Z` ~ ~~r ~' ~ s, ~O h ~ `lG~~ vYL.s ~~G ~ eFC! 5~.~ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthatSection 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). -~ If you are uncertain whether a potential conflict of interest exists or have questions abot~ec~~n 36~~i of thcf`nrlc of In~nia nlaacc rnntart the city 4ttnmav'c nffirP at '~~iF~i-~rl~ll `" '° ///~~~/// ~ Q ,.V .... D ~= ,., IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ®Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ®No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) 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 March 2008 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Pd l iGe ~i Ei ~-~X. ~~.t/'~ ~4= ~o~~~ Name ~~ ~c°_. l~l ~ t`?.1~1 ~ r ~~®~,~, CITY OF IOWA CITY Date ~ u.~ ZOUg Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS ~? -,,,. .+ 4:.~ L ~.. _` r3 ; ~ r ~:3 w~' D NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature Signature of parenvg//uaraian it Hge ~ 5 to ~ ~: ~_ Address f~~3 C~~~ ~~ e d ~~, ~o Gt1 ~ ~~ ~`~ , _.1~7 ~ 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 March 2008 Page 3 of 7 City of Iowa City - r 1 Adviso Board/Commission/Committee ~'~~*~~~~ rY .~. ~~ ,~-application Form -~-~-- CITY OF IOWA CITY Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name ~o~1c.E GTI~NS QEV~c~ ~+c-'A Term '~- vR.. Youth Advisory Commission, Age on the date of filing: ^ Age 15 to 17 (or) ~ age 18 to~21 _ t ; -~ Signature of parent/guardian if Age 15 to 17: ~~ __- ~~.~ rv ;,~:~. :~, ~ r_ i-ti O7: N c, HOME ADDRESS X528 t~-lCK-r1uE~l v~.acE Zlf~' Szz~ Is your home address (listed above) within the corporate limits of Iowa City? /~Yes ~ No How long have you been a resident of Iowa City? ~ y4s OCCUPATION ~~a~-~¢.N EMPLOYER ~t~ of ~~aA ecc^{ PHONE NUMBER: HOME C3~a~ 35a•47SP, BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: KE}l'8E'~. e~ 11~ C~'t1~N`S ~POt1cg AGII`DE1-l`I ~ C1TV eou, ~i ~- ~to~ef~SoN j ¢.a- e~\R. oP 'Z1~E 1a~A aC1`1 'rA~K. F+~FC6 c~N v~ale,Ne~ l~csiitNS'C Wo1•~eE~1 ~ M'A ~ l.Csk~Nc.~6s Gat~nM~'tt'r2.E (,Z.GD7 - Zoo$, •y ~NT13FzKSkI\p v~tl^M JeHtJSow7 C.vu,~.xT~( ClM1JC1ti.. 6~ Cate ER.Pt/..t.ENT 5 ~ ZOO( - 2l~G~ LLN1V61~t.SCN b'F 10~'~ S'I1.~U1e tJT VO~IERIV 1-lL-sNT ~CXECtAT1VE BUV~~+Z7 1-+LC'.I~~ts~'-' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application March 2008 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? -~, cae~4 mE~'S ot•-c.e A +aoN-c~t To R~v-e:~] ATI~ conrCF~.Rtr.11S mAOS 'facsA~uST ~~ ~'~er b1e.$/1~RI~lErt~': ~i~iE`~ E1c~-'~ Y.EEP RBeoZl~S ~~ 4tu~. c.omP~.A~~i'CS ~r-» 1'~v~6 a-~~5 ~' ~sE ~Vc.R~NC'S ~ Ttte. c.~'M ~-a~ct~. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? A~ A f-~~C!=t,IT' U~,t~l~~lE'~~t"'C'~l CAF ~esw'R Cad-Rl~~AcTE trE.c'(lYa-~.E u~~TN C~ 'BRe1WR.v~+~.K~ ~ u Soci prl. woQ_X.. , 1 ~EE~L- ~ ~~a.t~ ~3tz-t-~b q ~.~.ntt ouE ~t't R.S'PE c'[~ ~t E "~ 'Cl~~ ~iQGA.l7~. 1 4Cti.SP 'tt~'"L..II=VE 1-~1~ E~c'DE.I?IEIJC.L, u~bQ.1LANiC~ u~~'~ 'CL'tE C.t.'M~ "nciE. u.N~J~S~'M p~ ~o.~,.'~A ~cu~EnCC 'Y~'PU~-R~iLo-J, ttN~ ~~ l~c'PCI.. 'Po'L~CE 'DE.P'P~'l~t1CKT~ v-'sv~~-~-1~ ?~E ~;{ R Ll~t.q~~ ~ i~ 'C~4.'ts. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests including financial interests and your duties to an employer. particular, if you are applying to be a member of a board or commission which makes recommendations tothe t;ity Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthatSection 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Sectign 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. o e.u~sP.+~t~Ct1..~ EM'Pw~tED 8`{ ~ ca-r.~, o~ lati.~'yR C~~ ~ :'v' ~' ~M! ~ I ~:, ,-, ~, --: -= ~` - ;;. -~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes ~o ~' DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ l~s ~No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) 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 March 2008 Page 2 of 7 . ~I r i BOARD, COMMISSION AND COMMITTEES ~,, ~~`~ BUSINESS LISTING -~•~.a~._ CITY OF IOWA CITY Name of City Board/Commission/Committee Douce c~T~~.eNS 2~~t-tw e'soE~¢.l~ Date $1 zc/ ~$ Name A~s~,~ ~to~,~-. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS O ~., c~ ~.. ., a C ~ N ~. . r t O ~` 3 n ~" "' NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature Signature of parent/gua if AdtQ' 15 to 17: Address tS'L.~ ~IcIC.~r-~e`l '~-.~cE sz~zFt~o 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 March 2008 Page 3 of 7 24e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: YOUTH ADVISORY COMMISSION One Vacancy -Two-Year Term January 1, 2008 -December 31, 2009 One (1) person -Age 18 to 21 on the date of filing The mission of the youth Advisory Commission is to promote understanding and awareness of Iowa City among Iowa City youth, allow a select group of youth to help make decisions concerning them and their peers, enable youth members to utilize and expand on their leadership abilities, to serve as a mechanism for communication between youth and adults in Iowa City and create a bridge whereon youth and adults can develop partnerships. All members of the Commission shall be residents of Iowa City and must be the required age on the date of filing. Said age requirements may be waived by the Council due to a lack of applicants. Meeting time and location to be determined by the Commission. Applications must be received by 5:00 p.m., Wednesday, August 20, 2008. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.orq. Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City Clerk at 356-5041. YOUTH ADVISORY COMMISSION ATTENDANCE RECORD YEAR 2008 (Meeting Datel NAME TERM EXP. 1/16 2/25 4/21 5/14 6/26 7/7 7/8 Hannah Green 12/31/09 O/E O/E O/E X O/E X X Michelle Han 12/31 /09 X X O/E O/E X X X Michael Nelson 12/31 /08 X X X X X O/E O/E David Segar 12/31 /08 X X X O/E O/E O O/E Lin Weeks 12/31/08 X X X X X X X Danielle Malatek 12/31 /09 --- --- X X O O/E X Vacant 12/31 /09 --- --- --- --- --- --- --- KEY: X =Present O =Absent O/E = AbsentlExcused NM = No meeting --- = Not a Member Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in-law, step-father, step-mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 3 Council Announcement Date: September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008 Application Deadline: Wednesday, 5:00 p.m., August 20, 2008 Council Appointment Date: August 26, 2008 (Recommendations to be made by Council liaison) *** Said age requirements maybe waived by the Council due to a lack of applicants. YOUTH ADVISORY COMMISSION One Vacancy -Two Year Term January 1, 2008 -December 31, 2009 One (1) person -Age 18 to 21 on the date of filing (05-07-08) (Term expires for Maison Bleam) Patrick Diamitani ^D (Age 15 to 17) 2541 Clearwater Ct D Denotes applicant completed the Confidential page of the application. City of Iowa City ~ ~ ~ ~~ ~ .., Advisory Board/Commission/Commi~t~e`? Application Form =..~®~ ~~~~~~~ ._ _ , CITY OF IOWA CITY U i Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL RECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name ~f)y~ ~c~`i5nru C~~c'~~SS-U.~TermQ~ Youth Advisory Commission, Age on the date of filing: Age 15 to 17 (or) ~ Age 18 to 21 Signature of parent/gia~-if Age 15 to 17: ~(,~ ~~ ~~~.,~ ''AME ~-Er~[~l~C ~ ~hv.nF; i °~a.r, ~ HOME ADDRESS ? ~ %~ ~ ~~~~W f~T C1 ~fi ZIP 522L1 (~ Is your home address (listed above) within the corporate limits of Iowa City? Yes ~ No How long have you been a resident of Iowa City? _ I ~ \~~_~-~ OCCUPATION ~j-f-U (~C'.-~'1~-- ~-#I~R~-~E~ '~:i`~l.J G~ L' i~j ~,t){~<~..t- PHONE NUMBER: HOME `31 C~-~jUl-~-~ j ij (~ BUSINESS _'?>j~-5q~-a I u q EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~t-v c~.~~~ ~e-~-~-e- U - ~.~e- - ~r~ s ~ ~Q r~ ~- ~r ~~ f -tom ~ v C.u~--~~ ~ Z 2 ~/U ~ P ~ ~'~ ~ ~j~n ~Q-e c'~In U~v1~1 l~~b/r~t~.~ ~~ be.r a ~ W e j ~- ~- ~ ` c~ 1~ ~v~~ yes S ~YV~LSy~an~(~ lOC ~:~e,i~i~~'~ C~~~-), ~~~~( ~~~~l11~td~~ ~Vt~+'~-- ~.i (~ ~t1 t. ~ ~~'~SSn~u v~ ~ o~-v'C.. (~j 5 a.c~%S G ~ ~r.s~-~ 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 March 2008 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ ~ ~ ~ `r S U~ - trte ly ~''e- ~ (zt. ~t~C.i~ ~ ~~ ono w ~ (~ 5 ~~ (.~,M ~-. ~ ~~-~ i,c.~, e is-~e.. ~+t'7~jh ~- C~v~~ '•~t ~~t~~A ~{ o~ r~ -~o,~ oirour.E9, -lr-h~ ~~c~ C ~t~~ ~ o~ -f~ ,~-~~ ti k ~ c~Gur~ ('k (,cS~tiriS p~~ % i;~.ctil~ C?L ~f-L~. ~~il-~~r~j cc~!c yo::f-~ i~Gt•-5 Ctvt~~,.l~c~ ~'~-C~fy WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~. ~~ ~ C~-~ 10 f tY~ ~ ~~-4ti~ ~ ~C-c%~-(~e,~~~rr,~ ~ CR,ir~t~ l%~e..c: i~ ~c~. nM a l~~v~ c~jr S~~`~s `~ v ~~5 Cc}nr~M~ ~~-e e.. ~ C.W~ V'~~( (~t~ Bjorn ~~ C~/~(~ ~~- i~~lz (~ ti ~,?i,~~, 'Pe.~.p~~ ~.~ ~ i~ ~.~v~x~5 ~~~ t~.b; ~ ~t-y le..v~i s ~ ~ ~~-~/ Ca.l-c C~b~ ~~- ~1 -~ ~ a~ ~ M-a kc o~ r/ o m M - ~~e ~ t -~ C ~~~e~ ~-z, ot, is ~ s If-va+- a5 [~~a- ~5 a-bie~ i `IC.ur-~ t~ he~~~ `~-~ ~p~ ~.~d h~i p ~`~K~- ~#~~ ~, POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests including financial interests and your duties to an employer. particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation° includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also knowthat Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy ofSection 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ~ Currer~~.y irk. o~+- (~ci;1~~1 IZi?,-t;~.~~- t~s~r~ea~c~I bv~- ~ ~( °~~~ ~~ C. a c t~v. bL ~ ~ r v cti~c~ G~~ Ise ~~-ssct~~ . IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ©'No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) ...7 ::.t7 Misrepresentations on this application will constitute just cause for removal of an appcStr>~e. lf~rou fa~l~ to answer all the questions, Council may not consider your application. ~~~ ..r,.~ ~ : ~ , ,. w~~ General Application ~._ r'; ~ '°~`;'" March 2008 Page 2 of 7 ~~ ~:~ _, v I r ~~.®~ BOARD, COMMISSION AND COMMITTEES ~.~`10,~~`~ BUSINESS LISTING .,.t,,~._ CITY OF IOWA CITY Name of City Board/Commission/Committee `~~~`~~ ~:{~-C~~/l'~C~~ (~nrV~`~SS'n~ Date CJ' f1~ Name ~Q'T'r'i Cod-- 1 )~ ~+ `~~11 Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). BUSINESS NAME BUSINESS ADDRESS - .~ ~- :u y' _? ~-.j ~_~ t~'- 1 A ..y { ~ J .. ~/\ •• NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. _ Applicant Signature ~~~~ ..-s J "'` Signature of parent/g~a~~a+~-if Age 15 to 17: ~ Address 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 March 2008 Page 3 of 7