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HomeMy WebLinkAbout03/05/1991, C-3 - AWARD CONTRACT FOR ""MITCHELL PARK WELL IMPROVEMENTS"" TO NICK E. POKRAJAC, INC. IN THE AMOUNT OF $8871.00." 4IIN�I�IIIBIIIIII�f IJII � � - MEEnNG OATS: °TUI Cl Sdn WIS OBISPO March s 1991 MiGn COUNCIL AGENDA REPORT ITEM NUMBER :�f� FROM: (�-�' William T. Hetland, Utilities Directoxkl- Gary W. Henderson, Utilities Engineer,::�7•-,;'�' SUBJECT: Award Contract for "Mitchell Park Well Improvements" to Nick E. Pokrajac, Inc. in the Amount of $8,871. 00. CAO RECOMMENDATION: Waive the Architectural Review Commission's earlier requirement that a Master Plan for Mitchell Park be approved prior to consideration of a "Mitchell Park Well Improvements Project", and authorize the CAO to proceed with the $8, 871. 00 contract award to Nick E. Pokrajac, Inc. of Templeton, Calif. BACKGROUND: In July of 1988, the City drilled a well at Mitchell Park. The well production was measured at 50 gallons per minute and until now, the well has been used for irrigation of the park. Because of .the continuing drought, staff recommends activating this well for municipal purposes. The Architectural Review Committee reviewed the original proposed project approximately a year ago and indicated that they would not approve the project until a Master Plan for Mitchell Park was prepared. Utilities staff have requested that the Recreation Director budget for the preparation of a Master Plan for the park. Due to the continuing drought, staff requests that Council waive the Commission's requirement for the Master Plan as a condition of this project. The original project required permanent facilities to be constructed at the well site which is located in a high visibility area adjacent to the flag pole area. The current project would mitigate the visual impacts by locating the improvements behind the existing Senior Citizens Building within the fenced in area. The project will involve the construction a chlorine building similar to the existing buildings located at other City well sites. The building will be painted to match the existing Senior Citizens building and will use matching roofing materials. The existing well head has approximately 7 feet of piping exposed above ground. After modifications, there will be approximately 3 feet of exposed piping. The project will also install a driveway and gate for access to the chlorine building from Buchon Street. Parks and Recreation staff have been involved in the design of the project and have agreed to the proposed modifications. Bids were requested from three local contractors. The low bid was submitted by Nick E. Pokrajac of Templeton, Calif. in the amount of $8,871. 00. ;10111ibu►IVllll11 city of San lugs OBISp0 COUNCIL AGENDA REPORT Page Two FISCAL IMPACT: A total of $2, 350, 000 was approved as part of the 1990-91 Budget to support the Groundwater Development Project, Phase III, (1989-91 Financial Plan & Approved 1990-91 Budget, page H-16) . A total of $58, 480 has been expended to date, leaving a balance of $2, 291, 520 available to support this amendment. I i Attachment: Proposal I I i i I i I I p:\gary\mncneiimp I I CITY OF SAN LUIS OBISPO San Luis Obispo, California PROPOSAL Proposal is to be in a sealed envelope marked: Proposal: Mirrhell Park rhlnrine Building Anti Well TmnrnvPmanrs Due: Place: OFFICE OF CITY ENGINEER 955 Morro Street, SLO Date: February 18. 1991 Time• 3:00 P.M. CONTRACTOR NICK E. POKRAJAC INC. P. 0. BOX 539 TEIMPLETON, CA 93465 Date: February 19 . 1991 City Engineer City of San Luis Obispo 955 Morro Street San Luis Obispo, CA 93401 THE UNDERSIGNED, Contractor, hereinafter known as Contractor, hereby proposes to furnish at his own cost and expense all labor and material, together with the tools and other equipment, (except N 0 N r necessary to do and fully complete the following described work for the City of San Luis Obispo, hereinafter known as City, at Mitchell Park in the City of San Luis obispo, County of San Luis Obispo, Calif. The following is a description of the work: In eeneral. remove existing concrete and fencing; install new driveway. concrete slab electrical conduits and chlorine buildine. NOTE: It shall be the responsibility of the Contractor to notify each property owner or tenant, by phone, personal contact or door hanger (furnished by the City) approximately one (1) week before moving into the area, where work is to be conducted. - 1 - C3 -3 It is understood that the performance of said work is to be done in conformity with the standard specifications of the City of San Luis obispo and any special provisions currently in use by the City Engineer which becomes a part hereof and also that performance of said work is to be entirely under the Contractor's supervision, direction, and control. It is agreed that an extension of time for the completion of the work will be granted for a period equal to the period of any delays caused by any failure of the City on obtaining City furnished materials necessary for the prosecution of the work. Should the failure to obtain such materials delay the work for a period exceeding thirty (30) calendar days and result in a complete stoppage of the work, the Contractor will be compensated for any actual increase in cost of labor to him, which, in the opinion of the City Engineer, is caused by such delay. The Contractor waives hereby all claims against the City and its officers for any loss sustained by him on such delays of less than thirty (30) calendar days. It is agreed that where two or more contractors are employed on related or adjacent work, each shall conduct his operations in such a manner as not to cause any unnecessary delay or hindrance to the other. Each contractor shall be responsible to the other for all damage to work, to person, or property, or for loss caused by failure to finish the work within the time specified for completion. If at any time during one year after the date of completion and acceptance of the work described herein, any part of the material or workmanship furnished by the Contractor shall prove to be defective, the Contractor will, upon receipt of the City' s written notice to that effect, replace or repair defective parts to the satisfaction of the City without cost to the City. Any changes and/or alterations in the work required to be performed by the Contractor hereunder shall be made solely in the manner provided for in the standard specifications and special provisions currently in use by the City Engineer, which are incorporated herein and made a part hereof by reference thereto. The Contractor shall not be entitled to payment for changes and/or alterations unless the same are made as hereinabove provided. Any changes and/or alterations which are made as hereinabove provided shall not in any way release any surety on any Contractor' s bond furnished the City hereunder. Where no bond is required by the City, Contractor, upon written notice from City as a condition precedent to any payment to be made to Contractor hereunder, shall execute and deliver to the City or its representative an affidavit stating that the Contractor has paid in full for all labor, materials, rented equipment, transportation, and all other charges in connection with the work being performed under this proposal. 2 Contractor's Insurance: The Contractor shall not commence work under this contract until he shall have obtained all insurance required under this Section and such insurance shall have been approved by the City as to form, amount, carrier, nor shall Contractor allow any subcontractor to commence work on his subcontract until similar insurance required of the subcontractor shall have been so obtained and approved. (a) Compensation Insurance: The Contractor shall take out and maintain, during the life of this contract, workman' s compensation insurance for all his employees employed at the site of improvement, and in case any work is sublet, Contractor shall require subcontractor similarly to provide workmen's compensation insurance for all of the latter's employees are covered by the protection afforded by Contractor. Contractor indemnifies City for any damage resulting to it from failure of either the Contractor or the subcontractor to take out or maintain such insurance. (b) Public Liability and Property Damage Insurance: The Contractor shall take out and maintain during the life of this Contract, such public liability and property damage insurance as shall protect the City, its elective and appointive boards, officers, agents, and employees, Contractor and any subcon- tractor performing work covered by this Contract from claims for property damage which may arise from Contractor's or subcontractor's operations under this contract, whether such operations be by the Contractor, or by any subcontractor, or by anyone directly or indirectly employed by either Contractor or subcontractor, and the minimum amounts of such insurance shall be as follows: 1. Bodily Injury Liability $500, 000. 00 $1, 0001000. 00 each person each occurrence Property Damage Liability $250, 000. 00 $500, 000. 00 each person each occurrence 2 . A single limit for Bodily $500, 000. 00 $500, 000. 00 Injury Liability and each occurrence aggregate Property Damage Combined of PROOF OF CARRIAGE OF INSURANCE: CONTRACTOR SHALL FURNISH THE CITY OF SAN LUIS OBISPO, CALIFORNIA CONCURRENTLY WITH THE EXECUTION HEREOF WITH A CERTIFICATE OF INSURANCE REQUIRED, WHICH SHALL CONTAIN THE FOLLOWING: "NAME AS ADDITIONAL INSURED PARTIES: THE CITY OF SAN LUIS OBISPO, ITS ELECTIVE AND APPOINTIVE BOARD, OFFICERS, AGENTS AND ANY SUBCONTRACTORS IN THE PERFORMANCE OF WORK FOR THE CITY OF SAN LUIS OBISPO. 3 e-3-S THIRTY (30) DAYS PRIOR NOTICE SHALL BE GIVEN TO THE CITY OF SAN LUIS OBISPO OF ANY REDUCTION IN INSURANCE COVERAGE OR OF CANCELLATION OF INSURANCE. Contractor agrees to defend, indemnify, protect and hold City and its agents, officers and employees harmless from and against any and all claims asserted or liability established for damages or injuries to any person or property, including injury to Contractor's employees, agents or officers which arise from or are connected with or are caused or claimed to be caused by the acts or omissions of Contractor, and its agents, officers or employees, in performing work or services herein, and all expenses of investigating and defending against same; provided, however, that Contractor's duty to indemnify and hold harmless shall not include any claims or liability arising from the established sole negligence or willful misconduct of the City, its agents, officers or employees. Contractor will comply with all safety regulations as set forth in the Standard Specifications and special provisions currently in use by the City Engineer. City reserves the right to audit the records of the Contractor insofar as they apply to work performed on a cost-plus basis. Contractor will obtain and pay for licenses and permits which may be required by City, County, or State. Reference is hereby made to Section 3 . 24 . 190-B of the San Luis Obispo City Municipal Code entitled, "Preference given Residents, defining condition under which contracts for such work shall be awarded. " Acceptance of City endorsed hereon shall constitute this binding contract, and Contractor will commence said work within five ( S ) days after such acceptance hereof and notification to proceed, and will diligently prosecute the same to the completion within ten (10 ) days thereafter. In the event of cessation of labor for three or more consecutive working days or in the event of Contractor's failure of performance, City may take over the work and complete it or have the same completed at Contractor' s expense, deducting the cost thereof from the contract price. If required by City to do so, Contractor will furnish prior to the commencement of said work, a contractor' s bond with a surety company acceptable to the City, guaranteeing and conditioned for the Contractor's full and faithful performance of said work and this contract and also guaranteeing and conditioned for the payment in full of all the claims of all performing labor upon or furnishing materials to be used in said work, the form of said bond and the amount thereof to be approved by the City. 4 �3- � Contractor shall not assign or sublet any portion of said work without written consent of City. The hourly wage rate shall not be less than the general prevailing hourly wage rate for each craft or type of workman or mechanic needed to complete the project. All work is to be done in a thorough and workmanshiplike manner; and all labor and materials are to be the best of their kind, subject to the approval of the City's authorized representative, and in accordance with the above-mentioned provisions. The job is to be fully completed, including the removal of all surplus material and rubbish, all parkways and adjacent excavated areas shall be backfilled to grade. The backfill material shall be native material unless otherwise specified. All slope at back of walk shall be two to one. All lawn area shall be reseeded. Work at each individual property shall be awarded separately to the low bidder unless otherwise specified on the bid sheet. This PROPOSAL does not constitute authority to proceed with the work; such authority will be by PURCHASE ORDER properly executed and signed by the purchasing agent for the City. TWENTY-FOUR 24 HOUR NOTICE MUST BE GIVEN TO THE CITY ENGINEER PRIOR TO STARTING WORK. Licensed in accordance with an act providing for the registration of contractors, License No. 496795 Expiration Date 8/31/92 . The above statement is made under penalty of perjury, and any bid not containing this information "shall be considered nonresponsive and shall be rejected" by the City. Mitchell Park Chlorine Building and Well Improvements Proposed: February_ 19 19 91 (Description) NICK E . POKI2AJAACC INC . $8 , 871.00 �/ � ���^ President (Charge) (Contr or) Approved: , 19_ Accepted: , 19_ CITY OF SAN LUIS OBISPO Bond (_isj (is not) required By: 5 VSOt/ V1NVS m a J (� O C7 U OU N z`0 X p 1 co cc W m Oat Z CO co h- cc U. JO Um U WCaI 3 W z Da > > L O CL r, a ccz Q Jb w a Z Z z �g Fa- x w CO O LL 0C2� O Z3 0 LU Z T ��_ Z _ . O wLU —� w w` T EE O z � ¢ Z0 J Z az� / v � zW LLI z J GCC J O W _ U d z ,. ......._. 1 cc:r co ^W a LLI z �`— � W cc LLJ C J C \� .j n ) _ C� 3 a = \ �— W� 1S SO SO p 3 CONTRACT FOR MITCHELL PARK CHLORINE BUILDING. AND WELL IMPROVEMENTS 1. Remove existing curb, gutter and sidewalk, and install a 27 ' driveway ramp per City Standard #2110. 2. Remove 136 sq. ft. of existing walkway and replace with total 620 sq. ft. of new concrete. New concrete drive area. shall be 6" thick with 6" Class III base installed to City specifications. 3. Remove existing wood fence and install two 121w x5 'h chain link gates per State Standard F-10. Attach existing fences to new gate posts. Gates shall be installed to open away from sidewalks and shall have a standard hasp with drop pin to keep gate stationary when locked closed. 4. Install a 6 'x6 'x4" concrete slab with 12" wide x 12" deep footings around the perimeter. Slab and footings shall be reinforced with #4 bar 24" O.C. Construct a 61x6 ' wood frame building with T1-11 siding or approved equal. Trim and style to match existing pump house on Calle Joaquin. Paint color to match existing Senior Citizen's Center building. Roofing to match existing Senior Citizen's Center building. Building shall have one 2 '-6" x 618" exterior grade door with sweep. Door hardware and lock- keyed to match existing City system. Install a minimum of 3 lower vents and 2 upper vents in building. 5. Install two 1" conduits from interior of new building to existing well head. Install two 1" conduits to pump controls and switch gear. All conduits shall have long radius bends. All conduits shall have pull ropes. All trenching operations, conduit and pull boxes shall meet N.E.C. requirements. All conduits and fittings shall be Schedule 80. 6. Remove backflow preventer assembly and cap. Remove irrigation meter and vault assembly. Deliver used pipe, meter, vault, backflow to City yard at 25 Prado Road. 7. Remove existing 4" pipe above grade. Furnish and install approximately 7 ' of 4" diameter galvanized pipe and fittings below grade. Pipe and fittings shall include all necessary material to connect to existing water meter in existing vault. Disinfect all new piping and pressure test to the satisfaction of the City. 1 8. Provide all backfill, site clean-up and restore all turf and other landscaping to its original condition. Repair all irrigation lines and wiring to the satisfaction of the city, if damaged during trenching operations. All work is to be performed for the lump sum price of $ Contractor's Signature Date License No. rtt/mltchell 2 C'-3-1a Varies s" �I'high lip See note 5 Class 3 aggregate base 6"min.depth unless otherwise specified. R min.=55, SE min.--25 SECTION •Cold joint or .' expansion joint Dowels i Weakened plane joint'.: PLAN e'(6"curb) Driveway3'(6°curb) 4'(8"curb) Width 4'(8"curb) Sidewalk CURB FACE .,'. Gutter grade ELEVATION NOTES 1 -A depression in a new curb and gutter for a driveway will not be permitted unless the ramp is constructed also. 2-Slope of ramp is a straight grade from the top of the back of sidewalk to the top of the V lip at the gutter. 3 -Concrete shall be 5-sack,slump:2"min.,4-max. 4-Dowels at expansion, or cold,joint with new construction shall be 1/2"smooth bars, 18" long at 24"o.c. One end shall be sleeved or greased. 5-All driveways shall be reinforced with rebar, #4 CW 24" O.C., both ways. 6 -Commercial & industrial driveways and driveway ramps serving more than six(6) parking spaces shall be IOft. deep( long) unless otherwise approved by the City Engineer. 7-Gutter construction adjacent to existing A.C.paving shall include sawcutt ing,removal, and replacement of A.C.paving 18"min. from edgeof gutter, 2"thickerthan existing 5"min. ADOPTED BY RESOLUTION.No. 1156 (1989) APPROVED BY THE CITY ENGINEER DATE /) PARKING $ DRIVEWAY STANDARDS STANDARD. REVISIONS BY APP DATE ='' _°- ' DRIVEWAY RAMP wore, 5 d e. 1ZEsocu.hlo. grow J4/f/ 1 !-9! Reiarorcernerrt lxox 1.1w171 _gg • 2110 1-2so i ME Ell F iO �a a 3o O r• yg Y r aC H0W Z tia 8^ a 6 W o Z g U b 7 n W � N f' ry ez 3 Y .9 : G n ofm Sa m i aE N Q -C m d 2 a0 oz Z uV J��'aJ _ �• u - _ a. T N • _ N u vu w .r ' 1•_u•� O � y�i ti N o v �°' o m moA ,' R� •0 0 - . � :T :v a V Q �- N • 2- Eq' _' g 90 .5 sS_ m_O:a � BBF O• W - _ O' LL -N C W~ W VZ H ��• O I .wi ..i0 2 a° 6e vi •.6 'a - b 'a 8 Eao V i L o^- U � - W �e W L e ZQ X:o ,s6 02 oE._ fie t ' p 2 WI pa ' auo I «w 82 LAS -!� MEETING AUENUA A_f `TE �= ITEM # ��IIIIIIIIIIIIIIIIIIIIIII���� �llllllllllll sAn cit 0 loBispo 990 Palm Street/Post Office Box 8100 • Sart Luis Obispo, CA 93403.8100 February 25, 1991 MEMORANDUM TO: City Council FROM: Mayor Ron Dunin SUBJECT: APPOINTMENTS TO THE HOUSING AUTHORITY As required by State law (State of California Health and Safety Code, Sections 34200 et seq.), the Mayor is required to recommend appointments to the Housing Authority. After discussion with George Moylan, Executive Director of the Housing Authority, and review of all current applications on file, I am pleased to recommend the reappointment of those listed below. Tenant commissioners serve two year terms. Term to Expire Jamie Daniel 3/31/93 Alice M. Martin 3/31/93 Elizabeth "Biz" Steinberg 3/31/95 Applications of appointees are attached. All others are available for review in the Council Office. As Attachments COPLESM: ❑CJ Action n ❑' 11CDD DIR I ACRO ❑ FIMEC}EF WNEY El FW DIR. CLERK/ORIC. ❑ POpa CH ❑ . TFAMM.❑ DR s OINTMENT APPLIG. ON TO�IITTYPADVI ADVISORY BODY fMENT RECEIVED LE D4N I E Advisory Body Applied For: A10 1191 NAME OF APPUCANT CALg& SAIq // SIDENCE STREET RESS CITY X 5yq - x//33 5`1 1c/3s' 2) Nuwi�ti, o�L lr7 I bMol DAY PHONE EVENING PHONE (INTERVIEWS ARE REQUIRED FOR EACH CHOICE.) Registered voter of the city? / 0 NO How long have you lived in the city? `T Ihv"?Z S Present Occupation/Employer: clzll. ix 0- 5 LD 5 nci A j S&ALU c p s Education: Membership In Organizations: Please explain why you would like to serve (use reverse side for additional information): c7- 5 -d &,.,7'�r f �1 6X.0 IY n r/5 vL,i Previous service on SLO advisory bodies (names/dates):q PLEASE NOTE: If appointed to the Planning Commission,Architectural Review Commission, or the City Housing Authority, you are required by State law to file a Statement of Economic Interest disclosing all reportable Interests held by you at the time of appointment. A copy of this form is available from the City Clerk. Applications are accepted year-round, however, If you are applying for a current vacancy,your application must be returned ' to the City Clerk by to be considered for the current round of interviews. OFFICE USE ONLY SCREENING RECOMMEND FOR INTERVIEW DATE COMMITTEE APPOINTMENT_YES_NO SCREENING RECOMMEND FOR INTERVIEW DATE: COMMITTEE APPOINTMENT:_YES_NO TERM BEGINS: TERM ENDS: UNEXPIRED TERM: FULL TERM: JITIONAL COMMENTS: LTR SENT(Date) d:advbod.app APPLIC. .ON FOR ❑APPOINTMENT❑REAPF .TMENT / /1n TO A CITY ADVISORY BODY Advisory Body Applied For: l I NAME OF APPLICANT RESID CE STREET ADDRESS CITY LP DAY PHONEEVENING PHONE (INTERVIEWS ARE REQUIRED FOR EACH CHOICE.) Registered voter of the city? YES NO How long have you lived in the city? e_!g�E :�a Present Occupation/Employer: 1 9VV L r/n Z2-2- Education: V Membership in Organizations: A J si >7�1' tS 1/ Please expla n why you would like to serve (use reverse side for additional Information): Previous service on SLO advisory bodies (names/dates): DEC 1 l�uU '�CIT yC U CIL SAWLU S OBISPO, CA PLEASE NOTE: If appointed to the Planning Commission, Architectural Review Commission, or the City Housing Authority, you are required by State In.,to file a Statement of Economic Interest disclosing all reportable interests held by you at the time of appointment. A copy of this form is available from the City Clerk. Applications are accepted year-round, however, if you are applying for a current vacancy, your application must be returned to the City Clerk by to be considered for the current round of interviews. OFFICE USE ONLY SCREENING RECOMMEND FOR INTERVIEW DATE COMMITTEE APPOINTMENT_YES_NO SCREENING RECOMMEND FOR INTERVIEW DATE: COMMITTEE APPOINTMENT:_YES_NO TERM BEGINS: TERM ENDS: UNEXPIRED TERM: FULL TERM: DITIONAL COMMENTS: LTR SENT(Date) Madvbod.app APPL. ,ION FOR ❑APPOINTMENT❑REAF NTMENT TO A CITY ADVISORY BODY Fli .ah h "Biz" Steinberg Advisory Body Applied For: NAME OF APPUCANT 1585 Cordova Drive, San Luis Obispo, CA 93405 1) Housing Authority Commission RESIDENCE STREET ADDRESS CITY ZIP 544-4355 543-1392 2) DAY PHONE EVENING PHONE (INTERVIEWS ARE REQUIRED FOR EACH CHOICE.) Registered voter of the city? XYES NO How long have you lived in the city? 1 R years Present Occupation/Employer. Executive Director - Economic Opportunity Commission Education: B.S. Home Fe-University of Wisconsin. Madison. M.A. Thesis in progress at Pacific Oaks College, Human Development - Human Services Administration Membership in Organizations: NAFYC_ Cal Neva. Community Partners in Child Care Commission on Self Esteem, Delta Kappa Gamma, Homeless Coalition, SSCC, etc. Please explain why you would like to serve (use reverse side for additional Information): T would like to continue serve on the Housing Authority Commission I have a great concern for affordable housing in the City of San Luis Obispo, as a city resident. My job of working with the economically disadvantaged continues to be more challenging as the economics become more complex and devastating. The Housing Authority is committed to finding ways of creating more affordable housing - R Previous service on SLO advisory bodies (names/dates): ItLUIS U `� SAOBI 0.CA dousing Authority 1987 to Present PLEASE NOTE: If appointed to the Planning Commission,Architectural Review Commission, or the City Housing Authority, you are required by State law to file a Statement of Economic Interest disclosing a:l reportable Interests held by you at the time of appointment A copy of this form Is available from the City Clerk. Applications are accepted year-round, however, if you are applying for a current vacancy, your application must be returned to the City Clerk by to be considered for the current round of interviews. OFFICE USE ONLY SCREENING RECOMMEND FOR INTERVIEW DATE COMMITTEE APPOINTMENT_YES_NO SCREENING RECOMMEND FOR INTERVIEW DATE: COMMITTEE APPOINTMENT:_YES_NO TERM BEGINS: TERM ENDS: UNEXPIRED TERM: FULL TERM: DDmONAL COMMENTS: LTR SENT(Daze) d:advbod.app M EETI�-5-�JAGENDA TE ffEM # III�III cityof sAn WISOBISPO 990 Palm Street/Post Office Box 8100 • San Luis Obispo, CA 93403-8100 February 21, 1991 MEMORANDUM TO: City Council P FROM: Councilmembers Pinard and Roalman'�' �� Subcommittee to the Human Relations Commission SUBJECT: RECOMMENDATION FOR APPOINTMENT TO THE HUMAN RELATIONS COMMISSION During the last round of interviews and appointments (three) in October, 1990, the Subcommittee (Pinard/Roalman) recommended that should another vacancy occur, Mr. Dwight Brouillard would be appointed. The Subcommittee was highly impressed with Mr. Brouillard's qualifications and after reviewing the current file of applications (11), feel that he is the best candidate. He has become familiar with on-going issues and projects over the last few months by receiving the HRC agenda and minutes. The Subcommittee is pleased to recommend the appointment of Mr. Brouillard to serve a term of four years to expire on March 31, 1995. Mr. Brouillard's application is attached. All other applications are available in the Council Office for review. /ss Attachment. C�OI'lES'DO: ❑•Darooe�Action Ct Fri V [0] ' ❑ CSDnm FRKWIoHP-W MRNEY 0 CLEWO o r0= c. CK ❑ MC Wr TE&M ❑ RM DIR C3 ❑ °�"F;a T-T D5%721 APPOINTMENT REAPPOINTMENT APPLICATION FOR APPOINTMENT/REAPPOINTMENT TO A CITY ADVISORY BODY Advisory Body Applied For: Na a of Applicant 1 • 4t"wkaM 94 G Si_O Residence Street Address & City 2. ( If a second choice is indicated. a -5+9*—Phone 5 Evening `h Phone second interview will be required. ) Day Phone Evening Phone 1 . Are you a registered voter of the city? YES NO 2. How long have you lived in the city? -7 +• y 3. Present occupation and employer: En ine P,- ,,,-at 4. Education: --�YJ"� ..,L, E. l� � � ..o 11 ►9i1,4�. • 5. Membership In organizations: D;r -Ht- 6. }•grqFA� y�o�d� rJ A� N�,�� ��,• , 6. Please specify the reasons why ; you feel you shoe!,+ be oF,pointed to this adv1scry body (use reverse side for additional information) : S k O-Vr cc rr1n e , ,� w. ,n nn S± h�. 1^Pro 4 r vi i aa dV 11 n I /A ACS , o T� i (P[LuLO S 1 lel c ACi cl '.l�1. 1 n i._r L i e-a c 1 iWrAAA i C n o V 1n C.In AAA 0 n Sti n a-•�.P P('£-rt.e3,ti n Vl P n S w.� S� i+ -�- f 7. Previous service on any SLO advisory bodies (names and dates) : N N.9 PLEASE NOTE: If you are appointed to the Planning Commission. Architectural Review Commission, or the City Housing Authority, you are required by State law to file a Statement of Economic Interest disclosing all reportable interests held by you at the time of appointment. A copy of this form is available from the City Clerk. . Applications are accepted year round. however, if you are applying for a current vacancy, your application must be returned to the City Clerk by in order to be considered for the current round of interviews. ***TO 11 BE FILLED OUT BY CITY CLERK'S �OIFFICE*** Interview Date: �Z3 U Screening Committee P1.1n ***TO BE FILLED OUT BY SCREENING COMMITTEE CHAIR*** Recommend for Appointment: YES Q NO ` 3 10L+f1 Recommendation is for: Q SA term Full Unexpired term Irrcou IL� �-,//• D N LUIS UB ' 0, CA Additional comments: WXL�LlitieruP �39v