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Home My WebLink AboutItem No. 26 This item has been removed from Agenda This item has been removed CITY OF TT AKT 4� T SM0RE ?, �� DRE M EXTREME �TM. Report to City Council To: Honorable Mayor and Members of the City Council From: Susan M. Domen, City Clerk Date: May 23, 2017 Subject: Appointments to the Public Safety Advisory Commission (PSAC) Recommendation Consider subcommittee recommendations and appoint three members to serve on PSAC for a term of four years, commencing on July 1, 2017, through June 30, 2021. Background Chapter 2.46 of Title 2 of the Lake Elsinore Municipal Code (LEMC) governs the establishment and membership of the City's PSAC. The PSAC consists of five members who 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 (LEMC 2.46.030). Members of the PSAC are appointed by the Mayor with the approval of a majority of the members of the City Council (LEMC 2.46.030). PSAC Commissioners are appointed for a term of four years (LEMC 2.46.030). City Council Policy 200-5A sets forth the process in which applications will be accepted and reviewed. Discussion The term of office for three seats on PSAC expires on June 30, 2017; Commissioner, Carlos, Commissioner Sund and Commissioner Gregory. Pursuant to City Council Policy No. 200-5A, the City Clerk's Department published and posted the Notice of Accepting Applications for Consideration of Appointment. A total of twelve applications were received by the filing deadline; Coby Alaoui, Cherrian Chin, Jerry Carlos (incumbent), Edwin Castro, Jimmy Flores, Diana Kramer (withdrew) Roger Miller, Karen Pence, Alma Quinn, Pablo Visca, Richard Ward and Agnes Williams. The Council sub-committee, consisting of Mayor Pro Tem Johnson and Council Member Tisdale, conducted interviews with the remaining candidates on May 11tn and 15tn The Council subcommittee is recommending the Mayor appoint, with the Council's approval, Jerry Carlos, Jimmy Flores and Agnes Williams. Fiscal Impact There is no Fiscal Impact associated with this item. Exhibit Exhibit A—Applications From: Application@lake-elsinore.org To: Susan M.Domen. MMC;Diana Glron;Lux Reyes Subject: City of Lake Elsinore Commission Application Date: Tuesday,April 25,2017 4:06:34 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback ��ofi�n4 A new entry to a form/survey has been submitted: Form Name: Commission Application Date&Time: 04/25/2017 4:06 PM Response#: 10 Submitter ID: 1243 IP address: Time to complete: 57 min.,46 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: [x] PSAC Commission 2. Applicant Eligibility [x]City Resident 3. Applicant Information Last Name Alaoui First Name Coby Home Address _ Regatta Way City Lake Elsinore State CA Zip Code 92530 Phone Number Email Length of Residency in Lake 12 months Length in California 12 months Elsinore 4. Business Information Business Name Not answered Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered S. Education Information Name of School Attended Northern Virginia City&State Alexandria VA Community College Degree Earned In-Process No.of Units Completed 43 Name of School Attended Not answered City&State Not answered Degree Earned Not answered No.of Units Completed Not answered Certificates Attained -Graduate Realtor Institute -Real Estate Broker -Certified Military Residential Specialist -2014 Real Estate winner Forty under 40 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? [x] No 7. Work History Current Employer Realty One Group Address 41463 Margarita Rd Southwest Ste 100,Temecula CA 92591 From 12-20-2016 To Present Position Agent Duties Performed -Manage day to day operations of real estate portfolio -Provide customer service and educational training to prospective and existing homebuyers, sellers,and investors -Oversee all client transactions(Buyers,Sellers, & Investors)from inception to closing. Previous Employer Coby Realty Inc Address 9214 Robin Lynn Ct Manassa VA 22110 From 02-01-2012 To 12-20-2016 Position Principal Broker Duties Performed Primary Duties: -Owned &Operated Coby Realty Inc -Managed day to day operations -Trained New agents -Supervised all client transactions(Buyers,Sellers, &Investors) -Provided complimentary educational workshops to potential buyers and sellers. 8. References(Local Residents who are qualified to comment on your capabilities) Name Ruth Address 183 N. Phone Number (951) Atkins Main 678- i St. Lake 1537 Elsinore 92530 Name Nikki Adress Phone Number - Campbell . Lake Elsinore 92530 Name Mike Address Phone Number - Nicassio - i i Lake Elsinore 92530 9. Community Service Participation(please describe types of service you have performed,if any) Organization Lake Elsinore Types of Service Chamber of -Attend Member meetings each month Commerce -Participate in monthly events held throughout the city -Support local businesses achieve their goals Organization Lake Elsinore Types of Service Historical Society Currently serving as a Docent(in training)for the Lake Elsinore Historical Society Museum. Duties include: -Greeting guests -Answering historical facts and questions about the city -Attend monthly staff meetings Organization Not answered Types of Service Not answered Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes, Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving Although I have been a Lake Elsinore resident for the past year, my wife and I made the decision to settle here because we saw the great potential and growth in our city,as well as a wonderful community to raise our two children.I am a firm believer that in order to make a positive impact in our city we need to be involved and serve our city to the best of our abilities so that we can continue to build a happy,safe, and diverse community for our children and future generations. I It is for these reasons that I have joined local organizations such as the Chamber of Commerce and the Lake Elsinore Historical Society, in an effort to work towards the prosperity of Lake Elsinore while preserving the rich and proud history of our city. Thank you for your consideration to join the Public Safety Advisory Commission. I look forward to the opportunity to expand my service to our great city. 14. Please nQte: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 Coby Alaoui Date 04-25-17 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management SysternTM. Please do not reply directly to this email. From: Application@lake-elsinore.org To: Susan M.Domeier MMC; Diana Girdn; Lur e Subject: City of Lake Elsinore Commission Application Date: Sunday, May 7,2017 6:26:26 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback 52oofIng A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 05/07/2017 6:26 PM Response#: 19 Submitter ID: 1255 IP address: Time to complete: 51 min.,4 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: [x] PSAC Commission 2. Applicant Eligibility [x]City Resident [x] Business Owner 3. Applicant Information Last Name Carlos First Name Jerry Home Address ■Plaza Avila City Lake Elsiore State California Zip Code 92532 Phone Number Email Length of Residency in Lake 18 years Length in California 67 years Elsinore 4. Business Information Business Name Jerry Carlos's Business Type legal Eviction Professionals Business Address 31500 grape st#111 Lake Elsinore Business 012523 License Number Expiration Date 7/31/17 Phone Number 951.245.2001 Date Business Established 6/30/89 I 5. Education Information Name of School Attended Univ.of Ca, City&State Riverside,Ca Riverside j Degree Earned B.A. No.of Units Completed 181 J Name of School Attended Not answered City&State Lake Elsinore Degree Earned Not answered No.of Units Completed Not answered Certificates Attained Basic, Intermediate,&Advanced Law Enforcement Certificates,State of California California Interscholastic Federation Coaching 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? [x] No 7. Work History Current Employer Eviction Address 31500 grape st#111 Professionals Lake Elsinore From 1989 To present Position Owner Duties Performed My business is involved with obtaining court orders that are delivered to the sheriff to remove. unwanted occupants. i Previous Employer Lake Elsinore U.S.D. Address Lake Elsinore From 2001 To 2011 Position Head Coach Duties Performed Coached Boys&Girls Cross Country teams. Coached Boys Tennis teams. 8. References(Local Residents who are qualified to comment on your capabilities) Name Mark Address Phone Number Thomas Lake Elsinore Name David Adress Phone Number Bunch Ave 4055 Riverside Name Robert Address . Phone Number Not Grabau answered Lake Elsinore 9. Community Service Participation(please describe types of service you have performed,if any) Organization Youth Education Types of Service Motivation This program is similar to career day with added emphasis on education. I've been involved with giving talks to classes since 1974. Organization Fraternal Order of Types of Service Police Active&retired peace officers from all agencies(FBI, ICE, Police,Sheriff)offer support, education,and recognition to law enforcement. Organization Latino Business Types of Service Network Service organization involved with supporting high school and college youth with exposure to art and theater as well as political and educational programs. Additional Documentation 10. Are you an Officer or Member of a polity-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes, Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving I would like to pursue the completion of some projects that are barely in their infancy on PSAC. 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 f 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 Jerry Carlos Date 5/7/17 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management System1m.Please do not reply directly to this email. From: Application@lake-elsinore.org To: Susan M.Domen,MMC;Diana Giron; Luz Reyes Subject: City of Lake Elsinore Commission Application Date: Wednesday,April 26,2017 5:51:59 PM T, =-nder failed our fraud detection checks and may not be who they appear to be. Learn about Feedback snoofina A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 04/26/2017 5:51 PM Response#: 12 Submitter ID: 1246 IP address: Time to complete: 37 min.,55 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: [x] PSAC Commission 2. Applicant Eligibility [x]City Resident 3. Applicant Information Last Name Castro First Name Edwin Home Address -Ardenwood City Lake Elsinore way Unit 311 State California Zip Code 92532 Phone Number Email ] Length of Residency in Lake 4 years Length in California 12 years •J Elsinore 4. Business Information Business Name Not answered Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered S. Education Information Name of School Attended Forest Grove High City&State Forest Grove OR School Degree Earned H.S. Diploma No.of Units Completed Not answered Name of School Attended Long Beach City City&State Long Beach CA. College Degree Earned Associates AA No.of Units Completed Not answered Sociology Certificates Attained Not answered 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? [x] No 7. Work History Current Employer Wells Fargo Bank Address 1150 East Vista Way N.A. From 07/2011 To Current Position N.San Diego Region Duties Performed Ambassador Wells Fargo Volunteers Chapter inspires team members to use their personal interests and professional expertise to connect with and support the need of their communities.The program provides leaders and team members with a consistent portfolio of resources that enables them to select and engage in appropriate local market volunteer projects. Previous Employer Bank of America Address 640 W. Mission Ave Escondido CA. From 02/2008 To 07/2011 Position Teller Supervisor Duties Performed Supervised Teller team,assisted Senior Management with Operations,Scheduling, and Customer service.Assist in New Hire orientations. 8. References(Local Residents who are qualified to comment on your capabilities) Name Daniel Address Phone Number ■ Garcia Way Unit 364 Name Huriel Adress Phone Number Yanez way Unit - 311 Name Alva Address Phone Number Franco - way - 9. Community Service Participation(please describe types of service you have performed,if any) Organization Lake Elsinore Citzens Types of Service CORP Emergency preparedness Team. Citizen Corps is a program in Lake Elsinore that can improve the chances of an orderly recovery following disasters of all kinds. Organization L.E. Neighborhood Types of Service Watch Neighborhood Watch program that forms chapters in neighborhoods, Works in partnership with the Riverside County Sheriff's Department. Meetings are held monthly. Organization Healthy L.E. Types of Service -Making Lake Elsinore a healthier community with a better quality of life. Participant in the HEALTHY L.E.program. Attend quarterly meetings to better network and discuss opportunities to improve a healthy lifestyle. Additional Documentation EDWIN RESUM.docx 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes, Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving Iv been active in my community since the age of 16, 1 believe if one wants to make a change,one must get involved and make that change and inspire others to take the lead. I want to encourage a diverse and inclusive community.We have a people in our city that need a voice. I believe I am the right person to engage a more diverse group to our city decisions.As a former City Commissioner for the City of Escondido, I know first hand the footwork and Ambassadorship duties that is required for this position.With this experience, I would love the opportunity to be considered to serve in our Public Safety Commission. It is my intention to promote a universal audience to our commission meetings. "together we can change the world." 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 EDWIN CASTRO Date 04/26/2017 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management System"°.Please do not reply directly to this email. EDWIN CASTRO 39415 Ardenwood Way Unit 31.1, Lake Elsinore, CA 92532 Ph: 562-449-5039 EdwinCastrolgl@gmail.com Professional Summary Accomplished and energetic Community Banker with a solid history of achievement in Banking and Finance.Motivated leader with strong organizational and prioritization abilities.Areas of expertise include Community organizing,Financial literacy Presentations, and Public service. Skills Customer and Personal Service Speaking Judgment and Decision Making Persuasion Education and Training Experience Community Banker/N.San Diego Ambassador(CURRENT POSITION) Wells Fargo Bank N.A. - Vista, CA -Discuss one on one with clients all financial priorities and discover the best possible Banking solutions for our customers. -Responsible for opening New Checking and Savings accounts. Run Credit and Loan applications for customers. -Refer Customers to appropriate Bank Officer for complex products that include Mortgage applications or Merchant Services for Small businesses. Community Ambassador duties, -Serve as a Liaison for the North San Diego Region of Wells Fargo Bank for Community Volunteer projects. -Arrange Special presentations for Local Businesses and Schools to discuss Financial Literacy. -Meet with Regional Leadership and provide feedback on the community projects we assist and organize. -Official Representative to our city Leadership for Community Services. FMR. Community Services Commissioner Escondido City Hall-Escondido, CA Oversee expense allowances,ensuring that accounts are balanced at the end of each fiscal year. -Read and review concerns of constituents or the general public and determine if governmental action is necessary. -Seek federal funding for local projects and programs. -Speak to students to encourage and support the development of future political leaders. -Confer with colleagues to formulate positions and strategies pertaining to pending issues. -Hear testimony from constituents,representatives of interest groups,board and commission members, and others with an interest in bills or issues under consideration. -Represent their government at local,national,and international meetings and conferences. -Serve on commissions,investigative panels, study groups, and committees in order to examine specialized areas and recommend action. J Bank ofAmerica-Escondido, CA -Worked directly with customers and assisted in bank deposits. -Processed loan and credit card payments to appropriate accounts. -Use computers for various applications,such as database management or word processing. -Collect and deposit money into accounts,disburse funds from cash accounts to pay bills or invoices, keep records of collections and disbursements, and ensure accounts are balanced. -Supervise other clerical staff and provide training and orientation to new staff. -Mail newsletters,promotional material, or other information. Brand Representative Abercrombie&Fitch- Ontario, CA -Receive payment by cash, check, credit cards,vouchers,or automatic debits. -Issue receipts,refunds,credits, or change due to customers. -Assist customers by providing information and resolving their complaints. -Count money in cash drawers at the beginning of shifts to ensure that amounts are correct and that there Is adequate change. -Greet customers entering establishments. -Assist with duties in other areas of the store,such as monitoring fitting rooms or bagging and carrying out customers'items. Education High School Diploma Forest Grove High School-Forest Grove, OR Associate of Science:Political Science/Sociology Long Beach City College-Long Beach, CA Community Service -Active Member of the Republican Party of Riverside. 2oo8-Current -Community Services Commissioner for the City of Escondido 2014-2015 -Wells Fargo Volunteer Advocate. 20ii-Current -San Diego Beach Cleanup 2011-2014 -Los Angeles Aids Walk 2012-2014 -Candidate for Lake Elsinore City Council-2oi6 General Election Awards Outstanding Achievement in Customer Satisfaction, 2012-2015 Emerging Leader at Wells Fargo Bank, 2014 From: Application@lake-elsinore.org To: Susan M.Domen,MMC; Diana Ginin; Luz Reyes Subject: City of Lake Elsinore Commission Application Date: Tuesday,April 25,2017 8:30:13 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback spoofing A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 04/25/2017 8:30 PM Response#: 11 Submitter ID: 1244 IP address: Time to complete: 35 min.,55 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: [x] Planning Commission 2. Applicant Eligibility [x] City Resident 3. Applicant Information Last Name CHIN First Name CHERRIAN Home Address �ERSAILLES City LAKE ELSINORE ST State CA Zip Code 92530 Phone Number Email Length of Residency in Lake 1 MONTH Length in California 10 MONTHS Elsinore 4. Business Information Business Name ANGEL MARKETING Business Type ON-LINE SOCIAL MARKETING Business Address 16738 LAKESHORE Lake Elsinore Business NA DR.#H120 License Number Expiration Date NA Phone Number 727-310-9509 Date Business Established 4-18-2017 S. Education Information Name of School Attended PURCHASE City&State PURCHASE,NEW UNIVERSITY@SUNY YORK Degree Earned MASTER OF FINE No.of Units Completed 130.33 ARTS Name of School Attended PLATTSBURGH City&State PLATTSBURGH, NEW STATE YORK UNIVERSITY@SUNY Degree Earned BACHELOR OF FINE No.of Units Completed 200- ARTS Certificates Attained NA 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? i [x]Yes I 7. Work History Current Employer ANGEL Address 16738 LAKESHORE MARKETING(SOCIAL DR.#H120 MEDIA MARKETER) From APRIL 18 To PRESENT Position MANAGER/CONSULTANT Duties Performed PROMOTING MODERE.COM ECO-FRIENDLY PRODUCTS AND SIGNING UP NEW CUSTOMERS Previous Employer WOMEN OF WORTH Address 224 CHURCH ST. NEVADA CITY,CA. 95959 From 10-1-20-16 To 1-15-2017 Position VOLUNTEER Duties Performed VOLUNTEER STAFF-GUIDED CUSTOMER TO PRODUCT AREAS AND ASSISTING IN CLOTHING DEPARTMENT 8. References(Local Residents who are qualified to comment on your capabilities) Name PATRICK Address Phone Number MURRAY ST Name ANTOINETTE Adress Phone Number - HALL ST Name Not Address Not Phone Number Not answered answered answered 9. Community Service Participation(please describe types of service you have performed,if any) Organization NA Types of Service Not answered Organization NA Types of Service Not answered Organization NA Types of Service Not answered Additional Documentation Up ated cherriana- Chin CV3 1-19.docy 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes, Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving MY REASONS FOR APPLYING LIES PURELY IN WANTING TO IMPROVE MY COMMUNITY ON AN ECONOMIC AND ECOLOGICAL LEVEL. LAKE ELSINORE HAS THE POTENICIAL TO GROW AND TO DEVELOP IT'S ECONOMY AND ECOLOGICAL APPROACH MORE ON A RESIDENCIAL LEVEL. 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 CHERRIAN A CHIN Date 04/23/2017 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management SysternTM.Please do not reply directly to this email. CHERRIAN ANGELA CHIN cherrichin ahoo.com PH.# 727-310-9509 "It is the supreme art of the teacher to awaken joy in creative expression and knowledge."—Albert Einstein "A good teacher can inspire hope, ignite the imagination, and instill a love of learning"— Brad Henry PROFESSIONAL SKILLS Creative, detail-oriented, and personable teacher for people of all ages. With over 10 years of experience teaching English to students and sharing passion for art. Tailor lessons according to student needs and conduct activities to engage students. Thrive in fast-paced environments and consistently meet deadliness. Seek to benefit employers, artists, academics, businesses, and entrepreneurs by providing high quality services. AREAS OF EXPERTISE • Liaison with public - Adminstrative • Fluent in English Creative Thinking Classroom Management • Passed 3*d level Japanese Student Coaching • Public Speaking Language Test Lesson Planning • Volunteer ' Interpersonal Skills EDUCATION Master of Fine Arts, Purchase University, Purchase, New York, U.S.A., 1991-1993 Bachelor of Fine Arts, Plattsburgh State University, Plattsburgh, New York, U.S.A., 1987-1990 + WORK EXPERIENCE Women of Worth Nevada City,Ca *Volunteer Staff 2016-2017 Pinellas County School Board St. Petersburg,Fl Instructional Substitute Teacher 2015-2016 * Plan lessons,follow directions,be responsible for students. Shane Corporation Tokyo,Japan ESL Instructor 2012-2015 Taught kids and adults, ages 6-16 years the English language Kashiwa City International Association Kashiwa City Japan ESL Instructor 2009-2015 Instructed and mentored retired adults the English language ART EXPERIENCE Woodblock Artist New York and Japan 1997-2013 Work was displayed professionally in group exhibits in Japan Pace Editions New York (U.S.A.) Artist Intern 1996 Member of Nevada City Chamber of Commerce From: Application@lake-elsinore.org To: Susan M.Domen. MMC; Diana Gir6rt;Lux Reves Subject: City of Lake Elsinore Commission Application Date: Saturday,April 29,2017 4:39:55 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback ofino A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 04/29/2017 4:39 PM Response#: 13 Submitter ID: 1248 IP address: Time to complete: 24 min.,48 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: [x] PSAC Commission 2. Applicant Eligibility [x]City Resident 3. Applicant Information Last Name Flores First Name Jimmy Home Address _ White Birch City Lake Elsinore Ct State CA Zip Code 92530 Phone Number Email 1 Length of Residency in Lake 38yrs Length in California 55yrs J Elsinore 4. Business Information Business Name Retired Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered S. Education Information Name of School Attended Dominquez City&State Compton CA Degree Earned None No.of Units Completed 240 Name of School Attended San Bernardino City&State San Bernardino CA Degree Earned None No.of Units Completed 12 Certificates Attained State of California Department of Health-Water Treatment Operator T1 State of California Department of Health-Water Distribution Operator D.2 American Water Works Association-Backflow Tester American Water Works Association-Cross- Connection Control Specialist Inspector MDS&Associates-Paralegal 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? [x] No 7. Work History Current Employer Vargas Law Office Address Temecula CA From April 2017 To April 2017 Position Paralegal Duties Performed Immigration Previous Employer TK&J Inc Address 16779 Lakeshore Dr. From June 1993 To January 2017 (Retired) Position Owner Duties Performed CEO 8. References(Local Residents who are qualified to comment on your capabilities) Name Melissa Address Phone Number Melendez - St. M u rrieta, CA Name Victor Adress Phone Number r Pierson - L.E. CA Name Axle Address Phone Number Zannille - L.E. 9. Community Service Participation(please describe types of service you have performed,if any) Organization Lake Elsinore Types of Service Planning Business and Residential Development Commission Organization Lake Elsinore Unified Types of Service School District School Site Council Organization Elsinore Valley Types of Service Municipal Water Recycled Water Task Force District Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes,Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving The vast experience in serving on the Planning Commission,School Site Council and Recycle Task Force express deepest gratitude as a servant for the public.To have meaningful public participation and identify public issues and recommendations is the framework that benefits our community in a balanced and thoughtful manner. It would be a honor to serve on Lake Elsinore Public Safety Advisory Commission. 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 Jimmy Flores Date 04/28/2017 Thank you, City of Lake Elsinore ...... .. ................ This is an automated message generated by the Vision Content Management SysternTM. Please do not reply directly to this email. From: Application@lake-elsinore.org To: Susan M.Domgn. MMC; Diana Gir6 ;Lux Reves Subject: City of Lake Elsinore Commission Application Date: Sunday, May 7,2017 1:55:46 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback spoofing A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 05/07/2017 1:55 PM Response#: 18 Submitter ID: 1254 IP address: Time to complete: 19 min., 34 sec. Survey Details Pagel 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: [x] Planning Commission 2. Applicant Eligibility [x] City Resident [x] Business Owner 3. Applicant Information Last Name Miller First Name Roger Home Address _ Nectarine City Lake Elsinore Way State Ca Zip Code 92530 Phone Number Email Length of Residency in Lake 28 years Length in California 35 Elsinore 4. Business Information Business Name Roger Miller Heating Business Type hvac and air Business Address 16502 Nectarine Lake Elsinore Business not active Way License Number Expiration Date Not answered Phone Number 951 6747262 Date Business Established 01/01/1992 S. Education Information Name of School Attended Kelso High School City&State Kelso Washington Degree Earned high school diploma No.of Units Completed Not answered Name of School Attended Cypress College City&State Cypress Californin Degree Earned no No.of Units Completed 24 Certificates Attained Not answered 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? [x] No 7. Work History Current Employer retired Address Not answered From Riverside County To Not answered Position Building Inspector Duties Performed planning and building inspections along with many other duties Previous Employer self Address 16502 Nectarine Way From Roger Miller Heating To Not answered and air Position owner Duties Performed Owned and operated HVAC company for about 25 years. No longer active in the business now it is operated by a family member 8. References(Local Residents who are qualified to comment on your capabilities) Name John Address Dreycott Phone Number and in Lake Cerita Elsinore Metcalf Ca Name Zenida Adress Ralph Phone Number - Lopez Rd Lake - Elsinore - Name Robert Address Wildomar Phone Number - Ponce Ca - 9. Community Service Participation(please describe types of service you have performed,if any) Organization VFW in Wildomar Types of Service currently volunteer as Quartermaster and have for the last several years. Organization Riverside Grand Jury Types of Service volunteered as a Grand Juror for some of 2017 Organization Not answered Types of Service Not answered Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes,Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving Now that I am retired I would like to become more active in my community. 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 Roger L Miller Date 05/07/2017 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management System'".Please do not reply directly to this email. APR 5'17 PM4:11 CITY OF For Official Use Only LAY,E LS 1 r10 FEE Date Due: Date Received: Interview Date: Time: ?rw DREAM EXTREME Appointed: ❑ Yes ❑ No Date Appointed: Return completed application_ to: Commission Applied For: City of Lake Elsinore City Clerk's Department ❑ Planning Public Safety Advisory 130 S. Main Street, Lake Elsinore, CA 92530 (951)674-3124, Ext. 269 COMMISSION APPLICATION 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 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 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. Applicant Information City Resident Business Owner Last Name?64,l C L M_l First m � Home Addres Woa�lmirl�`� J ,fe_ City, State, Zip CA h you L e Elsinore Lengtr Business Info ation —Please complete the following if applicable. Business Name &Type Business Address City of Lake Elsinore Business License Number Expiration Date Business Phone Date Business Established Education/information Please List School Attended Units Completed Name �OQ City&State,_, Name U� -� it�&State �Z De rees or Certificates Attained ur--7b ro,W 1,75 Do you have Economic Interests s h as Income, Investmen , Real or Personal Property or Outstanding Loans which might present a potential conflict of interest? If es, lease ex lain. Work Experience(Beginning with current or last position) Employer Address From To LY� kCuDU-� (�1C�,�52 'iN1�G Vt C� it 3 ItSGn Position Heald and Duties Performed: 2 l t✓ 2 - c��fi� SvL4+lW-I, C' pry J,.ap L� f AMC) oc t &0 ri�J�GUQ.-ct 2 C L Pt/vltw G� �J it s/�3 Position eld and D ies erf rmed: 3�obo l iztba_P A.m ('/�i 91 503 6C4 References (Local residents who are qualified to comment on your capabilities) Name Address Phnnp �hvr Please Describe Communipi Service Participation if an (You may atta h aseparate sheet for additional Information Are you an officer or member of a policy-making board of a non-profit organization which receives funding from the City of Lake Elsinore? If yes, please list all organizations. U Have you ever been convicted of violating any Federal, State, County or Municipal law, regulation or Ordinance, excluding minor traffic violations? If yes, please explain. Q) Reasons For Interest in Serving on Commission (You may attach a separate sheet for additional information) w 15 a411 A-fit r 1 5 7� G Please note:Appointees will be required to take an Oath of Office and file a completed Statement of Economic Interests 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. rr. Applicant`s Declaration and Signature I certify unde penalty f far ury laws of the State of California that all information on this form is true and correct. r7 pplican s Signature Date From: Alma Quinn To: Susan M.Dom ri MMC Subject: FW: City of Lake Elsinore Commission Application Date: Monday, May 1,2017 1:57:18 PM Hello, I was informed just now that I could contact you to make changes to my application for PSAC? I noticed in question #5, 1 need to change it to B.A in Sociology not B.S. I also needed to remove Jason Hamm as one of my references and replace it with Jim Brown address is_Teakwood St. Lake Elsinore CA 92530 and phone number is_ M. Please confirm that this will be added to my application. Thank you Alma Quinn Claims Examiner I WC Claims ICW Group Insurance Companies aquinn a�icwgroup.com p: 858.350.7229 1 f: 858.369.7709 From: Application@lake-elsinore.org [mailto:Application@lake-elsinore.org] Sent: Monday, May 01, 2017 1:36 PM To: Alma Quinn Subject: City of Lake Elsinore Commission Application A new entry to a form/survey has been submitted. Form Name: Commission Application l Date&Time: 05/01/2017 1:35 PM Response#: 14 Submitter ID: 1249 IP address: Time to complete: 10 min., 43 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. i 1. Commission Applying For: [x] PSAC Commission 2. Applicant Eligibility [x]City Resident 3. Applicant Information Last Name QUINN First Name ALMA Home Address SINKS City SAN DIEGO State CA Zip Code 92530 Phone Number Email Length of Residency in Lake 1 YEAR Length in California 40 Elsinore 4. Business Information Business Name Not answered Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered 5. Education Information Name of School Attended SAN DIEGO STATE City&State SAN DIEGO UNIVERSITY i Degree Earned BS IN SOCIOLOGY No.of Units Completed 61 Name of School Attended SAN DIEGO MESA City&State SAN DIEGO COLLEGE Degree Earned AA IN LIBERAL No.of Units Completed Not answered STUDIES Certificates Attained Citizens Emergency Response Training(CERT) 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? [x] No 7. Work History Current Employer ICW GROUP Address 15025 INNOVATION POINT SAN DIEGO CA 92127 From 3/2014 To PRESENT Position WORKERS Duties Performed COMPENSATION Administer benefits to injured workers in CLAIMS ADJUSTER accordance with statutory and case law as well as pertinent regulations. Reserve, manages and bring Workers'Compensation claims to an equitable conclusion within the Company standards and best practices guidelines.Communicate effectively with other Company departments. Maintains a good working relationship with insureds, employers,agents and other employees. Previous Employer WAWANESA Address 9050 Friars Rd,San INSURANCE Diego,CA 92108 From 3/2012 To 3/2014 Position AUTO CLAIMS Duties Performed ADJUSTER Interpret policy wordings, determine policy coverage and ensure appropriate reserving.. .Investigate losses to determine liability including disputed liability claims.. Evaluate relevant information from sources such as appraisers,third party adjusters,contractors and repair facilities in order to quantify losses.. Negotiate with insureds, claimants, lawyers and insurers. Coordinate services with vendors and service providers. . Adjust claims from inception to completion in a proactive manner Maintain accurate records based on company standards and policies within the claims system 8. References(Local Residents who are qualified to comment on your capabilities) Name MIKE Address Phone Number- NORKIN LAKE ELSINORE CA 92530 Name LAURA Adress -. Phone Number WILSON — RD DAHLONEGA GA 30533 Name JASON Address Phone Number - HAMM - LAKE - ELSINORE CA 92530 9. Community Service Participation(please describe types of service you have performed,if any) Organization SUM M ERLY Types of Service NEIGHBORHOOD REVAMPED DORMANT NHW GROUP IN WATCH SUMMERLY. RECRUITED 126 NEW NEIGHBORHOOD WATCH PARTICIPANTS.. RESPONSIBLE FOR ORGANIZING QUARTERLY MEETINGS TO RAISE AWARENESS OF CRIME PREVENTION IN OUR COMMUNITY. I RAISE FUNDING FROM DEVELOPERS,AND LOCAL BUSINESSES TO INCLUDE LINKS GOLF COURSE, CYS,STARBUCKS,STATERBROTHERS,TARBELL REALTORS AND RESIDENT VOLUNTEERS TO SUPPORT OUR NHW GROUP METINGS. Organization CITY OF LAKE Types of Service ELSINORE I PARTICIPATED IN AN INTENSE 3 DAY TRAINING COMMUNITY TO BECOME CERTIFIED IN DISASTER EMERGENCY PREPAREDNESS. . I RECRUITED 40 PARTICPANTS RESPONSE TEAM FROM SUMMERLY BUT DUE TO TIME IT TOOK TO COORDINATE THE COURSE,WE ENDED UP WITH 18 CERT GRADUATES FROM SUMMERLY. I ALSO RECRUITED 14 STUDENT VOLUNTEERS FROM THE LOCAL COMMUNITY TO PERFORM COMMUNITY SERVICE HOURS AT OUR TRAINING Organization Not answered Types of Service Not answered Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes, Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving I FEEL THAT I WOULD BE AN EXCELLENT CANDIDATE AND ADDITION TO THE PSAC BECAUSE I AM PASSIONATE ABOUT HELPING TO MAKE LAKE ELSINORE A SAFE COMMUNITY FOR ITS RESIDENTS. I SHARE THE"DREAM EXTREME"VISION OF THE CURRENT CITY COUNCIL AND WANTTO ASSIST IN HELPING LAKE ELSINORE LIVE UP TO ITS FULLEST POTENTIAL. I AM POSITIVE,CHARISMATIC AND AN EFFECTIVE COMMUNICATOR.THESE QUALITIES WOULD ASSIST ME IN COLLABORATING WITH VARIOUS ORGANIZATIONS,PERSONNEL AND DEPARTMENTS WITHIN THE CITYTO ACHIEVE RESULTS. I AM AN EXCELLENTTEAM PLAYER THAT WOULD WORK WELL WITH CURRENT PSAC COMMISIONERS. I AM A COMPASIONATE LISTENER THAT WOULD WELCOME COMMUNITY INPUTAND IDEAS TO MAKE LAKE ELSINORE THE BEST CITY IT CAN BE. I AM LOOKING FORWARD TO THE OPPORTUNITYTO SERVE FOR THE CITY OF LAKE ELSINORE AND WOULD LOVE THE OPPORTUNITYTO SPEAK TO THE SELECTION COMMITEE IN �i PERSON TO ANSWER ANY ADDITONAL QUESTIONS.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 ALMA QUINN Date 5/1/2017 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management System•"^. Please do not reply directly to this email. From: Application@lake-elsinore.org To: Swan M.Domen,MMC; Diana Glydn;Luz Reves Subject: City of Lake Elsinore Commission Application Date: Monday,May 1,2017 1:44:15 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback s oo ofing A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 05/01/2017 1:44 PM Response#: 15 Submitter ID: 1250 IP address: Time to complete: 30 min., 10 sec. Survey Details Pagel 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: [x] PSAC Commission 2. Applicant Eligibility [x] City Resident 3. Applicant Information Last Name Visca First Name Pablo Home Address - lake trail City Lake Elsinore circle State California Zip Code 92530 Phone Number Email Length of Residency in Lake 30 years Length in California Close to 49 years Elsinore 4. Business Information Business Name Not answered Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered S. Education Information Name of School Attended Esperanza high City&State Yorba Linda,Ca school Degree Earned Not answered No.of Units Completed Not answered Name of School Attended Not answered City&State Not answered Degree Earned Not answered No.of Units Completed Not answered Certificates Attained Not answered 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? [x]Yes 7. Work History Current Employer Stay at home dad Address Not answered From 2015 To Present Position Dad Duties Performed Not answered Previous Employer M15 concert bar Address 9022 pulsar court and grill From Oct 2012 To Oct 2015 Position Stage manager Duties Performed It's now called the 80's bar running sound,light maintaining sound and light equipment, promoting and booking acts for the club. 8. References(Local Residents who are qualified to comment on your capabilities) Name Courtney Address Valencia Phone Number - Savard way - Name Randy Adress ' Phone Number - arnett chaumont - st Name Jack Address Heald Phone Number - Martin ave - 9. Community Service Participation(please describe types of service you have performed,if any) Organization Dream extreme Types of Service Helped with my family clean and paint. Organization Not answered Types of Service Not answered Organization Not answered Types of Service Not answered Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered i Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x]Yes If Yes, Please explain Not sure but I was arrested back in 1996 at the sundown in Parker for being in a bar fight. It was in Parker Arizona. But I just applied at my sons school for purple pass.I was granted and they ask me same question and I had to give a live scan of fingerprints . I guess I'm good. 13. Interest for Serving on a Commission Please list reasons for serving I would like to be more involved with my city. My wife says I complain too much. Maybe I should get involved more and see for my self. I love living in lake elsinore and would love to see it grow. I also think that there will be big changes in near future and I want to be apart of it. I do like to voice my opinion I come up with some good ideas some of the time. I want my kids to love Lake Elsinore as much las I do.Also be a part of a great community. 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 Pablo Visca Date 05/01/2017 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management SystemTM.Please do not reply directly to this email. LO ---- IV C 1 1-Y v F - For Official Use Only LADE `�OI�E Date Due; Date Received: Interview Date: Time: DREAM EXTREME Appointed: El Yes ❑ No Date Appointed: Return ctin�l�ied application to:City of Lake Elsinore Commission Applied For: City Clerk's Department ❑ Planning ❑ Public Safety Advisory 130 S. Main Street, Lake Elsinore, CA 92530 (951) 674-3124, Ext. 269 COMMISSION APPLICATION 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 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 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. Appjicant I ormatlon City Resident X Business Pwner Last Nam MI--, First Nam Home r !� � City, State,.zi ` Best Emai Length of Residency in Lake Osino 1 ,. lengthin Galifornia $uslness information—Please complete the following if applicable. Business Name &Type Business Address City of Lake Elsinore Business License Number Expiration Date Business Phone Date Business Established EducationtInformation Please List School Attended Units Completed Name City&State Name City&State Degrees or Certificates Attained Do you have Economic Interests such as Income, Investments, Real or Personal Property or Outstanding Loans which might present a potential conflict of interest? If yes,please explain. Work Experience(Beginning with cuerent or last position) Employer Address From To Position Heald and Duties Performed: z - Position Held and Duties Performed: ........... ........ ............ 3 References (Local residents who are qualified to comment on your capabilities) Name Address Phone Please Describe Community Service Partici ation (if an (You may attach a separate sheet for additional Information) Are you an officer or member of a policy-making board of a non-profit organization which receives funding from the Citv of Lake Elsinore?If yes, please list all organizations. Have you ever been convicted of violating any Federal, State, County or Municipal law, regulation or Ordinance, excluding minor traffic violations? If yes, please explain. Reasons For Interest in Serving on Commission (You may attach a separate sheet for additional Information) Please note:Appointees will be required to take an Oath of Office and file a completed Statement of Economic Interests 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. Applicant's Declaration and Signature I c tify e-5 ier penalty❑ perjury la s of the Late of California that all information on this form is true and correct. Applicant's Signature Date From: Aooiication@lak"Isinore.ora To: Susan M.Domen,MMC;D1ana Elba;Luz Reyes Subject: City of Lake Elsinore Commission Application Date: Wednesday,July 13,2016 4:16:59 PM A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 07/13/2016 4:16 PM Response#: 4 Submitter ID: 60 IP address: Time to complete: 51 min., 17 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: [x] PSAC Commission 2. Applicant Eligibility [x]City Resident 3. Applicant Information Last Name Ward First Name Richard Home Address ' Rawlings Way City Lake Elsinore State California Zip Code 92530 Phone Number Email Length of Residency in Lake One and one half Length in California 68 years Elsinore years 4. Business Information Business Name None Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered 5. Education Information Name of School Attended San Diego State City&State San Diego,California University Degree Earned Bachelor of Arts No.of Units Completed Not answered Name of School Attended National University City&State San Diego,California Degree Earned Master of Public No.of Units Completed Not answered Administration Certificates Attained California Peace Officer Standards and Training Basic, Intermediate,Advanced,Supervisory and Management Certificates. 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? [x] No 7. Work History Current Employer Golfsmith Address 1221 E. 19th St. International Upland,CA 91784 From September, 2004 To Present Position Club Repair Duties Performed Specialist Perform repairs on all makes of golf clubs, including:grip and shaft replacement; loft and lie alteration and length alteration. I am also reponsible for ordering all shop supplies. I am employed two days per week. Previous Employer California Address Various Department of Justice From August, 1980 To December,2003 (Retired) Position Special Agent in Duties Performed Charge During my career with DOJ I was assigned to: A. Bureau of Narcotic Enforcement San Diego, where I conducted investigations concerning controlled substance violations. B.Advanced Training Center Sacramento, where I developed and instructed classes in the enforcement of narcotic laws to local,state and federal law enforcement officers. C.Special Prosecutions Unit Los Angeles,where I conducted and supervised the investigation and vertical prosecution of organized criminal groups. D.California Bureau of Investigation Los Angeles, where I supervised general investigations and investigations of product counterfeiters and sexual predators. The last six years of my career I managed the California Bureau of Investigation Regional Offices in San Diego and Orange,which included San Bernardino, Imperial and Riverside Counties. Prior to being hired by DOJ, I was a Police Officer and Police Corporal for the El Cajon and La Mesa Police Departments for six years. 8. References(Local Residents who are qualified to comment on your capabilities) Name Steve Address Phone Number - Utter - Temecula, CA 92589 Name Kim Adress Phone Number - Nelson ■ - Poway, CA 92064 Name Bobby Address Phone Number Barrett - . La Jolla, CA 92037 9. Community Service Participation(please describe types of service you have performed,if any) Organization AYSO Types of Service Served as a team sponsor and referee for several years while living in Chino Hills. Organization Not answered Types of Service Not answered Organization Not answered Types of Service Not answered Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes,Please explain Not answered 1 I 13. Interest for Serving on a Commission Please list reasons for serving Having lived in Lake Elsinore for a year and a half, I would like to become more involved in the community in a volunteer capacity. I see the Commission as an excellent way to accomplish this. Having read the Duties and Functions of the Commission, I feel that I can utilize my education,training and experience to help make Lake Elsinore a safer and more enjoyable place to live. 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 Richard Ward Date 07/13/2016 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management SysteM—. Please do not reply directly to this email. Richard Ward Rawlings Way Lake Elsinore, CA 92530 IIonie: Cell: Professional Summary Accomplished law enforcement management professional with a successful track record for leadership, innovation and productivity. Skills • Team leadership. • Cultivating multi-county agency relationships and training. * Development of innovative enforcement and training programs. • Successful mentoring of subordinates. Professional Work History Department of Justice, California Bureau of Investigation, 10/1997 to 12/2003 (Retired). Position: Special Agent in Charge • Managed the San Diego and Orange CBI Regional Offices with responsibility for San Diego, Imperial, Orange, Riverside and San Bernardino Counties. • Oversaw implementation of the Indian Gaming Intelligence and the Imperial County Resident Agent Programs and the expansion of the Foreign Prosecutions Program, which involved obtaining extradition of fugitives accused of crimes in the United States, from Mexico. • Implemented the Riverside Field Office and Sexual Predator Apprehension Program. • Worked closely with local, state and federal agencies. Department of Justice, California Bureau of Investigation, Los Angeles 6/1991 to 10/1997. Position: Special Agent Supervisor • Supervised civil and criminal investigations. • Implemented and supervised the Sexual Predator Apprehension Program in Southern California, including Megans' Law. • Served as Acting Special Agent in Charge in the SAC's absence. • Selected for the Attorney Generals Award for Excellence in Supervision in 1993. Department of Justice, Special Prosecutions Unit, Los Angeles 6/1987 to 6/1991. Position: Special Agent/Special Agent Supervisor Supervised a team of Special Agents and Deputies Attorney General that investigated and vertically prosecuted crimes committed by organized criminal organizations. California Department of Justice, Advanced Training Center, Sacramento 6/1984 to 6/1987. Position: Special Agent/Program Manager • Developed and instructed courses on the techniques and enforcement of narcotic laws to local, state, out of state and federal law enforcement officers. • Instructed newly hired Special Agents at the DOJ Special Agent Academy. California Department of Justice, Bureau of Narcotic Enforcement, San Diego 10/1980 to 6/1984, Position: Special Agent + Conducted local, state and federal narcotics related investigations, including undercover operations, search warrant preparation and informant management, to enforce state and federal narcotics laws. * Specialized in the smuggling of controlled substances from Mexico by private aircraft. Cities of El Cajon and La Mesa Police Departments and the San Diego Unified School District Security Department, San Diego County 1/1973 to 10/1980. Position: Police Officer/Police Corporal (Emergency Medical Technician). • Conducted uniformed patrol to ensure pubic safety, enforced state and local criminal statutes, effected arrests, enforced traffic laws, investigated criminal activity and responded to medical emergencies. • Acted as a Field Training Officer and Administrative Office Supervisor . Education National University, San Diego, CA Master of Public Administration, 1980. San Diego State University, San Diego, CA Bachelor of Arts, 1972 Grossmont College, El Cajon, CA Associate of Science, 1974 Grossmont High School, La Mesa, CA Diploma, 1965 Professional Certificates California Commission on Peace Officers Standards and Training-Basic, Intermediate, Advanced, Supervisory and Management Certificates. Military United States Marine Corps 1968-1970 Rank: Corporal Awards: National Defense Service Medal,Vietnam Service Medal,Vietnamese Cross of Gallantry(Palm and Frame), Combat Action Ribbon. Discharge: Honorable State of California �7o�ei:tl,t�ut sIIcc �'�llfhn:i;i f3s1 MI,j of Ir:vi+lsgati��y IU01:1rd s�iccini ASm tt:('[urge RcUred Lake Elsinore,CA 92530 From: Application@lake-elsinore.org To: Susan M. Domen.MMC;Diana Girdn;Luz Reyes Subject: City of Lake Elsinore Commission Application Date: Sunday, May 7,2017 12:28:39 PM This sender failed our fraud detection checks and may not be who they appear to be. Learn about Feedback spoofing A new entry to a form/survey has been submitted. Form Name: Commission Application Date&Time: 05/07/2017 12:28 PM Response#: 17 Submitter ID: 1253 IP address: Time to complete: 9 min.,42 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: [x] PSAC Commission 2. Applicant Eligibility [x] City Resident 3. Applicant Information Last Name Williams First Name Agnes Home Address _Black Oak City Lake Elsinore State Ca Zip Code 92430 Phone Number Email t Length of Residency in Lake 1yr Length in California 68 years Elsinore -7 4. Business Information Business Name Not answered Business Type Not answered Business Address Not answered Lake Elsinore Business Not answered License Number Expiration Date Not answered Phone Number Not answered Date Business Established Not answered S. Education Information Name of School Attended Cal State University City&State Los Angels,Ca. at L.A. Degree Earned B.A. No.of Units Completed Not answered Name of School Attended Cal State University City&State Carson,Ca Degree Earned M.A. Public No.of Units Completed Not answered Adminstration Certificates Attained Trainer and Facilitator Conflict Resoultion and Mediation Citation Hearing Officer 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? [x] No 7. Work History Current Employer Not answered Address Not answered From Not answered To Not answered Position Not answered Duties Performed Not answered Previous Employer Employment Address 722 Capitol Mall, Development Sacramento 95814 Department From May 1975 To October 2006 Position Employment Duties Performed Development Apply the knowledge of principles and practices of Adminstrator public administration, including organization service goals, budget preparation, personnel and fiscal management. Ensure and provide a conducive environment whereby staff development programs can flourish.Coach and mentor managers to supervise staff engaged in carrying out major line operations and service delivery of the Employment Development Department which includes principles, purposes and problems of public employment security programs with special emphasis on provisions of the California Unemployment Insurance Code. Understand and implement basic policies and problem solving of various organizations concerned with Employment Development according to the provisions of the State Employer Employee Relations Act. The ability to use effective leadership tools which included effective listen skills,understanding data (not only the numbers but the actions or incidents which contributed to the data), review and analyze proposed and existing programs and operations. Plan, prepare and implement policies aligned with Emergency Preparedness and Response. Reach out to contiguous entities to discuss overlapping problems and collaborate on implementation of solutions.Analyze and solve administrative problems effectively representing the Director at meetings and conferences. 1 8. References(Local Residents who are qualified to comment on your capabilities) Name Margaret Address Not Phone Number - Williams answered - Name Starr Adress Not Phone Number - Ross answered - Name Brenda Address Not Phone Number - Elinborg answered - 9. Community Service Participation(please describe types of service you have performed,if any) Organization Gardena One Stop Types of Service As a volunteer I developed and delivered Job Search Workshop information which included transition skills, how to navigate the unemployment insurance process, resources available for choice,change, Mandy selection Organization Not answered Types of Service Not answered Organization Not answered Types of Service Not answered Additional Documentation 10. Are you an Officer or Member of a policy-making board of a non-profit organization which receives funding from the City? [x] No 11. If Yes,please list all Organizations Organization Not answered Position Not answered Organization Not answered Position Not answered Organizaton Not answered Position Not answered Additional Information 12. Have you ever been convicted of violating any Federal,State,County or Municipal law,regulation or Ordinance,excluding minor traffic violations? [x] No If Yes, Please explain Not answered 13. Interest for Serving on a Commission Please list reasons for serving I understand the workings of a functioning bureaucracy and the need to listen to the constituent base to improve and enhance the infrastructure in order to provide or attempt to provide seemless services. I have experience in informing the representative body of the results of the information received. For example,as a new member to this community I was faced with a problem concerning emergency services not having appropriate routing services to our community in cases of emergency. I was able to articulate the problem and requested appropriate action. I have followed up with Captain Ann of Lake Elsinore Sheriff Department and informed our community of the incremental steps and challenges. In my prior city of Gardena I addressed a problem about asbestos removal from a building and was heard which resulted in an ordinance that was passed by the City Council. I am known by my friends as someone who will read, research,ask questions,and seek the data to discern and offer potential solutions.As a trained facilitator and mediator I know the importance of teamwork, due diligence,and not being afraid to know when you got it wrong. I want to contribute to the flourishing of my community.The task and goals of this commission aligns with my education,experience,and belief in the importance to improve and enhance infrastructures and delivery of services to citizentry. 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 Agnes Williams Date 5/07/17 Thank you, City of Lake Elsinore This is an automated message generated by the Vision Content Management System'". Please do not reply directly to this email. 19