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HomeMy WebLinkAbout2018-01-16 AppointmentNotice The City Council Of Iowa City Is Considering Appointment To The Following Board: Airport Zoning Board Of Adjustment One vacancy to fill a five year term January 1, 2014 - December 31, 2018 • 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., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Board of Adjustment One vacancy to fill a five year term 1/1/2014 - 12/31/2018 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. Council Announcement Date: 8/20/2013 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 11/18/2013 After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: 0 Male: 1 Gender Name and Address No Applications 01-16-18 9b Notice The City Council Of Iowa City Is Considering Appointment To The Following Board: Airport Zoning Board Of Adjustment One vacancy to fill a 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., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Board of Adjustment One vacancy to fill a five year term 1/1/2016-12/31/2020 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. Council Announcement Date: 9/15/2015 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 12/14/2015 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender None Female:0 Male:1 Name and Address No Applications Ul -1 b-7 i3 9c Notice The City Council Of Iowa City Is Considering Appointment To The Following Board: Airport Zoning Commission One vacancy to fill a six year term January 1, 2018 - December 31, 2023 Duties of the Airport Zoning Commission are: • To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. • To recommend the adoption of new Airport Zoning regulations. The Board meets as required 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 Applications must be received by 5:00 p.m., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Commission One vacancy to fill a six year term 1/1/2018 -12/31/2023 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. Council Announcement Date: 12/5/17 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 3/5/1018 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 Female Current Gender Balance: Female: 0 Male: 1 Gender Name and Address Male Keitel, Dennis 1696 Ridge Road Male Wolford, Matthew Currently serving first term 1905 Jeffery St. t Advisory Board/Commission Application Form ry rarer This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY Or IOWA CITY considered for any vacancy during that time. UNESCO CRY Or EITERANRE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 1212112017 First Name* Dennis Last Name Kedel Home Address* 1696 Ridge Road City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number" 319-354-1949 Email Address keileldj@gmail com Boards & Commissions Select a Board or Commission you are interested in: Airport Zoning Commission Select a Board or Commission you are interested in Adjustment, Board of Select a Board or Commission you are interested in: Planning and Zoning Commission (P&Z) select a Board or Commission you are interested in Parks and Recreation Commission 2. How long have you been a resident of Iowa City?* 25 years 3. Occupation:* civil engineer 4. Gender:* Male S. Experience and/or activities which you feel qualifyyou for this position:* Licensed Professional Engineer, Private Pilot, previously served on lowa City Board of Adjustment 6. What Is your present knowledge of each advisory board you are Interested In?* general knowledge, except for Board of Adjustment which I am an expert. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract City Council Resolution # 15-300 established a policy that the following persons shall riot be eligible for appointment to Boards and Commissions: 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, sort-in4aw, 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* Iib 6. Do you currently serve on another Iowa City board or commission?* W Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 65 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion R. Catholic 13. Do you have a disability? No 14. Ethnicity caucasian 'NOTE: The Human Rights Commission s4ives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cukural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* e Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down i� t _4 Advisory Board/Commission Application Form y, �11I�1 This application is a public document and as such can be reproduced and distributed for r the public. This application well be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY OF LITERATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 11/16/2017 First Name Matthew Last Name Wolford Home Address* 1905 Jeffery St. City IOWA CITY State IA Zip Code 52246 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number 3093353944 Email Address" mattwolford 1 @gmail com Boards & Commissions Select a Board or Commission you are interested in:* Airport Zoning Commission 2. How long have you been a resident of Iowa City?' 7 years 3. Occupation: General Manager 4. Gender. Male 5. Experience and/or activities which you feel qualifyyou for this position:" Commercially rated pilot, aviation enthusiast, and I live off the approach end of one of the runways. 6. What is your present knowledge of each advisory board you are interested in? * I have served on this commission since 2012 and vould like to renew my position (it expires on 12131/2017). Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: 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-ir-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 Res. #15-300 states 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. Council policy is riot to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 27 10. Country of Origin United States 11. Sexual Orientation Straight 12. Religion Christian 13. Do you have a disability? No 14. Ethnlclty White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* �it AM 0. 1j —e Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down M01-16-18 9d Notice The City Council Of Iowa City Is Considering Appointment To The Following Board: Airport Zoning Commission One vacancy to fill a six year term January 1, 2016 - December 31, 2021 Duties of the Airport Zoning Commission are: To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. • To recommend the adoption of new Airport Zoning regulations. The Board meets as required 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 Applications must be received by 5:00 p.m., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp, Airport Operations Specialist at 356-5045. Board/Commission Application Cover Board/Commission: Airport Zoning Commission One vacancy to fill a six year term 1/1/2016 - 12/31/2021 It is hereby established, as a formal polity 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. Council Announcement Date: 3/1/2016 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 5/30/2016 After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: 0 Male: 2 Gender Name and Address Male Keitel, Dennis 1696 Ridge Road Male Wolford, Matthew Currently serving first term 1905 Jeffery St. Airport Commission April 7, 2014 Page 3 Airport Zoning Commission ATTENDANCE RECORD 2014 Key: X = Present X/E = Present for Part of Meeting O = Absent O/E = Absent/Excused NM = Not a Member at this time TERM o NAME EXP. J John Etheredge 12/31/14 X Christine Douglas 12/31/15 X Matthew Wolford 12/31/17 X Terry Dahms 03/01/16 X Key: X = Present X/E = Present for Part of Meeting O = Absent O/E = Absent/Excused NM = Not a Member at this time Notice The City Council Of Iowa City Is Considering Appointment To The Following Board: Board of Adjustment One Vacancy — Five — year term January 1, 2018—January 1, 2023 • Duties: The Board of Adjustment is a citizen panel that reviews requests for special exceptions and variances. • The Board also considers appeals when there is a disagreement about an administrative decision made by the City. • Members of the board act like judges, making decisions about individual properties and uses that may have difficulty meeting a specific zoning regulation or to resolve disputes about administrative zoning decisions. • The Board is assisted in its work by planning staff and the City Attorney's office. Decisions made by the Board of Adjustment are binding upon all parties unless overturned upon appeal to District Court. The Board meets the second Wednesday of each month at 5:15 p.m. 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 to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Board of Adjustment Commission should be directed to Sarah Walz, Associate Planner at 356-5239. Board/Commission Application Cover qe. Late Handouts Distributed Board/Commission: Adjustment, Board of I One vacancy to fill a five year term (Date) 1/1/2018-1/1/2023 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. Council Announcement Date: 9/19/2017 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 12/18/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender Male Male None Female:1 Male:3 Name and Address Hall, Ryan 200 S Summit St Keitel, Dennis 1696 Ridge Road Board/Commission Application Cover Adjustment, Board of One vacancy to fill a five year term 1/1/2018-1/1/2023 It is hereby established, as a fo al policy of the City Council of Iowa City, that a City Board or Commission will considered without regard to incumbency limited to one reappointment to a II term in order to increase the op po nit Council Announcement Date: 9 /2017 Application Deadline: Council Appointment Date: Date of Non -Gender Appointment: peh application for reappointment to reappointed, an individual would be �s for new applicants to serve. After datc\abgbe Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Femal . 2 ale: 2 Gender Name and Ad ess Male Hall, Ryan 200 S Summit St Male Keitel, Dennis 1696 Ridge Road BOARD OF ADJUSTMENT ATTENDANCE RECORD NAME TERM EXP. 8/10 9114 9121 9130 10112 1119 12114 1/11 4112 5110 6114 7112 PARKER, BRYCE 1/12022 — — — — — — — X 0/E X X O/E GOEB, CONNIE 1112020 X X X O/E X X X X X X X O/E CHRISCHILLES, T. GENE 1112019 X X X X X X X X X X X X SOGLIN, BECKY 1112018 X X X X X X X X X X X X WEITZEL, TIM 1/12021 X X X X X X X X X X X X KEY: X = Present O = Absent O/E = AbsenVExcused — = Not a Member MOM i CITY OF IOWA CITY VNEXOCIT OF UTEMMM Date of Application 1111312017 First Name Ryan Last Name Hall Home Addressor 200 S Summit St City IOWA CITY State A Zip Code 52240 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city linvts of lows City to apply 1. Is your horn address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 7347881810 Email Address* ryanryanhall@gmail.com Boards & Commissions Select a Board or Commission you are Interested In:* Planning and Zoning Commission (PBZ) Select a Board or Commission you are Interested in: Human Rights Commission Select a Board or Commission you are Interested in: Adjustment, Board of 2. How long have you been a resident of Iowa City?* January 2017 3. Occupation: * Student 4. Gender:* Male 5. Experience and/or activities which you feel qualify you for this position:* Three years service in AmeriCorps, Environmental Planning studies, ran for City Council in Iowa City, volunteered as Spanish interpreter for medical and legal clinics. 6. What is your present knowledge of each advisory board you are interested int* I am famliar with Planning and Zoning codes and the use of Form Based Code. I am familiar with Human Rights issues through my service in AmeriCorps. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenarally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: 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, brother4n-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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? Yes List potential conflicts of interest [See next page for information regarding conflict of Interest] Employed by Rocks Cole and Cole Law Firm Please identify any potenfial conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. 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). Business list of conflicts of interest Business Name * Cole Law Firm Business Address * 209 E Washington St, Ste 304 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the communityand the groups(s) which it serves, please provide your information for the following: 9. Age 24 10. Country of Origin United Stales 11. Sexual Orientation Pansexual 12. Religion n/a 13. Do you have a disability? No 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down ot .09A.9N 11"I CITY OF IOWA CITY UNESCO cm of LITERATURE Date of Application 12/21/2017 First Name ` Dennis Last Name* Keitel Home Address* 1696 Ridge Road City IOWA CITY State IA Zip Code 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application vall be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number* 319-354-1949 Email Address r` keiteldj@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Airport Zoning Commission Select a Board or Commission you are interested in:� Adjustment, Board of Select a Board or Commission you are interested in: Planning and Zoning Commission (P&Z) Select a Board or Commission you are interested in: Parks and Recreation Commission 2. How long have you been a resident of Iowa City? * 25 years 3. Occupation:* civil engineer 4. Gender:* Male S. Experience and/or activities which you feel qualify you for this position:* Licensed Professional Engineer, Private Pilot, previously served on lova City Board of Adjustment 6. What is your present knowledge of each advisory board you are interested in?* general knowledge, except for Board of Adjustment which I am an expert. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CB DG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federaly-assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. 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. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: 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-irrlaw, 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 65 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion R. Catholic 13. Do you have a disability? No 14. Ethnicity caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant's K/4rwel6 �Y1tl Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down as Notice The City Council Of Iowa City Is Considering Appointment To The Following Board: Board of Appeals One vacancy — Five Year term January 1, 2018 - December 31, 2022 HBA Representative or qualified by experience or training 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 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., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at 356-5122. Board/Commission Application Cover Board/Commission: Board of Appeals - Representative from Home Builders Association of Iowa City One vacancy to fill a five year term 1/1/2018-12/31/2022 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. Council Announcement Date: 9/19/2017 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 12/18/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: 1 Male: 3 Gender Name and Address No Applications 01-16-18 9g NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: COMMUNITY POLICE REVIEW BOARD One vacancy — unexpired term Upon appointment — July 1, 2021 • reviews police policies, procedures, and practices, and may recommend modifications to them. The board shall hold at least one community forum each year for the purpose of hearing views on the policies, practices and procedures of the Iowa City police department. • has only limited civil administrative review powers and has no power or authority over criminal matters or police discipline. It is not a court of law and is not intended to substitute for any form of legal action against the Police Department or the City. • reviews Police Department policies and practices and recommends changes to the City Council Iowa City -appointed members of boards and commissions must be 18 years of age and reside in the City of Iowa City. However, the City Council reserves the right to waive the residency requirement for good cause shown. The City Council also reserves the right, for good cause shown, to waive the requirement that the Board include one current or former "peace officer" as that term is defined by State law. The City of Iowa City encourages diversity in the appointment of people to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Community Police Review Board should be directed to Chris Olney at 356-5043. 1/5/2018 Board/Commission Application Cover Board/Commission: Community Police Review Board (CPRE) One vacancy to fill an unexpired term Upon appointment - 7/1/2021 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. Council Announcement Date: 12/5/2017 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 3/5/2018 After date above Council may appoint without regard to gender Gender Balance Requirement: 1 Female Current Gender Balance: Female:1 Male: 3 Gender Name and Address Male Ahmed, Ali 1520 McKinley Place Male Charles =1astham, anton St Female Johnson, Kristin 415 S. Van Buren St., Apt.1 Female McDonald, Sharon 1216 Jensen St Female Porter, Royceann 136 Appanoose Court Female Rose, Clare 928 E Bloomington St Male Taha, Mohamed Ahmed EI Mandi 2532 Bartelt Rd, #26 COMMUNITY POLICE REVIEW BOARD ATTENDANCE RECORD YEAR 2016-2017 (Meetime Date) KEY: X = Present O = Absent O/E — AbsenVEscused NM = No meeting — = Not a Member TERM 10/11 lln 11/15 IVIS 1/10 7114 7114 4112 519 7111 7131 a!6 Bl29 9112 10,10 IM4 NAME EXP. Joseph 7/1/17 X X X X X X X X O/ — — Treloar E — hlambir 7/1/21 O X O X X X O/E X O/ X X X X X X X sallh E Donald 7/1/19 O/E O/E O/E O/E O/E O/E X X X X X X X X X X Ions Monique 7/1/20 X X X X X X X X X X O/E X X X X X C,recn Orville 71120 X X X X X i X X X X X X X X X X X Towascad David 9/1/21 — — — — — — — — — X O/E X X O X O/E Selmer KEY: X = Present O = Absent O/E — AbsenVEscused NM = No meeting — = Not a Member r , �47*j"'®'®� Advisory Board/Commission/Committee m,r � CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. Advisory Board/Commission/Committee Name Date Nam in�rJ)t�r^t �C/ 1`�Cr{Ae.P_K.F �ij CSW �OGir� Home Address VXI14 ��// v Contact phone numberS,q q36 *(7) Email Address Cr L _+,;M,&w, aho1mou1-C6Wr Your home address must be within the corporate limits of Iowa City? \5 rnaj fess p. U. UvK A532 How long have you/dived in Iowa City?(" A Jc-e q/12 bDW�% Occupation: �e�Nip�UU��A�( 9GWA✓11"�� �Wne Gender: Male Female Experiences and/or activities which you feel qualify you for this position: I_ . n G)bo t✓ NlewibwI�ith I he SueJaviese A v,,krjeah A sso5i'&.�& sfAc-e 4 Q1300Yj Mewibe r I./ i' 11 Ce,,4,er �0L✓orR.,rat uS+ice . 5(ACe�10 t 2 0a Board merAbef wi4h "j'4unnah RiOW-S C0mMISSon5'I_WtVC4CjF j 5014 012 id MPmbe Y lvl+h,c✓CaC�a vc, ��ay PrUjee13C4ov�Catdv14, , What is your present knowledge, of this advisory /board? p 1141rfe f}�2nAl:1a)f Lvi�h Vw,rv�u��+yPJ�IC-2 l�et/i�iJ 13aa-v c�°I �� 1�%e�a���e 13001rd Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. 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. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shall not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children, step children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt,. uncle, niece, nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and persons whom the employee is.in an intimate relationship. Res. #15-300 states that each application for reappointment to a City Board or Commission will be conEdered.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. I— Council policy is not to permit an individual to serve on two Boards or Commissions at the same timetl''on will be asked to resign from one if appointed to another. Do you currently have a conflict of interest? YES_ NO—X- List potential conflicts of interest (See last page for information regarding conflict of interest) Please indicate if there are none. ADDRESS Do you currently serve on another Iowa City board or commission? YES_ NO_X_ If so which one do you prefer? The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) �which it serves, please provide your information for the following: Age 41 YeDrs Countryof Origin SLAC, L°l V — Sexual Orientation Religion 1_ S1aN(\ Do you have a disability? YES_ NO x Race, Color or Ethnic Group a a (_ k *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise finance and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. G+' _ r Advisory Board/Commission Application Form Flr�t This application is a public document and as such can be reproduced and distributed for 0 the public. This application will be considered for twelve months only and automatically CRY OF IOWA CITY considered for any vacancy during that time. UNESCO On OF LmMMU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 1/3/2018 First Name Charles Last Name Eastham Home Address* 953 Canton St City IOWA CRY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319 541-3972 Email Address eastham@outlook.com Boards & Commissions Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 45 years 3. Occupation:* Retired 4. Gender:* Male S. Experience and/or activities which you feel qualifyyou for this position:* I am currently actively participating in the following organizations and groups. My involvement with these groups requires analyang racial and ethnic disparities in numerous outcomes and developing strategies for reducing those disparities. lova City Community School District Equity Advisory Committee Center for Worker Justice Board of Directors Black Voices Project Coalition for Racial Justice 6. What Is your present knowledge of each advisory board you are interested Int* Currently, the Iowa City Community Police Review Board (CPRB) may review police policies, procedures, and practices, and recommend modifications to them as appropriate. The CPRB also provides a complaint process for claims of misconduct by individual police officers. At its April 18, 2017 Work Session the Council supported proposals by Police Chief Jody Matherly to aggressively address the lows City Police Department's disproportionate minority contact issues over the next five years by, among other measures, increasing the role of the CPRB in reviewing police policies. At the April 18, Work Session the Council also discussed a number of strategies proposed by Council Member Kingsley Botchwey to address racial disparities in ICPD policing outcomes. Those strategies include restructuring the CPRB so that the Board: • Focuses on policies and procedures and whether these policies and procedures align with community expectations; • Focuses on use of force data and whether patterns align with community expectations; • Reviews key areas of disproportionality and reports improvement; • Requires independent investigation of any police rrisconduct as determined by the CPRB If appointed, I am looking forward to working with other members of the CPRB, the police department and the Council to substantially reduce disproportionate minority contact by the ICPD and to conducting fair, thorough, and accurate investigations of misconduct complaints brought against individual officers. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describe some but not all potential conflicts. Potential Conflicts of Intent The Housing and Community Development Commission makes recommendations to the City Council regarding the disbibubon of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. 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. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: 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-ir-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 Res. 415-300 states 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 lens in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* Yes Board current serving on* Housing and Community Development Commission(HCDC) If Yes, preference on first choice* Community Police Review Board Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 76 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion None 13. Do you have a disability? NO 14. Ethnicity White 'NOTE: The Human Rights Commission staves to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant"` 6126444V 6 0"W Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I I Advisory Board/Commission Application Form rY #; —,=,I �t This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNFSCOCIY OF UUMIUU NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/5/2017 First Name Kristin Last Name Johnson Home Address* 415 S. Van Buren St., Apt.1 City IOWA CITY State IA Zip Code 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-594-1032 Email Address* sunshineariel99@gniaii.com Boards & Commissions Select a Board or Commission you are interested in:* Library, Board of Trustees Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Human Rights Commission Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) 2. How long have you been a resident of Iowa City?* 22 years 3. Occupation:* volunteer 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I am active in some support groups which help me slay connected to the community and help me to take good care of myself, and interact oath an interesting and diverse population in this city. 6. What is your present knowledge of each advisory board you are interested in?* I am aware that the library board term is a period of 6 years and helps determine policies and practices. I am aware that the Community Police Review Board is designed to help those concerned with criminal justice in this community. And I am aware that the Human Rights Commission is designed to help protect people with disabilities to be treated fairly in this community. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally—assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* M 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin USA 11. Sexual Orientation heterosexual 12. Religion Episcopal 13. Do you have a disability? Yes Please explain: I have a mental health condition which I manage wth medication and social activities and healthful activities. For example, I volunteer at a local peer support recovery center, volunteer for New Pioneer Co-op,& garden in the city garden. I also advocate with letters and phone calls to our elected representatives for a combination of issues I am concerned about, such as mental health parity, the environment and social justice.l also receive rental assistance. 14. Ethnicity Caucasian 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ( ll od&lar 0361 W Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will rat consider your application. You are encouraged to contact individual Council Members to express your interest in serving. t =d Advisory Board/Cornrnission Application Form t This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. uxEs Oo orurEsnruaE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 3/3112017 First Name Sharon Last Name McDonald Home Address* 1216 Jensen St City IOWA CITY State IA Zip Code 52246 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3196318270 Email Address* srrcdonald2128@grnail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 29 years 3. Occupation:* child care center director 4. Gender:* Female 5. Experience andlor activities which you feel qualify you for this position:* I have been interested in this topic for a long time. I live quite dose to the Pheasant Ridge complex I worked at the Fareway store on Mormon Trek for 14 years and got to know many of the residents of PR. I also used to live in the yellowlownhouses behind the Kwik Trip on MT. I was the 2016 precinct captain for these two neighborhoods and canvassed them personally and by phone quite often. I know that getting into these units is difficult and (also know there are significant challenges for those that do. 6. What is your present knowledge of each advisory board you are interested in?* I follow what's reported in the newspaper. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describes some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of Iowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members spouse, domestic partrier 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 Res. #15-300 states 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. Council policy is rot to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* KID 8. Do you currently serve on another Iowa City board or commission?* W Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 64 10. Country of Origin United States 11. Sexual Orientation n/a 12. Religion undarian 13. Do you have a disability? Yes Please explain: I have a bad back but I can valk fairly well win a walker. 14. Ethnicity caucasion 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ,Pater eWt0arrrl-t' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down er ..6 Advisory Board/Conrrrssion Application Form Is This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCOCITY OF UTERATURE NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 1/8/2018 First Name Royceann Last Name Porter Home Address* 136 Appanoose Court City IOWA CRY State A Zip Code' 42240 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number* (319)321-277 Email Address royceannporter@r n.com Boards & Commissions Select a Board or Commission you are interested in: Community Police Review Board (CPRB) 2. How long have you been a resident of Iowa City?* 25 years 3. Occupatlon: Teamster Union Organizer - 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have worked in a number of positions in the Iowa City community that have given me a variety of experiences into many facets of the Iowa City Governmental operations in the Iowa City community. Working with the Family to Family Program, Center For Worker's Justice, Coalition For Racial Justice, Shelter House, Juvenile Courts, Black Voices Project and the N.A.A.C.P. have provided me with a perspective of Justice from many points of view. Opportunities to listen to concerns regarding underrepresented community members and others helped me to be engaged in providing assistance and resolving conflicts related to misunderstandings about police protocol. it is with confidence and skilled development that I bring to this Citizen Review Board an experienced, dedicated and open minded member of the Iowa City Community. I would also like to add that my involvement with the Police Chief Round table has opened my eyes to the complexties in working together with a diverse population who encounter the officers on a regular bases. Communicating with ALL groups is a large part of ensuring a fair and equitable process. 6. What is your present knowledge of each advisory board you are interested in? * My current knowledge of the Citizen Police Review Board is associated with understanding the mission of the police department to be fair to all patrons and to use the CPRB to communicate the City's mission to provide due process for both officers and community members. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest? No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 52 10. Country of Origin United States 11. Sexual Orientation Straight 12. Religion Baptist 13. Do you have a disability? INo 14. Ethnicity African American 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* i =0 t Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down r AdvisoryBoard/CommissionApplication Form �t This application is a public document and as such can be reproduced and distributed for may._ the public. This application will be considered for twelve months only and automatically CITY OF IOWA CIN considered for any vacancy during that time. UNESOOCITY OF UTEAATURE NOTE: Must be 18 years of age and live within city limits of Iowa City to apply Date of Application 4/4/2017 First Name Clare Last Name Rose Home Address* 928 E Bloomington St City IOWA CITY State IA Zip Code 52245 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3192130477 Email Address* cmartin204@gniail.com Boards & Commissions Select a Board or Commission you are interested in:* Housing and Community Development Commission(HCDC) Select a Board or Commission you are interested in:* Community Police Review Board (CPRB) Select a Board or Commission you are interested in:* Historic Preservation Commission (HPC) Historic Preservation Commission Category* North Side 2. How long have you been a resident of Iowa City?* 26 years 3. Occupation:* Technical Project Manager 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* I have been a project manager for five years at Pearson Education. My skills as a project manager, including gathering information from stakeholders, planning processes and documenting decisions I feel would be applicable to these commissions. Previously 1 was a research intern at a small think tank in Washington DC called SpiritHouse, where I was tasked with gathering large amounts of research and distilling it down into easily understandable pieces for press releases. In college I worked for a development firm who built low. income assisted living facilities in Iowa City, I was tasked with reviewing potential resident applications and approving income requirements. Finally, I have lived in Iowa City for 26 years, experiencing it as a child, a college student and finally an adult. I have the good fortune to be able to call on the perspectives of these multiple roles in considering issues that night come to the attention of these commissions. 6. What Is your present knowledge of each advisory board you are Interested in?* I have limited knowledge of the specifics of each of these advisory boards. I have lived in the Northside neighborhood most of rry life and from a citizen observer perspective I am fanuliar with some of the duties of the Historic Preservation Commission. Regarding the Housing and Community Development Commission, I have reviewed the agendas and notes from the last few meetings. I recognize the role this commission plays in programs such as UniverCity and it work in providing assistance in allocating funds towards affordable house in Iowa City. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted acfivity either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowageneraly prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a Citycontract. City Council Resolution # 15-300 established a policythat the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, 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-iri-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 Res. #15-300 states 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 tern in order to increase the opportunities for new applicants to serve. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* tb 8. Do you currently serve on another Iowa City board or commission?* Kb Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 34 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? 1% 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* ewl-I/{, w Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will rat consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Vf Advisory Board/Commission/Committee CITY OF IOWA CITY Application Form UNESCO CITY OF LITERATURE This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. Advisory Board/Commission/Committee Name a L/ re Date ofApplication l / Name Apr�tMt?A 5L MaYI � Home Address „253 Contact phone number,`3a r/,Z 97-33 Email Address. Your Your home address must be within the corporate limits of Iowa City? How long have you lived in Iowa City? 3P �(/rS ti _ o L [/ C7 Occupation: S'Vn t�(i/J -_ h o Gender: Male _Lewo:f Female C-) �,; nT. m ��FW Experiences and/or activities which you feel qualify you for this position: ,L)d1LZFirS1c� %��jmjg �Po What is your present knowledge of this advisory board? /40 �adp i4 ti-aAAW-m) Fv/„ noA enj4s/i 5ped2-t- eb) d -&z�- -10 e M k w o%d wi// (ejd Auov17Cq � �e "' 6r6e G�o'./ 444u �n��r�21 SIf�A�ioNSi 1v14,i'eLj,/1y I c�,2 Ate, s, (it l✓1 OA a lrl"Cted' art 61/ a/J✓iCes To Ldla qs~P haf q u/,�r-e NAvaf the le)ed / SSrceS y Please contact the city attorney at 319-356-5030 to discuss questions or concerns regarding a potential conflict of interest. Potential Conflict of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision—making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, agreement with respect to the proceeds of the federally—assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. 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. Section 362.5 City Council Resolution #15-300 established a policy that the following persons shall not be eligible for appointments to Boards and Commissions. A council member's spouse, domestic partner or partner in cohabitation, children, step children, children for whom the Council Member assumes parental responsibility, mother, father, son-in-law, daughter-in-law, sister-in-law, grandparents, and grandchildren, aunt, uncle, niece, nephew, first cousin, foster parent, poster child, persons who are parents of the same child, and persons whom the employee is in an intimate relationship. Res. #15-300 states 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. N 0 Council policy is not to permit an individual to serve on two Boards or Commissii5hs at the' same time. You will be asked to resign from one if appointed to another. rC= A' " Do you currently have a conflict of interest? YES_ NO ---q C-) r M List potential conflicts of interest (See last page for information regarding conflict,l�junterast) Please indicate if there are none. v .. ry E Do you currently serve on another Iowa City board or commission? YES_ NO—Z If so which one do you prefer? The City Council values all types of diversity on its boards and commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the board and commission is representative of the community and the groups(s) which it serves, please provide your information for the following: Age 62 Country of Origin Sl/ Dan Sexual Orientation M d.1 e Religion m,u < 1:1 M Do you have a disability? YLS NO t -- Race, Color or Ethnic Group��/�aq M (G N *Note: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise finance and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Contact information is attached. o n t (- CJi M Tr O� q O 'T a9h Notice The City Council Of Iowa City Is Considering Appointment To The Following Commission: Historic Preservation Commission One Vacancy to fill a three year term July 1, 2016 — July 1, 2019 (1) Jefferson St Representative 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. • Applicants for district representatives to the Historic Preservation Commission must reside in the district that is specified. 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., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Historic Preservation Commission should be directed to Bob Miklo, Sr Planner at 356-5240. 1/5/2018 Board/Commission Application Cover Board/Commission: Historic Preservation Commission -Jefferson St. One vacancy to fill a three year term 7/1/2016- 7/1/2019 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. Council Announcement Date: 1/6/2016 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 4/6/2016 After date above Council may appoint without regard to gender Gender Balance Requirement: Current Gender Balance: Gender None Female:5 Male:5 Name and Address No Applications 01-16-18 9i 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, 2018 — January 1, 2021 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. • overseeing the Poetry in the Public Program. 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 to boards and commissions. Applications must be received by 5:00 p.m., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icgov.org. or by contacting the Clerk's office. Questions about the Iowa City Public Art Advisory Committee should be directed to Marcia Bollinger, Neighborhood Outreach Coordinator, 356-5237 or Marcia-Bollinger@Iowa-City.org. Board/Commission Application Cover Board/Commission: Public Art Advisory Committee One vacancy to fill a three year term 1/1/2018 -1/1/2021 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. Council Announcement Date: 9/19/2017 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 12/18/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: 4 Male: 0 Gender Name and Address Male Miller, Steven Public Art Professional 515 Oakland Ave Female Mitchell, Samantha Public Art Professional 1330 Highland Ave Female Purington, Nancy Public Art Professional __TTruitt, 1706 Prairie du Chien Road Female Andrea At -Large 815 N. Johnson St. Public Art Advisory Committee Attendance Record 2016.2017 Name Term Expires 3/3 515 8/4 9/15 11/3 1/5 215 31214/6 Bodkin Bryk, Tam 01/01/19 O/E x x OlE x I X x O/E O/E Brown, Wend 01/01/20 -- — — — — — x x x En elbrecht, John 01/01/18 X x O/E X X X x x O/E Hemann Sayuri Sasaki 01/01/18 X X X X X X x O/E x Erin Fitz erald 01/01/20 — — — — — — — x x Knoche, Ron X JFJ X X x x I x Se dell -Johnson, Jul! X X I X I O!E x x x x x Key: X = Present 0 n Absent O/E = AbSel UB=sed — = Not amember I r Advisory Board/Commission Application Form ,� It 1 Its, This application is a public document and as such can be reproduced and distributed for r the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNEKOCITYOFUTE MT NOTE: Must be 18 years of age and live within city limits of lows City to apply Date of Application 1/5/2018 First Name Steven Last Name Miller Home Address* 515 Oakland Ave City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 3193897519 Email Address* daedaldesigns@gmaii.com Boards & Commissions Select a Board or Commission you are interested in: Public Art Advisory Committee Public Art Advisory Committee Category* Art or Design Professional 2. How long have you been a resident of Iowa City?* lowa City 3. Occupation:* Architect 4. Gender:* Male S. Experience and/or activities which you feel qualify you for this position:* As an architect, I think daily about the effects of the built environment. rely favorite projects are inherently public and use design to improve the Hell -being of the community members who use the space. I am passionate and curious about art, poetry, urbanism and how local government affects public space. Artists such as James Turrell, Richard Serra, Andy Goldsworthy, and Theaster Gates are sources of great inspiration. My professional skill set (design, project management, building codes and arcing review, cross -disciplinary coordination, and budget administration) are a good fit for the duties of the Public Art Advisory Committee as described on the city website. I love Iowa City and would be honored to contribute to our local government and enhance our public spaces by serving on the Public Art Advisory Committee. 6. What is your present knowledge of each advisory board you are Interested In?* I first learned of the Public Art Advisory Committee while reading the City Council minutes and noticed that my high school friend, Erin Fitzgerald, was on the committee. I asked her about it the next time I saw her and was intrigued as it seemed to combine so many of my interests and passions. I recently met John Engelbrecht to learn more about the great work that PS1 is doing and discussed his role on the PARC. The third straw that convinced me to apply was a panel discussion for my Community Leadership Program where Kingsley Botchway encouraged us to get involved with local government and specifically mentioned the commissions and committees. I understand that the committee meets the first Thursday of each month at 3:30 PM. I work downtown and would have no problem attending the monthly greetings. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describe some but not all potential conflicts. Potential Conflicts of Intent The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* 10 8. Do you currently serve on another Iowa City board or commission?* W Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative oft xa community and the groups(s) which it serves, please provide your information for the following: 9. Age 35 10. Country of Origin United States 11. Sexual Orientation Heterosexual 12. Religion Christian 13. Do you have a disability? No 14. Ethnicity Caucasian `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down Advisory Board/Commission Application Form 11E� IN i This application is a public document and as such can be reproduced and distributed for w� the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESOOOTY OF UTEMN0.E NOTE: Must be 18 years of age and live Wthin city limits of lom City to apply Date of Application 11/16/2016 First Name IF Samantha Last Name* Mitchell Home Address* 1330 Highland Ave City IOWA CITY State IA Zip Code* 52240 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 540-435-2013 Email Address* samantha-rritchell@uiom.edu Boards & Commissions Select a Board or Commission you are interested In:* Public Art Advisory Committee Public Art Advisory Committee Category* Art or Design Professional 2. How long have you been a resident of Iowa City?* 5 years 3. Occupation:* Metalsmith and Healthcare professional in Quality and Safety 4. Gender:* Female 5. Experience and/or activities which you feel qualify you for this position:* rm a local artist, with an MFA, and BFA, in metalsmithing. My work has shown nationally at the Walker Art Center in MN, the Greenville Museum of Art, NC, and Arrownront School of Craft, TN. it has also shown internationally in Holland, France, and Lithuania to name a few. Last year I was featured in American Craft Magazine, Metalsrrith Magazine, and wrote for Art Jewelry Magazine.Locally I partner with Urs Ar Share to provide outreach workshops to smaller communities across Iowa. 6. What is your present knowledge of each advisory board you are interested In?* I know that board reviews public arts submissions, allocates funds, oversees donations, creates bylaws, oversees maintenance. Communicates with the community to discuss their wishes and relay board decisions Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of Interest. The following describea some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted acfivily, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family lies, during their tenure or for one year thereafter. Section 362.5 of the Code of bwageneralty prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, 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-ir-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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 31 10. Country of Origin us 11. Sexual Orientation Heterosexual 12. Religion Atheist 13. Do you have a disability? No 14. Ethnicity Caucasian `NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* "'^ A&& N �y Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. _�_,� Advisory Board/Commission Application Form 716 S This application is a public document and as such can be reproduced and distributed for OT the public. This application will be considered for twelve months only and automatically CITY OF IOWA CITY considered for any vacancy during that time. UNESCO CITY Of LITERATURE NOTE: Must be 18 years of age and live wthin city limits of Iowa City to apply Date of Application 1 11412 01 7 First Name Nancy Last Name Purington Home Address 1706 Prairie du Chien Road City IOWA CITY State IA Zip Code TE 52245 1. Is your home address (listed above) within the corporate limits of Iowa City? Yes Contact Phone Number 3195946789 Email Address* nancypurington@gmail.com Boards & Commissions Select a Board or Commission you are interested in:� Public Art Advisory Committee Public Art Advisory Committee Category Art or Design Professional 2. How long have you been a resident of Iowa City? 40 years 3. Occupation:" Art Consultant, Visual Artist 4. Gender: Female 5. Experience and/or activities which you feel qualify you for this position:* MFA Visual Art. Pubic Art Consultant, 28 years experience. Helped to design the Iowa City Public Art Program via the Arts/Business Partnership Committee of the Iowa city Area Chamber of Commerce 1997. Past President of Arts lova City and member since 1978. Designed concept narrative for the Iowe Avenue Literary Walk with the City of Iowa City as a Public Art Consultant. 6. What is your present knowledge of each advisory board you are interested in? While president of Arts Iowa City, I helped to design and propose the love City Public Art Program via the Arts/Business Partnership Committee of the Iowa City Area Chamber of Commerce 1996. Public Art Programs across the country were reviewed and incorporated. Accepted by IC City Council 1997. Served on first PAAC committee as both member and Chair. As a senior citizen, I once again have the time to devote to working as a volunteer to help the lova City Public Art Proposal maintain and grow its mission. Please contact the City Attorney at 356.5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate familyties, during their tenure or for one year thereafter. 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. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Members 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* W 8. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. in order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 70 10. Country of Origin 11. Sexual Orientation 12. Religion 13. Do you have a disability? 14. Ethnicity multi 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant's Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down I 241 O w.r._ CITY OF IOWA CITY UNESCO CITY OF UTERATURE Date of Application 11/1212017 First Name Andrea Last Name Truitt Home Address* 815 N. Johnson St. City IOWA CITY State IA Tip Code 52245 Advisory Board/Commission Application Form This application is a public document and as such can be reproduced and distributed for the public. This application will be considered for twelve months only and automatically considered for any vacancy during that time. NOTE: Must be 18 years of age and live within city limits of Iowa City to apply 1. Is your home address (listed above) within the corporate limits of Iowa City?* Yes Contact Phone Number* 319-359-8388 Emall Address* andrea.m.truitt@gmail.com Boards & Commissions Select a Board or Commission you are interested in: Public Art Advisory Committee Public Art Advisory Committee Category* At -Large 2. How long have you been a resident of Iowa City?* 3.5 years 3. Occupation:* Administrative Professional 4. Gender:* Female S. Experience and/or activities which you feel qualify you for this position:* My work and academic experience within the field of American art history make me a strong candidate for the Public Art Advisory Committee. I would love to combine my knowledge of American art with my love of Iowa City and interest in its collective well-being, of which public art is integral. I am currently on the board of the Association of Hstorians of American Art, acting as Web Coordinator since January 2017. We are an organization consisting of university faculty, museum professionals, and independent scholars who study American art (broadly defined as fine art, popular art, architecture, and material culture) from the seventeenth century to the present. We meet virtually, once per quarter, and because of this virtual format, clear and concise communication is key to success. 1 can easily transfer these skills over to the Public Art Advisory Committee and would love to be involved in more frequent and interactive committee work that has local relevance. I also hold a PhD in art history from the University of Minnesota, studying the American built environment, of Mich public art is most certainly a factor. People experience and interact with buildings and outdoor areas every day, and they are affected in different ways given race, gender, and socioeconomic status. I understand this as both an historian and as a citizen of Iowa City. it is not enough to make an aesthetic judgment on an artwork or to know only about the artwork itself; we must understand the location of installation, the demographics of the area it will be placed, and the history of Iowa City in order to fully contextualize the artwork. I understand all of this, and I knowthat I would be a valuable committee member. 6. What is your present knowledge of each advisory board you are Interested in?* I understand that the advisory committee takes care of many practical issues of public art projects, from the administering of grants to artists, to advising the city on appropriate artists and locations of projects to meaningfully enhance lows City and its quality of Irfe for residents. Please contact the City Attorney at 356-5030 to discuss questions or concerns regarding a potential conflict of interest. The following describe some but not all potential conflicts. Potential Conflicts of Interest The Housing and Community Development Commission makes recommendations to the City Council regarding the distribution of federal CBDG/HOME funds. The general rule is that no persons who exercise or have exercised any functions or responsibilities with respect to federally funded activities, or who are in a position to participate in the decision-making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a federally -assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a federally -assisted activity, or with respect to the proceeds of the federally -assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. Section 362.5 of the Code of lowagenerally prohibits, with certain important exceptions, a member of a City Board or Commission from having an interest in a City contract. City Council Resolution # 15-300 established a policy that the following persons shall not be eligible for appointment to Boards and Commissions: A Council Member's spouse, domestic partner or partner by cohabitation, children, stepchildren, 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 Res. #15-300 states 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. Council policy is not to permit an individual to serve on two Boards or Commissions at the same time. You will be asked to resign from one if appointed to another. 7. Do you currently have a conflict of Interest?* No S. Do you currently serve on another Iowa City board or commission?* No Demographic Information The City Council values all types of diversity on its Boards and Commissions. Your responses on this page provide valuable information to the Council in achieving that goal. In order to ensure that the Board and Commission is representative of the community and the groups(s) which it serves, please provide your information for the following: 9. Age 33 10. Country of Origin LISA 11. Sexual Orientation 12. Religion 13. Do you have a disability? No 14. Ethnicity White 'NOTE: The Human Rights Commission strives to ensure the Commission is representative of the community. Therefore, appointment shall take into consideration persons of various racial, religious, cultural, social and economic groups in the city. (Ordinance) The Housing and Community Development Commission strives to satisfy its purpose and intent, when possible to have at least one person with expertise in construction, at least one person with expertise in finance, and one person who receives rental assistance. (Resolution) Signature of Applicant* Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, except demographics, Council will not consider your application. You are encouraged to contact individual Council Members to express your interest in serving. Drop-down a9i NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION One vacancy— Three -Year Term July 1, 2017—July 1, 2020 • 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 cable 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; • monitoring and promoting community programming and the use of the local access channels by a wide range of individuals, institutions, and organizations; • informing and educating citizens on matters related to cable TV and other communications systems; and monitoring and reviewing State and Federal legislative and regulatory action or change • Iowa City -appointed members of boards and commissions must be at least 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 Telecommunications Commission meets the fourth Monday of each month at 5:30 p.m. Applications must be received by 5:00 p.m., Tuesday, January 9, 2018. An application can be completed and submitted on the City of Iowa City website at www.icclov.ora. or by contacting the Clerk's office. Questions about the Iowa City Telecommunications Commission should be directed to Ty Coleman, Media Production Services Coordinator, at 356-5454. 1/5/2018 Board/Commission Application Cover Board/Commission: Telecommunications Commission One vacancy to fill a three year term 7/1/2017 - 7/1/2020 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. Council Announcement Date: 3/21/2017 Application Deadline: 1/9/2018 Council Appointment Date: 1/16/2018 Date of Non -Gender Appointment: 6/19/2017 After date above Council may appoint without regard to gender Gender Balance Requirement: None Current Gender Balance: Female: 1 Male: 2 Gender Name and Address No Applications