HomeMy WebLinkAboutCity of Tamarac Resolution R-2021-027 Temp. Reso. #13544
Feb. 23, 2021
Page 1 of 3
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2021
A RESOLUTION OF THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA, APPOINTING
FIVE MEMBERS (5) TO THE SISTER CITIES
COMMITTEE; TO SERVE TERMS CONCURRENT
WITH THEIR APPOINTING COMMISSION
MEMBER, OR UNTIL SUCH TIME AS NEW
APPOINTMENTS ARE MADE; PROVIDING FOR
CONFLICTS; PROVIDING FOR SEVERABILITY;
AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the City Commission is desirous of appointing five members to
the Sister Cities Committee ; and
11111 WHEREAS, the City Commission created the Sister Cities Committee
through Ordinance No. 0-2020-002 and 0-2021-006; and
WHEREAS, members of the Sister Cities Committee shall serve terms in
accordance with the terms and provisions of §2-59 of the City's Code of
Ordinances; and
WHEREAS, in accordance with §2-57 and §2-58 of the Tamarac Code, the
City Commission shall select qualified individuals to their respective positions ; and
WHEREAS, the City Commission of the City of Tamarac, deems it to be in
the best interest of the citizens and residents of the City of Tamarac to appoint five
members to the Sister Cities Committee, in accordance with the procedures
provided for in § 2-58 and §2-59 of the Tamarac Code ; and
Temp. Reso. #13544
Feb. 23, 2021
Page 2 of 3
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA THAT:
SECTION 1: The foregoing "WHEREAS" clauses are hereby ratified and
confirmed as being true and correct and are hereby made a specific part of this
Resolution. All exhibits attached hereto are incorporated herein and made a
specific part of this Resolution.
SECTION 2: That the following individuals are hereby appointed to serve
as members of the Sister Cities Committee, and to serve terms concurrent with
their appointing commission member, or until such time as new appointments are
made.
Name of Appointee Committee Commission District Term Ending •
Patricia Parkins Sister Cities 1 Nov. 5, 2024
Delvin Rogers Sr. Sister Cities 2 Nov. 8, 2022
Jacqueline Campbell Sister Cities 3 Nov. 5, 2024
Adam Reynolds Sister Cities 4 Nov. 8, 2022
Jay Koutcher Sister Cities Mayor At Large Nov. 8, 2022
SECTION 4: All resolutions or parts of resolutions in conflict herewith are
hereby repealed to the extent of such conflict.
SECTION 5: If any clause, section, other part or application of this
Resolution is held by any court of competent jurisdiction to be unconstitutional or
invalid, in part or application, it shall not affect the validity of the remaining portions
or applications of this Resolution.
SECTION 6: This Resolution shall become effective immediately upon
adoption.
Temp. Reso. #13544
Feb. 23, 2021
Page 3 of 3
110
PASSED, ADOPTED AND APPROVED this 1011`°" day of mHf2C4
2021.
i/i/A Jdichelle J. Gomez
MAYOR
ATTEST:
Jennif Johns n, .,MC
CITY CLERK
• RECORD OF COMMISSION VOTE:
MAYOR GOMEZ
DIST 1: COMM BOLTON "7'
DIST 2: COMM. GELIN
DIST 3: VIM.VILLALOBOS
DIST 4: COMM. PLACKO
I HEREBY CERTIFY that I have
approved this RESOLUTION
as to form.
H S TTINO
II1TERIM CITY ATTORNEY
TAMARAC CITY OF TAMARAC
APPLICATION FOR BOARD AND COMMITTEE
The City For Your Life APPOINTMENTS
Service on an advisory Board or Committee provides citizens with an opportunity to help shape future policy and
strategic direction for the City of Tamarac. Tamarac residents are cordially invited to apply for appointment by the
City Commission to a Board or Committee. Advisory board and committee members are voluntary positions and
serve without benefit of compensation.
Please check Boards/Committees for which you wish to be considered:
Parks and Recreation Board ✓ Planning Board
Public Art Committee Veteran's Affairs Committee
I Sister Cities Committee Other(Please specify):
Application is for: Reappointment IP New appointment
PERSONAL:
Name: Jacqueline Campbell Telephone Number: 347 678 1601
Home Address: 7529 Fairfax Drive Zip Code: 11422
Length of Residence in Tamarac (If applicable) 1 Years 2 Months
4111 ngth of Time as Business Person in Tamarac (If applicable) Years Months
campjac20@yahoo.com
E-Mail Address:
Development/Section Name and Number:
i
Commission District Number: 3 Voting Precinct Number: J024
EDUCATION:
Name and location of High School: Mannings High School,Jamaica
College (if appropriate): Baruch College
Years Completed: 5 Degree: BBA & MBA Credits
Business
Field of Study:
Other professional or technical training (Name of school. course name, etc.):
American Institute of Banking, New York- Banking for Professionals Certificate
New York University School of Continuing Certificate, New York- Accounting for Financial Managers Course
Dekalb Leadership Institute - Leadership Certificate
Rockhurst University Continuing Education Center- Course Completion Certificate
New York Medical Career Training Center- Nurse Assistant Certificate
III
Rev.07106 16
EMPLOYMENT:
Current or most recent employer: New York City Administration For Children's Services
Address: 150 William Street, New York, N.Y. 10003
Position: Director, Finance and Payments Years of Service: 29
Duties: Managed, developed and monitored budgets and expenditure and ensure compliance to the financial
OTHER QUALIFICATIONS:
Please provide a brief statement outlining why you wish to potentially serve on the applicable advisory boards
and/or committees selected. In addition, please feel free to attach a copy of your resume or vita (optional):
Before I relocated to Tamarac from Queens, New York, I was an active community leader, organizer and advocate.
As a
result, I received numerous community service awards and acknowledgements from local politicians and
community organizations Some of these awards include Wbman of Distinction Award from the New York State
Senate; City of New York Proclamation from the City Council; and Certificate of Merit from New Sate Assembly. I
led the battle with the Metropolitan Transit Authority (MTA) and successfully had a new bus route added in Queens.
MEMBERSHIPS:
Completion of this section is optional.The information will be helpful to the press if you are appointed: however,
it is not a prime factor in making appointments.
Tamarac Organization Years Member Office Held (if any) •
Outside City of Tamarac
ACKNOWLEDGMENT
I understand that in accordance with the Florida Sunshine Law, this information will be posted for public review
and I waive any objection to such publication.
I understand that appointment to any of the positions indicated above is a voluntary service,with no Compensation
or benefits.
If appointed, I agree to faithfully and fully perform the duties of my office, will make every endeavor to serve my full
term, and will comply with all laws or ordinances of the City of Tamarac, Broward County and the State of Florida,
particularly those pertaining to the conduct of public office and related financial disclosure requirements, if
applicable to my position. I further agree to take the applicable statutory oath. I understand that if appointed, I
must take the oath of office prescribed in the Florida Statutes.
Section 2-56 of the Tamarac Code provides each member of a board or committee of the City of Tamarac shall be a
resident of the city. Failure to be a resident of the city shall result in forfeiture of the position on the board or
committee. This section does not apply to staff appointed to a board, committee or commission as part of their
work responsibilities. At their discretion, the Tamarac City Commission may waive the requirements of this
section.
cT ove ta.C' d'
Signature of Applicant Date
Rev.07�'06,16
PLEASE RETURN THIS APPLICATION TO THE CITY CLERK'S OFFICE FOR PROCESSING.
City of Tamarac, 7525 Northwest 88 Avenue, Tamarac, FL 33321-2401 (954) 597-3505
ADDENDUM TO ADVISORY BOARD AND COMMITTEE APPLICATION FORM
Campbell
Name: Jacqueline pbell
1 Do you have any relatives presently employed by the City of Tamarac? No
If yes, please state names and City departments/divisions:
2 Are you aware of any potential conflict of interest that may arise from your serving
on City of Tamarac advisory boards and committees? No If yes. please explain:
3 Do you presently have monies owed to the City of Tamarac which are delinquent?
If yes, please explain: No
4 Do you have any pending code violations relative to property owned by you within
The City of Tamarac? If yes, please explain: No
II
5 Doyou have anyexistingviolations relative toother Citycodes? No
a s e
If yes, please list:
411
Rev.07/06/16
TAMARAC CITY OF TAMARAC
APPLICATION FOR BOARD AND COMMITTEE
The City For Your Life APPOINTMENTS
Service on an advisory Board or Committee provides citizens with an opportunity to help shape future policy and
strategic direction for the City of Tamarac. Tamarac residents are cordially invited to apply for appointment by the
City Commission to a Board or Committee. Advisory board and committee members are voluntary positions and
serve without benefit of compensation.
Please check Boards/Committees for which you wish to be considered:
Parks and Recreation Board Planning Board
Public Art Committee Veteran's Affairs Committee
✓ Sister Cities Committee Other (Please specify):
Application is for: Reappointment New appointment
PERSONAL:
Name: Jay Koutcher Telephone Number: 954-479-4792
Home Address: 8173 Royal Palm Court Zip Code: 33321
Length of Residence in Tamarac (If applicable) 20 Years 7 Months
Length of Time as Business Person in Tamarac (If applicable) Years Months
jay.koutcher@gmail.com
E-Mail Address:
Development/Section Name and Number:
Commission District Number: 4 Voting Precinct Number: as advised
EDUCATION:
Name and location of High School: Northeast High School, Cottman Avenue, Philadelphia, Pa 19111.
I College (if appropriate): Temple University, North Broad Street, Philadelphia, Pa.
Years Completed: 3 Degree: Associate
Psychology, business
Field of Study:
Other professional or technical training (Name of school, course name, etc.):
United States Army. 54; security for all entering or leaving the base located in Fort Sill, Okla.
Rev.07'06:16
EMPLOY11 NT:
rrent or most recent employer: Retired
Address:
Position: Years of Service:
Duties:
OTHER QUALIFICATIONS:
Please provide a brief statement outlining why you wish to potentially serve on the applicable advisory boards
and/or committees selected. In addition, please feel free to attach a copy of your resume or vita (optional):
Pleasantly served on several Boards in the City of Tamarac. Appointed to (with letters from the City Clerk and the
Mayor, of the city of Lauderhill)the Code Enforcement Board (as a judge), joined and became the President of
District 7's Police Advisory Board, and District 7's Community Council. Also served with pleasure; as recording
secretary to the old VVoodmont Property Owner's Association, for many enjoyable years.
MEMBERSHIPS:
Completion of this section is optional.The information will be helpful to the press if you are appointed; however,
it is not a prime factor in making appointments.
IIITamarac Organization Years Member Office Held (if any)
District 7 Community Council 9 President
Outside City of Tamarac
Educational Advisory Board 5 City of Lauderhill
Police Advisory Board 5 above.
ACKNOWLEDGMENT
I understand that in accordance with the Florida Sunshine Law, this information will be posted for public review
and I waive any objection to such publication.
I understand that appointment to any of the positions indicated above is a voluntary service,with no compensation
or benefits.
If appointed, I agree to faithfully and fully perform the duties of my office, will make every endeavor to serve my full
term, and will comply with all laws or ordinances of the City of Tamarac, Broward County and the State of Florida,
particularly those pertaining to the conduct of public office and related financial disclosure requirements, if
applicable to my position. I further agree to take the applicable statutory oath. I understand that if appointed, I
must take the oath of office prescribed in the Florida Statutes.
Section 2-56 of the Tamarac Code provides each member of a board or committee of the City of Tamarac shall be a
resident of the city. Failure to be a resident of the city shall result in forfeiture of the position on the board or
committee. This section does not apply to staff appointed to a board, committee or commission as part of their
4 ork responsibilities. At their discretion, the Tamarac City Commission may waive the requirements of this
tion.
Cf C lte,t July 08, 2020
Signature of Applicant Date
Rev.07/06/16
PLEASE RETURN This APPLICATION TO THE CITY CLERKS OFFICE FOR PROCESSING.
City of Tamarac, 7525 Northwest 88 Avenue, Tamarac, FL 33321-2401 (954)597-3505
ADDENDUM TO ADVISORY BOARD AND COMMITTEE APPLICATION FORM
Applicant Name: Jay Koutcher
1 Do you have any relatives presently employed by the City of Tamarac? No
If yes, please state names and City departments/divisions:
2 Are you aware of any potential conflict of interest that may arise from your serving
on City of Tamarac advisory boards and committees? If yes, please explain:
None
3 Do you presently have monies owed to the City of Tamarac which are delinquent?
If yes, please explain: None
4 Do you have any pending code violations relative to property owned by you within
The City of Tamarac? If yes, please explain: None
5 Doyou have anyexistingviolations relative to other Citycodes? None •
If yes, please list:
Rev.07106:16
CITY OF TAMARAC
APPLICATION FOR BOARD AND COMMITTEE
:,' For Your Lite APPOINTMENTS
Service on an advisory Board or Committee provides citizens with an opportunity to help shape future policy and
strategic direction for the City of Tamarac. Tamarac residents are cordially invited to apply for appointment by the
City Commission to a Board or Committee. Advisory board and committee members are voluntary positions and
serve without benefit of compensation.
Please check Boards/Committees for which you wish to be considered:
Parks and Recreation Board Planning Board
Public Art Committee Veteran's Affairs Committee
t -- Sister Cities Committee Other (Please specify):
Application is for: Reappointment New appointment
PERSONAL:Name: r�P-1 a-VA A- -T(�
A-irt I V )� Telephone Number:954-C(3 4--- 74)
Home Address: LOS° (\ SOJDCd Pc2J rr L.. LD Zip Code: .33;t' C
Length of Residence in Tamarac (If applicable) Years Months
illigth of Time as Business Person in Tamarac (If applicable) Year Months
E-Mail Address: tbci 130,(1-K.in s ��-
Development/Section Name and Number: L c kes q'-e-t --''& I I1
Commission District Number: I- Voting Precinct Number:
EDUCATION:
Name and location of High School: H c}mF c-,r 'c
�l nti'�✓Si ( v� Tecx_�)a1S�, . (+� CYC�til Lj r
College (if appropriate): i . ��� e_�I El c t-��,.et' ,c)-- ';
Years Completed: I II _3 Degree: i a �+ +r ec
Field of Study: s� - :�
Other professional or technical training (Name of school, course name, etc.):
4-'_ ro N t - -- � _e� P C;1 } J c �C C e- -
C Cam. Pc-)
CITY OF TAMARAC
CITY COMMISSION
DEC 4 2020
RECEIVED
Rev. 07/06/16
PLEASE RETURN THIS At _ICATION TO THE CITY CLERK'S 0 ,CE FOR PROCESSING.
City of Tamarac, 7525 Northwest 88 Avenue, Tamarac, FL 33321-2401 (954) 597-3505
ADDENDUM TO ADVISORY BOARD AND COMMITTEE APPLICATION FORM •
Applicant Name: `- �
1 Do you have any relatives presently employed by the City of Tamarac? '_j
If yes, please state names and City departments/divisions:
2 Are you aware of any potential conflict of interest that may arise from your serving
on City of Tamarac advisory boards and committees? {"JD If yes, please explain:
3 Do you presently have monies owed to the City of�TTamarac which are delinquent?
If yes, please explain: /�
4 Do you have any pending code violations relative to property owned by you within
The City of Tamarac? If yes, please explain: !"f G
5 Do you have any existing violations relative to other City codes? lei •
If yes, please list:
3
•
Rev.071/06/16
EMPLOYMENT:
rrent or most recent employer:
Address:
Position: Years of Service:
Duties:
OTHER QUALIFICATIONS:
Please provide a brief statement outlining why you wish to potentially serve on the applicable advisory boards
and/or committees selected. In addition, please feel free�l to attach a copy of your resume or vita (optional):
r-aLA_A--f-za- U u �-.Jre-'r-=' -- 7�,, a cJ? i v�.r n J-e_s S crl. C-, -a c2�zs�� v��C
MEMBERSHIPS:
Completion of this section is optional. The information will be helpful to the press if you are appointed;however,
it is not a prime factor in making appointments.
Tamarac Organization Years Member Office Held (if any)
Ilkv- .�. . ��-e.n.,.v cr t CL �� „-1,C , e c-r ef-t - Ti caS'tic--r
Outside City of Tamarac
,
e, -\ i LA)e c,.c� C�c�� 1 4_ eC;r e =.----1 ..
N H-g A-A- PL, t-4.4x- Li-ee,,- c_ic f-e_ -,---1
ACKNOWLEDGMENT
I understand that in accordance with the Florida Sunshine Law, this information will be posted for public review
and I waive any objection to such publication.
I understand that appointment to any of the positions indicated above is a voluntary service, with no compensation
or benefits.
If appointed, I agree to faithfully and fully perform the duties of my office, will make every endeavor to serve my full
term, and will comply with all laws or ordinances of the City of Tamarac, Broward County and the State of Florida,
particularly those pertaining to the conduct of public office and related financial disclosure requirements, if
applicable to my position. I further agree to take the applicable statutory oath. I understand that if appointed, I
must take the oath of office prescribed in the Florida Statutes.
Section 2-56 of the Tamarac Code provides each member of a board or committee of the City of Tamarac shall be a
resident of the city. Failure to be a resident of the city shall result in forfeiture of the position on the board or
committee. This ction does not apply to staff appointed to a board, committee or commission as part of their
'ork responsibi i s. At their discretion, the Tamarac City Commission may waive the requirements of this
7 tion. /..
,\_,
,0_,
ature of pplicant Date '
Rev. 07/06/16
MARAC CITY OF TAMARAC
APPLICATION FOR BOARD AND COMMITTEE
City For Your Life APPOINTMENTS
Service on an advisory Board or Committee provides citizens with an opportunity to help shape future policy and
strategic direction for the City of Tamarac. Tamarac residents are cordially invited to apply for appointment by the
City Commission to a Board or Committee. Advisory board and committee members are voluntary positions and
serve without benefit of compensation.
Please check Boards/Committees for which you wish to be considered:
Parks and Recreation Board Planning Board
I Public Art Committee Veteran's Affairs Committee
I Sister Cities Committee Other (Please specify):
Application is for: Reappointment ! New appointment
PERSONAL:
Name: Ronald Adam Reynolds Telephone Number: 786-423-8037
Home Address: 7410 NW 83rd Ave Zip Code: 33321
Length of Residence in Tamarac (If applicable) 3 Years 0 Months
Length of Time as Business Person in Tamarac (If applicable) Years Months
apuzer65@gmail.com
E-Mail Address:
Development/Section Name and Number:
Commission District Number: District 4 Voting Precinct Number: J021
EDUCATION:
Name and location of High School: Enka High School, Asbury Rd, Enka NC
College (if appropriate): University of North Carolina at Charlotte
Years Completed: 4 Degree: BS
Accounting
Field of Study:
Other professional or technical training (Name of school. course name. etc.):
Vlbodmont Tract 70 106-39 B LOT 3 is my development/section name and number. The box above would create an
error and state "add correct email address"--I called 954-597-3500 and was advised to put this info elsewhere and
they would inform IT
Rev.07,06;16
EMPLOYMENT:
•Jrrent or most recent employer: American Airlines
Address: Miami International Airport
Position: Manager of Training and Development Years of Service: 11
Duties: Manage training and compliance for over 800 employees
OTHER QUALIFICATIONS:
Please provide a brief statement outlining why you wish to potentially serve on the applicable advisory boards
and/or committees selected. In addition, please feel free to attach a copy of your resume or vita (optional):
I am a reserved and effective communicator, and can easily digest opposing views in a conflict and find a
resolution. I am vested in the beautiful City of Tamarac, and wish to see it continue to evolve in this century.
MEMBERSHIPS:
Completion of this section is optional.The information will be helpful to the press if you are appointed; however,
it is not a prime factor in making appointments.
IIITamarac Organization Years Member Office Held Of any)
Vbbodmont Tract 70 HOA 3 President
Outside City of Tamarac
USA Hockey 2
U S TA 15
ACKNOWLEDGMENT
I understand that in accordance with the Florida Sunshine Law, this information will be posted for public review
and I waive any objection to such publication.
I understand that appointment to any of the positions indicated above is a voluntary service,with no compensation
or benefits.
If appointed, I agree to faithfully and fully perform the duties of my office, will make every endeavor to serve my full
term, and will comply with all laws or ordinances of the City of Tamarac, Broward County and the State of Florida,
particularly those pertaining to the conduct of public office and related financial disclosure requirements, if
applicable to my position. I further agree to take the applicable statutory oath. I understand that if appointed, I
must take the oath of office prescribed in the Florida Statutes.
Section 2-56 of the Tamarac Code provides each member of a board or committee of the City of Tamarac shall be a
resident of the city. Failure to be a resident of the city shall result in forfeiture of the position on the board or
committee. This section does not apply to staff appointed to a board, committee or commission as part of their
iiork responsibilities. At their discretion, the Tamarac City Commission may waive the requirements of this
Lion. .s,fl,:N.,.=.,,.:...o�._.nn
yrc �c..faxz July 17, 2020
Signature of Applicant Date
Rev.07'0616
PLEASE RETURN THIS APPLICATION TO THE CITY CLERK'S OFFICE FOR PROCESSING.
City of Tamarac, 7525 Northwest 88 Avenue, Tamarac, FL 33321-2401 (954) 597-3505
ADDENDUM TO ADVISORY BOARD AND COMMITTEE APPLICATION FORM
Applicant Name: Ronald Adam Reynolds
1 Do you have any relatives presently employed by the City of Tamarac? No
if yes, please state names and City departments/divisions:
2 Are you aware of any potential conflict of interest that may arise from your serving
on City of Tamarac advisory boards and committees? No If yes, please explain:
3 Do you presently have monies owed to the City of Tamarac which are delinquent?
If yes, please explain: No
4 Do you have any pending code violations relative to property owned by you within
The City of Tamarac? If yes, please explain: No
5 Do you have any existing violations relative to other City codes? NO •
If yes, please list:
• 1
Rev.07.'0616
TAMARAC CITY OF TAMARAC
APPLICATION FOR BOARD AND COMMITTEE
The City For Your Life APPOINTMENTS
Service on an advisory Board or Committee provides citizens with an opportunity to help shape future policy and
strategic direction for the City of Tamarac. Tamarac residents are cordially invited to apply for appointment by the
City Commission to a Board or Committee. Advisory board and committee members are voluntary positions and
serve without benefit of compensation.
Please check Boards/Committees for which you wish to be considered:
I Parks and Recreation Board Planning Board
I Public Art Committee Veteran's Affairs Committee
Sister Cities Committee Other (Please specify):
Application is for: Reappointment II New appointment
PERSONAL:
Name: Delvin Cyrus Rogers Sr. Telephone Number: 3056845662
Home Address: 6794 N. Pine Island Rd. Zip Code: 33321
Length of Residence in Tamarac (If applicable) 8 Years Months
Sngthf Timr Months
o e as Business Person in Tamarac a livable Yea s(Ifapplicable)
rogers.delvin@yahoo.com
E-Mail Address:
Development/Section Name and Number:
Commission District Number: 2 Voting Precinct Number:
EDUCATION:
Name and location of High School: Miami Central Sr. High
College (if appropriate): Florida Memorial univ.
Years Completed: 4 Degree: B.A.
Professional and Leadership Studies
Field of Study:
Other professional or technical training (Name of school, course name, etc.):
1!1°
Rev.07.06 16
EMPLOYMENT:
Current or most recent employer Franklin Academy Sunrise
•
Address: 4500 NW 103rd Ave
Specials Teacher
Position: Years of Service: 1
Duties: Provide basic skills ans communication curriculum to K-5 grade levels
OTHER QUALIFICATIONS:
Please provide a brief statement outlining why you wish to potentially serve on the applicable advisory boards
and/or committees selected. In addition, please feel free to attach a copy of your resume or vita (optional):
I have been employed within the Broward County School System for 6 years. I also worked within the Juvenile
Justice System(Juvenile Assessment Center), Case Manager in Miami-Dade, Asst. Director of Admissions, Mentor,
Tutor etc.
MEMBERSHIPS:
Completion of this section is optional.The information will be helpful to the press if you are appointed; however,
it is not a prime factor in making appointments.
Tamarac Oroanization Years Member Office Held Of any)
•
Outside City of Tamarac
ACKNOWLEDGMENT
I understand that in accordance with the Florida Sunshine Law, this information will be posted for public review
and I waive any objection to such publication.
I understand that appointment to any of the positions indicated above Is a voluntary service, with no compensation
or benefits.
If appointed, I agree to faithfully and fully perform the duties of my office, will make every endeavor to serve my full
term, and will comply with all laws or ordinances of the City of Tamarac, Broward County and the State of Florida,
particularly those pertaining to the conduct of public office and related financial disclosure requirements, if
applicable to my position. I further agree to take the applicable statutory oath. I understand that if appointed, I
must take the oath of office prescribed in the Florida Statutes.
Section 2-56 of the Tamarac Code provides each member of a board or committee of the City of Tamarac shall be a
resident of the city. Failure to be a resident of the city shall result in forfeiture of the position on the board or
committee. This section does not apply to staff appointed to a board, committee or commission as part of their
work responsibilities. At their discretion, the Tamarac City Commission may waive the requirements of this
section.
411
cDel44.4t C4tu4 aet
ray 21.1,,,lhArIPnA4..ac133re2,11
Signature of Applicant Date
Rev.07/06116
PLEASE RETURN THIS APPLICATION TO THE CITY CLERK'S OFFICE FOR PROCESSING.
City of Tamarac, 7525 Northwest 88 Avenue, Tamarac, FL 33321-2401 (954) 597-3505
• ADDENDUM TO ADVISORY BOARD AND COMMITTEE APPLICATION FORM
Applicant Name: DeNin Cyrus Rogers Sr.
1 Do you have any relatives presently employed by the City of Tamarac? No
If yes, please state names and City departments/divisions:
2 Are you aware of any potential conflict of interest that may arise from your serving
on City of Tamarac advisory boards and committees? No If yes, please explain:
3 Do you presently have monies owed to the City of Tamarac which are delinquent?
If yes, please explain: No
4 Do you have any pending code violations relative to property owned by you within
The City of Tamarac? If yes, please explain: No
• 5 Doyou have anyviolations relative to other Citycodes? No
existing
If yes, please list:
•
Rev.07/06'16