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HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 12192017 - Internal Ops Agenda Pkt       INTERNAL OPERATIONS COMMITTEE SPECIAL MEETING December 19, 2017 1:00 P.M. 651 Pine Street, Room 108-A, Martinez Supervisor Candace Andersen, Chair Supervisor Diane Burgis, Vice Chair Agenda Items: Items may be taken out of order based on the business of the day and preference of the Committee         1.Introductions   2.Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to three minutes).   3. INTERVIEW candidate for the two Board of Supervisors appointed seats on the East Contra Costa Fire Protection District Board of Directors and DETERMINE recommendations for Board of Supervisors appointment effective February 5, 2018 and until such time that elected successors assume office. (Julie DiMaggio Enea, County Administrator's Office)   4.Adjourn   The Internal Operations Committee will provide reasonable accommodations for persons with disabilities planning to attend Internal Operations Committee meetings. Contact the staff person listed below at least 72 hours before the meeting. Any disclosable public records related to an open session item on a regular meeting agenda and distributed by the County to a majority of members of the Internal Operations Committee less than 96 hours prior to that meeting are available for public inspection at 651 Pine Street, 10th floor, during normal business hours. Staff reports related to items on the agenda are also accessible on line at www.co.contra-costa.ca.us. Public comment may be submitted via electronic mail on agenda items at least one full work day prior to the published meeting time. For Additional Information Contact: Julie DiMaggio Enea, Committee Staff Phone (925) 335-1077, Fax (925) 646-1353 julie.enea@cao.cccounty.us INTERNAL OPERATIONS COMMITTEE - SPECIAL 3. Meeting Date:12/19/2017   Subject:APPOINTMENTS TO THE EAST CONTRA COSTA FIRE PROTECTION DISTRICT BOARD OF DIRECTORS Submitted For: David Twa, County Administrator  Department:County Administrator Referral No.: IOC 17/5   Referral Name: ADVISORY BODY RECRUITMENT  Presenter: Julie Enea Contact: Julie DiMaggio Enea (925) 335-1077 Referral History: The East Contra Costa Fire Protection District (“District”) is currently governed by a nine-member appointed Board of Directors. Four members of the Board of Directors were appointed by the Brentwood City Council, three members were appointed by the Oakley City Council, and two members were appointed by the Contra Costa County Board of Supervisors. California law allowed voters to change an appointed fire protection district board of directors to a board of directors whose members are elected by the voters. The District Board of Directors adopted a resolution asking voters to decide whether to change the District governing board “from an appointed Board of Directors of nine members to a Board of Directors of nine members, elected at-large.” A majority of voters in the November 2016 election supported changing the governing board to an elected board. The District Board subsequently passed a resolution, attached hereto, establishing even-year elections and requesting to consolidate the first of these elections with the November 2018 general election. Additionally, on November 6, 2017, the District Board of Directors adopted a resolution to conduct an all mail ballot election on March 6, 2018 to transition from a nine-person elected board to a five-person elected board and to designate the seats "at large" rather than representative of wards. Under either the prospective 9-member or 5-member elected board, the members of the District Board of Directors will be elected at the next general District election in November 2018, and the elected officers will likely take office on December 7, 2018.  Referral Update: ↵The terms of office for the two Board of Supervisors-appointed Directors, Robert Kenny and Cheryl Morgan, will expire on February 4, 2018, leaving vacancies that will not be filled until successors are elected in November 2018 and assume office. On October 13, 2017, staff opened a recruitment (see attached media release) with an application deadline of November 20. The recruitment garnered seven applications. Below is the timeline for the remaining steps. December 19 or some time in January 2018 Board of Supervisors Meeting: Board consideration of IOC recommended appointments February 5, 2018 Appointments take effect The Internal Operations Committee interviewed six candidates on December 11. Scheduled for interview today is Karin Schnaider of Brentwood, whose application is attached. Below is a summary of the eligible candidates: Name Resident of Current Employment Education Current Volunteering Work Also Applied for Anthony Bargiacchi Brentwood Engineer/Firefighter, Novato Fire Protection District; Adjunct Faculty, EMT-First Responder, Los Medanos College BS, Columbia Southern Univ; criminal justice coursework at San Jose State Univ Not specified Not specified Lito Calimlim Clayton Real Estate Broker BA, Econ & Psychology, UCLA Comstock Gardens HOA Board President Not specified Karin Schnaider Brentwood City of Tracy Finance Director MBA, Public Policy Administration, San Diego State Univ.; BA, Public Policy Administration, CSU Long Beach Not specified Byron-Brentwood-Knightsen Union Cemetery District Board Sandra Strobel Knightsen Real Estate Broker; Project Manager/Admin GED, community college coursework, real estate license Knightsen Neighborhood Watch Chairperson Not specified Stephen F. Smith Brentwood Retired. Formerly, IT programmer analyst for banking institutions. MS, BS, UC Berkeley ECCFPD Board member since 2011 Not specified Susanna Thompson Clayton Co-owner, electrical contracting business; equine transportation services GED, junior college and university coursework in History Not specified Not specified Mark Whitlock Bethel Island Owner, carpet cleaning business since 1978 Not specified Not specified Not specified Recommendation(s)/Next Step(s): ↵INTERVIEW candidate for the Board of Supervisors appointed seats on the East Contra Costa Fire Protection District Board of Directors and DETERMINE recommendations for Board of Supervisors appointment effective February 5, 2018 and until such time that elected successors assume office. Fiscal Impact (if any): None to the County. Attachments ECCFPD Recruitment Media Release ECCFPD Election Resolution_Feb 2017 ECCFPD Resolution_Election to Reduce to 5 members_Nov 2017 Candidate Application_Karin Schnaider_ECCFPD Board of Directors Candidate Application_Anthony Bargiacchi_ECCFPD Board of Directors Candidate Application_Lito Calimlim_ECCFPD Board of Directors Candidate Application_Stephen F. Smith_ECCFPD Board of Directors Candidate Application_Sandra Strobel_ECCFPD Board of Directors Candidate Application_Susanna Thompson_ECCFPD Board of Directors Candidate Application_Mark Whitlock_ECCFPD Board of Directors Contra Costa County County Administrator’s Office • 651 Pine Street • Martinez, CA 94553 • www.co.contra-costa.ca.us Media Release FOR IMMEDIATE RELEASE Contact: Julie DiMaggio Enea Thursday, October 13, 2017 Phone: (925) 335-1077 Email: julie.enea@cao.cccounty.us WOULD YOU LIKE TO SERVE ON THE BOARD OF DIRECTORS FOR THE EAST CONTRA COSTA FIRE PROTECTION DISTRICT ? The Contra Costa County Board of Supervisors is seeking individuals to serve on the East Contra Costa Fire Protection District’s (ECCFPD) Board of Directors. The Board of Directors is composed of nine members; four appointed by the City of Brentwood, three appointed by the City of Oakley and two appointed by the Contra Costa County Board of Supervisors. Each Director appointed by the County Board of Supervisors must be a resident of the East Contra Costa Fire Protection District. The ECCFPD covers over 250 square miles and over 100 miles of waterway. The District comprises two incorporated cities (Brentwood and Oakley) and five distinct unincorporated communities (Bethel Island, Byron, Discovery Bay, Knightsen, and Morgan Territory/Marsh Creek Corridor). The ECCFPD is responsible for providing first responder and emergency medical services as needed. The Board of Directors serves as the governing body of the ECCFPD and, among other things, is responsible for establishing an annual budget and making decisions impacting district operations. The Board of Supervisors is seeking to fill two vacancies for a term commencing February 5, 2018. The ECCFPD intends to conduct an election on November 6, 2018, to determine the successors. Application forms can be obtained from the Clerk of the Board of Supervisors by calling (925) 335-1900 or by visiting the County webpage at www.co.contra-costa.ca.us. Applications should be returned to the Clerk of the Board of Supervisors, Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553 no later than Monday, November 20, 2017 by 5 p.m. Applicants should plan to be available for public interviews in Martinez on Monday, December 11, 2017. For more information about the District, please contact Chief Brian Helmick at (925) 584-8468 or bhelmick@eccfpd.org. # # # # , ·( ( ( EAST CONTRA COSTA FIRE PROTECTION DISTRICT BOARD OF DIRECTORS STATE OF CALIFORNIA * * *· RESOLUTION NO. 2017-03 CALLING AN ELECTION TO BE CONSOLIDATED WITH THE STATEWIDE GENERAL ELECTIONS IN EACH EVEN-NUMBERED YEAR, BEGl.NNING Of\,! NOVEMBER 6, 2018, . AND ORDERING THAT THE ELECTIONS OF DIRECTORS BE SUBMITTED TO THE VOTERS AT THOSE ELECTIONS WHEREAS, since the East Contra Costa Fire Protection District (District) was formed in 2002, members of the Boc;trd of Directors (Scare!) have been ~ppointed by the City Councils of Brentwood and Oakley, and by the Contra Costa County Board of Supervisors (Appointing Authorities); and WHEREAS, on November 8, 2016, as provided for in the Distrid's enabling legislation, specifically at California Health and Safety Co.de 13848, the District's voters approved Measure N, thereby req!Jiring the District to transition from an appointed Board to an elected Board; and · WHEREAS, California Health arid Safety Code Section 13848 specifies that, when voters approve transitioning from an appointed Board to an elected Board, the first elected directors will be elected at the next general district election; and WHEREAS, California Elections Code Section 1303 provides that general district el~ction$ CJte h~lcl oli the first Tuesday following the first Monday in November of each odd-numbered ye·ar and therefore, but for this action , the District's voters wouid elect di rectors on November 7, 2017 ; and WHEREAS, pursuant to Caiifornia Health and Safety Code Section 13886 and California Elections Code Section 10404, the Bo~rd may require that its dire.ctors are elected on the same day as the statewide general election; and WHEREAS, California Elections Code Section 1001 provide.s that elections held in November of each even-numbered year are statewide general elections, and the dates of those elections are statewide election dates; and WHEREAS, the next statewide general election In November of an even- numpered year is November 6, 201 $; and Page 1 Qf ~ 13089094,2 ( ( WHEREAS, the Board wishes to maximize voter participation, and minimize the costs associated with District elections; and WHERE:AS, the Board desires , as permitted by law, to consolidate the District's first election of members of its Board of Directors with the next statewide general election 'on . November 6, 201 a, anc:J:. . . WHEREAS, the Board desires, as permitted by law, to lie.Id future elections for members of the District's Board of Directors on statewide general eleQtion dates held on the first Tuesday after the first Monday in November, of each even-numbered year thereafter. NOW, THEREFORE, BE IT RESOLVED that pursuant to its rights, powers and authority, the Board of Directors of the East Contra Costa Fire Protection District hereby: 1. Orders the first election of members of the District's Board of Directors tq occur on November 6, 2018 and requests that such election be consolidated with applicable portion of the Statewide General Election conducted by the County of Contra Costa on that date, 2. Orders future elections of members of the District's Board of Directors to occur regularly on the same date as, and to be corisolidateq with, statewide general elections occurring on the first Tuesday after the first Monday in November of each even-numbered year thereafter. 3. Acknowledges that, in accordance with Section 10404(i) of the California Elections Code, ahd subject to any recippointment or replacement actions that may be taken by their respective Appointing Authorities before November 2018, these members of the Board of Directors, whose terms of office will expire prior to the statewide gen_eral election in November 2018, will continue in offic~ until their successors are elected and qualified at the November 2018 election: Meghan Bell , Robert Kenny, Cheryl Morgan, Brian Oftedal, Randy Pope, Joe Youhg; and 4. Acknowledges the terms of all preViously"'.appointed members of the Board of Directors will expire upon the election and qlialification of directors elected at the November 2018 election; Clnd · 5. Directs the Clerk to submit this Resolution to the Contra Costa County Board of Supervisors no later than 240 days prior to the next scheduled District election. 6. Requests the Contra Costa County Board of Supervisors administer this Resolution as set forth in Section 10404 of the California Elections Code and, within 60 days of the submission of this Resolution, approve this Resolution unless it finds that the ballot style, voting equipment, or computer Page 2 of 3 130119094.2 ( ( capacity cannot handle additional elections or materials, in accordance with Section 10404(e) of the California Elections Code. PASSED AND ADOPTED this 6th day of February 2017, by the following vote of the Board: AYES:Barr, Bell, Bryant, Kenny, Oftedal, Stonebarger, Young NOES:Mo~an . ABSENT: Pope ABSTAIN: J e Bryant . resident, Board of Directors ATTEST: Hugh Henderson, Clerk of the Board Page 3 of 3 13089094.2 Submit Date: Dec 01, 2017 Seat Name (if applicable) First Name Middle Initial Last Name Email Address Home Address Suite or Apt City State Postal Code Primary Phone Employer Job Title Occupation Contra Costa County Boards & Commissions Application Form Profile Which Boards would you like to apply for? Byron-Brentwood-Knightsen Union Cemetery District: Submitted East Contra Costa Fire Protection District Board of Directors - BOS Appointees: Submitted This application is used for all boards and commissions Do you, or a business in which you have a financial interest, have a contract with Contra Costa Co.? Yes No Is a member of your family (or step-family) employed by Contra Costa Co.? Yes No Education History Karin S Schnaider Brentwood CA 94513 City of Tracy Finance Director Finance Director for City of Tracy Karin S Schnaider Page 1 of 6 If "Other" was Selected Give Highest Grade or Educational Level Achieved Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Select the highest level of education you have received: Other College/ University A Type of Units Completed Semester Degree Awarded? Yes No College/ University B Masters in Public Policy Administration San Diego State University Accountancy 150 Bachelors of Science 2001 Cal State University, Long Beach Public Policy Adminstration 40 Karin S Schnaider Page 2 of 6 Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Course Studied Type of Units Completed None Selected Degree Awarded? Yes No College/ University C Type of Units Completed None Selected Degree Awarded? Yes No Other schools / training completed: Masters 2016 Karin S Schnaider Page 3 of 6 Hours Completed Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Certificate Awarded? Yes No Work History Please provide information on your last three positions, including your current one if you are working. 1st (Most Recent) Volunteer Work? Yes No Employer's Name and Address City of Tracy 333 Civic Center Plaza Tracy, CA 94513 Duties Performed Responsible for completion of annual budget, quarterly financial updates, annual audits. 22 employees in Finance Department, 550 employees citywide, $65 million General Fund budget. 2nd 03/13/2017 to present 40 Finance Director 09/12/2014 to 03/10/2017 Karin S Schnaider Page 4 of 6 Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Volunteer Work? Yes No Employer's Name and Address City of Benicia 250 East L Street Benicia CA 94510 Duties Performed Responsible for completion of annual budget, quarterly financial updates, annual audits. 10 employees in Finance Department, 270 employees citywide, $35 million General Fund budget. 3rd Volunteer Work? Yes No Employer's Name and Address City of Sierra Madre 232 W Sierra Madre Blvd Sierra Madre CA 91024 Duties Performed Responsible for completion of annual budget, quarterly financial updates, annual audits. 6 employees in Finance Department, 125 employees citywide, $15million General Fund budget. 40 Finance Director 11/12/2006 to 09/01/2014 40 Finance Director Karin S Schnaider Page 5 of 6 If "Other" was selected please explain Final Questions How did you learn about this vacancy? Contra Costa County Homepage . Do you have a Familial or Financial Relationship with a member of the Board of Supervisors? Yes No If Yes, please identify the nature of the relationship: Do you have any financial relationships with the County such as grants, contracts, or other economic relations? Yes No If Yes, please identify the nature of the relationship: Karin S Schnaider Page 6 of 6 Submit Date: Dec 05, 2017 Seat Name (if applicable) First Name Middle Initial Last Name Email Address Home Address Suite or Apt City State Postal Code Primary Phone Employer Job Title Occupation Contra Costa County Boards & Commissions Application Form Profile Which Boards would you like to apply for? East Contra Costa Fire Protection District Board of Directors - BOS Appointees: Submitted This application is used for all boards and commissions Do you, or a business in which you have a financial interest, have a contract with Contra Costa Co.? Yes No Is a member of your family (or step-family) employed by Contra Costa Co.? Yes No Education History Anthony Bargiacchi Brentwood CA 94513 Novato Fire Protection District Engineer Firefighter Anthony Bargiacchi Page 1 of 6 If "Other" was Selected Give Highest Grade or Educational Level Achieved Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Select the highest level of education you have received: Other College/ University A Type of Units Completed Semester Degree Awarded? Yes No College/ University B Bachelors of Science Columbia Southern University Environmental Management 120 Bachelors of Science 12/31/2013 Shasta Community College Fire Science 50 Anthony Bargiacchi Page 2 of 6 Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Course Studied Type of Units Completed Degree Awarded? Yes No College/ University C Type of Units Completed Semester Degree Awarded? Yes No Other schools / training completed: San Jose State University Criminal Justice 29 Anthony Bargiacchi Page 3 of 6 Hours Completed Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Certificate Awarded? Yes No Work History Please provide information on your last three positions, including your current one if you are working. 1st (Most Recent) Volunteer Work? Yes No Employer's Name and Address Novato Fire Protection District 95 Rowland Way Novato, Ca 94945 Duties Performed Respond safely to emergency incidents with crew in a specialized fire apparatus, manage county hazmat response team for all trainings, use fiscal prudence when working with budget items for hazmat team, be able to provide for medical care for sick and injured residents 2nd 5/5/2003-Present 56 Engineer 9/1/2009-Present Anthony Bargiacchi Page 4 of 6 Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Volunteer Work? Yes No Employer's Name and Address Los Medanos College 2700 East Leland Rd. Pittsburg, Ca 94565 Duties Performed Ensure all fire cadets are trained in life saving procedures, coordinate with multiple instructors training schedule and target objectives, use ethical standards when testing cadets to state requirements 3rd Volunteer Work? Yes No Employer's Name and Address Napa Valley College 2277 Napa-Vallejo Hwy Napa, Ca 94558 Duties Performed Lead and instruct up 30 college students in Emergency Medical Technician Basic training, ensure all students were brought to highest state level proficiency, manage up 6 skills instructor and regulate all required state mandated testing procedures 10 Adjunct Faculty 2/3/2004-6/5/2009 8 Adjunct Faculty Anthony Bargiacchi Page 5 of 6 If "Other" was selected please explain Final Questions How did you learn about this vacancy? Newspaper Advertisement . Do you have a Familial or Financial Relationship with a member of the Board of Supervisors? Yes No If Yes, please identify the nature of the relationship: Do you have any financial relationships with the County such as grants, contracts, or other economic relations? Yes No If Yes, please identify the nature of the relationship: Anthony Bargiacchi Page 6 of 6 Submit Date: Nov 30, 2017 Seat Name (if applicable) First Name Middle Initial Last Name Email Address Home Address Suite or Apt City State Postal Code Primary Phone Employer Job Title Occupation Contra Costa County Boards & Commissions Application Form Profile Which Boards would you like to apply for? East Contra Costa Fire Protection District Board of Directors - BOS Appointees: Submitted This application is used for all boards and commissions Do you, or a business in which you have a financial interest, have a contract with Contra Costa Co.? Yes No Is a member of your family (or step-family) employed by Contra Costa Co.? Yes No Education History Lito Calimlim Clayton CA 94517 Mobile: Town & Country Realty Associates Broker/Partner Real Estate Broker Lito Calimlim Page 1 of 6 If "Other" was Selected Give Highest Grade or Educational Level Achieved Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Select the highest level of education you have received: Other College/ University A Type of Units Completed Quarter Degree Awarded? Yes No College/ University B College graduate UCLA Economics & Psychology BA 6/83 Lito Calimlim Page 2 of 6 Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Course Studied Type of Units Completed None Selected Degree Awarded? Yes No College/ University C Type of Units Completed None Selected Degree Awarded? Yes No Other schools / training completed: Lito Calimlim Page 3 of 6 Hours Completed Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Certificate Awarded? Yes No Work History Please provide information on your last three positions, including your current one if you are working. 1st (Most Recent) Volunteer Work? Yes No Employer's Name and Address 1) Town & Country Realty Associates - current 1026 Oak St., Ste. 204, Clayton, CA 94517 2) Re/Max Town & Country 1026 Oak St., Ste. 204, Clayton, CA 94517 3) Keller Williams Realty Citrus Plaza, Walnut Creek, CA 94598 4) Prudential California Realty Contra Costa Blvd., Pleasant Hill, CA 94523 Duties Performed Facilitate sales and purchases of residential properties 1-4 units, property management of residential properties 1-4 units throughout the Bay Area with most business conducted in Contra Costa County. 2nd 2002 - present 60-70 Real Estate Agent/Broker 1994? - Present Lito Calimlim Page 4 of 6 Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Volunteer Work? Yes No Employer's Name and Address Comstock Gardens Condominium Complex Sierra Rd Concord, CA 94518 Duties Performed Attend HOA board meetings, manage the HOA finances, budget, and issues related to maintaining a well- run and managed complex. 3rd Volunteer Work? Yes No Employer's Name and Address Diablo Hills Condominium Complex Marchbanks Dr Walnut Creek, CA 94598 Duties Performed Attend HOA board meetings, manage the HOA finances, budget, and issues related to maintaining a well- run and managed complex. Comstock Gardens HOA - Board President 1991? - Present Diablo Hills HOA - Board Treasurer Lito Calimlim Page 5 of 6 If "Other" was selected please explain Final Questions How did you learn about this vacancy? Other . Do you have a Familial or Financial Relationship with a member of the Board of Supervisors? Yes No If Yes, please identify the nature of the relationship: Do you have any financial relationships with the County such as grants, contracts, or other economic relations? Yes No If Yes, please identify the nature of the relationship: Debbie Allen - Morgan Territory Rd resident, Cheryl Morgan - Board Member ECCFPD Lito Calimlim Page 6 of 6 Submit Date: Dec 04, 2017 Seat Name (if applicable) First Name Middle Initial Last Name Email Address Home Address Suite or Apt City State Postal Code Primary Phone Employer Job Title Occupation Contra Costa County Boards & Commissions Application Form Profile Which Boards would you like to apply for? East Contra Costa Fire Protection District Board of Directors - BOS Appointees: Submitted This application is used for all boards and commissions Do you, or a business in which you have a financial interest, have a contract with Contra Costa Co.? Yes No Is a member of your family (or step-family) employed by Contra Costa Co.? Yes No Education History Board Member Mark Whitlock Bethel Island CA 94511 All City Carpet Cleaning Owner Mark Whitlock Page 1 of 6 If "Other" was Selected Give Highest Grade or Educational Level Achieved Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Select the highest level of education you have received: Other College/ University A Type of Units Completed None Selected Degree Awarded? Yes No College/ University B Mark Whitlock Page 2 of 6 Degree Type Date Degree Awarded Name of College Attended Course of Study / Major Units Completed Degree Type Date Degree Awarded Course Studied Type of Units Completed None Selected Degree Awarded? Yes No College/ University C Type of Units Completed None Selected Degree Awarded? Yes No Other schools / training completed: Mark Whitlock Page 3 of 6 Hours Completed Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Dates (Month, Day, Year) From - To Hours per Week Worked? Certificate Awarded? Yes No Work History Please provide information on your last three positions, including your current one if you are working. 1st (Most Recent) Volunteer Work? Yes No Employer's Name and Address All City Carpet Cleaning P.O. Box 132 Bethel Island, CA 94511 Duties Performed Carpet Cleaning 2nd 1978 - Current 40 Owner Mark Whitlock Page 4 of 6 Position Title Dates (Month, Day, Year) From - To Hours per Week Worked? Position Title Volunteer Work? Yes No Employer's Name and Address Duties Performed 3rd Volunteer Work? Yes No Employer's Name and Address Duties Performed Final Questions How did you learn about this vacancy? District Supervisor Mark Whitlock Page 5 of 6 If "Other" was selected please explain . Do you have a Familial or Financial Relationship with a member of the Board of Supervisors? Yes No If Yes, please identify the nature of the relationship: Clean carpet for the District Supervisor's office annually. Do you have any financial relationships with the County such as grants, contracts, or other economic relations? Yes No If Yes, please identify the nature of the relationship: Mark Whitlock Page 6 of 6