HomeMy WebLinkAbout2003-04-22 Appointment NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
PARKS AND RECREATION COMMISSION
One Vacancy - Unexpired Term
Ending January 1, 2004
The duties of the members of the Parks and Recreation Commission are to recommend and review
policies, rules, regulations, ordinances, and budgets relating to parks, playgrounds, recreation centers,
and cultural functions of the City and make such reports to the City Council as the Commission deems in
the public interest; to exercise broad responsibility for the development of parks, recreation centers,
playgrounds, and cultural facilities to serve the City--including the creation and appointment of advisory
groups to make studies.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa
City. The Parks and Recreation Commission meets the second Wednesday of each month at 5:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, April 16, 2003. 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 the Civic Center, 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 Parks and Recreation Commission should be directed to Terry
Trueblood, Parks & Recreation Director at 356-5110.
February 24, 2003
PARKS AND RECREATION COMMISSION
ATTENDANCE RECORD
YEAR 2002
DATE
NAME SEATED JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC.
Kevin
Boyd 9/5/01 X X X X NM X O X O O O X
Toni
Cilek 4/1/99 O X O X X X X X O X X
Doug
Ginsberg 2/14/01 X X O X O O X X O X O
Craig
Gustaveson 1/1/99 X X X X O X X O X X O
Nancy
Ostrognai 1/1/01 X X X X O X X X O X X
Matt
Pacha 1/t/97 X O X X X X X X O X X
Rex
Pruess 1/1/95 X X X X X X X X 0 X X
Al
Stroh 1/1/96 X X X X 0 X 0 X X X X
John
Westefeld 1/1/02 X X X X X X X X 0 X X
KEY: X = Present
O = Absent
NM -- No meeting
PARKS AND RECREATION COMMISSION
ATTENDANCE RECORD
YEAR 2003
DATE
NAME SEATED JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC.
Kevin
Boyd 9/5/01 X X X NM
Doug
Ginsberg 2/14/01 O .... NM
Craig
Gustaveson 1/1/99 O O X NM
Judith
Klink 1 / 1/03 X X X NM
Nancy
Ostrognai 1/1/01 X X X NM
Matt
Pacha 1/1/97 X X X NM
Al
Stroh 1/1/96 X X X NM
Sarah
Walz 1/1/03 X X X NM
John
Westefeld 1/1/02 X O O NM
KEY: X = Present
O = Absent
NM = No meeting
PARKS AND RECREATION COMMISSION
ATTENDANCE RECORD
YEAR 2003
DATE
NAME SEATED JAN. FEB. "M4R. APR. MAY JUNE JU, L'~ AUG. SEPT. OCT. NOV. DEC.
Kevin
ToniB°yd 9/5/01 X X
Cilek 4/1/99 O X
Doug
Ginsberg 2/14/01 O --
Craig
Gustaveson 1/1/99 X X
Nancy
Ostrognai 1/1/01 X X
Matt
Pacha 1/1/97 X
Rex
Pruess 1/1/95 X// X
Al ~X
Stroh 1/1/96 / X
John /~2
Westefeld 1 X O
KEY: X = Present
O = Absent
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: /~_.~
Council Announcement Date: March 11, 2003
Application Deadline: Wednesday, 5:00 p.m., April 16, 2003
Council Appointment Date: April 22, 2003
PARKS AND RECREATION COMMISSION
One Vacancy - Unexpired Term
Ending January 1, 2004
Doug Ginsberg resigned
Dave Fleener []
72 Goldfinch Circle
Margaret Loomer []
1248 Jensen Street
[] Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commissions 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.
PLEASE USE A BLACK INK PEN. 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.
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? L.~' l./,~'~z~~.~
OCCUPATION '~-fl Sol ~4~ c..~__ v ~'/~e.,~ ~~ ¢-~,
EMPLOYER 3'o/,~.~¢,~
F ..)NE NUMBER: HOME~'~I?~ .~"/-/1{ .~'~ BUSINESS ~f~')
EXPE~,,ENCE AND/OR ACTIV,T,ES w,~cH you fE5 QUAUFY YOU fOR TH,S POS,T,~'~
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
cclerk\bdcomapp{ 1 ) doc
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V'" ~AT CONTRIBUTIONS DO YOU FEEL YOU C,AN MAKE TO THIS ADVISORY BOARD (OR'STATE REASON FOR
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" 'ncludes 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.
I ~u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code
of Iowa, please contact the City Attorney's office at 356-5030.
~;~ __ ;-:-,~
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? KYES 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.)
iMisrepresentations on this application will constitute just cause for removal of an appointee.
I, 'f you fail to answer all the questions, Council will not consider your application.
cclerk\bdcomapp( 1 )doc
April 2002
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CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
/ PPLICATION FORM
Individuals serving on Boards/Commissions p ay an important role in advising the C,o_u ,~,'.i~0n matters.of nterest to our
community and its future. Applicants must reside in Iowa City. t.'~.'?':~, ,~:7-:.',),
After a vacancy has been announced, the Council reviews all app ications during the w0;k ~e~Sior~"'!:~e appointment
is made at the next forma Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME~ TERM~[~i:~
NAME I'~'~o.~,~,~.,¢,.-['" L~t,-c~,~.~- HOME ADDRESS j~
Is your home address (listed above) within ~e ~orate limits of Iowa Ci~? ~ Yes No
How long have you b~n a resident of Iowa Ci~ ~ ~ ~ ~
OCCUPATION R~ ~
- - - EMPLOYER
~ DNE NUMBER: HOME .~1-~ BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
April 2002
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V'"~AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
POTENTIAL CONFLICTS OF INTEREST
Please identi~ any potential conflicts be~een membe~hip on the adviso~ board and your personal3nterests,
including financial interests and your duties to an employer.
In padicular, if you are applying to be a member of a board or commission which makes re~mmendations to the
Ci~ Council about the allo~tion of Ci~ funds, please list any present a~liations you have with agencies that apply
for funding from the Ci~. "Affiliation" includes being a board member or employee of the agency. Other types of
a~{iations must be examined on a case by case basis by the City A~omey's o~ce.
You should also know that Section 362.5 of the C~e of Iowa generally prohibits, with ~ain impo~ant ex~ptions, a
member of a ci~ Board or Commission from having an interest in a ci~ contraS. A copy of Section 362.5 is
attached.
I. _ Ju are un~dain ~ether a potential conflict of interest exists or have questions about Section 362.5 of the C~e
of Iowa, please conta~ the City A~orney's o~ce at 356-5030.
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.
f you fail to answer all the questions, Council will not consider your application.
cc~e rk'~bdcornapp(1 ).doc
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NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
PLANNING AND ZONING COMMISSION
Two Vacancies - Five-Year Terms
May 1,2003 - May 1, 2008
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.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa
City. This Commission conducts formal meetings the first and third Thursdays of each month at 7:30 p.m.
(Informal workshops are held the preceding Mondays at 7:30 p.m.)
Applications must be received by 5:00 p.m., Wednesday, April 16, 2003. 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 the Civic Center, 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 Planning and Zoning Commission should be directed to Robert Miklo,
Sr Urban Planner at 356-5240.
PLANNING & ZONING COMMISSION
12 MONTH ATTENDANCE RECORD
07~18~82 to CURRENT
Meeting Date Jer~ An~ B~bJ~rg B~njami~ D~a d EliZabeth
7-18-02 X X X X X X X
8-1-02 X O X X X X X
8-15-02 X X X X X X X
9-5-02 X X X X O X X
9-19-02 X X X × X X O
10-3-02 X X X X X X X
10-17-02 O X X X X O X
11-7-02 X X X X X X X
11-21-02 X X X X X X X
12-5-02 X X X X X X X
12-19-02 X X X X X X X
1-16-03 X X X X X X X
2-6-03 X X O X X X X
2-20-03 X X X X X X X
3-6-03 X X X X X X X
3-20-03 O X X X X O X
(X} = Present
(O) = Absent
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: 2
Council Announcement Date: March 11, 2003
Application Deadline: Wednesday, 5:00 p.m., April 16, 2003
Council Appointment Date: April 22, 2003
PLANNING AND ZONING COMMISSION
Two vacancies - 5 Year Terms
May 1, 2003 - May 1, 2008
Term expired for Dean Shannon and Ann Freerks
John Kammermeyer []
116 Ferson Avenue
George McCune []
434 Crestview Avenue
Dean Shannon [] Currently serving full term (5/98-5/03)
PO Box 3353
Helen Burford []
604 Ronalds St
Ann Freerks [] Currently serving unexpired term (ending 5/03)
443 S. Governer St
[] Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
/' °PLICATION FORM
~',~,~i~,~ I3 i'~ z, Oj
Individuals serving on Boards/Oommissions play an important role in advising the O0.g~cil on matt~ers 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 dunng the work sess on. ~'he appo ntment
is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME'-'~LPdr~'~I ~ ~' 7-~//~](~ TERM ~-~ Y~'
HO "ADDR Ss Hb
Is your home address (listed above) within the ~orate limits of Iowa Ci~ ~ Yes No
How long have you been a resident of Iowa Ci~? ~/~ ~ / ~ ~
OCCUPATION ~t~ ~ EMPLOYER ~
PHONE NUMBER: HOME ~ ~-~5~ BUSINESS ~ ~-~0 (~
EXPERIENCE AND/OR ACTIVITIES~WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
cclerk~bdcomapp( 1).doc April 2002
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V'" 'aT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE RF..ASON FOR
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the adviso~ 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.
h, Ju are uncertain whether a potential conflict of interest exists or have questions about ~_~. ction ~2.5 of the Code
of Iowa, please contact the City Attomey's office at 356-5030.
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.
'f you fail to answer all the questions, Council will not consider your application.
cderk~dcomapp(~).doc April 2002
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CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
PPLICATION FORM
Individuals serving on Boards/Commissions play an impodant 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.
PLEASE USE A BLACK INK PEN, 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.
ADVISORY BOARD/COMMISSION NAME Planning and Zoning TERM 5 years
NAME. Ceor. ge D. McCune HOME ADDRESS 434 Crestview Avenue
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?. 51 years
(' ~CUPATION Supervisor
EMPLOYER McComas-Lacina Construction L
PHONE NUMBER: HOME (319) 351-4759 BUSINESS (319) 338-1125
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
Life lon~ resident of Iowa City area. Familiar with city and its past areas of growth. I
have ~O y~rg of experq~n~ and edn~qnn ~n the build,n? tradeg and because of tbi~. have
been involved in historic, residential, business and commercial construction. These can all
exist toe'ether with the nrooer ~lannine and foresight.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY " ". :~' "7]
BOARD? --, ~' '~ __
No direct knowledge of the Iowa City board but have attended many county me~i~gs.~-I
studied their rules and interactions with the Iowa City board.
Misrepresentations on this applicati.on will constitute just cause for removal of an appointee.
,, If you fail to answer all the questions, Council will not consider your application.
Apd12002
~.. iAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING)? As a life long resident of Iowa City, I can add some insight as to the direction
the residents of Iowa City would like to see the town grow. My construction experience is a
plus as to whether certain zoning changes or modifications are a positive or negative for the
lonm term of the city and its residents.
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 Attomey'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
a~'~ched.
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code
of Iowa, please contact the City Attorney's office at 356-5030.
No conflicts of interest at this time. Do have a part ownership in a farm~t_. .... i~'~_~n_ .'
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 will not consider your application.
cclerk~bdcomapp( 1 ).doc April 2002
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CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
/ PPLICATION FORM
Individuals serving on Boards/Commissions 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.
PLEASE USE A BLACK INK PEN. 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.
NAME D~'~;~ -~/-//~(,/~,,/o,,I/ HOME ADDRESS
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?
OCCUPATION ~)'~ 7- ~,{,/,,,,,~, k 'T'¢c// EMPLOYER (~U~ .~T
ONE NUMBER:
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADV SORY BO~D? ~o~ ~P
Misrepresentations on this application will constitute just cause for removal of an appointee. I
If you fail to answer all the questions, Council will not consider your application.
cclerk~dcornapp( 1 ).doc
April 2002
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W'4AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING)?
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.
I.' .~u are uncertain whether a potential conflict of interest exists or have questions about Section 362,5 of the Code
of Iowa, please contact the City Attorney's office at 356-5030. ~ ~
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Y'~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.)
cc[e rk~bdcomapp( I ).doc
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CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
- PPLICATION FORM ::::' '
Individuals serving on Boards/Oommissions play an imporlant role in advising t~e Councit-o~, matters of interest to our
community and its future. Applicants must reside in Iowa City. ~.', i
After a vacancy has been announced, the Council reviews all applications dU~ ~tl'ie work
is made at the next formal Council meeting. Appointees serve as unpaid volunteers, session. The appointment
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME ~1,~1~/(~'
N~E ~ ~~ HOME ADDRESS
Is your home address (listed a~ve) within ~e ~orate limits of Iowa Ci~ V Yes ~ No
How long have you been a resident of Iowa Ci~
OCCUPATION~
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADV SORY BOARD?
Review and consideration of sensitive overlaps of ordinances, zoning regulations, and development in Iowa
City. The Board reaches out to listen to all voices in the community and works closely with the City Planning
department. The Board takes a long range view of the community and works to recommend changes that will
foster growth and improve the quality of life in Iowa City.
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EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
In my former position of Marketing Director for Celebrity Cruises, I was a member of the steering committee,
responsible for planning and design of the nine vessel fleet. Each ship represents a major capital investment (over
450M) that is expected to have a life of 20+ years. Building a cruise ship is like building a floating city; requiring a
massive infrastructure to provide water, sewage, safety, and security as well as passenger flow/access to support a
community. Coast Guard, marine, health and environmental standards are very stringent and it is a challenge to both
meet and exceed these standards when building a new ship. As a member of this team, I not only had the opportunity to
contribute new product ideas but also work with the architects and designers to deliver these concepts.
I have a historical perspective of Iowa City having been in the community when urban renewal was introduced and
observing the city grow over the last 30 years (my family has resided in Iowa City since 1945) I have also been
fortunate to have lived in two planned communities, Shaker Heights, Ohio (notable for its mass t~ansit system ,and ring
of parks) and Weston, Florida (an example of new urbanism) as well as the urban communities o~S~ho and t:ore~t
Hills in New York City. Since moving to Iowa City, I have become an active member in my neighborhood association
and have volunteered to assist the Historical Preservation Committee.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING)? I have a strong sense of commitment to the future of the community and the patience to work through the
technical as well as social changes necessary to carry out the city's plan.
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.
I )u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code
of Iowa, please contact the City Attorney's office at 356-5030.
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,)
April 2002
(2)
Page 1 of 1
Marian Karr
From: Helen Burford [hburford@mchsi.com]
Sent: Tuesday, April 15, 2003 3:32 PM
To: council@iowa-city.org
Subject: Planning and Zoning Commission
Hello-
I wanted to introduce myself to you before you receive my application for one of the vacancies on the Planning and
Zoning Commission.
I have come back home. That is, my family and I came back to Iowa City after leaving 30 years ago like so many other
residents. My husband grew up here as a child and his family still resides in Iowa City. This is a wonderful place to raise a
family and as the May/June edition of the AARP Magazine noted it's one of the top 15 dream towns in the U.S.
Since I have returned, I have made it a point to be active in my local neighborhood organization and to volunteer to help
the Historic Preservation Commission. Within this short period of time we have also been trying to purchase an historic
home and have learned a lot about the history of Iowa City in the process (my husband, Kevin Burford works at the State
Historical Society).
However, it is my marketing background and strong sense of branding which has led me to apply for the position on the
planning and zoning board. I believe that the City needs to be always thinking of the future while protecting its strongest
assets. We need to create more value for the City and its residents while at the same time creating economic opportunity.
While away from Iowa City, I was a founding member of the management team that started Celebrity Cruises. We built
floating cities of the future to meet and exceed consumer desires. Iowa City can do this too-shape a city that will meet
and exceed the needs of its citizens.
Thank you for considering my application.
Helen Burford
4/15/03
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
/ ,PPLICATION FORM 71!
Individuals serving on Boards/Oommissions play an important role in advising the C~unci! 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 duilr~g.the work sess~t~Q. The appointment
is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME ? !,,~.lrl~ i1'I,~ fl rift '~.~ C,,~
NAME ~ ~.C~ HOME ADDRESS ~.~ ~, ~~ ~.
Is your home address (listed above) within the ~rporate limits of Iowa Ci~ ~ Yes No
How long have you been a resident of Iowa Ci~? I ~
OCCUPATION '~r[~/~ ~.:~ EMPLOYER
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
WHA ~ ~ YOUR PRESENT KNOWkEDGE OF THIS ADVISORY BOARD7
I 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.
cc~ erk'~bdco mapp( 1 ).doc April 2002
WqAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING)? ~ o.,r¢ c~,c¢,~v ~.~r~. ~ c;~ r~ r~ri~ 4~,~ h'~ ~ ~ ~,,, +~ ~ ~ ~:
POTENTIAL CONFLICTS OF INTEREST eo~i~W
Please identi~ any potential ~nflicts be~een membership on the adviso~ board and your personal interests,
including financial interests and your duties to an employer.
In paAicular, if you are applying to be a member of a board or ~mmission which makes recommendations to the
City Council about the allo~tion of Ci~ funds, please list any present affiliations you have with agendes that apply
for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of
affiliations must ~ examined on a case by case basis by the City Afforney's office.
You should also know that Section 362.5 of the Code of Iowa generally prohibits, with ~dain impodant exceptions, a
member of a ci~ Board or Commission from having an interest in a ci~ ~ntra~. A copy of Section 362.5 is
attached.
I. )u are unceAain whether a potential conflict of interest exists or have questions about Section 362.5 of the C~e
of Iowa, please ~nta~ the City AEomey's office at 356-5030.
'.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ YES NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA Cl~ BOARD OR COMMISSION? YES ~ NO
(It has been ~uncil ~licy not to pe~it an individual to se~e on ~o Boards or Commissions at the same time.)
J Misrepresentations on this application will constitute just cause for removal of an appointee.
you fail to answer all the questions, Council will not consider your application.
cclerk~dcomapp(l ).doc April 2002
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Planning and Zoning Commission Application questions and answers
Ann Freerks
443 S. Governor Street
Home: 354-8671
Work: 384-0059
1) Experience and/or Activities which you feel qualify you for this position:
I currently serve on the Iowa City Planning and Zoning commission and would like to
continue to serve my community in this role. I have acquired considerable knowledge
about zoning and community planning during my time on P & Z. This expands on what I
have learned in the past while on the IC Historic Preservation Commission and work to
rezone the Govemor/Lucas/Bowery neighborhood in order to stabilize it. I have helped in
the formation of the first conservation district in Iowa City, and have been active in the
Neighborhood Council and the Longfellow Neighborhood (past president and Garden
Walk chair). As you can see from my volunteer work, the development, growth and
harmony in our community is important to me.
2) What is you present knowledge of this advisory board?
Since I have the privilege of being a current member of the Planning and Zoning
Commission, I have first-hand experience/knowledge of what this board does and how it
works most effectively. I have come to better understand the importance of the
comprehensive plan as a guide/tool. We have the excellent support of the IC planning
staff to present background and guidance.
3) What contributions do you feel you can make to this advisory board (or state
reason for applying)?
We are currently working on the city code rewrite and I would like to continue to help
formulate the best plan possible. Most of my contributions and reasons for applying stem
from my beliefs in my community. I believe in both preservation and development. I feel
that through careful planning we can have a balanced and healthy community with much
gain. ! believe in the development and maintenance of strong neighborhoods. I
understand and support the need to increase our tax base and feel that the current P & Z
Commission is keen to pursue this in a thoughtful manner. A well developed community
is key to a healthy population. I am eager to be a part of this.
"
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
POLICE CITIZENS' REVIEW BOARD
One Vacancy - Unexpired Term
Ending September 1, 2005
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.
"Peace officers", sometimes designated "law enforcement officers", include:
a. Sheriffs and their regular deputies who are subject to mandated
law enforcement training.
b. Marshals and police officers of cities.
c. Peace officer members of the department of public safety as
defined in chapter 80.
d. Parole officers acting pursuant to section 906.2.
e. Probation officers acting pursuant to section 602.7202, subsection
4, and section 907.2.
f. Special security officers employed by board of regents institutions
as set forth in section 262.13.
g. Conservation officers as authorized by section 456A. 13.
h. Such employees of the department of transportation as are
designated "peace officers" by resolution of the department under
section 321.477.
i. Employees of an aviation authority designated as ''peace officers"
by the authority under section 330A.8, subsection 16.
j. Such persons as may be otherwise so designated by law.
Applications must be received by 5:00 p.m., Wednesday, April 16, 2003. 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 the Civic Center, 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 Kellie Turtle at 356-
5041.
2/24/03
POLICE CITIZENS REVIEW BOARD
ATTENDANCE
7/1/02 to 6/30/03
DATE
I~ Biil H~eft L~¢~ H6~ B~ S~ith J~h S~ratto~ j~h~ watson
RE~OR~ING
07/09/02 X X X X X
Regular Mtg
09/10/02 Absent (E) X X X X
Regular Mtg Called
10/22/02 Absent (UE) Absent (E) X X X
Special Mtg No Call Out of Town
11/12/02 X X Absent (E) Absent (E) X
Regular Mtg Called Out of Town
12/10/02 X X Absent (UE) X X
Regular Mtg No Call
12/20/02 Absent (E) X Absent (UE) X X
Special Mtg Called No Call
01/21/03 Absent (UE) X Absent (E) X X
Special Mtg No Call Called
02/11/03 N/A N/A N/A N/A N/A
Regular Mtg
Re-scheduled
No Quorum
02/18/03 Absent (E) Absent (E) Absent (UE) X X
Special Mtg- Called Out of Town No Call
No Quorum Resigned
03/04/03 N/A X Absent (UE) X X
Special Mtg No Call
03/11/03 N/A X Absent (UE) X X
Regular Mtg No Call
03/24/03 N/A X Absent (UE) X X
Special Mtg No Call
04/09/03 N/A X Absent (UE) X X
Special Mtg No Call
05/13/03
Regular Mtg
05/27/03
Special Mtg
(E) = Excused
(UE) = Unexcused
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: 1
Council Announcement Date: March 11, 2003
Application Deadline: Wednesday, 5:00 p.m., April 16, 2003
Council Appointment Date: April 22, 2003
** 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.
POLICE CITIZENS' REVIEW BOARD
One Vacancy - Unexpired Term
Ending September 1, 2005
Bill Hoeft resigned (Peace Officer)
David Bourgeois []
1477 Buckingham PI
Ronald Fort []
1120 Carver St
Candy Barnhill []
154 Friendship St
[] Denotes applicant completed the Confidential page of the application.
__CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
APPLICATION FORM
Individuals serving on Boards/Commissions play an impodant 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.
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME Police Citizens' Review Board TERM
NAME David F. Bourqeois HOMEADDRESS 1477 Buckingham Pi
IS your home address (listed above) within the corporate limits of Iowa City? x Yes __ No
How long have you been a resident of Iowa City? 5 Yea rs
OCCUPATION sales EMPLOYER Pactiv
P NENUMBER: HOME 3]9 358-1373 BUSINESS Same
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Wel 1
educated, concerned US Citizen willing to work toward sound
professional qoals and objectives. C3 ~r~
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? NoneS?/' .'77
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.
cclerk~bdcomapp{ 1 ) doc April 2002
(1)
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
A~PLYING)? Ny success has been based on fair but consistant qoals and
b]ectlves and a willinqness to work to achive these goals.
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.
)u are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code
ot Iowa, please contact the City Attorney's office at 356-5030.
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.
~f you fail to answer all the questions, Council will not consider your application.
cclerk\bdcomapp[ 1 ) doc April 2002
(2)
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
%PPLICATION FORM
Individuals serving on Boards/Commissions 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.
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME Police Citizen Review Board TERMUnexnired
1120 Carver -qtreet
NAME Ronald R. Fort HOME ADDRESS Iowa City IA 52240
Is your home address (listed above) within the corporate limits of Iowa City? XX Yes __ No
How long have you been a resident of Iowa City? 36 Years
OCCUPATION Retired Police Officer EMPLOYER City of I~3Ci~
.'HONE NUMBER: HOME 319-351-4179 BUSINESS
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I worked for the Iowa City Police Department for over 34 years, co
I held the rank of Seraeant and Lieutena~]~. While in these ranks I was a
Watch Commander. I have done several internal affairs investigations.
I ha~;~ been in charge of Drug Task Forces, Bomb Teams, Investi~atlons (Der.)
Units, su[~ervised on all three watches, & led teams durino the var~ou.~
riots, protests, and demonstrations Iowa City has had.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I have read the By-laws of this board.
I have had one unfounded complaint filed against me with this board.
I Misrepresentations on this application will constitute just cause for removal of an appointee. I
I
If you fail to answer all the questions, Council will not consider your application.
c~erk ~llbdc°rn~pP ( ~ I'd °c April 2002
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
PPLYING)?T hav~ knowledge
police work in oeneral, have conducted Internal Affair investiqations
s~ ? know f.h~ procedure, and Towa C~ty has sent me to many hours of
management schools. I enjoyed my time with ICPD and workin~ for Iowa City.
Now it is time to give something back to 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.
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the
' ;ode of Iowa, please contact the City Attorney's office at 356-5030.
NONE
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ×X 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.)
IMisrepresentations 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.
,~lef k~allbdcomap~ 1 ).~oc April 2002
(2)
CITY OF IOWA CITY
ADVISORY BOARD/COMMISSION
/~PPLICATION FORM
Individuals serving on Boards/Commissions 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 dudng the work session. The appointment
is made at the next formal Council meeting. Appointees serve as unpaid volunteers.
PLEASE USE A BLACK INK PEN. 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.
ADVISORY BOARD/COMMISSION NAME 5 -. -.. --.
Is your home address (listed above) within the corporate limits of Iowa City?. ~'v Yes
How long have you been a resident of Iowa City?. ~'~/'/,/-~-~,
EXPER,ENCE AND/OR ACT,VInES WH,CH YOU FEE, OUAL,~ YOU FOR TH,S POS,T,ON: ~ ~-~,~
Misrepresentations on this application will constitute just cause for removal of an appointee. I
I
If you fail to answer all the questions, Council will not consider your application.
cc~erk~comapp(~).doc April 2002
(1)
W~AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
· /., . - . . / .
/
POTENTIAL CONFLICTS OF INTEREST
Please identi~ any potential conflicts be~een membership on the adviso~ board and your personal interests,
including financial interests and your duties to an employer.
In pa~icular, if you are applying to be a member of a board or ~mmission which makes re~mmendations to the
City Council about the allo~tion of Ci~ 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 A~omey's office.
You should also know that Section 362.5 of the C~e of Iowa generally prohibits, with ~ain impodant exceptions, a
member of a ci~ Board or Commission from having an interest in a ci~ contraS. A ~py of Section 362.5 is
attached.
I ~u are uncedain whether a potential conflict of interest e~sts or have questions about Section 362.5 of the C~e
of Iowa, please conta~ the City A~orney's office at 356-5030.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ YES NO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CI~ BOARD OR COMMISSION? YES ~ NO
(It has ~en Coundl poli~ not to pe~it an individual to se~e on ~o Boards or ~mmissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee.
f you fail to answer all the questions, Council will not consider your application.
cclerk~bdcornapp(1 ).doc Apdl 2002
(2)