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HomeMy WebLinkAbout2015-11-10 Appointment11-10-15 16a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy — Five -Year Term January 1, 2016 - December 31, 2020 • The powers and duties of the Airport Zoning Board of Adjustment are to hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. • To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. • To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. The Board meets at the call of the Chairperson. • Iowa City -appointed members of boards and commissions must be at least 18 years of age and live in Iowa City. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. • Applications must be received by 5:00 p.m., Wednesday, November 4, 2015. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. A Council Member's spouse, domestic partner or partner by cohabitation, children, step- children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship. A current member of a City Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. A current member of a comparable County Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy — Five -Year Term January 1, 2016 — December 31, 2021 Term expires for Keith Ruff Council Announcement Date: September 15, 2015 Application Deadline: Wednesday, 5:OOp.m., November 4, 2015 Council Appointment Date: November 10, 2015 After 12/14/2015 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. Gender Balance Requirement: 1 Female No Applications as of Wednesday, 5:OOp.m., November 4, 2015 Males: 1 Females: 0 0 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 APPEALS One Vacancy — Five Year term January 1, 2016 - December 31, 2020 One (1) Licensed Electrician Or A qualified trade representative, with experience and training (if after 3 months no professional applies or is appointed) • It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the International Building Code, International Residential Code, Uniform Plumbing Code, National Electric Code, International Mechanical Code, International Fire Code, and the Iowa City Housing Code. • The Board meets the first Monday of each month at 4:00 p.m. or at the call of the Building Official. • City -appointed members of boards and commissions must be at least 18 years old and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment to boards and commissions. • Applications must be received by 5:00 p.m., Wednesday, November 4, 2015. Questions regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at 356-5122. A Council Member's spouse, domestic partner or partner by cohabitation, children, step- children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship. A current member of a City Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. A current member of a comparable County Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. BOARD OF APPEALS One Vacancy — to fill a five year term January 1, 2016 — December 31, 2021 Term expires for John Forman Gay One (1) Licensed Electrician Or A qualified trade representative, with experience and training (if after 3 months no professional applies or is appointed) Council Announcement Date: September 15, 2015 Application Deadline: Wednesday, 5:00 p.m., November 4, 2015 Council Appointment Date: November 10, 2015 After 12/14/2015 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. Gender Balance Requirement: 1 Female No Applications as of Wednesday, 5:OOp.m., November 4, 2015 ❑O Denotes applicant completed the Confidential page of the application. Males: 2 Females: 1 NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION Three Vacancies —Three -Year Term January 1, 2016 - January 1, 2019 Duties of the Commission include: • disseminating information to educate the public on illegal discrimination and civil rights, such as organizing and facilitating educational public forums that address one or more of the broad range of topics included within the rubric of human rights; • making recommendations to the City Council for such further legislation concerning discrimination as it may deem necessary and desirable; • cooperating within the limits of any appropriations made for its operation with other agencies or organizations both public and private whose purposes are not inconsistent with those of Title 2 of the City Code (Human Rights Ordinance) • planning programs and activities designed to eliminate racial, religious, cultural and other intergroup tensions including but not limited to sex, color, creed, disability, gender identity, sexual orientation, marital status, age, and national origin. • Iowa City -appointed members of boards and commissions must be at least 18 years of age and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Human Rights Commission meets the third Tuesday of each month at 6:00 p.m. in the Lobby Conference Room at City Hall, 410 E. Washington Street. • Applications must be received by 5:00 p.m., Wednesday, November 4, 2015. Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers, Human Rights Coordinator at 356-5022. A Council Member's spouse, domestic partner or partner by cohabitation, children, step- children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship. A current member of a City Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. A current member of a comparable County Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. HUMAN RIGHTS COMMISSION Three Vacancies — Three Year Term January 1, 2015 - January 1, 2018 Term expires for Edie Pierce -Thomas, Joe Coulter, and Harry Olmstead Council Announcement Date: September 15, 2015 Application Deadline: Wednesday, 5:00 p.m., November 4, 2015 Council Appointment Date: November 10, 2015 After 12/14/2015 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. Gender Balance Requirement: 1 Male, 1 Female, 1 None Males: 3 Females: 3 (M) Joe D. Coulter 0(Currently serving 1s` term) 1818 N. Dubuque St. (F) Andrea Cohen ❑X 1582 Vesh Lane (F) Eliza Jane Willis O 821 S.7 1h Ave. (F) Nidal Besher I] 2604 Bartelt Rd Apt 1A (F) Joylene Beadleston O 1570 S. 1st Ave., Unit 13 (M) Adil D. Adams X❑ 2532 Bartelt Rd #1C ❑X Denotes applicant completed the Confidential page of the application City of Iowa City r j Advisory Board/Commission/Committee x Application Form CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCN DURING THAT TIME. Advisory Board/Commission/Committee Name I f ( . CbI S Term NAME e C0� I "� HOME ADDRESS 1$� N. i�i'rL�y� c ��, Z'6w,4 Is your home address within the corporate limits of Iowa City? o Yes F -J No 5 z- 45 -How long have you lived in Iowa City? _ 3DyrS� Gender: MaleQ Female Contact#_.Email Address COL7jte ry Cee, CLa5MA't).<'0M OPP CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: See arc.he-(t WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Py-cvov-5 S-eYViCe ; Ad he -C U(v2y'6-1i' �dYYt�'1r1l �-2 LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest Tc UNiveC5�iy (4- Iowa - IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? FPJ Yes ❑ No DO YOU CURRENTkY'1j `' ,iaj. THER IOWA CITY BOARD OR COMMISSION? Yes No (If yes, please indicate wf i ►i r d hp vnt tr Fire} nFtninn +., �.,. , . � r. f i n � _ I _ in __.___,__....... ,..,... —owe rcvtt.1 rtVTYlitN K1 ntS C�YYIt'Y1t�j)d Misrepresentatid&*hnWis Wp ill constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. 3eneral Application, April 2015 Page 2 of 7 a Joe Dan Coulter, Ph.D. Professor Emeritus College of Public Health Carver College of Medicine The University of Iowa Dr. Coulter received the Ph.D. in Biological Psychology from the University of Oklahoma Medical Center and completed post -doctoral training at the University of Texas Medical Branch, Galveston, the Universita de Pisa, Italy, and the University of Edinburgh, Scotland. He came to The University of Iowa as Head of the Department of Anatomy and subsequently served as Director, Neuroscience Graduate Program, as Associate Provost for Diversity and Director, Opportunity at Iowa, and as Associate Dean for Diversity in the College of Public Health, Dr. Coulter is an enrolled member of the Citizen Potawatomi Nation of Oklahoma and currently active in teaching, research/scholarship, and community service in American Indian/Alaskan Native health. He has conducted collaborative research and scholarship in the areas of children's oral health in Northern Plains tribal communities, tribal preparedness and emergency response, establishing working relations in clinical and translational research in partnership with Federally Qualified Community Health Centers, and development/evaluation of biomedical research programs in tribal colleges and communities. Dr. Coulter is a member of the External Advisory Committee of the Montana State University (MSU) Idea Networks for Biomedical Research Excellence (INBRE) program, an NIH program to improve biomedical research infrastructure for Montana's higher education system and tribal colleges. He also serves MSU on the External Advisory Committees of the NIH supported American Indians into Research Program, Center for Native Health Partnerships, and the Culturally Connected Community Goals programs. In 2008, he was appointed to the External Advisory Committee of the Northern Plains Tribal Epidemiology Center of the Great Plains (Aberdeen Area) Tribal Chairman's Health Board. He has served on the Association of Schools of Public Health (ASPH) Diversity Committee, and the ASPH-Indian Health Service Taskfor�9d Ma 'Aito VM01 Dr. Coulter is an advisor to the Historical Preservation P4911'Y e W'skwaki Nation of Iowa, served on the Iowa Governor's Equal Employment Op@-tWVWi4s talk ESSrO06nd has served three terms on the Iowa Advisory Committee of the United States Commission on Civil Rights. ( In 2008, Dr. Coulter was appointed to the Iowa Commissiornati j 4erican Affairs, State Department of Human Rights, In 2011, he began service to the Governance Board of the Heartland Regional Health Equity Council, and serves as a member of the American Indian/Alaskan Native Caucus of the National Partnership for Action (NPA) to End Health Disparities of the Office of Minority Health, U.S. Department of Health and Human Services. Joe D. Coulter, Ph.D. Professor Emeritus College of Public Health Carver College of Medicine 200 Newton Road, 5147 Westlawn The University of Iowa Phone (319) 335-7700 Iowa City, Iowa 52242 Jae Dan Coulter 0s : � 1,118 L 183S 9102 3 BOARD, COMMISSION AND COMMITTEES►,"""� " h -� BUSINESS LISTING � .is.T CITY OF IOWA CITY Name of City , Board/Commission/Committee _ u My [� D1►'1� 5..5 ian Date __I ����l 67 Name a� �a�r G�csv Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings), Please indicate if there are none. L` BUSINESS NAME BUSINESS ADDRESS (Vo ne NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature CJ Misrepresentations on this application will constitute just cc -Me JOWEPtJXJ ppointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size {Poverty Level) Income Income clow income) Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21;500 35,800 42,960 _ 57,250 71,600 4 _ 23,850 39,750_ 47,700 63,600 79,500 _5 _ 25,800_ 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 78,900 92,300 98,600 7 29,600 _ 49,300 59,160 $ ._.. 31,500 52,500 63,000 1 84,000 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various racial, religious, cultural, social and economic groups in the city." (Ord. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. ElAge C�le-7 Gender ~` �v 008 Income (see table) YYldl.�2 Sexual Orientation = Other (Please explain below) E _ riuman Rights Commission Application February 2015 page 4 of 8 Religion f r16Y1e Disability why l+'1 mlfli� T;� Race, color or ethnic group National origin 'aI'A113 W-01 11 JS :� Ind L I d3� SIDi City of Iowa City I r , Advisor Board/Commission/Committee ft wit Application Form am CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANC` DURING THAT TIME. L Advisory Board/Commission/Committee Name 40MOV1 IC IG k�S (QMMI'6S)0Y1Term NAME dY i (DAPi11 HOME ADDRESS 15'92- Ve,Sh I-al,19.f IC,b"ZZ'tD Is your home address within the corporate limits of Iowa City? Yes F]No How long have you lived in Iowa City? 3 y e y S Gender: MaleQ Female Contact # 311-333 -15'gQ Email Address Qnd rPs• GOh q mal • c,om CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: w&s on 1-h>, Co rn ni i 5 s i o ✓i sarin res, s, P.GI• ILe,I H i H be-W&r 4v c11oau bomec�rne et se. 1 -ab, e o rvrl-:Jn�' h� s � ra-F�er �-Kovn Fold rn s oF: I was ov1-o� I -h t_ e -c n0 - H -17 1,�h i le . 1 I�w� been aGhv p�l �, p . Pin ed ; n ct> m rn un 1h� i n h� hv�g ktir kv n1c,N , �Gvrh'Lvl car{ v��c-ham . Wo AA wP,I arh P, +4n e o qc v i rn I h,* con`Yi n ve.. wayr A � l slz%v`i�he•d on 14i e. WLJAT 10 Vf%1 10 00CCCU'r 1lh1A\A11 Cr%t%L- ^1 Tull A r% ne.Awv �A www •- • - ­ -. •.. _ . yr — .. nv__.I riv/1fw: N LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Merest none. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? R Yes FJNo DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes No (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 rn 1 IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? R Yes FJNo DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes No (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 ► r BOARD, COMMISSION AND COMMITTEES,�"1°�� BUSINESS LISTING CITY OF IOWA CITY Name of City Boa rd/Commission/CommitteeV MC11 1 �G h I�rn rn i5 510✓1 Date O / Name AareA sok en Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS CD �^ —a NOTE: A new form must be completed if the above information changes or an wnersl p interest is acquired in an additional business. Applicant Signature. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 I TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92.300 -- 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 ( 84,000 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various racial, religious, cultural, social and economic groups in the city." (Ord. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT, J-6 Age Gender Income (see table) h Sexual Orientation 1:1 Other (Please explain below) Human Rights Commission Application February 2015 page 4 of 8 I n/a � l Religion L_ Yl Ot Disability tin Race, color or ethnic group D5 �� National origin 2n City of Iowa City I r i Advisor Board/Commission/Committee Application Form FILED CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION UYF16 &PAPARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY ANCr, l TtQ 4 li ! -LY CONSIDERED FOR ANY VACANC DURING THAT TIME. riTY, I 1P;: Advisory Board/Commission/Committee Name _���LVI.K �• Q.1.f Ll, C M wA Ulf 6 Term 2 0 110'201 q NAME -& HOME ADDRESS 2 S . Ay -L w -Lo -t. Is your home address within the corporate limits of Iowa City? Yes F-] No How long have you lived in Iowa City? _ 2 I ,/s Gender: Male[] Female Contact # 3 t'ti, 3 5 y rH Y 2. Email Address e. JjZt Wt. 1.1; s 40.cd,„}-L I#&% Lc • L44"t CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: i k aV-t r,,. aL t-u;P4 4 s A k A..t v& cam, t ct a % s 16 6 t� 4 �" (�vrhKd.L-L to W �,e.1� t kt ht .� t L. S 1'�•i.t I A Ot I. 1 , t�-.e. v�e. 4 �- t * 64.4. k t K vo t Y -&A t�S,..}'�-1w� v� ►v 1 PH a. Lo vzs 4v a k,swrt !�r.& X 1.- ALvnvs ► W`L►� '1lu& Z -S LF J. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? V^w4.4. *"3!M A. It 1%+#% G w` wt t t 6tss,.� •� �.��-w,,l :,. j, 1�.. yw�. K..+ A.'�'�s-kt..t•e...�t wfr.�.i In s ti� � 7 1� t�l/�. "�.,M. Vii 1 ` sL�f./�+N� G t/ 1 K LIST POTENTIAL CONFLICTS OF INTE EST: S page 1 for informs iop rega ding Confligt of Inte IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ® Yes F -I No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? []Yes kNo (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING CITY OF IOWA CITY Name of City Board/Commission/Committee _ W4,•� �► �► w�wt is t 1"L- Date Name _ ; Iowa !TwV4 - w �< < Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Ir M.d. a r Qq NOTE: A new form must be completed if the above information changes or an owNdrship interest is acquired in an additional business. Applicant Signature t Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 1 2 3 30% Median Income (Poverty Level) $16,700 19,100 21.500 50% Median 60% Median Income Income 80% Median Income (low income) Median Income IS27,850 $33,420 $44,550 _ S55,700 63,600 71,600 31,800 38,160 50,900 35,800 42,960 57,250 63,600 4 23,850 39,750 47,700 79.500 85,900 _ 5 25.800 42,950 51,540 68,700 73,800 78,900 84,000 6 27,700 _ 46,150 55,380 49,300 59,160 92,300 7 29,600 -+-52,500 98,600 8 31,500 63,000 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of ttg city from discrimination as defined in the Human Rights Ordinance. In order to furtheg g0l, the city strives to ensure that the Human Rights Commission is representative qe Rmm. Therefore, "appointments shall take into consideration men and women 7tSf-awartdus ratial, religious, cultural, social and economic groups in the city." (Ord. 94-3647, 11 f4 ra r1 OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER�WHEN CHOOSING AN APPLICANT. Age Gender AA * 61 M Income (see table) Sexual Orientation ElOther (Please explain below) Human Rights Commission Application February 2015 page 4 of 8 Kt+K' Religion Mdli.s 1. 61- ?%vo Disability r•S Race, color or ethnic group V S National origin City of Iowa City Advisory Board/Commission/Committee Application Form CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANC' DURING THAT TIME. Advisory Board/Commission/Committee Name kxW\d'N't S Cn y(\KSS�aV� Term VA¢°0--\6 u NAME N i k0, rooe 5�e� HOME ADDRESS 9,604 �af'�eit� A4�'�i►�p►�1a Cit Is your home address within the corporate limits of Iowa City? Fy Yes ❑ No I-N6WA How long have you lived in Iowa City? \on Yv\oMW$ Gender: Male® Female ❑ Contact# �� 2i O� 0'960 Email Address h�`f�e1 CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: © A c�r\ Ye 00 vhY ho,rl\p- Cot-T*v7 beg�re 0' "Yhca k� k.%- \Y\ NAL,eoA Yv QAI5 ortl- t �°p L- ar � \ t oue � f itA of �Vwv^av\`��jY*- - WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? �: vis d,�n o P O� n��� ire (e� o,,vf k(•l fok \ n vine co rnyftxy\ (za v� ri tor'ocess \0e YwpeA c"> en ark e%c4 f'e reSe>n- m), Yyveb 'e o cor&7\w% k,MeBoras, Ca ihYY��S ONS MV.,A, ca ceeh V�"/'^e ►5e n Skke LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑ Yes o DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ❑Yes (If yes, please indicate which board would be your first choice to serve on.) QNo Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 c� 00 IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑ Yes o DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ❑Yes (If yes, please indicate which board would be your first choice to serve on.) QNo Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING moi► � r": fl) '�,� �Il�li� CITY OF IOWA CITY Name of City Board/Commission/Committee �\Lk^( 4`� NNN C0 4\V S'g 01'1 Date 1©' 213 1 Name [\J Section 362.5 of the. Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS j 1 M f': ::q %-AJ NOTE: A new form must be completed if the above information changes or ars f ns hip Wjrest is acquired in an additional business. Applicant Signature nc,k\Cs a.qqN rod 4� n� S�9v�. .ice k�n�st 'Yh�'��btr� �rl'g9e abOutl �3v s� h�SS or unhereS} a^n \ eadc 3,62r!; b e,,,,I� ���56.�,.�ajt° �rrt oy oy) � ,� Or - Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household 30% Median Income 50% Median 60% Median 80% Median Income (low income) Median Income Size (Poverty Level) Income Income 1 $16,700 $27,850 31,800 $33,420 38,160 $44,550 50,900 $55,700 63,600 2 19,100 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 31,500 52,500 63,000 84,000 105,000 g ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION it is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of 21rious racial, religious, cultural, social and economic groups in the city." lord. 94-3647,8-9� - co OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO 11611 WI CHOOSING AN APPLICANT. Y ry Age Religion Gender Ei\� Income (see table) EEV� :� Sexual Orientation 1:1 Other (Please explain below) Human Rights Commission Application February 2015 page 4 of 8 I _ )(I j Disability Race, color or ethnic group ( f 0 V- ► S44*\ 4 National origin City of Iowa City ► r — - Advisory Board/Commission/Committee =" Application Porta CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANC DURING THAT TIME. 44man Advisory Board/Commissi Committee Name 't$ (b'j� /(�h� Term NAME J0,/ HHOME ADDRESS , I LV 13 Is your hom4 address within the corporate limits of Iowa City? Yes F-] No How long have you lived in Iowa City? 7 xwf-s Gender: Maleo Female J2 Contact t(_�+g)6q,1_q8-1 q Email Address e Nr C;'3t'vl CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Tam (x p.I^,tt1 wu ha5 9pe-0(z �r���--�cfi`v,_ Cx/ar�C�r�� ¢r e i7a Y0��+2�5 �ar� 6 �co-��, 1��� l r h ,in Ll►'irnan r!l5, wr�s'�'°Jn�v,� �/r�ceo'e (t� �'/1cf�"new— nn �j' �'.""�" �P �1� sx .i WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? JKYes n No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSIO n Yes CgNo (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail I to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 c-� o M = c,a IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? JKYes n No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSIO n Yes CgNo (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail I to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 � r BOARD, COMMISSION AND COMMITTEES ( BUSINESS LISTING CITY OF IOWA CITY Name of City — Boa rd/Comm ission/Committ Date _ Name„Il fr1Q, �����Frih Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. _ BUSINESS NAME I BUSINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additioF)al business. i, A Applicant Signature C1- ; w t gMN Misrepresentations on this application will constitute just cause for removal o6 Wi si pp l to answer all the questions, Council may not consider your application. c.a General Application April 2015 Page 3 of 7 you fail TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 1 78,900 1 98,600 8 31,500 52,500 63,000 1 84,000 1 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various racial, religious, cultural, social and economic groups in the city." (Ord. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. Age Gender Income (see table) Sexual Orientation F-1 Other (Please explain below) Human Rights Commission Application February 2015 f 6 '2 Religion art isability mace, color y or ethnic group cLGS l National origin CD K'3 W. W r ! CJ "L7 r S page 4 of 8 �f City of Iowa Cid i r Advisory Board/Commission/Committee' c Application Farm CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANC DURING THAT TIME. Advisory Board/Commission/Committee Name Vey, a, n R " nj �, k . Term 2-,o NAME A- p % - `D, P� Q N- ors S HOME ADDRESS 25 3 2 ga I,-,R,L� •� r•Lo� 4k-1 C - Is your home address within the corporate limits of Iowa City? [V Yes F1 No How long have you lived in Iowa City? Gender: Male Female ❑ Contact # 1_1 �& 'S c(14 � q 6 2 Email Address CL J A © to J 2q Q �A 64--rn a4 0 CO -, CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR T141S PnSlTlnN- (' U � j� y6 v✓,V AOr\ V y1.1 Q _ WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? \)�J CA G6 .Tt- t.\� v^ E-� AS V^ -A --Irk mit _j LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest I-G> --/^ S, -.,,c,-\\ \,o \.,s ( v,,a a V\ - kk C-etb ) ra cz IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR OMM '. Yes [ZNo (If ves. Dlease indicate whirh Marti wni dri ha uni it fire+ ..+,.,c..e +., M '0 inMisrepresentations on this application will constitute just cause for removal df -an ap;dointee. If you fail to answer all the questions, Council may not consider your application. vwi ic, ai mppncauon April 2015 Page 2 of 7 �NAWMEM"=4 I BOARD, COMMISSION AND COMMITTEES ,x`01 BUSINESS LISTING CITY OF IOWA CITY Name of City Board/Commission/Committee Date Name Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS a ' ` `Z-5 3 2 " C ®vs- fi, v NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature C.;, Misrepresentations on this application will constitute just cause for removal dt'*i,ap inteV f you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective May 1, 2014 Household Size 30% Median Income (Poverty Level) 50% Median Income 60% Median Income 80% Median Income (low income) Median Income 1 $16,700 $27,850 $33,420 $44,550 $55,700 2 19,100 31,800 38,160 50,900 63,600 3 21,500 35,800 42,960 57,250 71,600 4 23,850 39,750 47,700 63,600 79,500 5 25,800 42,950 51,540 68,700 85,900 6 27,700 46,150 55,380 73,800 92,300 7 29,600 49,300 59,160 78,900 98,600 8 31,500 52,500 63,000 84,000 105,000 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various racial, religious, cultural, social and economic groups in the city." (Ord. 94-3647, 11-8-94) PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. Age VV",- *- Gender 2 5 qcry Income (see table) nn Sexual Orientation F-1 Other (Please explain below) IM S V, Religion S A0 \L. Q iS C-ar Disability ,�a 1 Race, color or ethnic group :5\J 4n �rn� �`�� , National origin a Human Rights Commission Application February 2015 page 4 of 8 rte; Human Rights Commission ATTENDANCE RECORD YEAR 20142015 (Mwfina natal NAME TERM EXP. 102/ 14 1021/ 14 11/18/ 14 12/15/ 14 120/ 15 2/17/ 15 3/17/ 15 4/1/ 15 421 15 5/19 15 6/16 15 721 15 8/18 15 Edie Pierce- Thomas 1/1/2016 - - - - X O/E X X X O/E X X X Joe D. Coulter 1/1/2016 X X X X X X X X X X X O/E X Harry Olmstead 1/1/2016 X X X X X X O/E X X X O/E X X Paul Retisb 1/1/2017 X O/E O/E X X X X X X X X X X All Ahmed 1/1/2017 X X X X O X O/E X X X O/E X X Orville Townsend, Sr. 1/1/2017 X X X X X X X X X X O/E X X Kim Haurahan I/l/2018 ' X X X X X X X X X X O/E X X Shams Ghoneim 1/1/2018 X X X X O/E X O/E X X X X X X Stella Hart 1/1/2018 X X X X X X X X X O/E X X X KEY: X - Present O = Absent O/E = Absent/Excused NM = No meeting — = No longer a member R = Resignation a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: PARKS AND RECREATION COMMISSION Two Vacancies — Four -Year Terms January 1, 2016 - January 1, 2020 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 18 years of age and live in Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Parks and Recreation Commission meet the second Wednesday of each month at 5:00 p.m. • Applications must be received by 5:00 p.m., Wednesday, November 4, 2015 Questions about the Iowa City Parks and Recreation Commission should be directed to Mike Moran, Parks & Recreation Director at 356-5110. A Council Member's spouse, domestic partner or partner by cohabitation, children, step- children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship. A current member of a City Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. A current member of a comparable County Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. PARKS AND RECREATION COMMISSION Two Vacancies — Four -Year Terms January 1, 2015 — January 1, 2019 Term expires for Cara Hamann and Joe Younker Council Announcement Date: September 15, 2015 Application Deadline: Wednesday, 5:00 p.m., November 4, 2015 Council Appointment Date: November 10, 2015 After 12/14/2015 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. Gender Balance Requirement: 1 Female, 1 None (M) Wayne Fett 811 Spencer Dr. (F) Cara Hamann 1112 2nd Ave. (F) Joylene Beadleston 1570 S. 1st Ave, Unit 13 (M) Joe Younker 1011 Sixth Ave. 0 17](Currently serving 1st term) ❑O ❑x (Currently serving 1s` term) Males: 4 Females: 3 El Denotes applicant completed the confidential page of the application. City of Iowa City 1 r 1 Advisory Board/Commission/Committee ift� i pplication Form CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURINGTHATTIME. p n Advisory Board/Commission/Committee Name i ikS "4 P eC I6"d f 0' 1 OOAt Term NAME U-)a�n e -Fe, 4+ HOME ADDRESS $ I ( WC-ak (I%Q.. -_0 14 Is your home address within the corporate limits of Iowa City? Yes ❑ No �� L`Fb How long have you lived in Iowa City? r7 VQQX b Gender: Maley❑ Female Contact #-3/9 " 5 `{/ lV 95 S Email Address W6 -P-+4 a gmcu i • Co At , CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: haJ¢ bFzc� ex Rv e { t 64&F -Z 4�E1' 3 ,il dab du4ice, En.c ace n�nn�,, �ar�w.ir��s za;0; '1orrL7 J s6t "U'eQ I : WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ke4 -to l -F ct�-k) mac- - d L ` 65, S,cv 2U S�aNcQ �-I*CJ Y14/y COKAAcissrvzn ,�o-kY.s J�2co& uePce+' k� i`tte Q/i�2Q4�Ck��Ct � Yi &LI'�5 /1. 0. ( � i�S Rk � i¢.r 1v�iLl.u-�C/ �fz tP� �4 ✓/CS Q�1 1 LIST"POTENTIAL dONFLICTS OF INTEREST: See page 1 for information regard/ ing Conflict of interest r.. C102. -moo �- 3 M tD IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? EZYes ❑ N; DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes QNo (If yes, please indicate which board would be your first choice to serve on.) ` Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail 1 to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City nn Board/Commission/Committee NCE��D Cts CQ Aeayx64 Name � r Ste wr®'o� CITY OF IOWA CITY Date q lJ Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME I BUSINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature a)a.,e,f V r--( Incn = rTn I� Misrepresentations on this application will constitute just cause for removal of a poVWRee. �f you fail I to answer all the questions, Council may not consider your application.;,; General Application April 2015 Page 3 of 7 City of Iowa City r , ®4 Advisory Board/Commission/Corit!#e �.� • wir®r0- i.dplication Form--�.••.- 7615GCT 13 AM 8 4 CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTIONwvigLL PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLYja P�Y1jALLY CONSIDERED FOR ANY VACAN( DURING THAT TIME. Advisory Board/Commission/Committee Name Parks & Recreation Term 1/1/16-1/1/19 NAME Cara Hamann HOME ADDRESS 1112 2nd Ave Is your home address within the corporate limits of Iowa City? Ft—/]Yes F—] No How long have you lived in Iowa City? 7 years Gender: MaleQ Female Q Contact # 319-594-5770 bi Email Address carahamann@gmail.com CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: am a current Parks & Rec commission member, applying to renew my position. I have enjoyed my time on the :ommission and feel I am qualified through my knowledge and use of the parks system. I am an avid bicyclist, -ner, and general lover of the outdoors. My background is transportation safety research, which is relevant to the .s & rec system in terms of access and utilization. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? aoc . fy� >s bdar-w Ja LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑V Yes ❑ No D'^ YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? FYes �✓ No (k -,es, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Veneral Application A—;1 001 r Dono 7 of 7 � r � BOARD, COM IIND COMMITTEES �rm,��1>I�, B (STING now: 2815 OCT 13 AN B. 54 CITY OF IOWA CITY Name of City CITY CLERK Board/Commission/Committee Parks & FWaWVgq- 10�VA Date 10/06/2015 Name Cara Hamann Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME I BUSINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant 1112 2nd Ave Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application Anril 7n1 r. Pnno 4 of 7 City of Iowa City r i Advisory Board/Commission/Committee, Application Form CITY OF OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT 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. I _ Advisory Board/Commission/Committee Name / of 15 Qin I jGrtej 7/ ( 6110 Termfix NAME ¢ (2 S HOME ADDRESSMO Is your ho le address within the corporate limits of Iowa City? Yes ❑ No How long have you lived in Iowa City? J Gender: MaleO Female Contact q t Email Address CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: 6A C6 piftr'j4Wt/1;/cZ P1XT'.0451'le 117atk,(- a/r)/recr �G/Yl en lR COY (n !7 /"J� �7/vbh/1i'isWat Ql/� (ppalFtt IP Sr WHAT IS YOUR,,PkESENT KNOWLE16GE OF THIS ADVWORY BOARD4 v � LIST POTENTIAL CONFLICTS OF INTEREST: See page 7 for information regarding Conflict of Interest N Qi �1 UI :»} C) i C _ M IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ®Yes ❑ ND DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION.-`, ❑Yes XNo (If yes, please indicate which board would be your first choice to serve on.) :1, ChUiqe' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. I General Application April 2015 Page 2 of 7 � r BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING CITY OF IOWA CITY Name of City' Board/Commission/Committee Date Namefl'.1L I FA Section 3d2.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if thele are none. I BUSINESS NAME I BUSINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature VIV Misrepresentations on this application will constitute just cause for removal ofb ppeintee,, you fail to answer all the f questions, Council may not consider your application.'" General Application ` Y` April 2015 Page 3 of 7`', F. James Bradley Byron G. Riley Patrick M. Courtney Donald G. Thompson Kelly R. Baier Gregory J. Seyfer Dean A. Spina Joseph E. Schmall Bradley G. Hart William J. Neppl William T. McCartan Maureen G. Kenney Vernon P. Squires Timothy J. Hill Paul D. Burns Janice J. Kerkove November 2, 2015 VIA HAND DELIVERY Marian Karr Iowa City City Clerk 410 East Washington Street Iowa City, IA 52240 Shannon P. Thompson Kimberly H. Blankenship Joseph W. Younker Jessica A. Doro Sherry L. Schulte Natalie K. Ditmars Raymond R. Rinkol, Jr. BRADLEY & RILEY PC Laura M. Hyer ATTORNEYS AND COUNSELORS Mark R. Van Heukelom CEDAR RAPIDS - IOWA CITY Ryan S. Fisher TOWER PLACE WEBSITE ADDRESS: ONE SOUTH GILBERT STREET www.bradleyriley.com IOWA CITY, IA 52240-3914 BRAD Y & RILEY PCO,*n EMAIL ADDRESS: TELEPHONE: 319-466-1511 jyounker@bradleyriley.com FAX: 319-358-5560 DIRECT DIAL: p 319-363.5569 RE: Iowa City Parks & Recreation Commission Application Dear Marian: Please find enclosed my application for the Iowa City Parks and Recreation Commission. Please contact me if you have any questions, or if you require any further information. Thank you. Very truly yours, BRAD Y & RILEY PCO,*n Mn N p 7 Jo ph W. Younker' F S� JWY Enclosure �r {01969245.DOCX} City of Iowa City r 1 ( Advisory Board/Commission/Committee; rLp .� Application Form CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. Advisory Board/Commission/Committee Name Parks and Recreation Commission Term 1/1/16-1/1/20 NAME ,Joe Younker HOME ADDRESS 1011 Sixth Ave. Is your home address within the corporate limits of Iowa City? [7 Yes ❑ No How long have you lived in Iowa Cky? Over 30 years Gender: MaleQ Female F Contact #319-321-5587 Email Address !Younker@bradleyriley.com CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Attachment A. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? See Attachment A. LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for infonnation regarding Conflict of Interest IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0✓ Yes F]No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? F] Yes No (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. if you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 See Attachment A. 7-. i `r. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0✓ Yes F]No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? F] Yes No (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. if you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Parks and Recreation Commission Name Joe Younker ► r 1 CITY OF IOWA CITY Date 11/02/2015 Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Bradley & Riley PC (my law firm) One South Gilbert Street, Iowa City, Iowa Easo-Et, Inc. 5952 Winthrope Street, Troy Mills, Iowa (wife is a shareholder in a family business) I '.r NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional bygines,% A Applicant Signature 1011 Sixth Ave. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 F. James Bradley Byron G. Riley Patrick M. Courtney Donald G. Thompson Kelly R. Baier Gregory J. Seyfer Dean A. Spina Joseph E. Schmall Bradley G. Hart William J. Neppl William T. McCartan Maureen G. Kenney Vernon P. Squires Timothy J. Hill Paul D. Burns Janice J. Kerkove November 2, 2015 VIA HAND -DELIVERY Marian Karr Iowa City City Clerk 410 East Washington Street Iowa City, IA 52240 Shannon P. Thompson Kimberly H. Blankenship Joseph W. Younker Jessica A. Doro Sherry L. Schulte Natalie K. Ditmars Raymond R. Rinkol, Jr. BRADLEY &RILEY PC Laura M. Hyer ATTORNEYS AND COUNSELORS Mark R. Van Heukelom CEDAR RAPIDS - IOWA CITY Ryan S. Fisher TOWER PLACE WEBSITE ADDRESS: ONE SOUTH GILBERT STREET WWW.bradleyriley.com IOWA CITY, IA 52240-3914 E-MAIL ADDRESS: TELEPHONE: 319-466-1511 jyounker@bradleyriley.com FAX: 319-358-5560 DIRECT DIAL: FS 319-363.5569 RE: Iowa City Parks & Recreation Commission Application Dear Marian: Please find enclosed Attachment A for my Parks and Recreation Commission Application. I neglected to include the attachment with the rest of my application materials which were delivered to your office earlier today. Thank you. Very truly yours, BRADLEY & RILEY PC J/oph er JWY Enclosure V FS �y cn crI t01969324.DOCX) Attachment A Contribution and/or activities which you feel qualify you for this position: My background as a lawyer will help qualify me for this position. I maintain a general practice including the areas of land use, environmental law, and civil litigation. My practice requires me to engage in creative problem solving, strategic planning, analysis of rules and regulations, and analytical thinking on a daily basis. Through my practice, I am also familiar with assessing financial information and developing budgets. I also have experience serving on other boards and commissions and have engaged in strategic planning for those groups. For instance, I am the Past President of the Board of Directors of the Iowa City Free Medical Clinic. In the past, I have served as a board member for Corridor Free Wireless, Iowa Volunteer Lawyers for the Arts, and the City High Alumni Association, among others. In 2012, I served on the City's Ad Hoc Zoning Committee. In 2014, I chaired the City's Ad Hoc Committee on Senior Services. I am also a graduate of the Iowa City Chamber's Community Leadership Program. All of these experiences will help qualify me for this position. Having lived here for over thirty years, I am very familiar with Iowa City. I attended Regina, South East, City High, and the University of Iowa. I have worked for many local employers ranging from a hardware store, a factory, and a department store, to a data center and a law firm. 4 I am invested in the community and expect that my experience of growing up in Iowa City will be of benefit to the Commission. As the parent of a toddler, I understand how important a strong Parks and Recreation system is for Iowa City's children. The Parks and Recreation Department's opportunities must be available to all of the City's youth. I live just a few blocks from Creekside Park, so I also understand how important a strong Parks and Recreation system is for the health of our neighborhoods. Neighborhood parks serve to foster strong, friendlier neighborhoods. I also understand the role that the Parks and Recreation system plays in the economic development of our city. A city with a variety of recreational and cultural opportunities will be in a better position to attract and retain employers and workers, and to improve the quality of life for its citizens. Also, I currently serve on the Parks & Recreation Commission. I have a good workinL relationship with the Department Staff and other Commissioners." What is your present knowledge of this advisory board? ry The Commission recommends and reviews rules, regulations, and budgets rel"-- -'to A Citr'H park system, recreation centers, and cultural functions. Additionally, the Com"sionflmvides input in the development of new parks and recreation opportunities. {01969154.DOCX} List potential conflicts of interest: Although it is unlikely that these relationships would present a conflict of interest, I am an attorney with Bradley & Riley PC, my wife is a freelance writer for The Gazette, and I serve on the Board of the Iowa City Free Medical Clinic. {01969154.DOCX} a,-, - 6Yc&n.agCn is f i n (-!I {01969154.DOCX} PARKS AND RECREATION COMMISSION August 12, 2015 Page 6 of 6 PARKS AND RECREATION ATTENDANCE RECORD NAME v r v7 'nv, w TERM ,-+ •� ao EXPIRE o a V-4 S Suzanne 1/1/17 X X X X X X X X X X O/E X X Bentler David 1/1/15 X X X X X X X O/E O/E X X X X Bourgeois Larry Brown 1/1/18 X X X X X X O/E X X X X X X Clay 1/1/18 X X X X X X X X X X X X X Claussen Maggie 1/1/17 O/E X X X O/E X X X O/E X X X X Elliott Cara 1/1/16 X X X X X O/E X X X X X O/E X Hamann Katie Jones 1/1/18 X X X X X O/E X X X X X * X Lucie 1/1/15 O/E X O/E X X X X X X X X O/E O/E Laurian Paul Roesler 1/1/18 * * * * * * * * * * * * X Joe Younker 1/1/16 O/E X X X X X X X X O/E KEY: X = Present O = Absent O/E = Absent/Excused NM = No meeting LQ = No meeting due to lack of quorum * = Not a member at this time 16e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMITTEE: PUBLIC ART ADVISORY COMMITTEE One Vacancy - Three Year -Term January 1, 2016 - January 1, 2019 Duties of the Committee: • include developing by-laws and procedures for the Iowa City Public Art Program; • administering the Public Art Program by determining the placement of public art, the type of art to be used in a specific project, and the artist to be engaged; • overseeing the acceptance of gifts of art; • overseeing the maintenance and disposition of public art; • overseeing expenditures of the Public Art Program budget. • Iowa City appointed members of boards and commissions must be at least 18 years of age and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Public Art Advisory Committee meets the first Thursday of each month at 3:30 p.m. • Applications must be received by 5:00 p.m., Wednesday, November 4, 2015. Questions about the Iowa City Public Art Advisory Committee should be directed to Marcia Klingaman, Neighborhood Services Planner at 356-5237. A Council Member's spouse, domestic partner or partner by cohabitation, children, step- children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship. A current member of a City Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. A current member of a comparable County Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. PUBLIC ART ADVISORY COMMITTEE One Vacancy — Three Year Term January 1, 2016 - January 1, 2019 Term expires for Tam Bodkin Bryk Council Announcement Date: September 15, 2015 Application Deadline: Wednesday, 5:00 p.m., November 4, 2015 Council Appointment Date: November 10, 2015 After 12/14/2015 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. Gender Balance Requirement: 1 Female No Applications as of Wednesday, 5:OOp.m., November 4, 2015 ODenotes applicant completed the Confidential page of the application. Males: 3 Females: 1 NOTICE 1171=9011V9816111ZNIWel aNPiTGVe71VA6YK61ZMIQ:[VIZ H_1:2Ii11Z1IAI:1t!Iifolk 1 ff. I:87i1411iPi91RKKULVA ILVA 1MUelZI SENIOR CENTER Two vacancies — Three -Year Term January 1, 2016 - December 31, 2019 The duties of members of the Senior Center Commission are to: • Serve in an advisory role to the City Council with regard to needs of the Senior Center. • Make recommendations with regard to policies and programs at the Senior Center. • Join staff and other interested persons in seeking adequate financial resources for operation of the Senior Center. • Encourage full participation by senior citizens in the programs of the Senior Center. • Ensure that the Senior Center is effectively integrated into the community and cooperates with organizations with common goals in meeting the needs of senior citizens. • Serves in an advocacy role with regard to the needs of senior citizens in Iowa City. • Iowa City -appointed members of boards and commissions must be at least 18 years for age and reside in the City of Iowa City. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. • The Senior Center Commission meets the third Tuesday of each month at 3:00 p.m. • Applications must be received by 5:00 p.m., Wednesday, November 4, 2015. Questions about the Iowa City Senior Center Commission should be directed to Linda Kopping, Senior Center Coordinator at 356-5225. A Council Member's spouse, domestic partner or partner by cohabitation, children, step- children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, mother-in-law, father-in-law, step-parent, brother, sister, step -siblings and half -siblings, brother-in-law, sister-in-law, grandparents and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, foster child, persons who are parents of the same child, and persons with whom the employee is in an intimate relationship. A current member of a City Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. A current member of a comparable County Board or Commission, unless dual or joint memberships are provided for in the resolution, ordinance, or statute which creates the Board or Commission to which appointment is being made. It is hereby established, as a formal policy of the City Council of Iowa City, that each application for reappointment to a City Board or Commission will be considered without regard to incumbency. If reappointed, an individual would be limited to one reappointment to a full term in order to increase the opportunities for new applicants to serve. SENIOR CENTER COMMISSION Two vacancies — Three Year Term January 1, 2016- December 31, 2019 Term expires for Charles Felling and Kathy Mitchell Council Announcement Date: September 15, 2015 Application Deadline: Wednesday, November 4, 2015 Council Appointment Date: November 10, 2015 After 12/14/2015 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. Gender Balance Requirement: 2 Female, 1 None Males: 3 Females: 1 (F) Kathy Mitchell ((Currently serving 1s` term) 722 Iowa Ave. (F) Joylene Beadleston t7 1570 S. Vt Ave.. Unit 7 A third vacancy is for an at -large member, who is an eligible elector of Johnson County Iowa but not a resident of the City of Iowa City, and will be appointed by majority vote of the six City Council appointees to the Commission. (Margaret Reese). ❑x Denotes applicant completed the Confidential page of the application. City of Iowa Cityt i , Advisory Board/Commission/Committee C MIL, r Xpplication Form --�-- CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT 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 Boardt ission ommittee Name yCWIOK CANTER Term 401b (- NAME a M 1fr HOME ADDRESS 711 .SQWq WhL24b Is your home address within the corporate limits of Iowa City? © Yes ❑ No How long have you lived in Iowa City? OXF- 1W Gender: Male❑ Female Contact# 31q-338- ` 0150 Email Address mi I cheII, Why 5 a,) small- com CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: 1 have been a tntmhero( the CeorcR 4irw Nov, Zoit,r 5erue on tZ,e 5t-eerjnq Counulj Outfe(theowmitfeei memhei011pCommiltee- o monoge the 144 ary, fie" Est , Gm port- Of (leaet,nq /loud, prererv,nq Spo,1-w mern61101, scry. f currerlt-� Serve Or) tyle Senlc✓ Crv)mlislvn. ovos DE031)uls-) WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? As 6 7-tff n �L-,S PW 0/AWWru' 0 5CV'08 cornMrssion cf have 000 0WOfiq Qdvdcafe fiy wto/s aylo iuoRken uERy ffnrn OPeGdrul w/zt#q rw— iMon of nuc M Hoc eommI rrci WcOA10-5ev-aat of my svggEs>^ious piw& t1VrJgg# n INro f rix- RtPa)q-- LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest Non e, CJ t CLL L O O IF YOU ARE NOT ALECTED, DO YOU WANT TO BE NOTIFIED? ® Yes n No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes ®No (If yes, please indicate which board would be your first choice to serve on.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail CI to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 BOARD, COMMISSION AND COMMITTEESNZI., r°`rwii s BUSINESS LISTING �,QTI .�,_ CITY OF IOWA CITY Name of City Board/Commission/Committee Date Name Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. I BUSINESS NAME I BUSINESS ADDRESS I NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 3 of 7 Marian Karr From: kathy mitchell <mitchell.kathy5@gmail.com> Sent: Saturday, October 17, 2015 11:22 AM To: Council Subject: Senior Center Commission I have applied for a second term on the Senior Commission. We are in the middle of fundraising and continuity is of the utmost importance. I am hopeful that the council will reappoint me for a second term. Thank You, Kathy Mitchell Senior Center Commission c City of Iowa City I r Advisory Board/Commission/Committeeulc�lil IIi.- SIM,®..� Application Form ""kA -- CITY OF IOWA CITY THIS APPLICATION IS A PUBLIC DOCUMENT WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCI DURING THAT TIME. Advisory Board/Commission/Committee Nan C nr a j^ l ('/ITS L,0tVMi$/O4 Term lhw rncot. NAME- LiLrw , ASL64N HOMEADDRESS I51O S. 1-1 Av,, t1n4E Is your hom�address within the corporate limits of Iowa City? � Yes [:] No How long have you lived in Iowa City? E2 Gender: Male[] Female Contact �I' .� Email Address_tuYbneL97Ieddfz-10gft40,eoh CONTRIBUTION AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: �am Q-1 0&w� twmr zr `S 41"?nor &4, r qnd l ra d f -f�2Ln 'yt?b5f (1-� l (• /7,��-�Q ahc(I n e ��`LLfjP.�l m Cs"rti�nS.e,O� 1 V :nm)Wvw *GtT. Cr an _ 3t� a6. /� fi3s arzG� cr✓x hvy�'`c }�. WHAT IS OUR PRESEN KNOWLEDGE OF THIS ADVISORY BOARD?KhO�/'Q, J "T LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for Information regarding Conflict of Interest Norm-. N _ CS C) CJ} O W �eC^ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [KYes O T] o DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION Yes RNo (If yes, please indicate which board would be your first choice to serve on.) c/ h!1% Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application April 2015 Page 2 of 7 I r BOARD, COMMISSION AND COMMITTEES0.`10�`t BUSINESS LISTING CITY OF IOWA CITY Name of City Board/Commission/Committee F eoal&�iot) Date Name LAO Section 36 .5 of the Code of owa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you, or your spouse/domestic partner, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. I i BUSINESS NAME I BUSINESS ADDRESS NOTE: A new form mA be complete ' the above information changes or an ownership interest is acquired in an add' on business.// r') CD C-3 y - q c-' Misrepresentations on t is application will constitute just cause for removal ofgo— inte you fail to answer all the questions, Council may not consider your application. A General Application April 2015 Page 3 of 7 Approved Minutes June 11, 2015 Senior Center Commission Attendance Record Year2015 Name Term Expires 6/19 7/17 10/23 11/20 12/18 1/22/15 2/13/15 2/19 3/19/15 4/16 5/21 6/11 Cheryll Ciamon 12/31/18 — — — — — X O/E X O/E NM X X Chuck Felling 12/31/15 X X X X NM X X X X NM X X Rose Hanson 12/31/14 X X X X NM — — — — — — — Jack Hobbs 12/31/16 X X X X NM O/E X X X NM X X Mark Holbrook 12/31/18 X X X X NM X X X O/E NM X X Jay Honohan 12/31/16 X X X X NM X X X X NM X X Kathy Mitchell 12/31/15 X X X X NM X X X X NM X O/E Margaret Reese 12/31/15 O/E X X X NM X O/E X X NM X X Key: X = Present O = Absent O/E = AbserWExcused NM= No meeting — = Not a member 11-10-15 L Wendy Mayer 17d t` Subject: FW: HCDC i From: angel taylor[mailto:angeltaylor99@hotmail.com] Sent: Wednesday, October 28, 2015 10:43 AM To: Kristopher Ackerson Subject: Re: HCDC Hi Kristopher, This email is to confirm that effective immediately, I am stepping down from my position from the HCDC due to personal obligations. It was a pleasure to have serve for the time that I did, and it is my hope that in the near future, I will be able to partake on the board. Thank you and it was a pleasure to meet you as well. Sincerely, Angel Taylor From: Mark Signs <mark@bigguyhomes.com> Sent: Friday, October 30, 2015 1:59 PM To: Peter Boer Cc: Kristopher Ackerson; Tracy Hightshoe; Council Subject: HCDC Resignation Peter, It is with great disappointment and frustration that I am submitting my resignation from the Iowa City Housing and Community Development Commission, effective at the end of the November Commission meeting. Upon further discussion with City Staff - and considerable thought and consideration on my part - it has become apparent that the conflict of interest limitations that are imposed on commission members due to Federal and State regulations are so broad in scope that I cannot effectively serve on the Commission while working in my chosen profession as a Realtor. I would either be forced to recuse myself from many (most?) programmatic and funding discussions and decisions made by the Commission, or I would be forced to sacrifice significant income potential during my time on the commission - plus for one year after my term ends. Unfortunately, I need to support my family. Hopefully City Staff, City Council and the Commission will review the application/nomination process for HCDC members, and can find a way to better emphasize these conflict of interest standards and expectations prior to anyone's future application or appointment to the Commission. As I discussed these standards with City Staff, it became apparent that the rules that members of this Commission are required to adhere to are likely the strictest of any city commission or even those required of City Council. Interesting, but unfortunate for me. It seems that many local business people would be challenged to serve within the current HUD conflict of interest guidelines. I am very excited that you will continue to lead the Commission forward in the coming years. I feel that the Commission, the City Council, and the community -at -large are poised to make some significant advances in improving the lives and housing opportunities for the thousands of lower-income, senior and disabled residents of Iowa City. It is a just cause and an important one! I look forward to serving on the commission one last time in November.