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2021-03-16 Ex 03 (Revised)Citizen Board Selection Matrix Tally Sheet Initial Vote Tie Breaker Rev�secl Ex•3 M ar. It�1 20 21 Committee Appointment: Flagler Park Desiqn Review Advisory Committee Point System is reflected as follows: 1 st Selection = 3 Points 2nd Selection = 2 Points 3rd Selection = 3 Points 4th Selection = N/A The Point System is based on the number of applicants. Mayor Council Council Council Council Applicant Name Watford Member Member Member Member Total Abney Clark Jarriel Keefe Burdge, Bob 2 1 2 3 3 11 Cable, Magi 1 3 3 2 2 11 Cohen, Adam 3 2 1 1 1 8 Turgeon, Sharie N/A N/A N/A N/A N/A 0 Mayor Council Council Council Council Applicant Name Watford Member Member Member Member Total Abney Clark Jarriel Keefe Burdge, Bob 2 1 2 2 2 9 Cable, Magi 1 2 1 1 1 6 TALLY SHEET REVISED 3/16/2021 INDIVIDUAL RANKING SHEETS REVISED 3/15/2021 & EMAILED TO MAYOR & COUNCIL, S. TURGEON WITHDREW HER APPLICATION ON 3/15/2021. Created: Jan. 27, 2021-BJ Citizen Board Selection Matrix Individual Ranking Sheet �ev� 5ed CX.. 3 IUI ar. I lo� Zd 2/ INSTRUCTIONS: Complete this form prior to the meeting. Submit to the City Clerk before the meeting begins in order to input the points in the tally sheet. Committee Appointment: Flagler Park Design Review Advisory Committee Alternate Member Ranker Name: ���" �✓��-✓c"— v� Point System is reflected as follows: 1 st Selection = 3 Points 2nd Selection = 2 Points 3rd Selection = 1 Point Applicant Name Burdge, Bob Cable, Magi Cohen, Adam Turqeon, Sharie Points � � I ''l� ' �'"' �'C-�-� �. � � � APPLICATION The Point System is based on the number of applicants. NOTE: The same procedure will be utilized to select a winner in the event of a tie. Adopted by City Council 2-2-2021 � Citizen Board Selection Matrix Individual Ranking Sheet INSTRUCTIONS: Complete this form prior to the meeting. Submit to the City Clerk before the meeting begins in ortler to input the points in the tally sheet. Committee Appointment: Flagler Park Design Review Advisory Committee Alternate Member Ranker Name: �� �-� �� � Point System is reflected as follows: 1 st Selection = 3 Points 2nd Selection = 2 Points 3rd Selection = 1 Point Applicant Name Burdge, Bob Cable, Magi Cohen, Adam Turgeon, Sharie Points �'� � r�`'�'�' r� 2r`� � _ 1SJ 2 r-D APPLICATIO i 5 � 02 The Point System is based on the number of applicants. NOTE: The same procedure will be utilized to select a winner in the event of a tie. Adopted by City Council 2-2-2021 Citizen Board Selection Matrix Individual Ranking Sheet INSTRUCTIONS: Complete this form prior to the meeting. Submit to the City Clerk before the meeting begins in order to input the points in the tally sheet. Committee Appointment: Flagler Park Design Review Advisory Committee Alternate Member Ranker Name: � � � (�- �'{C.r�� C° l�- r�-G. ! � ��� Point System is reflected as follows: 1st Selection = 3 Points 2nd Selection = 2 Points 3rd Selection = 1 Point � I � � Y Q.G�.,IC.�,� Name I Points Burdae. Bob � �• � ��: Cable, Magi � � Cohen, Adam � Turgeon, Sharie The Point System is based on the number of applicants. NOTE: The same procedure will be utilized to select a winner in the event of a tie. Adopted by City Council 2-2-2021 Citizen Board Selection Matrix Individual Ranking Sheet INSTRUCTIONS: Complete this form prior to the meeting. Submit to the City Clerk before the meeting begins in order to input the points in the tally sheet. Committee Appointment: Flagler Park Design Review Advisory Committee Alternate Member Ranker Name: f� �� :S A�'(� � c-; U Point System is reflectetl as follows: 1 st Selection = 3 Points 2nd Selection = 2 Points 3rd Selection = 1 Point Applicant Name Points T� �- �� Burdae. Bob 3 �� � Cable Cohen, Adam � � 1 1 Turgeon, Sharie I APPLICATION The Point System is based on the number of applicants. NOTE: The same procedure will be utilized to select a winner in the event of a tie. Adopted by City Council 2-2-2021 Citizen Board Selection Matrix Individual Ranking Sheet INSTRUCTIONS: Complete this form prior to the meeting. Submit to the City Clerk before the meeting begins in order to input the points in the tally sheet. Committee Appointment: Flagler Park Design Review Advisory Committee Alternate Member � ,_ Ranker Name: l� `,,.F�`�''' d J r� a f'`� '�; �L� � Point System is reflected as follows: 1 st Selection = 3 Points 2nd Selection = 2 Points 3rd Selection = 1 Point 1 � .� � ��i�� icant Name �oints Burdae. Bob �s Cable, Magi +�'' Cohen, Adam �f Turgeon, Sharie I APPLICA The Point System is based on the number of applicants. NOTE: The same procedure will be utilized to select a winner in the event of a tie. Adopted by City Council 2-2-2021 J.J. Smith �� �b� � 3 From: Sharie Turgeon <sturgeon@co.okeechobee.fl.us> �'' � �I ��l Sent: Monday, March 1 S, 2021 1028 AM To: J.J. Smith Subject: RE: Flagler Park Committee Hello J.J., Since applying I have been appointed to another board and feel that I would be stretching myself thin. I do believe this is important and believe that Main Street is well represented with Mrs. Scott and tourism will be well represented by the board in whole. So I must withdraw my application. Thanlc you for the consideration, (`,►l��f�t°lt��l'7t!i} (�r'rrrrft� •... . ����� � � + , �, : ,, �-� ;: � ,, , ,� =�� �...m- � ,., ��[`l(t'r;� f�cfr"c^it`����[c+i��( (�c`cl�tc'r( Sharie '1'urgeon — Tourism Coordinator 55 S. Parrott Ave. Olceechobee, FL. 34972 O: (8b3) 763-3959 C: (863) 53z-5000 www.visitokeechobeecountv.coin T<: (u����l:�;�chobee�idc Request the Award Winning Visitor Guide Today! From: J.1. Smith [mailto:jsmith@cityofokeechobee.com] Sent: Monday, March 15, 2021 10:10 AM To: Sharie Turgeon <sturgeon@co.okeechobee.fl.us> Subject: Flagler Park Committee Good Morning Sharie, Paulette Bragel resigned from the Flagler Park Design Review Committee and they will be voting on a replacement to appoint at tomorrow night's City Council meeting. Are you still interested in being in consideration for the alternate spot? I know it's been a few months so we are just double checking with everyone. Thanks! J.J. Smith- Administrative Secretary City Clerk's Office City of Okeechobee 55 SE 3�d Avenue Okeechobee, FL 34974 Phone: (863) 763-3372 ext. 9815 Direct: (863) 763-9815 Fax:(863)763-1686 .'�.i:l -:JkFf:•.�•,. ��, ��$`2 . ^�+....a ' � �l � _ `;+`�KJ _ _ ' -•1'. �' _-- NOTICE: Florida has a very broad public records law. As a result, any written communication created or received by the City of Okeechobee officials and employees will be available to the public and media, upon request, unless otherwise exempt. Under Florida law, e-mail addresses are public records. If you do not want your e- mail address released in response to a public records request, do not send electronic mail to this office. Instead, contact our office by phone or in writing. Citizen Board Selection Matrix Individual Ranking Sheet Committee Appointment: Flagler Park Design Review Advisory Committee Alternate Member Ranker Name: Point System is reflected as follows: 1st Selection =4 Points 2nd Selection =3 Points 3rd Selection =2 Points 4th Selection =1 Point Applicant Name Burdge, Bob Cable, Magi Cohen, Adam Turgeon, Sharie Points The Point System is based on the number of applicants. NOTE: The same procedure will be utilized to select a winner in the event of a tie. INSTRUCTIONS: Complete this form prior to the meeting. Submit to the City Clerk before the meeting begins in order to input the points in the tally sheet. Adopted by City Council 2-2-2021 CITY OF OKEECHOBEE 55 Southeast 3r Avenue * Okeechobee * Florida * 34974 * (863) 763-3372 APPLICATION -FOR CITY CITIZEN BOARD/COMMITTEE APPO r easr rrr i -ors - - 'i i ' p y/ a farm t r i -i used by the City Council in considering action on your appointment. The application MUST BE COMPLETED IN FULL. Answer "None" "Not Applicable" or "N/A" where appropriate. CHECK (0) THE BOARD(S) OF INTEREST TO YOU 6LEDACOPYOFEACHBOARDSDUTIES, MEETING DATES, AND TIMES ARE AT Planning Board/Board of Adjustment & Appeals/Design Review Board Okeechobee Utility Authority Board of Directors (city Residents only) Police Officers Pension, Firefighters Pension, or General Employees' Retirement System Board( City Resident Trustee: 0__ OR Fifth Member Trustee: ) Fla ler Park Desi n Review Advisor CommitteeOther: J 9 Y APPLICANT'S FULL NAME: Robert J. Burdge AI AA-AAR fi-11 \/ r IJIVHIVI I IJIVIIVIIJ tV Lam' USt=U. 1J%J" RESIDENCE ADDRESS: 4204 Birkdale Dr. Fort Pierce, FI 34947 HOW LONG AT ADDRESS: Years: recent Is this in the City Limits? Yes E]No MAILING ADDRESS: 4204 Birkdale Dr. Fort Pierce, FI 34947 TELEPHONE/ CELL: 772-466-0032 (home) ARE YOU AN US CITIZEN? EI Yes No, explain: FLORIDA REGISTERED VOTER? 0 Yes County Registered in: St. Lucie No EDUCATION: High School Name & Location Year Graduated Dan McCarty H.S 1968 ATION: College Name(s) Certificate/Degree(s)"AwaMe Eastern Kenkucky Univ B.A. 1972-74 MILITARY. CC1RV1('C• Dates f Spn/icp, JAischaraeDate None CURRENT OR MOST RECENT EMPLOYER: School Board Of St. Lucie County JOB TITLE/DESCRIPTION: Teacher WORK ADDRESS: Retired after 35.5 years of service WORK TELEPHONE: ARE YOU CURRENTLY EMPLOYED AS: General Contractor Business Person Architect CHECK ALL THAT APPLY) Engineer Sub -Contractor Realtor Attorney Doctor Surveyor I] Lay Person Urban Planner Landscape Architect p I Of q Have you ever been appointeVyl or do you currently serve on, a citizen or community board for any other agency or government? No es,and list: AGENCY BOARD NAME POSITION DATE(S) City of Fort Pierce Planning Board member 2009-current city of Fort Pierce Parks committee member 2019-current city of fort pierce Chairman 2018-present Are you now, or have you ever been, elected or appointed to any public office? No El Yes, and list: LEVEL OF GOVERNMENT OFFICE TITLE DATE OF ELECTION _ TERM(S) City of Fort Pierce Commissioner 1988-1996 2=4year terms Do you work with or hj3ve any association with a current member of the board/committee to which you are requesting appointment? No Yes, and list: NAME OF BOARD/COMMITTEE MEMBER(S) RELATIONSHIP/ASSOCIATION Are you related to, or employed by, any City of Okeechobee employees or elected officials? VNo Yes, and list: NAME OF EMPLOYEE/ELECTED OFFICIAL RELATIONSHIP/ASSOCIATION Have lint-r- ever been for 1n +n ho_in ,Aa[a-j Florida Statutes (G`I o.,+e 17 +TI (`r csf Fthirs for_Pi ihlir nffiCers and Employees? N(No Yes, and list: DATES NATURE OF VIOLATION Have you ever been convicted of a FELONY, plead guilty or no contest, or entered into an agreement setting forth the terms leading to the reduction or dismissal of the charges? C5(No Yes, and list: DATES VIOLATION CITY AND STATE ALL INFORMATION PROVIDED ON THIS FORM IS A PUBLIC RECORD. Information for certain individuals with a specific public records exemption can be withheld. In order to claim the exemption complete the following: A.-.. ...... a ....-....,.t_3i 8i rrcr Fi rE s v'"u z rTiTi Vic..—r ,."il f 1 ry_..n F<,.r.,_._,._.,.....-......,i..ili., v I wl, VI lII V r u Jr G VUlll.rll r fVr.l.r SVV Vrrr-or- Civilian l lawv ,..Y tJu..cr..,,,a Yuri , ., F enforcement personnel, certified firefighter, EMT, paramedic, code enforcement officer, or other covered employee who is exempt from pu lc records disclosure under Florida Statute 119.071? Review list of other covered employees before responding. MNo Yes, and list: JOB TITLE OR COVERED POSITION TITLE RELATIONSHIP Wr t, is , rci A ot-1-i Describe any skills, experiences, interests and/or background information about yourself that would be helpful to the Board you wish to serve on. Include personal accomplishments that qualify you for the appointment. If more space is needed, please attach an additional page. Have worked on many committees in Fort Pierce which could help in the development of the park. THE FOLLOWING INFORMATION IS USED WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, DISABILITY, OR MARITAL STATUS. HOWEVER, THE FEDERAL AND STATE GOVERNMENTS REQUIRE THE CITY TO PROVIDE STATISTICS ON THE NUMBER OF WOMEN, MINORITIES, VETERANS, AND DISABLED PERSONS THAT ARE APPOINTED TO BOARDS. INFORMATION WILL BE USED FOR STATISTICAL PURPOSES ONLY AND HAVE NO BEARING ON YOUR APPOINTMENT: SEX: 2 MALE El FEMALE ETHNIC GROUP: ;/CAUCASIAN BLACK SPANISH HERITAGE NATIVE AMERICAN AN OR PACIFIC ISLANDER OTHER(specify): ALL THAT APPLY: WARTIME IPEE RIIO D_VETERAN DISABLED VETERAN L0-' IE-i AM--V LTL A- V- HANDICAPPED STATUS: 140 YES, AND LIST THE HANDICAP: P9 STATEMENT OF APPLICANT: I certify that the answers are true and complete to the best of my knowledge. I authorize nvestiaation of all Stat .mentG contained in this application. I hereby release all companies ..sck 4I or oersons from all liability for any damage for issuing this information. I understand that the City may request a copy of my driver's license. I have the right to request that the City completely and accurately disclose to me the contents of any investigation or reports upon request to the Office of the City Clerk. I further understand all information provided becomes a matter of public record. CERTIFICATION: I understand that falsification, omission, misleading statements, or misrepresentation is cause for rejection of this application. I understand that this application is a Public Record and is subject to the provisions of Florida Statutes Chapter 119. FINANCIAL DISCLOSURE REPORTING: I understand that should I be appointed to a City of Okeechobee citizen board I am required to complete and file a State of Florida Financial Disclosure Form 1 upon my appointment, annually and a Financial Disclosure Form 1-Final upon my resignation/sunset of term. PUBLIC RECORDS/OPEN MEETINGS LAWS: I understand and agree that should I be appointed to a citizen board/committee for the City of Okeechobee, I will comply with all State Statutes, Florida Administrative Code, and State Constitution regarding public records, records retention, public record requests, and the open public meeting requirements. ve read and un rstand ach of t above statements. Signature of Applicant: Date: 1. The City Code Book Sec. 70-151, 70-171, 70-19170-211 read: "....membership of the board, where possible, shall consist of any of the following: architect, engineer, surveyor, urban planner, landscape architect, general contractor, realtor, business person, and lay persons." 2. Other covered jobs include current or former, their spouse, and children: correctional and correctional probation officers; juvenile probation officers, supervisors, detention superintendents and assistants; Department of Juvenile Justice: detention officers I and 11, detention office supervisors, residential officers, residential officer supervisors I and 11, counselors and supervisors, human services counselor administrators, senior human services counselor administrators, rehabilitation therapists, and social services counselors; certain personnel of: the Department of Children and Families; the Department of Health; the Department of Financial Services; and the Department of Revenue or local governments whose responsibilities include revenue collection and enforcement or child support enforcement; investigators or inspectors of the Department of Business and Professional Regulation; the Office of the Inspector General or internal audit department; justices of the Supreme Court; judges of the district court of appeals, circuit court, and county court; general and special magistrates, judges of compensation claims, administrative law judges of the Divisions of Administrative Hearings, and child support enforcement hearing officers; state attorneys and assistants, statewide prosecutors and assistants; public defenders and ass is an s, cnm vial conflict and civil regional counsel and assistants; guardians adTitem; uman resource, labor relations, or employee relations directors and assistants, managers or assistant managers of any local government agency or water management district whose duties include hiring and firing employees, labor contract negotiations, acirrl rris'irai o i, cir—crii rs r rei related—ituiies, tax cullecturs, certain p [see 119.071, Florida Statues]. PLEASE RETURN COMPLETED APPLICATION TO: CITY OF OKEECHOBEE OFFICE OF THE CITY CLERK 55 SE 3RD AVENUE, ROOM 100 OKEECHOBEE, FLORIDA 34974 CITY CLERKS OFFICE USE ONLY APPOINTED TO: CITY COUNCIL MEETING: INITIAL TERM DATES: NOTIFICATION SENT: RE -APPOINTED TERM DATES: RE -APPOINTMENT NOTIFICATION SENT: RESIGNED/TERM SUNSET: CERTIFICATE OF APPRECIATION PRESENTED: Ali UGLI CUP I r 91 Of Rev. 11-03-2020/JS CITY OF OKEECHOBEE 55 Southeast 3rd Avenue * Okeechobee * Florida * 34974 * (863) 763-3372 APPLICATION FOR CITY CITIZEN BOARD/COMMITTEE APPOINTMENT Please print or type all information. The information from this application will be used by the City Council in considering action on your appointment. The application !MUST BE COMPLETED /N FULL. Answer "None" "Not Applicable- or 'N/A" where appropriate. CHECK (Y-) THE BOARD(S) OF INTEREST TO YOU A COPY OF EACH BOARDS DUTIES, MEETING DATES, AND TIMES ARE ATTACHED Planning Board/Board o` A _s ar; & .Azzes s Design Review Board Okeechobee Utility Authcr-ry =_=~ QirE _: s City R.id.'tsoMy) 0 Police Officers Per:slio- F e .: -^s , c, General Employees' Retirement System Board of Trustees City Resident Trustee: OR Fifth Member Trustee: __.__.—) E]Other.Flagler Park DesAdvisory Committee 0 APPLICANT' S Margaret J. Cable NAME COY%10N_'* U5=_- Magi Cable RESsc_: 5852 SW 37th Avenue ZNGA-___ __ : 42 Is this in the City Limits? []Yes EINo KlAj ,.G `: REss 1852 S'vV 37th Ave, Okeechobee, FI 34974 TELEPHONE CELL: 863-610-2662 ARE YOU AN US CITIZEN? 0 Yes = tic. exolain: FLORIDA REGISTERED VOTER? O Yes Cc.,nry Registered in: Okeechobee j do EDUCATION: z;- S--,, , --, s _ Year Graduated Okeechobee High School 1972 POST SECONDARY EDUCATION: a—e < Certi(Cate/Degree($)Awarded Date(s)Attended F S U BS 1973-1975 MILITARY SERVICE: 3a-rs,es Dates of Service Discharge Date N/A CURRENT OR MOST RECENT EMPLOYER: Retired- OCSB JOB TITLE/ DESCRIPTION: Retired Science Teacher WORK ADDRESS: NIA WORK TELEPHONE: N/A ARE YOU CURRENTLY EMPLOYED AS: General Contractor Business Person Architect CHECK ALL THAT APPLY) Engineer Sub -Contractor Realtor Attorney Doctor O Surveyor Lay Person Urban Planner Landscape Architect ob-6Ie / N I a q Have you ever been appointed to, or do you currently serve on, a citizen or community board for any other agency or govemment? No El Yes, and list: AGENCY $OARD NAME POSITION DAT S City of Okeechobee City Centennial Con,-M >_ `a —e- 2014-2015 Healthy Start Coalition of Okeechobee Healthy Start Coal,c- t Ok_:_ oc e :-a—a, 2010-current Our Village Okeechobee Our Village Okeec =-ze • >-.'.e' 201.7-ourent Are you now, or have you ever been, elected or appointed to any public office? El No Yes, and list: LEVEL OF GOVERNMENT OFFICE TITLE CA—E C= EL_CTiON TERM(S) Do you work with or have any association with a current member of the board/committee to which you are requesting appointment? El No Yes, and list: NAME OF BOARDfCOMMITTEE MEMBER(S) RE_A.TIONSHIP ASSOCIATION Are you related to, or employed by, any City of Okeechobee employees or elected officials? El No Yes, and list: SAME OF EMPLOYEE. ELECTED OFFICIAL RELATIONSHIP/ASSOCIATION Have you ever been found to be in violation of Florida Statutes Chapter 112, Part III, Code of Ethics for Public Officers and Employees? El No Yes, and list: CA-E SNATURE OF VIOLATION Have you ever been convicted of a FELONY, plead guilty or no contest, or entered into an agreement setting forth the terms leading to the reduction or dismissal of the charges? El No Yes, and list: DATE( S) VIOLATION CITY AND STATE ALL INFORMATION PROVIDED ON THIS FORM IS A PUBLIC RECORD. Information for certain individuals with a specific public records exemption can be withheld. In order to claim the exemption complete the following: Are you a current or former, the spouse of a current or former, or the child of a current or former sworn or civilian law enforcement personnel, certified firefighter, Eh4T, paramedic, code enforcement officer, or other covered employee who is exempt from public records disclosure under Florida Statute 119.071? Review list of other covered employees before responding. El No Yes, and list: JOB TITLE OR COVERED POSITION TITLE RELATIONSHIP t t Describe any skills, experiences, interests and/or background information about yourself that would be helpful to the Board you wish to serve on. Include personal accomplishments that qualify you for the appointment. If more space is needed, please attach an additional page. As president of the Okeechobee Historical Society, I feel that I can assist in the planning of the themed parks by providing the historical background neccessary. THE FOLLOWING INFORMATION IS USED WITHOUT REGARD TO RACE. COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, DISABILITY, OR MARITAL STATUS. HOWEVER, THE FEDERAL AND STATE GOVERNMENTS REQUIRE THE CITY TO PROVIDE STATISTICS ON THE NUMBER OF WOMEN, MINORITIES, VETERANS, AND DISABLED PERSONS THAT ARE APPOINTED TO BOARDS. INFORMATION WILL BE USED FOR STATISTICAL PURPOSES ONLY AND HAVE NO BEARING ON YOUR APPOINTMENT: SEX: MALE El FEMALE ETHNIC GROUP: EI CAUCASIAN BLACK SPANISH HERITAGE NATIVE AMERICAN ASIAN OR PACIFIC ISLANDER OTHER(specify): ALL THAT APPLY: WARTIME PERIOD VETERAN DISABLED VETERAN VIETNAM VETERAN HANDICAPPED STATUS: EINO YES, AND LIST THE HANDICAP: CtbIE, STATEMENT OF APPLICANT: I certify that the answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application. I hereby release all companies, schools, or persons from all liability for any damage for issuing this informatior. I understand that the City may request a copy of my driver's license. I have the right to request that the City completely and accurately disclose to me the contents of any investigation or reports upon request to the Office of the City Clerk. I furtrer uncerstand all information provided becomes a matter of public record. CERTIFICATION: I understand that falsification. omission. misleading statements, or misrepresentation is cause for rejection of this application. I understand that this acc'Icat on is a Public Record and is subject to the provisions of Florida Statutes Chapter 119. FINANCIAL DISCLOSURE REPORTING: I unoersta-c :ha: should (be appointed to a City of Okeechobee citizen board I am required to complete and file a State o` Flonca Financial Disclosure Form 1 upon my appointment, annually and a Financial Disclosure Form 1-Final upon my resicna.:on sunset of term. PUBLIC RECORDS/OPEN MEETINGS LAWS: I understand and agree that should I be appointed to a citizen board/committee for the City of Okeechobee. I ,ti it comply with all State Statutes, Florida Administrative Code, and State Constitution regarding public records. records retention, public record requests, and the open public meeting requirements. I hereby acknowledge that I have read a7o urze,starc each of the above statements. Signature of Applicant ! C"-- Date: 1. The City Code Book Sec. 7a-15'. 70-171 70-'9170-211 read: ....membership of the board, where possible, shall consist of any of the fc lowing: architect. engineer. surveyor, urban planner, landscape architect, general contractor, realtor, business person. arc lay persons.' 2. Other covered ,obs include cu`Tent or former. their spouse, and children: correctional and correctional probation officers; juvenile probation of-,cers, supervisors, detention superintendents and assistants; Department of Juvenile Justice: detention officers I and II, detentior office supervisors, residential officers, residential officer supervisors I and II, counselors and supervisors, human services counselor administrators, senior human services counselor administrators, rehabilitation therapists, and social services counselors; certain personnel of: the Department of Children and Families; the Department of Health; the Department of Financial Services; and the Department of Revenue or local governments whose responsibilities include revenue collection and enforcement or child support enforcement; investigators or inspectors of the Department of Business and Professional Regulation; the Office of the Inspector General or internal audit department; justices of the Supreme Court; judges of the district court of appeals, circuit court, and county court; general and special magistrates, judges of compensation claims, administrative law judges of the Divisions of Administrative Hearings, and child support enforcement hearing officers; state attorneys and assistants, statewide prosecutors and assistants; public defenders and assistants, criminal conflict and civil regional counsel and assistants; guardians ad litem; human resource, labor relations, or employee relations directors and assistants, managers or assistant managers of any local government agency or water management district whose duties include hiring and firing employees, labor contract negotiations, administration, or other personnel -related duties; tax collectors; certain impaired practitioners and consultants; [see 119.071, Florida Statues]. PLEASE RETURN COMPLETED APPLICATION TO: CITY OF OKEECHOBEE OFFICE OF THE CITY CLERK 55 SE 3RD AVENUE, ROOM 100 OKEECHOBEE, FLORIDA 34974 CRY CLERKS OFFICE USE ONLY APPOINTED TO: CITY COUNCIL MEETING: INITIAL TERM DATES: NOTIFICATION SENT: RE -APPOINTED TERM DATES: RE -APPOINTMENT NOTIFICATION SENT: RE:SIGNEWTERM SUNSET: CERTIFICATE OF APPRECIATION PRESENTED: 1 Rev. 11-03-2020/JS CITY OF OKEECHOBEE 55 Southeast 3r Avenue * Okeechobee * Florida * 34974 -* (863) 763-3372 APPLICATION FOR CITY CITIZEN BOARD/COMMITTEE APPOINTMENT Please print or type all information. The information from this application will e p!City Council in considering action on your appointment. The application MUST i ,L'.]i31VIAL '_rr,kdy FULL. Answer "None" "Not Applicable" or "N/A" where appropriate. CHECK (®) THE BOARD(S) OF INTEREST TOY A COPY OF EACH BOARDS DUTIES, MEETING DATES, AND TIMES A TTACHE CQ0PlanningBoard/Board of Adjustment & Appeals/Design Review Board 1 Okeechobee Utility Authority Board of Directors (City Residents Only) Police Officers Pension, Firefighters Pension, or General Employees' Retirement System Boar las City Resident Trustee: OR Fifth Member Trustee: 0 El Other: Flagler Park Design Review Advisory Committee APPLICANT'S FULL NAME: Adam Cohen NAME COMMONLY USED: Adam Cohen RESIDENCE ADDRESS: 3355 SE 44 Avenue, Okee, FL 34974 HOW LONG AT ADDRESS: Years: 2 Is this in the City Limits? Yes I] No MAILING ADDRESS: 3355 SE 44 Avenue, Okee, FL 34974 TELEPHONE/CELL: 954-682-5532 ARE YOU AN US CITIZEN? I] Yes No, explain: FLORIDA REGISTERED VOTER? 121 Yes County Registered in: Okeechobee No EDUCATION: High School Name & Location Year Graduated Coral Springs HS 1993 POST SECONDARY EDUCATION: College Names) Certificate/Degree(s) Awarded Date(s) Attended Univ of Florida Masters Accounting 1993 - 1997 MILITARY SERVICE: Branch(es) Dates of Service Discharge Date NONE CURRENT OR MOST RECENT EMPLOYER: Self employed / Colony One On -Line, Inc. JOB TITLE/DESCRIPTION: Executive WORK ADDRESS: Work from home WORK TELEPHONE: 954-341-7031 x 302 ARE YOU CURRENTLY EMPLOYED AS: General Contractor 0 Business Person Architect CHECK ALL THAT APPLY) Engineer Sub -Contractor Realtor Attorney Doctor Surveyor Lay Person Urban Planner Landscape Architect Have you ever been appointed to, or do you currently serve on, a citizen or community board for any other agency or government? No 0 Yes, and list: AGENCY BOARD NAME POSITION DATE(S) Okeechobee County Planing, Review, Appeals Mmeber 2020 - present Are you now, or have you ever been, elected or appointed to any public office? 0 No Yes, and list: LEVEL OF GOVERNMENT OFFICE TITLE DATE OF ELECTION TERM(S) Do you work with or have any association with a current member of the board/committee to which you are requesting appointment? 0 No Yes, and list: NAME OF BOARD/COMMITTEE MEMBER(S) RELATIONSHIP/ASSOCIATION Are you related to, or employed by, any City of Okeechobee employees or elected officials? 0 No Yes, and list: NAME OF EMPLOYEE/ELECTED OFFICIAL RELATIONSHIP/ASSOCIATION Have you ever been found to be in violation of Florida Statutes Chapter 112, Part III, Code of Ethics for Public Officers and Employees? 0 No Yes, and list: DATE(S) NATURE OF VIOLATION Have you ever been convicted of a FELONY, plead guilty or no contest, or entered into an agreement setting forth the terms leading to the reduction or dismissal of the charges? 0 No Yes, and list: DATE(S) VIOLATION CITY AND STATE ALL INFORMATION PROVIDED ON THIS FORM IS A PUBLIC RECORD. Information for certain individuals with a specific public records exemption can be withheld. In order to claim the exemption complete the following: Are you a current or former, the spouse of a current or former, or the child of a current or former sworn or civilian law enforcement personnel, certified firefighter, EMT, paramedic, code enforcement officer, or other covered employee who is exempt from public records disclosure under Florida Statute 119.071? Review list of other covered employees before responding. 0 No Yes, and list: JOB TITLE OR COVERED POSITION TITLE RELATIONSHIP Men, m4a t Describe any skills, experiences, interests and/or background information about yourself that would be helpful to the Board you wish to serve on. Include personal accomplishments that qualify you for the appointment. If more space is needed, please attach an additional page. Traveled USA extensively with focus on smaller towns. Have gotten perspective from thriving and not doing well towns across USA. Have lived the "coast life" and while appreciate the economic benefits the commercialization can provide, moved to Okeechobee for its small town appeal (while still retaining easy access to more population -dense commercial outlets. Am interested in helping Okeechobee thrive while maintaining its character. Have a formal education in Accounting, spent some time in Law School, and have been self- employed since 1996 in technology and online marketing fields. Understand cost/benefit and limited budget implications and how to get things done with limited resources, work with a diverse set of people, and the challenges inherent in all aspects of running a small business. Diverse exposure. THE FOLLOWING INFORMATION IS USED WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, DISABILITY, OR MARITAL STATUS. HOWEVER, THE FEDERAL AND STATE GOVERNMENTS REQUIRE THE CITY TO PROVIDE STATISTICS ON THE NUMBER OF WOMEN, MINORITIES, VETERANS, AND DISABLED PERSONS THAT ARE APPOINTED TO BOARDS. INFORMATION WILL BE USED FOR STATISTICAL PURPOSES ONLY AND HAVE NO BEARING ON YOUR APPOINTMENT: SEX: 0 MALE FEMALE ETHNIC GROUP: 0 CAUCASIAN BLACK SPANISH HERITAGE NATIVE AMERICAN ASIAN OR PACIFIC ISLANDER OTHER(specify): ALL THAT APPLY: WARTIME PERIOD VETERAN DISABLED VETERAN VIETNAM VETERAN HANDICAPPED STATUS: 0 NO YES, AND LIST THE HANDICAP: C ),o, P0,6b-P] STATEMENT OF APPLICANT: I certify that the answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application. I hereby release all companies, schools, or persons from all liability for any damage for issuing this information. I understand that the City may request a copy of my driver's license. I have the right to request that the City completely and accurately disclose to me the contents of any investigation or reports upon request to the Office of the City Clerk. I further understand all information provided becomes a matter of public record. CERTIFICATION: I understand that falsification, omission, misleading statements, or misrepresentation is cause for rejection of this application. I understand that this application is a Public Record and is subject to the provisions of Florida Statutes Chapter 119. FINANCIAL DISCLOSURE REPORTING: I understand that should I be appointed to a City of Okeechobee citizen board am required to complete and file a State of Florida Financial Disclosure Form 1 upon my appointment, annually and a Financial Disclosure Form 1-Final upon my resignation/sunset of term. PUBLIC RECORDS/OPEN MEETINGS LAWS: I understand and agree that should I be appointed to a citizen board/committee for the City of Okeechobee, 1 will comply with all State Statutes, Florida Administrative Code, and State Constitution regarding public records, records retention, public record requests, and the open public meeting requirements. I hereby acknowledge that I have read a,4understa ach of the above statements. Signature of Applicant: Date: 11-10-2020 1. The City Code Book Sec. 70-151, 70-171, 70-19170-211 read: "....membership of the board, where possible, shall consist of any of the following: architect, engineer, surveyor, urban planner, landscape architect, general contractor, realtor, business person, and lay persons." 2. Other covered jobs include current or former, their spouse, and children: correctional and correctional probation officers; juvenile probation officers, supervisors, detention superintendents and assistants; Department of Juvenile Justice: detention officers I and II, detention office supervisors, residential officers, residential officer supervisors I and 11, counselors and supervisors, human services counselor administrators, senior human services counselor administrators, rehabilitation therapists, and social services counselors; certain personnel of: the Department of Children and Families; the Department of Health; the Department of Financial Services; and the Department of Revenue or local governments whose responsibilities include revenue collection and enforcement or child support enforcement; investigators or inspectors of the Department of Business and Professional Regulation; the Office of the Inspector General or internal audit department; justices of the Supreme Court; judges of the district court of appeals, circuit court, and county court; general and special magistrates, judges of compensation claims, administrative law judges of the Divisions of Administrative Hearings, and child support enforcement hearing officers; state attorneys and assistants, statewide prosecutors and assistants; public defenders and assistants, criminal conflict and civil regional counsel and assistants; guardians ad litem; human resource, labor relations, or employee relations directors and assistants, managers or assistant managers of any local government agency or water management district whose duties include hiring and firing employees, labor contract negotiations, administration, or other personnel -related duties; tax collectors; certain impaired practitioners and consultants; [see 119.071, Florida Statues]. PLEASE RETURN COMPLETED APPLICATION TO: CITY OF OKEECHOBEE OFFICE OF THE CITY CLERK 55 SE 3RD AVENUE, ROOM 100 OKEECHOBEE, FLORIDA 34974 CITY CLERKS OFFICE USE ONLY APPOINTED TO: CITY COUNCIL MEETING: INITIAL TERM DATES: NOTIFICATION SENT: RE -APPOINTED TERM DATES: RE -APPOINTMENT NOTIFICATION SENT: RESIGNEDITERM SUNSET: CERTIFICATE OF APPRECIATION PRESENTED: P4 L2 CITY OF OKEECHOB 55 Southeast 3r Avenue * Okeechobee * Florida * 34974 * (863) 763-3372 APPLICATION FOR CITY CITIZEN BOARD/COMMITTEE APPOINTMENT -_ Please print or type all information. The information from this application will be used by the City Council in considering action on your appointment. The application MUST BE COMPLETED IN FULL. Answer "None" "Not Applicable" or N/A" where appropriate. CHECK (0) THE BOARD(S) OF INTEREST TO YOU A COPY OF EACH BOARDS DUTIES, MEETING DATES, AND TIMES ARE ATTACHED Planning Board/Board of Adjustment & Appeals/Design Review Board Okeechobee Utility Authority Board of Directors (city Residents only( Police Officers Pension, Firefighters Pension, or General Employees' Retirement System Board of Trustees City Resident Trustee: p OR Fifth Member Trustee: 0 ) t7 Other: Flagler Park Design Review Advisory Committee Q APPLICANT'S FULL NAME: Sharie Turgeon NAME COMMONLY USED: Shade RESIDENCE ADDRESS: 1063 12th St. Okeechobee, FL. 34974 HOW LONG AT ADDRESS: Years: 4+ Is this in the City Limits? Yes EI No MAILING ADDRESS: Same TELEPHONE/CELL: 863-634-7482 ARE YOU AN US CITIZEN? t7 Yes No, explain: FLORIDA REGISTERED VOTER? 17 Yes County Registered in: Glades No EDUCATION: Hiah School Name & Location Year Graduated Northglenn H.S, Colorado 1989 POST SECONDARY EDUCATION: ColletteName(s) CertiBcatelDearee(s)Awarded Date(s)Attended N/A MILITARY SERVICE: Branchles) Dates of Service Discharae Date N/A CURRENT OR MOST RECENT EMPLOYER: Okeechobee County JOB TITLE/DESCRIPTION: Tourism Coordinator WORK ADDRESS: 2800 NW 20th Trail Okeechobee, FL. 34972 WORK TELEPHONE: 863-763-3959 ARE YOU CURRENTLY EMPLOYED AS: General Contractor El Business Person Architect CHECK ALL THAT APPLY) Engineer Sub -Contractor Realtor Attorney Doctor Surveyor Lay Person Urban Planner Landscape Architect TUxgecan, pg i Have you ever been appointed to, or do you currently serve on, a citizen or community board for any other agency or government? No Yes, and list: AGENCY BOARD NAME POSITION DATE(S) Okeechobee Mein Street Okeechobee Main Street Board Director At Large September 202010 present City of Okeechobee _ -Centennial Celebration Ad Hoc Committee Media Liesion Juno 2014-Jy082616 — Are you now, or have you ever been, elected or appointed to any public office? O No Yes, and list: LEVEL OF GOVERNMENT OFFICE TITLE DATE OF ELECTION TERM(S) Do you work with or have any association with a current member of the board/committee to which you are requesting appointment? I@ No Yes, and list: NAME OF BOARD/COMMITTEE MEMBER(S) RELATIONSHIP/ASSOCIATION Are you related to, or employed by, any City of Okeechobee employees or elected officials? O No Yes, and list: NAME OF EMPLOYEE/ELECTED OFFICIAL RELATIONSHIP/ASSOCIATION Have you ever been found to be in violation of Florida Statutes Chapter 112, Part III, Code of Ethics for Public Officers and Employees? El No Yes, and list: DATE(S) NATURE OF VIOLATION Have you ever been convicted of a FELONY, plead guilty or no contest, or entered into an agreement setting forth the terms leading to the reduction or dismissal of the charges? O No Yes, and list: DATE(S) VIOLATION CITY AND STATE ALL INFORMATION PROVIDED ON THIS FORM IS A PUBLIC RECORD. Information for certain individuals with a specific public records exemption can be withheld. In order to claim the exemption complete the following: Are you a current or former, the spouse of a current or former, or the child of a current or former sworn or civilian law enforcement personnel, certified firefighter, EMT, paramedic, code enforcement officer, or other covered employee who is exempt from public records disclosure under Florida Statute 119.071? Review list of other covered employees before responding. El No Yes, and list: JOB TITLE OR COVERED POSITION TITLE RELATIONSHIP Describe any skills, experiences, interests and/or background information about yourself that would be helpful to the Board you wish to serve on. Include personal accomplishments that qualify you for the appointment. If more space is needed, please attach an additional page. Former Executive Director of Main Street which gave me the opportunity to understand the needs of the downtown festivals and events in the parks. Former Executive Director of Main Street where I gave a presentation for park improvements which focused on walkability and pedestrians. Current Board Member of Main Street where we hope to see more public art brought to our community. Being a current County employee that is subject to Public Records, Sunshine as well as reporting to the Board of County Commissioners and the Tourist Development Council Advisory board I am prepared to work with a committee that is held to these same standards and rules. Most importantly is my position as the Tourism Coordinator for Okeechobee. I believe the parks are one of the most valuable assets we have to inspire drive by visitation. By bringing an inviting look to our downtown brings visitors from the main highway to our downtown area. This corridor could be invitation for those that typically would just be driving through to now stopping and spending time in our community. Visitation should be a priority when these improvements are being considered as well as business development and downtown revitalization. Currently tourism's focus is the drive market and now would be the time to take advantage of this trend. THE FOLLOWING INFORMATION IS USED WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, DISABILITY, OR MARITAL STATUS. HOWEVER, THE FEDERAL AND STATE GOVERNMENTS REQUIRE THE CITY TO PROVIDE STATISTICS ON THE NUMBER OF WOMEN, MINORITIES, VETERANS, AND DISABLED PERSONS THAT ARE APPOINTED TO BOARDS. INFORMATION WILL BE USED FOR STATISTICAL PURPOSES ONLY AND HAVE NO BEARING ON YOUR APPOINTMENT: SEX: MALE O FEMALE ETHNIC GROUP: O CAUCASIAN BLACK SPANISH HERITAGE NATIVE AMERICAN ASIAN OR PACIFIC ISLANDER OTHER(specify): ALL THAT APPLY: WARTIME PERIOD VETERAN DISABLED VETERAN VIETNAM VETERAN HANDICAPPED STATUS: 0 NO YES, AND LIST THE HANDICAP: ll-tL)n,()0j3'q STATEMENT OF APPLICANT: I certify that the answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application. I hereby release all companies, schools, or persons from all liability for any damage for issuing this information. I understand that the City may request a copy of my driver's license. I have the right to request that the City completely and accurately disclose to me the contents of any investigation or reports upon request to the Office of the City Clerk. I further understand all information provided becomes a matter of public record. CERTIFICATION: I understand that falsification, omission, misleading statements, or misrepresentation is cause for rejection of this application. I understand that this application is a Public Record and is subject to the provisions of Florida Statutes Chapter 119. FINANCIAL DISCLOSURE REPORTING: I understand that should I be appointed to a City of Okeechobee citizen board I am required to complete and file a State of Florida Financial Disclosure Form 1 upon my appointment, annually and a Financial Disclosure Form 1-Final upon my resignation/sunset of term. PUBLIC RECORDS/OPEN MEETINGS LAWS: I understand and agree that should I be appointed to a citizen board/committee for the City of Okeechobee, I will comply with all State Statutes, Florida Administrative Code, and State Constitution regarding public records, records retention, public record requests, and the open public meeting requirements. I hereby acknowledge that I have read and understand each of the above statements. Signature of Applicant: Date: 1. The City Code Book Sec. 70-151, 70-171, 70-19170-211 read: membership of the board, where possible, shall consist of any of the following: architect, engineer, surveyor, urban planner, landscape architect, general contractor, realtor, business person, and lay persons." 2. Other covered jobs include current or former, their spouse, and children: correctional and correctional probation officers; juvenile probation officers, supervisors, detention superintendents and assistants; Department of Juvenile Justice: detention officers I and II, detention office supervisors, residential officers, residential officer supervisors I and II, counselors and supervisors, human services counselor administrators, senior human services counselor administrators, rehabilitation therapists, and social services counselors; certain personnel of: the Department of Children and Families; the Department of Health; the Department of Financial Services; and the Department of Revenue or local governments whose responsibilities include revenue collection and enforcement or child support enforcement; investigators or inspectors of the Department of Business and Professional Regulation; the Office of the Inspector General or internal audit department; justices of the Supreme Court; judges of the district court of appeals, circuit court, and county court; general and special magistrates, judges of compensation claims, administrative law judges of the Divisions of Administrative Hearings, and child support enforcement hearing officers; state attorneys and assistants, statewide prosecutors and assistants; public defenders and assistants, criminal conflict and civil regional counsel and assistants; guardians ad litem; human resource, labor relations, or employee relations directors and assistants, managers or assistant managers of any local government agency or water management district whose duties include hiring and firing employees, labor contract negotiations, administration, or other personnel -related duties; tax collectors; certain impaired practitioners and consultants; [see 119.071, Florida Statues]. PLEASE RETURN COMPLETED APPLICATION TO: CITY OF OKEECHOBEE OFFICE OF THE CITY CLERK 55 SE 3RD AVENUE, ROOM 100 OKEECHOBEE, FLORIDA 34974 CITY CLERKS OFFICE USE ONLY APPOINTED TO: CITYCOUNCILMEETING: INITIAL TERMDATES: NOTIFICATION SENT: RE -APPOINTED TERM DATES: RE -APPOINTMENT NOTIFICATION SENT: RESIGNED/TERM SUNSET: CERTIFICATE OF APPRECIATION PRESENTED: TLLge-orN, y '