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HomeMy WebLinkAbout2003-05-20 Appointment Johnson County Pat Harney, Chairperson Mike Lehman Terrence Neuzil Sally Stutsman Carol Thompson May 7, 2003 Marian Karr City Clerk 410 East Washington Street Iowa City, Iowa 52240 Re: Appointment on the SEATS Paratransit Advisory Committee Dear Marian: Please note the attached list regarding Mike O'Donnell term ending on June 30, 2003. When your Council appoints a member on this committee, please mail the Board of Supervisors an updated list· If you have any questions, please feel free to give me a call. Thank you. Siv, cere!y, Pat Hamey · Chairperson 913 SOUTH DUBUQUE STREET, SUITE 201 ~. IOWA CITY, IOWA 52240-4207 * PHONE: (319) 356-6000 * FAX: (319) 356-6036 TERM TERM BEGINS EXPIRES Melvin Dvorsky July 1 June 30 320 East Washington Street 2001 2003 Iowa City, Iowa 52240 Res: 338-0850 Doris Gerot (Replace Robert Simpson) July 1 June 30 4547 520th Street SE 2001 2003 Iowa City, Iowa 52240 Res: 351-7993 Mike O'Donnell - Appointed by the Iowa City City July 1 June 30 City of Iowa City Representative Council 2001 2003 City of Iowa City 410 East Washington Street Iowa City, Iowa 52240 Res: 356-5000 Appointed by the Coralville Tom Gill (Replaced Henry Herwig) City Council July 1 June 30 City of Coralville Represemative 2002 2004 808 8th Avenue Coralville, Iowa 52241 Res: 351-4571 Nancy Ostrognai July 1 June 30 2003 Glendale Road 2002 2004 Iowa City, Iowa 52245 Res: 338-7690 Lyrme Stamus (Replaced Keith Ruff) July 1 June 30 2318 Russell Drive 2002 2004 Iowa City, Iowa 52240 Res: 354-1390 Dee Vanderhoef- Appointed by the Iowa City City July 1 June 30 City of Iowa City Representative Council 2002 2004 City of Iowa City 410 East Washington Street Iowa City, Iowa 52240 Bus: 356-5000 TERM TERM BEGINS EXPIRES BOARD OF SUPERVISORS REPRESENTATIVES Pat Hamey Jan. 1 913 South Dubuque Street, Suite 201 2002 Iowa City, Iowa 52240-4207 Bus: 356-6000 Mike Lehman Jan. 1 913 South Dubuque Street, Suite 201 2002 Iowa City, Iowa 52240-4207 Bus: 356-6000 EX-OFFICIO William Gorman July 1 June 30 1674 Polk Avenue NE 2002 2003 Solon, Iowa 52333 Res: 644-2140 Dave Purdy July 1 June 30 Elderly Services 2002 2003 28 South Linn Street Iowa City, Iowa 52240 Bus: 356-5217 Marc Rahe (Replaced Jim Gaffey) July 11 June 30 Goodwill Industries of SE Iowa 2002 2003 1410 South First Avenue Iowa City, Iowa 52240 Bus: 337-4158 Nancy Snider Overstreet July 11 June 30 Goodwill Industries of SE Iowa 2002 2003 1410 South First Avenue Iowa City, Iowa 52240 Bus: 337-4158 NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy - Unexpired Term Ending December 31,2003 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, May 14, 2003. 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 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 Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Ron O'Neil, Airport Manager 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: April 16, 2002; May 1, 2002; June 11, 2002; July 16, 2002; August 20, 2002; September 24, 2002; November 5, 2002; December 10, 2002; January 21, 2003; February 18, 2003; April 8, 2003 Application Deadline: Wednesday, 5:00p.m., May 14, 2003 Council Appointment Date: May 20, 2003 AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy - Unexpired Term Ending December 31, 2003 No applications as of 5:00 p.m, Wednesday, May 14, 2003 [] Denotes applicant completed the Confidential page of the application. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy - Unexpired Term Ending December 31,2003 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, May 14, 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 Airport Zoning Commission should be directed to Ron O'Neil, Airport Manager 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: 2 Females: 1 Council Announcement Date: April 16, 2002; May 1, 2002; June 11, 2002; July 16, 2002; August 20, 2002; September 24, 2002; November 5, 2002; December 10, 2002; January 21,2003; February 18, 2003 Application Deadline: Wednesday, 5:00p.m., May 14, 2003 Council Appointment Date: May 20, 2003 AIRPORT ZONING COMMISSION One Vacancy - Unexpired Terms Ending December 31, 2003 No applications as of 5:00 p.m, Wednesday, May 14, 2003 [] Denotes applicant completed the Confidential page of the application. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF I..~BRARY TRU~'I'EE$ Three Vacancies - Six-Year Terms July 1, 2003 - July 1, 2009 The Board of Library Trustees is a semi-autonomous body of nine persons empowered by State Law to plan, direct, and control all affairs of the Public Library. This includes determining long-range goals of Library service, adopting written policies to govern operation of the Library, and employing a competent staff to help plan and implement the Board's service goals. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Library Board meets the fourth Thursday of each month at 5:00 p.m. Applications must be received by 5:00 p.m., Wednesday, May 14, 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 Board of Library Trustees should be directed to Susan Craig, Library Director at 356-5200. 4/2/03 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: April 8, 2003 Application Deadline: May 14, 2003 Council Appointment Date: May 20, 2003 BOARD OF LIBRARY TRUSTEES Three vacancies . Six Year Terms July 1, 2003 - July 1, 2009 Term expires for Linda Dellsperger, Lisa Parker, Shaner Magalhaes Linda Dellsperger [] Currently serving unexpired term 227 Magowan Avenue Shaner Magalhaes [] Currently serving unexpired term 2139 Abbey Lane Thomas Dean [] 3223 Shamrock Dr [] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY APPLICATION/' OVISORY BOARD/COMMISSIONFoRM Individuals serving on Boards/Commissions play an important role in advising the Councd on matters ~nterest to our community and its future. Applicants must reside in Iowa Cit~. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the oext 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 Cit~, 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 Library. Board of Trustees TERM 200~-20[~9 NAME Thomas K. Dean HOME ADDRESS 3223 Shamrock Dr., Iowa City, 52245 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? 3 )rears 10 mo. (prev±ousl¥ lived here ~986-1991) t~.CUPATION Special Assistant to the President EMPLOYER The University of Iowa PHONE NUMBER: HOME 688-9456 BUSINESS 335-1995 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Board and community committee experience: Board of Directors, East Lansing Food Co-op (East Lansing MI); Executive Committee Fargo/Moorhead Communiversity (community continuing education program, ND/MN); Lucas Elementary Site Council (Iowa City); Iowa City Community School District Nutrition Task Force. I have also been involved in several strategic planning processes in community organizations and higher education institutions. I am a strong advocate of community service and outreach, manifested in my founding the Iowa Project on Place Studies at The University of Iowa. I also assist the President of The University of Iowa in outreach activities in my role as Special Assistant to the President. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? __ I have talked with current board member and incoming board president Shaner Magelhaes about thc responsibilities and activities of the board. I have also done so with a former board president, Charles __ Dram. I understand that the board's role is in policy-making and reviews, budget oversight, strategic planning, and operational issues. 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. clerk~aNbdcomapp{ 1 ),doc April 2002 ", ,AT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING) ? I would bring with me to the board a deep appreciation and great enthusiasm for the Iowa City Public Library in particularly, and public libraries in general. I am a regular patron (personal and family) of our library (at least once a week, often more) and believe it is one our city's most important assets. I have sung the library's praises in public writing on more than one occasion. I believe that the public library, second only to public education, is one of the most important institutions in a democratic society, as providing free __ and open access to information is the greatest method for insuring our freedoms. I would bring to the board extensive experience in community and higher education administrative activities, as well as a deep commitment to Cur public institutions and community outxeach. I wish to commit public service time to our city, and the Iowa City Public Library is at the center of my own community life. 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 Councii 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. It 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. ]~4"~-r~-ity of Iowa. 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 X 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. I I I If you fail to answer all the questions, Council will not consider your application. clerk ~allbdcomapp{ 1 }.doc April 2002 (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the d~ned on,mattb[S,r¢,~nterest 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 ~]~[~ ~~E~ 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 ~O/~ ~ Z~ ~ ~'A~.~ EMPLOYER PHONE NUMBER: HOME ~F~- O~g BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD7 ~ ~Z 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. cler~/~l~bdcomapp( 11.dec April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? 2~5 ~£Xr'F.r--o,*/£D /~Z£~'.~ou.~) ~_ ~A~ ~ POIENTIA[ CONFLICT8 OF INTE~ESI Please identify any potential conflicts between membership on the advisory boa rd and your personal interests, includin~ financial interests and your duties to an employer. In particular, if you are applying to bo a member of a board or commission which makes recommendations to tho GiW Council about the allocation of City funds, please list an~ present a~filiations you have with a~encies that apply for fundin~ from the City. "Affiliation" includes being a board member or employee of the agency. Other types of a~filiations must be examined on a case by case basis by the CiW Attorney's office. You should also know that Section 362.5 o~ the Code of Iowa generally prohibits, with certain important exceptions, a member of a ciW Board or Commission from havin~ an interest in a ciW 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 Code of Iowa, please contact the Ciw Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? I~YES NO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? YES k/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 I If you fail to answer all the questions, Council will not consider your application. clerk\allbdcomapp( l).doc April 2002 (2) CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advisin~he,~oi~nci!}0n .h~atters of interest to our community and its future. Applicants must reside in Iowa City. 'lkJy?/ 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. ADVlSORYBOARD/COMMISSIONNAME ID?L- Po~p~ M:: 3~r~ TERM ~y~-~¢~ 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 VOt~., ~ ~j~ D~MPLOYER ~ PHONE NUMBER: HOME 5~[~ O BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT, KNOWLEDGE OF THIS ADVISORY BOARD? ~ ~ ~ ~ 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. clerk\allbdc omapp( 1 hdoc April 2002 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory boa rd 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 po tential conflict of interest exists or have questions about S~ion 362.5 of t he Code of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? I,'//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. ctelk\~llbdcom~pp{ ll.doc April 2002 (2) Marian Karr ~ From: Kevin and Linda Dellsperger [LKBD@mchsi.com] Sent: Monday, April 28, 2003 8:49 AM To: council@iowa-city.org Subject: RE: ICPL Board of Trustees Good Morning: Just wanted to drop a line and let you know that I have decided to apply for one of the 3 open positions on the Library Board of Trustees. I am finishing an unexpired term of Margaret Cox, who moved to University Heights shortly after she was appointed nearly 6 years ago. This would be my first official 6 year term. During the last 6 years, I have gained a very complete understanding of how the library functions and how it operates as a part of the city. I have a desire to remain on the board and see through the completion of the new library and help direct efforts of this institution into the future. I think I bring a different, but essential voice to the board. I am interested in the mission of the library and am also interested in being a voice for the tax payers of Iowa City and think the library needs to be good stewards of those monies that the citizens of Iowa City pay to the city for all services. I would appreciate your support of my application and urge you to appoint me to the ICPL Board of Trustees. Please feel free to contact me if you have any questions about me and this appointment. Sincerely, Linda Dellsperger 227 Magowan Ave. Iowa City, IA 52246 351-5869 4/28/03 Marian Karr From: Thomas Dean [thomaskdean@hotmail.com] Sent: Thursday, May 15, 2003 3:41 PM To: council@iowa-city.org Subject: Library board application Dear City Council members, I have submitted an application for one of the openings on the Library Board of Trustees. I would be very happy to answer any questions any of you may have about my application or my background. I can be contacted at this e-mail address or by phone at 335-1995 (work} or 688-9456 (home). Thank you very much for considering my application. Best wishes, Tom Dean The new MSN 8: smart spam protection and 2 months FREE* http://join.msn.com/?page=features/junkmail NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION One Vacancy - Unexpired Term Ending March 13, 2004 The duties of the Telecommunications Commission include serving as a review board to resolve disputes between any subscriber or potential subscriber and the cablevision company; reviewing and auditing reports by the cablevision company to the City as required by the Cable Television Ordinance; working with the public, the media, the City, and the cablevision company for the purpose of making recommendations on various issues; engaging in other activities pursuant to the effective monitoring and evaluation of the CATV system in the City. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Telecommunications Commission meets the fourth Monday of each month at 5:30 p.m. Applications must be received by 5:00 p.m., Wednesday, May 14, 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 Telecommunications Commission should be directed to Drew Shaffer, Cable Television Administrator at 356-5046. 3/25/03 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: April 8, 2003 Application Deadline: Wednesday, 5:00 p.m., May 14, 2003 Council Appointment Date: May 20, 2003 TELECOMMUNICATIONS COMMISSION One Vacancy - Unexpired Term Ending March '13, 2004 Kembrew McLeod resigned Robert Kemp [] 1122 Estron St Brett Custillo [] 613 E Court St #1 [] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION °PLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on ~rs d'f'intere~st 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 se~!~. 'l'-h"e aP~o. 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. W.~,~shlngt .c~. 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 R 0 ~ ,~ ~,,'"1~ Z~.. ~?// l~ 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 '"/-/~ ' ~' ~' o 1~ ~ ~ - - EMPLOYER PnONENUMBER: HOME ~ c~ + dr.-.~ )~, BUSINESS '~ ~) ~'-- '~ ~7~-" EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: s.c. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? 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\bdcornapp{ 1 )dcc Apdl 200.; v" CO,TR BUT O,S OO YOU FE.L CAN TO T, S ^DWSO.¥ BO^RD (OR ST^ .. SON FO. 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. h ~ Ju are uncertain whether a potential conflict of interest exists or have quesbons about Se.~ic~I~362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. ~' ~': ~-~ '~--I 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 (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 /' °PLICATION 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 'T~ ],~. ,~.~, ~,.,,-,' ~-,'f.,,~" ('~ .. ~ ~ ~,~' ~ TERM NAME ~,~,, (.,~:(!~ HOMEADDREsS(~ ~ /~.~ ~.~ Is your home address (listed above) within ~e ~morate limits of Iowa Ci~ ~ Yes How long have you been a resident of lowa Ci~ ~ ~ P~ONENUMBER: HOME ~/ff /'~/-7~, BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALI~ YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~k.'r, T IMisrepresentations on this application will constitute just cause for removal of an appointee. II II If you fail to answer all the questions, Council will not consider your application. ccierk~bdcomapp(1) doc April 2002 V'" '~,T CONTRIBUTIONS DO YOU FEEL YOU CAN 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" 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 ,,~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.) Misrepresentations on this application will constitute for removal of just cause an appointee. .f you fail to answer all the questions, Council will not consider your application. cde~kX~dcomapp0)doc April 2002 (2)