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Home My WebLink AboutCC ADA Access Advisory Committee 2014 ReappointmentAgenda Item No: 3. b Meeting Date: October 6, 2014 SAN RAFAEL CITY COUNCIL AGENDA REPORT Department: City Clerk Prepared by: Esther Beirne City Manager Approvao' File No.: 9-2-56 SUBJECT: REAPPOINTMENT OF FREDERIC DIVINE, ERIC HOLM, ROB SIMON AND GLADYS GILLILAND TO FILL FOUR, FOUR-YEAR TERMS ON THE SAN RAFAEL ADA ACCESS ADVISORY COMMITTEE TO EXPIRE THE END OF OCTOBER, 2018 (CC) RECOMMENDATION: a) It is recommended that Council reappoint Frederic Divine, Eric Holm, Rob Simon and Gladys Gilliland to fill four, four-year terms on the San Rafael ADA Access Advisory Committee to expire end of October, 2018. SUMMARY BACKGROUND: The current two-year terms of Rob Simon, Eric Holm, Fredric Divine and Gladys Gilliland will expire at the end of October, 2014; however going forward, as per Resolution No. 13681, adopted on February 18, 2014, appointments to the ADA Access Advisory Committee have been extended to two consecutive four-year terms. Their applications were the only ones received by the deadline of Wednesday, September 24, 2014. ACTION: Approve staff recommendation. Enclosures: Vacancy Notice Applications (4) FOR CITY CLERK ONLY File No.: Council Meeting: _,,, -,�� .,r, ,,,............ .... Disposition:_ .. Ij r eek I=SOME n �,a� M Lk Iw, .... • "�, I -W144- c ■www w CITY OF ACitY of San APPLICATION TO SERVE AS MEMBER OF ADA ACCESS ADVISORY COMMITTEE NAME. STREET ADDRESS' CODE: ?410 /L RESIDENT OF THE CITY OF SAN RAFAEL FOR YEARS PRESENT WORK POSITION: A- t NAME OF FIR ° C- -' BUSINESS ADDRES& ADDRESS (optional): r , kac'�k ( r, \A r PEOPLE DISABILITIES? YES NO -F YES, PLEASE INDICATE THE NAME OF THE GROUP AND YOUR POSITION, AND ATTACH A _F i_ r -* Information kept confidential to the extent permitted by law additional paper is necessary '` providing please attach - o this application -7 DO YOU REPRESENT THE BUSINESS COMMUNITY? YES N 0 N IF YES, PLEASE INDICATE THE NAME OF THE BUSINESSA D YO POSITION: EFO- Tq'( e-K YOUR REASONS FOR WANTING TO SERVE: VerL 4 g 6 V0<307 IF SELECTED TO SERVE, WHAT REASONABLE ACCOMMODATION REQUESTS SHOULD THE COMMITTEE FACILITATOR KNOW, IN ORDER FOR YOU TO FULLY PARTICIPATE? SIGNATURE: DATE:IL41—/4— FILING DEADLINE: MAIL OR DELIVER TO: Date: Wednesday, September 24, 2014, City of San Rafael Time: 5:00 p.m. City Hall, Dept. of City Clerk 1400 Fifth Avenue, Room 209 P.O. Box 151560 San Rafael, CA 94916-1560 (The information you provide in this application will be used solely by the City of San Rafael.) CITY OF SAN RAFAEL APPLICATION TO SERVE AS MEMBER OF ADA ACCESS ADVISORY COMMITTEE NAME: Eric Holm STREET ADDRESS: 820 Mission Avenue, #12 (, CITYISTATEIZIP CODE. San Rafael, CA 94901 Time'. RESIDENT OF THE CITY OF SAN RAFAEL FOR 8 YEARS ty B I PRESENT WORK POSITION: President State Board Guide Dogs for the Blind NAME OF FIRM, State of California BUSINESS ADDRESS: 1625 North Market Blved., Suite S 202, Sacramento, CA I - HOME & BUSINESS PHONE #'s: I. E-MAIL ADDRESS (optional): ,, EDUCATION: Doctor of Jurisprudence DESCRIBE YOUR INVOLVEMENT WITH THE DISABLED COMMUNITY IN SAN RAFAEL: Currently, I am incumbent to this Rosition and would reatly a reciate thg,QggnCjl'§ qMrgygi o ontinu Sailors. DO YOU OFFICIALLY REPRESENT AN ORGANIZATION, AGENCY, OR GROUP WITH SERVICES FOR PEOPLE WITH DISABILITIES? YES X NO IF YES, PLEASE INDICATE THE NAME OF THE GROUP AND YOUR POSITION, AND ATTACH A LETTER OF REFERENCE: Guide Dogs for the Blind. * Information kept confidential to the extent permitted by law If additional paper is necessary when providing answers, please attach them to this application form. DO YOU REPRESENT THE BUSINESS COMMUNITY? YES NO ,IF YES, PLEASE INDICATE THE NAME OF THE BUSINESS AND YOUR POSITION: 156• a �11 k a �kk �*; 0 I have successfullv served on this committee and do not reaulre anv special accommodations to Derform my duties. WFR�� DATE'. Zqll 5 ��—z Date: Wednesday, September 24, 2014, Time: 5:00 p,m, 5,.0. Box 151560 Ran Rafael, CA 94915-1560 (The information you provide in this application will be used solely by the City of San Rafael.) CITY OFSAN RAFAEL, zzmau m.� CITY/STATE/ZIP CODE. San Rafael, CA 94901 Q1:0 20% RESIDENT OF THE CITY OF SAN RAFAEL FOR 29 YEARSTime: PRESENT WORK POSITION: Retired City Clerk's Off City o�f San Raif ,12yJ,Tj1;u* &SIVITA BUSINESS ADDRESS: ................. • HOME & BUSINESS PHONE #'s. • E-MAIL ADDRESS (optional): EDUCATION: Hlgh School and several semesters, of iunior collegi DESCRIBE YOUR INVOLVEMENT WITH THE DISABLED COMMUNITY IN SAN RAFAEL: I he livnd.worked in San Rafael for over 25 years. I have life exl2erience with disabilities. During this time I worked with the disabilities -go-mmunit y In a variety -of ways. DO YOU OFFICIALLY REPRESENT AN ORGANIZATION, AGENCY, OR GROUP WITH SERVICES FOR PEOPLE WITH DISABILITIES? YES NO X IF YES, PLEASE INDICATE THE NAME OF THE GROUP AND YOUR POSITION, AND ATTACH A LETTER OF REFERENCE: * Information kept confidential to the extent permitted by law I (If additional paper is necessary when providing answers, please attach them to this application form.) II DO YOU REPRESENT THE BUSINESS COMMUNITY? YES NO X IF YES, PLEASE INDICATE THE NAME OF THE BUSINESS AND YOUR POSITION: REASONS FOR WANTING TO SERVE: IF SELECTED TO SERVE, WHAT REASONABLE ACCOMMODATION REQUESTS SHOULD THE MITTEE FACILITATOR KNOW, IN ORDER FOR YOU TO FULLY PARTICIPATE? SIGNATURE;,........... DATE: qhoolq Lyl�l[PL�l�l�a17�11�1� Date: Wednesday, September 24, 2014, Time: 5:00 p.m,, MAIL OR DELIVER TO: City of San Rafael City Hall, Dept. of City Clerk 1400 Fifth Avenue, Room 209 P.O. Box 151560 San Rafael, CA 94915-1560 (The information you provide in this application will be used solely by the City of San Rafaet.) M V STREET ADDRESS: — CITY/STATE/ZIP CODE., RESIDENT OF THE d F SAN RAFAEL F YEARS PRESENT WORK POSIT )p BUSINESS ADDRESS: Time'. HOME & BUSINESS P City of San 10 YOU OFFICIALLY REPRESENT AN ORGANIZATION, AGENCY,�5�ROUP WITH SERVICES F -OR PEOPLE WITH DISABILITIES? YES M iF YES, PLEASE INDICATE THE NAME OF THE GROUP O ATTACH extentLETTER OF REFERENCE: * Information kept confidential to the permitted brl additional paper is necessary when providing- attach them to this application 9 c— DO YOU REPRESENT THE BUSINESS COMMUNITY? YES NO IF YES, PLEASE INDICATE THE NAME OF THE BUSINESS AND YOUR POSITION, A REASONS FOR�ANTING TO SERVE: It- bt:Lt:U I 11U101ATTO-77A F TYWW'111�� COMMITTEE FACILITATOR KNOW, IN ORDER FOR YOU TO FULLY PARTICIPATE? SIGNATURE11111-12. D AT' : A d" FILING DEADLINE, MAII-4 U&N-1441614 Date., Wednesday, September 24,, 2014,, City of San Rafael Time: 5:00 p.m, Cfty Hall, Dept of City Clark 1400 Fifth Avenue, Room 209 130. Box 151560 San Rafael, CA 94915-1560 (The information you provide in this application will be used solely by the City of San Rafael,)