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HomeMy WebLinkAbout1999-02-23 Appointment FEB 16 1999 CI1'f MANAGER'S OFFICE Trudy Day 1949 Meadow Ridge Lane Iowa City, Iowa 52245 Home Phone 319-338-1758 Eraall Day@iowa-city. kl 2, ia us February 14, 1999 Scott Kugler, Associate Planner Civic Center 410 E. Washington Iowa City, Iowa 52240 Dear Scott, Unfortunately, my work schedule continues to demand a significant amount of time which does not allow my full participation as a member of the Iowa City Histodc Preservation Commission. I am resigning my position effective immediately. I have greatly enjoyed my tenure with the commission. I am dedicated to the work and mission set forth by this group in our community. Please call on my whenever I can be of assistance in a more informal role. Thank you for your support and leadership for historic preservation in Iowa City. Sincerely, Trud ay 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: 4 February 23, 1999 HISTORIC PRESERVATION COMMISSION Four Vacancies - Three Year Terms March 29, 1999 March 29, 2002 (Two At-Large, One Brown Street District Rep and One Moffitt Cottage District Rep) At-Large Richard Carlson [] 309 Finkbine Lane #10 John E. Beasley [] 602 N. First Avenue William T. Downing [] 232 S. Summit Street A-1 AS OF 4:00 P.M. 2/11/99 Susan L. Licht [] 3109 Raven Street Lars Anderson [] (has served an unexpired term) 45 Heron Circle NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION COMMISSION Four Vacancies - Three-Year Terms March 29, 1999 - March 29, 2002 (Two At-Large, One Brown Street District Rep and One Moffitt Cottage District Rep) Duties of the Historic Preservation Commission include: conducting studies for the identification and designation of Historic Districts; reviewing and acting upon all applications for Certificate of Appropriateness; cooperating with property owners and city agencies regarding remedy of dangerous conditions; furthering the efforts of historic preservation in the City by making recommendations on preservation issues, when appropriate, by encouraging the historical, architectural or cultural value, and by encouraging persons and organizations to become involved in preservation activities. This Commission meets the second Thursday of each month at 5:30 p.m. Iowa City appointed members of the boards and commissions must be eligible electors of the City of Iowa City. Appointment will be made at the February 23, 1999, meeting of the City Council at 7:00 p.m. 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. 12/17/98 Brown Street District Representative NO APPLICATIONS AS OF NOON 2/18/99 Marc Mills [] (has served an unexpired term) 530 Brown Street Moffitt Cottage District Representatives NO APPLICATIONS AS OF 4:00P.M. 2/11/99 Doris Malkmus [] (Has served one full term.) 1328 Muscatine Avenue [] Denotes applicant completed the Confidential page of the application. 2 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, brothe~ sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, oY,~uncle. {Resolution 85-354) P Males: Female. 4 February 23 1999 HISTORIC RESER. Y TIC COM MIS~SJON Four Vacancies - Three Year Terms ~. / a ne r stri ,,ep / and One Moffitt Cottage District Rep) ~ / At-Large ~ne ne ~10 Richard Carlson ~ / 309 Finkb' La John E. Beasley ~ / 602 N. First Avenue / William T. Downing 232 S. Summit Street A-.~ AS OF 4:00 P.M. 211,1199 Susan L. Licht ~ 3109 Raven Street Brown Street District Representative NO APPLICATIO AS OF NOON 2/18/99 1 Moffitt Cottage District Representatives NO APPLICATIONS AS OF 4:00P.M. 2/11/99 Doris Malkmus [] (Has served one full term.) 1328 Muscatine Avenue [] Denotes applicant completed the Confidential page of the application. 2 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION ; , PLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Cou~Ci 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 N;sTor;e-~-cscr,rd{on TERM NAME 5t~sa-n L. b~'~ HOME ADDRESS Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? I 7. L{r5 O"CUPATION ~<-cSecxr~-~', on PHONE NUMBER: HOME 5~t -oqq ?~ Yx Yes No EMPLOYER BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ivt. -Z~ WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~ ~ ~ .T c~ ~c,'~ ~ ~ ~ ~ ~ SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY. AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE. YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN IMPORTANT EXCPETIONS, 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 HAVE ANY QUESTIONS, PLEASE CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030. IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE. 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. cclerk~bdcomapp.doc If you fail to answer all questions on the application you may not be considered for appointment. ,-,: ,:~i- " January 1998 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. ADVISORY BOARD/COMMISSION NAME NAME /_.-r_,4,"'.~, Ar~JC,~o'Ft ~/;5ttor~c Pr,'~crv,,l,un HOME ADDRESS TERM 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? { ~P,~ r :~ OCCUPATION '~ 714 Nor a,' y EMPLOYER PHONE NUMBER: HOME 3 5'~' - ~ ~3'.,3 BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I. t-I, t ,y c /I,3 :. 7- Pf t;,t' ~(>,r,.,/l(:: tOil ( (/.,,ft/.~,,I31(,y'j . WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? prier SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY. AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE. YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN IMPORTANT EXCPETIONS, 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 HAVE ANY QUESTIONS, PLEASE CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030. IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE. 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. cclerk\bdcomapp,doc If you fail to answer all questions on the application you may not be considered for appoi, n3~ment. 'CITY' OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on Boards/Commissions play an important role in advising the Council on to our community and its future. Applicants must reside in Iowa City. rfi~tters of interest 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 NAME //~A~C/~11,--l,--~ Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? ~Y2, Yt?- % OccuPATIoN ttFTC,/zN~ EMPLOYER PHONE NUMBER: HOME '3c~ i- c7~"{ ~ BUSINESS Ht~TGfLI C ~'gJESC-,~V^.T!o~ ('C,/'¢/V~ TERM HOME ADDRESS 5~0 6~ ~- ~ Yes No EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? c~~7 ~n~ ~ C~s~. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY. AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE. YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN IMPORTANT EXCPETIONS, 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 HAVE ANY QUESTIONS, PLEASE CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030. IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE. 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.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all questions on the application you may not be considered for appointment. cclerk\bdcomapp .doc danuary 1998 CI"FY OF IOWA CITY ADVISORY BOARD/COMMISSION / ?PLICATION FORM ~"' cn 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 ~oPzs ~lk~us HOMEADDRESS/32S' ~t~,.~ ~ 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? ~n~ /99~ C ' ~UPATION ~, V6t. 5r~& ~~: EMPLOYER ~,;z,ri,~ o~ ~ ,~ PHONE NUMBER: HOME~/~) 3~-~10/ BUSINESS 335- ~Ob~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~urre, v~ ly~nvl'az-,- ~4qc, e/G~,r 'c~,;~ since ~e Iqq ~ WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY. AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE. YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN IMPORTANT EXCPETIONS, 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 HAVE ANY QUESTIONS, PLEASE CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030. IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE. 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 :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. If you fail to answer all questions on the application you may not be considered for appointment. cclerk\bdcomapp.doc January 1998 7'he Historical Division of the Department of Cultural A/jatrs STATE HISTORICAL SOCIETY OF IOWA American Gothic House Eldon Blood Run NHL Latchwood Centennial Building Iowa City Matthew Edel Blacksmith Shop Marshalltown Abbie Gardner Cabin Arnolds Park Iowa Historical Building Des Moines Montauk Governor's Home Union Sunday School Clermont Museum Clermont Plum Grove Governor's Home Iowa City Toolesboro Indian Moun& Toolesboro Western Historic Trails Center Council Bluffs Where past meets fiaure Febx~_Rry 16, 1999 Doris Malknaus 1328 Muscatine Ave Iowa City, IA 52240 RE: Requirements for Historic Preservation Commission Composition Dear Doris: Thi.~ is in response to your phone request regarding CLG program requirements for Historic Preservation Cornrni-~sion composition. As I pointed out in our phone conservation, commission composition is controlled by the Iowa City Historic Preservation Ordinance (Ordinance No. 95-3691. p 5, 14-4C~ 3.B). and by the CLG Agreement between the State of Iowa and the City of Iowa City (gxhi.bit A., Article 1.B.) In essence, both require that Iowa City appoint individuals with professionR] expertise in one or more of the di-~cip]ines that relate to hi-toric preservation. At present, the commission appears to lack professionR] trained members in the prlmRry hi-~toric preservation disciplines. Given the number of locally designated hi-~toric di-qtricts and ]gndmarks and the com~ni-~sion's design review responsibilities, it is important that commi-~sion include members with professional expertise in architecture (licensed architect) and architectural hl-qtory to assist in both the designation and design review processes. Given the cornrni-~sion's responsibilities in complying with Section 106 of the National Historic Preservation Act and the Sensitive Areas Ordinance, it 'would be advisable to have an archaeologist on the covnn~i.~sion. Of all the cities in Iowa, Iowa City has the highest per capita number of individua]-~ with tr~inln~ and profession_~] expertise in the htqtoric preservation disciplines. I am confident that well placed announcements and notices will elicit a positive response particn]Rrly from those aefi]iated with the University, not only faculty but staff, spouses and other family members. If I can assist in the search, please do not hesitate to contact me address listed below, by phone at 515/281-6826 or by email at km o2rat @ max. state. is. us Sincerely, ---') C Kerry C. McGrath Local Governments Coordinator at the cc: Scott Kugler, Iowa City Department of planning and Community Development IOWA HISTORICAL BUILDING 600 East Locust · Des Moines, Iowa 5031%0290 Phone: (515) 281-6412 · Fax: (515) 242-6498 or (515) 282-0502 www. uiowa.edu/'shsi/index.htm NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION Two Vacancies - Three-Year Terms March 13, 1999 - March 13, 2002 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, Appointment will be made at the February 23, 1999, meeting of the City Council at 7:00 p.m. 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. 12/17/98 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: 1 Females: 2 February 23, 1999 TELECOMMUNICATIONS COMMISSION Two Vacancies - Three-year Terms March 13, 1999 - March 13, 2002 Terry L. Smith [] 2220 Balsam Court AS OF 4:00 P. M. 2/11/99 James P. Pusack [] (has served an unexpired term) 4750 Inverness Court [] Denotes applicant completed the Confidential page of the application. CITY 'OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM 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 sere 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 ~ST PAGE MARKED "CONFIDENTIAL" THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMIS ION NAME i C- NAME ~'(-~ jl~ i~-_<j' P- ? t/f_ -( -PTJ24~L Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? ~ ~ ~ OCCUPATION ~ .F~, pFO ~3~ PHONE NUMBER: HOME ~j 3 ' ~ ~~ es No EMPLOYER BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THiS ADVISORY BOARD? WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? SPECIFIC ATTENTION SHOULD BE DIRECTED TO A POSSIBLE CONFLICT OF INTEREST. PLEASE LIST ANY PRESENT AFFILIATIONS YOU HAVE WITH AGENCIES WHICH MAY APPLY FOR FUNDING FROM THE CITY. AFFILIATION MEANS BEING A BOARD MEMBER OR EMPLOYEE OF THE AGENCY. OTHER TYPES OF AFFILIATION MUST BE EXAMINED ON A CASE-BY-CASE BASIS BY THE CITY ATTORNEY'S OFFICE. YOU SHOULD KNOW THAT SECTION 362.5 OF THE CODE OF IOWA GENERALLY PROHIBITS, WITH CERTAIN IMPORTANT EXCPETIONS, 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 HAVE ANY QUESTIONS, PLEASE CONTACT THE CITY ATTORNEY' S OFFICE AT 356-5030. IF YOU ARE UNCERTAIN WHETHER OR NOT A POTENTIAL CONFLICT OF INTEREST EXISTS, PLEASE LIST THE AGENCY AND THEN CONTACT THE CITY ATTORNEY'S OFFICE. 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 t/NNO (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. cclerk\bdcomapp.doc If you fail to answer all questions on the application you may not be considered for appointment. ~ ' .Jar~ary 1998