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HomeMy WebLinkAboutItem No. 17 Planning Commis Appointment to fill VacancyText File City of Lake Elsinore 130 South Main Street Lake Elsinore, CA 92530 www.lake-elsinore.org File Number: ID# 16-383 Agenda Date: 9/13/2016 Status: BusinessVersion: 1 File Type: ReportIn Control: City Council Agenda Number: 17) Page 1 City of Lake Elsinore Printed on 9/8/2016 Page 1 of 2 REPORT TO CITY COUNCIL To:Honorable Mayor and Members of the City Council From:Grant Yates, City Manager Prepared by: Susan M. Domen, City Clerk Date:September 13, 2016 Subject:Appointment to the Planning Commission Recommendation Consider the subcommittee recommendation and appoint one member to serve on the Planning Commission for an unexpired term ending on June 30, 2018. Background Per the Lake Elsinore Municipal Code, 2.24.020 Membership, the Planning Commission shall consist of five members who shall not be officials or employees of the City and shall legally reside within the City limits of the City of Lake Elsinore or be the owner of a business that is established and currently licensed inside the City limits; 2.24.030 Appointment – Removal, the members of the Commission shall be appointed by the Mayor with the approval of a majority of the members of the City Council and may be removed by the Mayor at his pleasure, but subject to the approval by a majority of the members of the City Council; 2.24.040 Term of Office, the members of the Planning Commission shall be appointed for a term of four years. City Council Policy 200-5A sets forth the process in which applications will be accepted and reviewed. Discussion The term of office for an unexpired term on the Planning Commission ends on June 30, 2018; one seat is currently vacant as Commissioner Jordan resigned from the position. Pursuant to City Council Policy No. 200-5A, applications remain on file through December. In addition, the City Clerk’s Department posted the Notice of Accepting Applications for Consideration of Appointment from August 23, 2016, through September 2, 2016. A total of four applications were received by the filing deadline (three from the July appointment and one new one); Mike Alwardt, Darrill Andreis Rendell Klaarenbeek and Fred West. The Council sub-committee has nominated the following applicant for consideration by the City Council: Rendell Klaarenbeek Page 2 of 2 Fiscal Impact There is no fiscal impact associated with this item other than staff time. Exhibits Exhibit A - Applications CITY OF r LAKE'jLSII`S.ORE DREAM EXTREME Please sign and return completed form to: City Clerk's Office 130 South Main Street Lake Elsinore, CA. 92530 For Official Use Only Date Due: Interview Date: Appointed: ❑ Yes ❑ No Tenn: COMMISSION APPLICATION Date Received: Interview Time: Date Appointed: ECEI ED APR 2 9 2016 Commission Applying For: Planning ❑ Publ.' � Safety Advisory ��TYF(� The City of Lake Elsinore Planning/PSA Commissions consist of five members each who shall not be officlais or employees o the ity'ra ' s N legally reside within Lake Elsinore City limits or be the owner of a business that is established and currently licensed inside Lake Elsinore City limits (LEMC Section 2.24.020). Members are appointed to four year terms by the City Council. Instructions: Please answer each question as completely as possible. This application will be maintained for a period of one year. After one year, it is necessary to file a new application for another year of eligibility. Please be advised that this application is subject to the Public Records Act. (Please type or print using black or blue ink) Your commitment to our City and your willingness to serve your fellow citizens is greatly appreciated. --• PlICA7idN iNf C]RMATIO[� --'" C}. City Resident- 1�? Business Owner`; ;.' �' ..._ WO Name: Ms. Mrs. r First: MI: Last: (Please circle that which app es) MIr,E K �w�Ror Residence Street Address: City: AKG C-LS��oi2G State, Zi Code: to 2S3ra Mailing Address: City: LAK—L5� 02� State ZipZ57v Y Home Phone: Cell Phone, Work Phone: Email: Length of Residency in Lake Elsinore:rz', A2S Length of Residency in California: 38 ��KS Are you a citizen of the United States: WYes CJ No If no, country of citizenship: Are you a registered voter: KYes ❑ No If yes, county where you are registered: ny Employer: Business Phone: CA, AGR - Co,v 2 c c. Employer Street Address: Occupation Title: lq3o3OE C/A 5o RIv F- oZ T-�L City: State: Zip Code: LAIGV-- MA -FH 6t u5 CA 7Z ?0 BUSINESS -INFORMATION: a . limblej -: -- Business Name*Business Phone:�- Business Street Address: _ �— City of Lake Elsinore Business License Number: Expiration Date: Date Business Established and Type of Business: - �{ (] •t' ,..>=AiJ A71o�) -1 F±�►4•l�l N �Q:- :<�:r:; •�, ���.:::;;: � •; ;t,, 0,�i�. - :F' .'77 ..+�.r. ..�:�_N.�•.-5;..,�„_..7�=-i^"5°= v... :.. w7tiY.,� .,?'-`.�•ri9�'. .��i .��r _ Please List School(s) Attended . P=�'.:P'4.`!.. ,f.. ^: n• .-i''1•-.moi-:• School's City and State Units Completed O,tNT�r-Jf-J,T-AL- H SCHOOL- - •r�f - COtZC,,IIA CA Gi k� o u4T r-- C. C,.LvC- Addres: 3v W� ,., o 5T-O 6 C A 3RV,&(- cc-A55e5 (A. x70 Position Held: CLV- r L Employment Dates: %s rn►ri�ry w1r/r'cuntor fast o a�+' :woi�lc: p�>; c>r / Name . P=�'.:P'4.`!.. ,f.. ^: n• .-i''1•-.moi-:• ':'i*. �45i i:5.i =..3' "'�:�_. ,:�-- - •'. i!'.y]'[.�; C•:.J-d::: - •r�f - - .? -Z. Employer: C — - c Nr2 L. 4 Addres: 3v W� ,., o bile. Lr s' (A. x70 Position Held: CLV- r L Employment Dates: From - Zoo y Toto&5�,I Duties Performed: V LOMPLO'W I-IVAC AT IvW C 2(L' o S Po&Z ND vv MEN c -i c I - X65 5C"Lv- MZ -1,213-i FARK5, AtipE VA AQv11--gAw 64, [iE.� i M NT PF E C ►.j 5 var: u-ovdv- ,-,t) APPL P65 l�D Employer:Address: , T A.,r) O Q Nr&4 !V7/'7(,, (15J ,,O PA K T" M L/ C Z S O Position Held•J �o Dates: From �- Z00 Toy�Zoo,/ ��Employment Duties Performed: Tir--Am T:5 carr( oP 60-:ti`'E55 TN a- NW AC S rJD 6V 5fW, Jof I ,AE NC>~$ � a� reSlden_�7 7A W1'�i u�i ..��--�� •c ork.`� moi: l•-�•.L-Y;'.''c_--�•.-•'-; � •.,. .. .. i�_�.. �p� c Y jxe �?fi. FSr 11 •,..��. S.rr-•-.� •C:..� •h. �'i �'�: �'; Name Address Phone LA,/ArCoT OR. LK. ELs CA /' Zl l2� LOUM E Z Z5 2U 0 < 909 -S18 - 7Z L O n/S Ll/A�/ UK cJ No a 9Y-1, 10 G 7 Zs�s$ 5��sw��s !f. =65 .,1g PLEASE,M$PRIBRICQ1 Mll�It.1 �.S i- • C ., •r. ..:r i•. r?+. .mac IP Fl nc(P ilofil jlf'Ohy�; fO aisaY,att iclt, se y ra4ej F r aid�I�tiQn ipia ^�' ,;i i.�"• _--:RiT: ti�'N.:.i� •v fs-'�;.r a%a?�: .4• -_ `i• �o- i;r. �nj^�','�; ' .7., r- �.5e;v `-.';,'• :'.`: _ . i�Fi�i,.-af�r,,.V;:: Y �� 7..�L•3h.-r. AL/Qc ,s . tG EICL9.5 6CROXE CAeael 1" -c - Cv R M ✓qc-L_ S(92 - Ca3(- 3M SUMMARIZE YOUR QUALIFICATIONS FOR YOUR APPOINTMENT ficanses, etc-) (A F R,/AC- O e," rA( dN r V " dN PZpC,,JpANN N PA C V uvOIKIC w V LOMPLO'W I-IVAC AT IvW C 2(L' o S Po&Z ND vv MEN c -i c I - X65 5C"Lv- MZ -1,213-i FARK5, AtipE VA AQv11--gAw 64, [iE.� i M NT PF E C ►.j DO YOU HAVE ECONOMIC INTERESTS. SUCN AS INCOME;`INVESTMENTS, REAL OR PERSONAL PROPERTY.OR.OUTSTANDING . . LOANS WHIG"AIGHT PRESENT;A_POTENTIAL:CONFLIC..F OF-INTEREST7 .0'Yes..: K;N. o.[lf.Yes piepse,iisty_ _...- ..-..-.-._ `ARE,Y47iJ.CURRENTLY E ENGA D IN, OR PLAN TO'ENTER 'INTO, EMPLOYMENT, BUSINESS ACTIVITY OR ENTERPRISE WHICH IS RELATED TO YOUR POTENTIAL DUTIES AS A MEMBER OF THIS CITY,'CoMMISSION OR WHICH MAY BE SUBJECT TO REVIEW OR APPROVAL BY SUCH COMMISSION? 1 f�f No IF. YES, DFESCRI'BE THE NATURE OF THF. BUSINESS OR ACTIVITY AND EMPLOYER I€.a lice ARE YOU: CURRENTLY AN;OFFICER OR MEMBER OF A POLICY-M�IKING BOARD OF 'A NONPROOF1T. ORGANIZATION WHICH RECEIVES FUNDING BY THE CRY OF. LAK.E.ELSINORE7 F11 Yes ,No IF YES, LIST THE ORGANIZATION{S)' HAVE YOU EVER BEEN.-CONVICTED OF VIOLATING ANY FEDERAL, STATE, COUNTY OR MUNICIPAL LAW, REGULATION OR ORCIINANC ,:E}CGLl11]ING MAJOR 313AFFICr..,V.FOLATI.CjN0,r�i Yes�R IES., .EXPL41N ?, ARE YOU CURRENTLY:UNDER FEDERAL, -STATE`.OR LOCAL INVESTIGATION FOR POSSIBL:E:VLOLATION,OF A:CRIMINAL'-LAW OR '.. ORDINANCE?- f.i Yes i f No IF YES, EXPLAIN ..PLEAS RIEFLY. EXPLAIN WHY YOU. WISH TO SERVE ON THIS. COMMISSION wrk,-T To :3E Mirrr a_ Tii - 'A L5 ,)M WEW Li►2 tYK - r M � y vv vis 'V c7 kegg 62A A Lo,--(g C v r�N ai C 2 ELS ,.1645 JH� tQ 0 1-+0 FIAT CC-7>njP .aT 1-f v H 3�to.L�r/a 2 FLK LS o E _ - f _C f��N (C YD , F02 I��vR 77EM E N CUN ;mac A1 6 Fox Acgr oF.. rf/� Cotir,nZ�siaA/ --- -- Please note: Appointees will be required to take an Oath of Office and complete and file Statements of Economic Interests if appointed to a position specified in the City's Conflict of Interest Code. Also, appointees are not considered to be City employees for purposes of benefits, such as workers compensation, health insurance, etc. Again, thank you. Your assistance is appreciated. Applicant's Declaration and Signature I certify under penalty of perjury under the laws of the State of California that all the information on this form is true and correct. Sign tore Date REME CITY OFA LAI(E GLsNORL Please sign and return completed form to: City Clerk's Office 130 South Main Street Lake Elsinore, CA 92530 For Official Use Only Date Due: Date Received: Interview Date: Interview Time: Appointed: n Yes n No Date Appointed: Term: REGEIV COMMISSION AEPLICATIO APR 2 9 2096 Commission Applying For: 6P-1-aanning o Public "fbtjl%6VM0FFIGF The City of Lake Elsinore Planning/PSA Commissions consist offive members each who shall not beofficials oremployees ofthe City and shall legally reside within Lake Elsinore City limits or bethe owner of a business that isestablished and currently licensed inside Lake Elsinore City limits (LEMC Section 2.24.020). Members are appointed to four yearterms bythe City Council. Instructions: Please answer each question as completely as possible. This application will be maintained for a period of one year. After one year, it is necessary to file a new application for another year of eligibility. Please be advised that this application is subject to the Public Records Act. (Please type or print using black or blue ink) Your commitment to our City and your willingness to serve your fellow citizens is greatly appreciated. 1f APPLICATION INFORMATION City Res€dent 'Ll Business OWMr. 1; ...... .a.:. _.,...... --, , !Please indicate which aaaliesl Name: Ms. Mrs. Mr. First:Darrill 1 ast Andries (Please circle that which Residence Street Addres City: State: Zip Code: 92532 Lake Elsinore CA Mailing Address: City: State: ZipCode: Home Phone: Cell Phone: Work Phone: Email: Length of Residency in Lake Elsinore:8 years Length of Residency in California:28 years Are you a citizen of the United States: Yes [I No If no, country of citizenship: Are you a registered voter: Yes n No If yes, county where you are registered: Riverside Employer: Business Phone: Norcraft Companies Employer Street Address: Occupation Title: Territory 950 Blue Gentian Road Suite #200 manager City: State: Zip Code: Eagan MN 55121 — BUSINESS INFORMATiQN. (If;appflaeble) .: Business Name: Business Phone: Business Street Address: City of Lake Elsinore Business License Number: Expiration Date: Date Business Established and Type of Business: I EDUCATION INFORMATION -- -- -- — — — Please List School(s) Attended School's City and State Units Completed Bachelor Arts SDSU San Diego, CA None ...ifs time to give back and participate in my community WORK EXPERIENCE (Beginning Wflh Current or last POS00n) I Employer: Norcraft Companies Position Held: Territory Manager Duties performed: Sales, marketing, promotion, problem resolution Employer: KraftMaid Cabinetry Position Held: Regional US Trainer Duties performed: Training (computers, Design, Sales) Address: Eagan, MN Employment dates: 2007 - present Address: Middlefield, OH Employment dates: 1998- 2007 f REFERENCES (Local residents that are qualifies€ to comment on your capalaif�ies) Name Adslres s Phone Sean Jorgenson — Peter Acoch — Katina Olafson — pLEA5 .r1€ C0VMUNiTY SEne.A i IGPA'><M (if any) (You may attach a S"rate sheetfor adcflflonallEnformation� p None ...ifs time to give back and participate in my community SUMMARIZE YOUR QUALIFICATIONS FOR YOUR APPOINTMENT (i.e., education, training, ernployrnenl; experience; liccnsp5 etc; I have a Bachelor of Arts Design degree. I have studied architecture and urban planning for years. I am a member of the National Kitchen & Bath Association and teach its national course on sustainability as it relates to the built environment. Versed in LEED certification and many other green building initiatives. Being born and raised in Chicago Illinois, where urban planning and public facilities are world class, inspired me into the design and remodeling field. I have worked with architects and can - easily interpret site plans and architectural docs. Excellent wayfinding and cartography skills. I am - constantly improving the existing built environment in my mind's eye and have a good eye for design, always being mindful of the low cost possibilities. I work very well in groups and compromise in a fair manner, I'm not stubborn but certainly principled in beliefs. Lastly, my brother produced the PBS TV special "10 Towns that Changed America" (a reach, I know, but every little bit helps) Ciuv bb YOU HAVE ECONOMIC INTERESTS SUCH AS INCOME, INVESTMENTS, REAL OR PERSONAL PROPERTY OR OUTSTANDING L.OANSWHtCH IYIIGNT.PR£SFNT A.P.QTtUTIAL CONFLICT OF:iNTERESL7 -0. es .i No (If yes please r4st) ARE YOU CURRENTLY ENGAGED IN, OR PLAN TO ENTER INTO, EMPLOYMENT, BUSINESS ACTIVIITY OR'ENTIERPRISE WHICH IS - RELATED To YOUR POTENTIAL DUTIES AS A MEMBER OF THIS CITY, COMMISSION OR WHICH MAY BE SUBJECT TO REVIEW OR APPROVAL BY SUCH COMMISSION? 0 Yes J No IF YES, OF -SCRIBE THE NATURE OF THE BUSINESS OR ACTIVITY AND EMPLOYER If.a liable = - -- ARE YOU CURRENTLY AN OFFICER OR MEMBER OF A POLICY-MAKING BOARD OF A NONPROOi"IT ORGANIZATION WHICH RECEIVES FUNDING BY THE CITY OF LAKE EL.SINORE? (.l Yes n No IF YES, LIST THE ORGANIZATION(S) HAVE YOU £VER BEEN CONVICTED OF VIOLATING ANY FEDERAL, STATE, COUNTY OR MUNICIPAL LAW, REGULATION OR �O.MWANCE; EX4CLUDING MINOR iRAFRC V112 ATMNSY I I Yes 11. No IF YES; EXPLAIN ARE YOU CURRENTLY UNDER FEDERAL, STATEOR LOCAL INVESTIGATION FOR POSSIBLE VIOLATION OF A CRIMINAL LAW OR ORDINANCE. Yes F1 No IF YES, EXPLAIN I't EASE BRit FLY Ei[PLAIf VYHY YOU WISH TO SERVE ON TRIS COMMISSION I wish to serve my community to its benefit and set an example for my 8 year old son in civic engagement. The planning commission is a natural fit for me. I have lived in Elsinore for 8 years and I appreciate what it is and would like to maintain and improve it for the benefit of all citizens. I recognize the built environment has a major influence on our personal and professional lives. Looking toward the future I see the values and aspirations of those who live here being served by ambitious projects. A state of the art library and a dynamic community center that promotes public gathering are just two examples that come to my mind. I would be proud to serve with the planning commission that told a national powerhouse (Walgreens) their new store has to integrate aesthetically into the ballpark district. Put people before cars, give public space primacy, get the State to support innovative sustainable projects that can put us in the "green" conversation. Lake Elsinore has many unique aspects, let's build upon that and make it an even more desirable community and destination. Please note: Appointees will be required to take an Oath of Office and complete and file Statements of Economic Interests ifappointed to a position specified in the City's Conflict of Interest Code. Also, appointees are not considered to be City employees for purposes of benefits, such as workers compensation, health insurance, etc. Again, thank you. Your assistance is appreciated. !cant's Declaration and Signature I certify under penalty ofperiM uudq�the laws of the State of California that all the Information on this form Is true and correct. 17ate 1 Luz Reyes From:Application@lake-elsinore.org Sent:Tuesday, August 30, 2016 11:09 AM To:Susan M. Domen, MMC; Diana Girón; Luz Reyes Subject:City of Lake Elsinore Commission Application A new entry to a form/survey has been submitted.   Form Name:  Commission Application  Date & Time:  08/30/2016 11:08 AM  Response #: 9  Submitter ID:  1087  IP address:  158.61.0.233  Time to complete:  52 min. , 47 sec.     Survey Details  Page 1      The City of Lake Elsinore Planning/PSAC Commission’s consist of five members who shall not be officials or employees of  the City and shall legally reside within the City limits of the City or be the owner of a business that is established and  currently licensed inside the City limits (LEMC Section 2.24.020).  Members are appointed to four year terms, by the City  Council.     Instructions: Please answer each question completely. This application will be maintained until December 31st of each  year. After December 31st, it is necessary to file a new application for another year of eligibility. Please be advised that  the City Clerk’s Department uses Voter Registration information for verification of residency. Note: This application is  subject to the Public Records Act and may be released to the public.     1.  Commission Applying For:  [×] Planning Commission      2.  Applicant Eligibility  [×] City Resident      3.  Applicant Information  Last Name Klaarenbeek    First Name Rendell    Home Address    City Lake Elsinore    State California    Zip Code 92530    Phone Number    Email    Length of Residency in  Lake Elsinore  23 years     Length in California 58 years       4.  Business Information  Business Name     Business Type     Business Address     Lake Elsinore Business  License Number      Expiration Date     Phone Number     Date Business Established Not answered        2 5.  Education Information  Name of School Attended California Babtist University    City & State Riverside California    Degree Earned Bachelors of Arts    No. of Units Completed 60    Name of School Attended Santa Ana College    City & State Santa Ana California    Degree Earned Associate of Science    No. of Units Completed 60    Certificates Attained  1. Bachelor of Arts Degree: Interdisciplinary Studies (Public  Administration), California Baptist University, (2012; 4.0  G.P.A.)   2. Associates of Science Degree: Fire Science Technology,  Santa Ana College (1985)  3. Co. of Riverside Management Academy Graduate  4. Co. of Riverside Supervisory Academy Graduate  5. I.C.B.O./ICC Certified Plans Examiner  6. I.C.B.O./ICC Building Inspector  7. Santa Ana College Fire Academy Graduate, 2nd in Class  8. CA‐OES Governors Safety Assessment Certification       6.  Do you have Economic Interests, such as income, investments, real or personal property, or outstanding loans which  might present a potential conflict of interest?   [×] No     7.  Work History  Current Employer Riverside County Building &  Safety    Address 4080 Lemon Street, Riverside    From 08/10/2000    To Present    Position Deputy Director, Building &  safety    Duties Performed  • Assist in planning organizing, reviewing, and evaluating  activities and performance of the assigned department  and programs to assure their effective and efficient  operation; assist in the development of goals objectives  and policies for assigned areas.   • Plan and direct such support operations as procurement  and contract administration; direct the resolution of  complex departmental administrative problems; interview,  hire, train, and evaluate performance of subordinate staff,  assist in planning, organizing, and administering the  department’s annual budget.   • Interact with members of the Board of Supervisors and  their staff regarding community issues and/or constituent  complaints/concerns; conduct presentations at Board  meetings, and community and social interest groups.   • Participate in the development and implementation of  the operating and administrative policies; participate in  the development of new programs to facilitate long and  short term strategies and financial plan objectives.   • Plan, organize, and direct the activities of the regional  offices; facilitate the coordination of the office activities  with other County Departments; design and maintain  tracking and administrative processes; coordinate the  training and rotation of staff.   • Assist in providing supervision, policy and procedures  over the community permit assistance operations with  interdepartmental staff including dispatch, land  use/planning, building counter, building inspection and  plan check staff.   • Receive, investigate, identify and respond to problems,  3 complaints in a professional manner. Direct investigations  and recommend solutions.   • Research and analyze new innovative methods, materials  and techniques that may improve service and quality.   • Represent the Building Department in the Land  Development Committee (LDC) reviewing and provided  guidance and recommendations to staff, design  professionals and the general public.  Previous Employer B.W. Enterprises Inc    Address Irvine , Ca    From 1994    To 2000    Position Foreman    Duties Performed  • Involved with all types of masonry construction. Uses  included but were not limited to:  Structural buildings, retaining walls, property walls,  industrial and public works projects.  • Responsible for reading and interpreting building plans  and implementing all required guidelines and plan  requirements.  • Supervising all staff and coordinate staff on multiple sites  with various projects, meeting all required deadlines and  time tables.    8.  References (Local Residents who are qualified to comment on your capabilities)  Name Mike  Lara    Address Beaumont,  Ca    Phone Number      Name James  Galloway    Adress Ave 10,  Lake  Elsinore,  Ca    Phone Number    Name Barry  Lewis    Address Temecula,  Ca    Phone Number        9.  Community Service Participation (please describe types of service you have performed, if any)  Organization Lake Elsinore N.A.B.    Types of Service  Currently appointed to the lake Elsinore Nuisance  Abatement Board in June, 2015. This board serves as an  appeals board for Code Enforcement cases; however no  cases have come for hearing before the board up to this  point in time.   Organization Not answered    Types of Service  Not answered   Organization Not answered    Types of Service  Not answered   Additional  Documentation  RESUME 2016.docx         10.  Are you an Officer or Member of a policy‐making board of a non‐profit organization which receives funding from the  City?   [×] No     11.  If Yes, please list all Organizations  Organization  N/A    Position N/A    Organization N/A    Position N/A    Organizaton N/A    Position N/A    Additional Information         4 12.  Have you ever been convicted of violating any Federal, State, County or Municipal law, regulation or Ordinance,  excluding minor traffic violations?   [×] No   If Yes, Please explain  Not answered       13.  Interest for Serving on a Commission  Please list reasons for serving  I have been interested in being involved and helping our community for some time. I believe I am at a point in my life and  career and where my background, experience and knowledge can be of a benefit to our city and its businesses and  residents. I look forward for an opportunity to help provide guidance and vision for the future of our community with insight  and team work that will provide a safe environment for our the city residents, and to work in preserving our past and city  charm, while developing exciting new projects for future generations to come. I do hope my application and included  resume will be considered for the planning Commission vacancy and an interview opportunity, thank you.     14.  Please note: Appointees will be required to take an Oath of Office and file a completed Statement of Economic Interest  form, if appointed to a position specified in the City’s Conflict of Interest Code. Appointees are not considered to be City  employees for purposes of benefits, such as workers compensation and health insurance.    15.  Applicant's Declaration and Signature  I certify under penalty of the perjury laws of the State of California that all information on this form is true and  correct.  By typing my name and the date completed on this form, I am affirming my intent to be a candidate for  appointment to a Commission for the City of Lake Elsinore. If appointed I pledge to follow the laws of the City of Lake  Elsinore, the policies as set forth by the City Council and to conduct myself in such a manner as to be a good  representative of the City.  Name Rendell M.Klaarenbeek    Date 08/30/2016           Thank you,  City of Lake Elsinore  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