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Item 4G
CITY OF SOUTHLAKE MEMORANDUM Item 4G May 10, 2016 To: Shana Yelverton, City Manager From: Lori Payne, City Secretary Subject: Approve Resolution No. 16-025, Appointing members to the Zoning Board of Adjustment and naming a Chairman and Vice Chairman Action Requested:Approve Resolution No. 16-025, Appointing members to the Zoning Board of Adjustment (ZBA) and naming a Chairman and Vice Chairman Background Information: A Home Rule Charter of the City of Southlake was approved by the voters in a duly called Charter election on April 4, 1987. In the Home Rule Charter, Chapter XI concerns Planning and Zoning, and Section 11 .02 allows for a Board of Adjustment, which shall have all of the powers and authority as set forth in state law and such additional powers and privileges as may be duly assigned to it by the ordinances of the City. Pursuant to Section 44.1 , of Ordinance No. 480, as amended, the Board of Adjustment was established to consist of five members and four alternates to be appointed by the City Council. The term of office for said members shall be for two years. Three members and two alternates shall be appointed to serve terms beginning in odd numbered years and two members and two alternates shall be appointed to serve terms beginning in even numbered years. Section 44.2, of Ordinance No 480, as amended, provides for the proceedings of the board. "All cases to be heard by the Board of Adjustment shall always be heard by a minimum of four members." Likewise, Section 44.7, states that "the concurring vote of four members of the Board shall be necessary to reverse any order, requirement, decision, or determination of the Administrative Official, or to decide in favor of the applicant on any matter upon which the Board is required to pass under this ordinance, as amended), or to approve any variance." Recently, the Council received two resignations from board members: 1 . Scott Dyche, Place 2 (term expiring June 30, 2017); and, 2. Bonnie Panhoff, Alternate No. 2 (term expiring June 30, 2016). These resignations, coupled with the existing term limits, place the Board at risk of not having a quorum to conduct business. The following citizens currently serve on the ZBA: Name Term Expires Mike Smietana, Place 1 (Mr. Smietana is June 30, 2016* current Vice Chairman) Vacant, Place 2 June 30, 2017* Kourosh Panahy, Place 3 June 30, 2017 Guy Midkiff, Place 4 June 30, 2016* Jeff Medici, Place 5 June 30, 2017 Rob Baker, Alternate No. 1 June 30, 2017 Vacant, Alternate No. 2 June 30, 2016* Brett Nickel, Alternate No. 3 June 30, 2017 Ronell Smith, Alternate No. 4 June 30, 2016* Please note, the asterisked items (*) indicate appointments needing to be made on May 17, 2016. To assist Council with appointments, please note the following persons have expressed an interest in serving on ZBA and attached are copies of applications: • Michael Carter • Randy Colvin • Robert Kemins • John Kutch, Jr. • Guy Midkiff — current ZBA member — Place 4 (He noted that his workload has increased and that he might do better as an alternate or expressed interest in serving on Teen Court Advisory Board) • Gina Phalen • Mike Smietana — current ZBA member— Place 1 • Ronell Smith — current ZBA member—Alternate No. 4 • Lloyd Summy Please keep in mind that Council will also need to name a Chairman and Vice Chairman. Financial Considerations: Not applicable Strategic Link: C5: Promote opportunities for partnerships and volunteer involvement Citizen Input/ Board Review: Not applicable Legal Review: Not applicable Supporting Documents: Resolution No. 16-025 Applicant alphabetical listing Existing membership listing Existing membership attendance listing Existing membership training verification data Applications RESOLUTION NO. 16-025 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SOUTHLAKE, TEXAS, APPOINTING MEMBERS TO THE ZONING BOARD OF ADJUSTMENT AND NAMING A CHAIRMAN AND VICE CHAIRMAN; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City of Southlake has a Zoning Board of Adjustment as stated in the City Home Rule Charter, Chapter XI, Section 11 .02; and, WHEREAS, the Zoning Ordinance No. 480, Section 44, calls for a five member board with four alternate members to serve for two-year terms; and, WHEREAS, there are two vacancies and three places with terms expiring in June 2016 for the following: Name Term Expires Mike Smietana, Place 1 (Mr. Smietana is June 30, 2016 current Vice Chairman) Vacant, Place 2 June 30, 2017 Kourosh Panahy, Place 3 June 30, 2017 Guy Midkiff, Place 4 June 30, 2016 Jeff Medici, Place 5 June 30, 2017 Rob Baker, Alternate No. 1 June 30, 2017 Vacant, Alternate No. 2 June 30, 2016 Brett Nickel, Alternate No. 3 June 30, 2017 Ronell Smith, Alternate No. 4 June 30, 2016 WHEREAS, pursuant to Zoning Ordinance No. 480, Section 44, Council must also appoint a Chairman and Vice Chairman. THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SOUTHLAKE, TEXAS, THAT: Section 1 . All of the findings in the preamble are found to be true and correct and the City Council hereby incorporates said findings into the body of this resolution as if copied in their entirety. Section 2. The City Council hereby appoints the following persons to serve on the Zoning Board of Adjustment: Place 1 , term expiring June 30, 2016 Place 2, term expiring June 30, 2017 Place 4, term expiring June 30, 2016 Alternate 2, term expiring June 30, 2016 Alternate 4, term expiring June 30, 2016 Section 3. The City Council hereby names as Chairman and as Vice-Chairman. Section 4. This resolution shall become effective after its passage and approval by the City Council. PASSED AND APPROVED THIS THE 17th DAY OF MAY, 2016. CITY OF SOUTHLAKE, TEXAS BY: Laura Hill Mayor ATTEST: Lori Payne City Secretary Applications in alphabetical order i I I RECEIVED S4UTHLAKE M AY - 5 2415 fTY JO aEE# ETA rRY.. Name:W Michael Carter Address: 1808 Native Dancer Place,Southlake,TX 76092 E-mail Address: mlke carter@ver€mn.net Home Phone:8174-$1-7808 Cell Phone:2142442817214-2442517 Work Phone: Occupation: Retired Pension Actuary Employer.Towers Watson,and then Gabriel Roeder Smith i Are you a resident of Southlake?�. ,II iL.IrqsC]No Length of residency: 154-Years i Are you a registered voter? Dyes No Voter registration number: 1049142528 I I Do you, your spouse or your employer have any financial interest, directlyor indirect the Board and Commission to which u seek �* in matters might came before You appointment? I ❑YeS M✓ No If yes, explain: Do you, your spouse or your employer have any financial intent,directly or indirectly, in the sale to the City of any land, materials, supplies or service? 6�Yes M No if yes,explain: Building Board of Appeals , CommunityEn Planning and Zoning Commission Engagement Committee Senior Advisory Commission Crime Control and Prevention District Board Southlake Arts Council Library Boats Southlake Parks Development Corporation Metroport Teem Court Parks Board Zoning Board of Adjustment and Recreation AN Education: ❑ High School y :' College -Course Study: �►in Econpmics from y Rice University Other-explain What is your occupational experience? 1967-1976 Southland Life insurance company. 1976-2001 The Wyatt Company/Watson Wyatt Worldwidelhow Towers Watson.2001 -2009 Gabriel Roeder Smith&Company Areas of interest:Personal•. Family,'travel,Orfshcre Fishing. Other. Help Southlake continue to be a desirable place 10 live J lI SOUTHLAKE I i E hold Please any MGM "0 aridiorem plalRtreirt wrm alt�osrds, ammisaions Corporeho,�a,Nal-E+ro >rititias.q or aCier£relies an illy other sovwment Board or Commission that you have held. Adcftnai inromratbn may be attached. None on Government Boards or Commissions Muliple volunteer activities with No Entities between the late 1970s through today. These include the governing bodies for my local church congregation,for the multi-slate regional governing body of those congregations,for various national business_mlated organizations,the Board of Directors of my last employer,and the Board of Trustees for the Board of Pensions of(first) the Lutheran Church in America,and its successor Evangelical Lutheran Church in America. See attached for more details. i I Are you involved In any community activities?l rx"Ter'tlY ssfm On the BOaW of oirecbors or my reardentiai common f ltys Home owners�oaado», I have appearod before the southiake Coura and zoning Cornnrt<tas mrdtlpla trrnea over the last 18 years to otter MY support or dimpRml of items before timet oodles. ff IlleriRi> PIOM gftffih Rbjef nanythM outlining inte[gsts and guaLfffigglons for seeking appointment. You may also add a resume or additional Information. Please check box, if resume attached What do you hope to accomplish by serving on a board or commission? 1 hope cc bdrg the viewpoint of just an interestedSotttitlake resident"to issues brought before the P&Z Committee. I have na"ax to grind"Or I 9 personal agenda in these matters. I simply want to help Southlake retain and nd what makes it a desirable Place to live. What else would you like to tell us about yourself?SeG attached. Board and Commission members are representatives of the City of Southlake. Is there anything in your past that would be harmful or embarrassing to the City of Southlake? No No Completed forms may be delivered to the City Secretary's Office, Town a Hall '14 78092, faxed (817) 748-8270, or e-mailed I � g0 Main Street, Suite 270, Southlake, Texas year. After that time it will be neces �` re j. outhlake be us. Applications are kept on file for a period of one (1) sary to reapply and update the information herein if you wish to be considered for appointment. By signing below, you certify that all information on this form is represented accurately. The applicant further authorizes the City Council, or its designee, to verify any Information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information provided is considered public pursuant to the Texas Public Information Act. � 4 Signature: Date: May 4.2015 I W Michael Carter Application for Southlake Planning & Zoning Commission Supplemental Information Contact Information W Michael Carter 1808 Native Dancer Place 817-481-7805 (home phone) 817-421-4087 (Fax) 214-244-2517 (cell phone) mike—carter@verizon.net ! + Volunteering Background o In the 1980s i was a trustee on the Board of Trustees for the Board of Pension of, first, the Lutheran Church in America, and then of its successor organization, the Evangelical Lutheran Church in America. 4n the Board of Trustees of the ELCA, I chaired the Board's Benefits Committee and was a member of its j Executive Committee. o I also served a two year term as a member of the Board of Directors of my last employer, GRS, and I have served on Boards of several minor non-profit organizations. o I currently serve on the Finance Committee of our local congregation, Living Word Lutheran Church, in Grapevine. o I have served as a co-chair for the Rice Class of 1966 Giving Committees for my graduating class' 3511 and 401h Reunions, and I am currently serving as a co-chair for our Class' 50th Reunion Giving Committee. o For 2014 and 20151 have volunteered to organize and recruit volunteers to help the Rice Track Team host one track meet each school year. i • Community Activities o I currently serve on the Board of Directors of the HOA for my residential neighborhood, Southlake Woods. o While not currently or previously serving on any City of Southlake boards or commissions, I closely follow activities within my city. o As a result, over the 95+ years that I have lived in Southlake, i have provided citizen input from time to time on agenda items that have come before the City Council and the Planning and Zoning Commission. I have also attended and participated in numerous SPIN Meetings during this time. o I became very actively involved in combating the City Charter proposed amendment to allow liquor stores in Southlake. o I actively support and recommend to friends and acquaintances to attend such City events as Art in the Square and the annual duly 3rd Stars and Stripes celebration. o i actively participate in voting in all elections held in Southlake. • Reasons for Seeking Appointment o i have lived in my home in Southlake for a little over 15 years. I have never lived in any other single home this Fong during the rest of my life. o I love Southlake, and I am proud to say that i live here. o My wife and I not only live in Southlake, we shop, entertain, and eat in Southlake. o I am now fully retired, and I would like to give back to this City that I love so much. z � 1 e i i o My wife and I previously lived 33 years in another DFW-area suburb. During those 33 years, I watched how decisions by that city's leaders could help improve or hurt that city's quality of life and the value of its houses. o As I note above, I am now fully retired from my career as an actuary. I am involved in no business activity, and the only property interest that I have in Southlake is my home. I o As such, I believe I can bring to the Planning and Zoning Commission the viewpoint of"just a resident and citizen" of 1 Southlake. I believe this will enable me to look at items corning before the Commission through the eyes of other plain citizens and to evaluate how the proposals will affect the value of our homes and the quality of our lives in Southlake, but at the same time balancing that evaluation with any legal constraints communicated to me by the City Attorney. o I have always been a strong worker who always gives my best to anything that I commit to do. You would see this first-hand if I am appointed to the Commission. I For the reasons that I have cited in this application, I believe I would be a strong addition to the Planning and Zoning Commission and that the Council would be pleased with my appointment to it. Respectfully Submitted, Al W Michael Carter i I i � I t W Michael Carter 1808 Native Dancer Place 817-481-7805 (home phone) 817-481-4087 (Fax) 214-244-2517 (cell phone) mike carter@a verizon.net Objective Be selected to be a member of the City of Southlake Planning and Zoning Commission Education Rice University 1966 • BA, Economics Professional Designations (at time of retirement) • Fellow, Society of Actuaries • Fellow, Conference of Consulting Actuaries • Member, American Academy of Actuaries • Enrolled Actuary under ERISA Experience Southland Life Insurance Company 1116/1967-- 111611976 Assistant Vice President & Associate Actuary Responsible for Individual Life Insurance Product Development Towers Watson & Company (Previously The Wyatt Company and Watson Wyatt & Company) 2/111976 — 8/31/2001 • Vice President and Senior Actuary responsible for obtaining and retaining on-going clients and project W Michael Carter clients • Specialized in providing actuarial and pension consulting services to governmental retirement plans Effective 813112001, my public plan practice was sold by Watson Wyatt to Gabriel Roeder Smith & Company • Remained employed by GRS as a Senior Actuary until my retirement on 12/31/2009 During my career as a pension actuary, I obtained as clients and served as their consulting actuary the following governmental pension funds, most of them continuously until my retirement • Teacher Retirement System of Texas • Arkansas State Highway Employees Retirement System • Oklahoma Teachers Retirement System • New Mexico Educational Retirement Board • Utah Retirement System • Arizona State Retirement System j • North Dakota Teachers Fund for Retirement • Hawaii Employees Retirement System i • Employees Retirement System of Rhode Island • California State Teacher Retirement System • Virginia Retirement System • South Carolina Retirement System • Colorado Public Employee Retirement Association • Army Air Force Exchange Service • Numerous public plans in Texas o Harris County Hospital District o Parkland Hospital o Houston Municipal Employees Retirement System o Dallas-Fort Worth International Airport o City of Irving Supplemental Benefit Plan o City of Piano i o City of Austin Municipal Employees Retirement System i 20 W Michael carter f o City of Fort Worth Employees Retirement Fund i Also during my career, I performed project assignments for numerous state and local public retirement programs, including • Alabama Retirement Systems • Georgia Teacher Retirement System • Ohio State Teachers' Retirement System • North Dakota Public Employees Retirement System • Pennsylvania Public School Employees Retirement System • Florida Retirement System • City of Dallas Fire & Police Retirement System I was an active participant in the following national or regional public retirement system organizations: • National Council on Teacher Retirement (NCTR) • National Association of State Retirement Administrators (NASRA) • Southern Conference on Teacher Retirement (SCTR) • Mid Winter Conference of Large Public Retirement Systems • Government Finance Officers Association (GFOA) • Associates Advisory Committee for NASRA • Member, NASRA Executive Committee + Associates Advisory Committee for NCTR • Texas Association of Public Employees Retirement Systems (TEXPERS) ; DII' urng my career, I was a frequent speaker on pension matters for numerous organizations and conferences, including the following: • NCTR Annual Conference • NCTR Directors Meeting • NASRA Annual Conference 3' i I * cn,c of RECEIVES] SOUTHLAKE JUN 1 5 2015 ail WE , ME Name:Randy G Colvin Address: 310 Silverwood Circle &mailAddress: rgc730@gmall.com Home Phone: 817-421-1039 Cell Phone:817-296-8976 Work Phone: Occupation;Sales Employer:Dendreon, Inc Are.you a;resident of Southlake?=Yes. No Length of residency: 22 Years Areyou a registered voter's Dyes 0 No Voter registration number: 1046765213 Do you, your spouse or your employer have any financial interest, directly or-indirectly, in matters that might come before the Board and Commission to which you seek appointment? . '=Yes M No If yes, explain: Do you;,your spouse or your employer have any financial interest, directly or indirectly, in the sale to the City of any land, materials, supplies or service? Yes D No if yes, explain: 3 Building Board of Appeals Planning,and Zoning Commission B Community Engagement Committee Senior Advisory Commission Crime Control and Prevention District Board 9 Southlake.Arts Council 10 Library Board 4 Southiake Parks-Development Corporation 3a Metroport Teen Court z Zoning Board of Adjustment 5 Parksand Recreation Board Ig Education: ❑ High School ❑✓ College -Course Study: BS,business,criminaljustice- ❑ Other-explain What is your occupational experience? safes,intemational distribution specialty pharma. Process planning,strategic planning,business development Areas of Interest: reading,traveling,history,spending time with my wife,all sports activities W Michael Carter Mid Winter Conference of Large public Retirement Systems i • SCTR Annual Conference • Texas Pension Review Board Educational Conferences I • TEXPERS Conferences • GFOA Annual Conference • National Association of State Treasurers • Texas GFOA • Virginia GFOA My service to my clients included providing testimony at committee or subcommittee hearings for state legislatures or government oversight agencies and to provide information in private meetings with state legislators, governors, and state finance directors in virtually every state where I had clients. I 1 i i i I I_ i i i 4• r CITY OF SOUTHLAKE i eases ecify membership angive tale and dalles,an or emp agmen a. oa s,: mm ss ons, orpora ons; an, : n es;Agencies,orovier Entities on any other government Board or Commission that you have held. Additional intorrnation may attached. Are you involved in any community activities? no interests and qualifications:for seeking Please attach a brief narrative_authninp:yaur i appointment: You may also add a resume or additional information. Please.check box, if resume:attached What do you hope to accomplish by serving orl a board or commission? I have lived in this great city for 22+years and I wouldlike to see at"":remain a great place to live and visit. I want to:giveback to"the city and participating;in local government is an excellent way of doing,.so. What else would you like to tell us about yourself?please see attached Board and Commission members are representatives of the City of Southlake. Is there anything-in your past that would _ be harmful or embarrassing to the City of S.outhlake? not that i am aware of not that i am aware of Completed forms may be delivered to the City Secretary's Office, Town Hall, 1400 Main Street, Suite 270,Southlake, Texas 76092, faxed (817) 748-8270, or e-mailedI a ne ci.southlake.tx.us, Applications are kept on file for a period of one (1) year. After that time it will be necessary to reapply .and update the information herein if you wish to be considered for appointment. By signing below, you certify that all information on this form is represented accurately. The applicant further authorizes the City.Council, or its designee, to verify any information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information provided is considered public pursuant to the Texas Public Information Act. Signature: Date: r' Dear Council Members, E Please allow this correspondence to serve as a means of introduction. My name is Randy Colvin and I would like to submit my application to serve on boards and or commissions, as you deem appropriate. I have lived in Southlake since Oct'93 and have seen this community grow and become a "destination" city. Participating as a volunteer allows me the opportunity to "give back" to Southlake and my fellow citizens. While I do not possess special skill sets.or experience's the city might find of value, do possess a keen intellect, highly developed business acumen and insatiable curiosity. The past 20 years in the bio-pharmaceutical business has allowed me to develop and refine many skills; such as process improvement, strategic planning, and financial and accounting to name a few. The.foundation for all of my successes has ''been the ability to collaborate across a wide range of diverse backgrounds and life experiences. I Thank you in advance for your consideration of this application. Warm regards Randy Colvin i I i Y CITY.OF RECEIVED. SOUTHLAKE MAY 1 3 2015: : ENNUINi, -1a NagnO;AD4*Kerhins Address. 605,W Highland Street E-mallAddress. kio6kemin6@y;ahoo corn 817-4243169' Horne„Phartea Ceil''Phane 817=775-1169 Work Phone X94-88]--978 Orxupatlon. ederai Fr i ar l=.mploy®r.United:$4ates Oeparin�nt nf: justice Ar�yau a reslderrt of SoutliE[af�e? Yes;QNO: LEngth of residency 15-yeas Are you a n-9 a”1stared water' Dyes , ;No Voter registnkion:nunther.104911827 8 EO YOU yourspouse.;eryouremployer h�ny maned interest,direrrFfy or 1nc1[reCtly in matters that mlght;come before:. ,the Board and;Commission to wh[cl you-seek appolntment?' =Yes No It yes,-explain: I Do yozi=your spouse,:or your eniplayer have any financial inferest, directly or rtdlrectly rn thesale ta9`the Cly of any land, -. matedols,supplies or service? Yes Delo If.yes, exlalbin: Bq r Board of Appeals ' Planning and Zoning Carnmssion Convnuny Ecgagement Carrlrrrittee Sent©r Adv[sory lomnisston s Cnrne Cantrrsl:and Prevention District Board Southlake Arts'.Cooncil tibrary Hoard Snuthlake.Parks Development- corporation' f Ietroport Teen Court i Zoning Board of Adjustment.... F adcs 111.and IRec fico Board.. d fill!if! 11 r - Education: ducation High:S.chool College -Course Study: See atraohed resume Z Other-explain 11UIYdf. $]IOUs Occupational.experience? i have beena:lawyar 9irt�1982..Beaideslieieg a-prose[w�ir t have been a.ta®sl advisor and s CongrassfoE.liatsan: While.ln the Navy l served b.oth asl ore.and;atsea. . Areas of interest. My primary focus during my legal career-has been the:inyestigabon;ano prosecution of white odliar crirrle. M Crry OF SOUTHLAKE oihereovert►WtEoard..oiGomm onthatyou:Have;held.AdditI hWinfonmadondi y a,.Otadhed bdo:net rememberthe exadt-defes.but.'Ihave seared (sumessfuiiy l think)art many-CISD committees indudi'ng: Bond Planning,$Bond.0Versigtif:. CISD`'Bud et&FinarYce - CISD District Advisory CISID,Srte:B9sed>AdW9*-for Carroli Senior!High School - I "YOU ovolfred in$nY comrriunity'ectr les?Just-106t i mentioned above ifyntr:oountr ising-th daughters in'the.cgmmunity pie a fake thal.into a ountralso. I alsp actfue'lysupport candidates during iodate ec ioh"n;important part af;the.derrioaatic:pnnc�ss. - - I Please mach a brief narratnr�ouginmra irour rnterests:and au�l' ions far seeficing appa%rttrnerrl: You rrray alsti'Add gN*Wnie or add itbnal,inforrnaLW1 Please cheeCc bo5c, rF resume atlaehed' Whatdo you hope to;accomp#ish;by serving on a.tioard ar commissron'?:It my sound trig,but ,l warit:ta help make Souttilake a i j `better place to iive. When my chi,Id were m scF r�o!I foccrsed my efforts an CtSI] d drd what I could fa.make s the b school district k could be NOW-#hat.ffieyt ve,gcaduatod:f vuant'fofocus mYefforis pan oo yyhet:l can to'help tfie C y mat.else would you'likoto tail.-us about>yourseif�>I would be�honored to:be selected -1 v,ouldtake.anyapp.oWment.senousiy; l enfoy berng part ofthe: prates,% arid;l*ievc,l:co�ld:tie-an asset,to whatever board or committee I was appointed to.-I think-the City. doesan excellent oh it udl,- : Clt>xen;talent;and takes:senous. jhe iiri 1 � � _lY . portance of the work of these entities; Board'aril Commission members-are.repr+esentatives,of`the City of Sauthlake: `Is there..anything in your past that would be liarrnful:or ern6arrassltj to the City of Southlake? No#h_in that 1 can tFnnk of. 9 Nothing that I care think of - Cornpleted forms:may be:delivered to the City Secretary's Office, Town Hall,14t30 Main Street, Suite 270, Southlake,Texas 76092, faked (817)74"270, or e=rndiledi§a ne ci:so.uthlake.bc.us. Applications:arse kept on file#or a period of:one (1) year. After that time it.will be necessary°to 'reapply and update:the informatrorf -herein- if you wish to be .considered for appointment: By signing below, you certify that ail information:on this form is re accurately. The applicant further authorizes the City Council;,or its.designee, to yerifiy any infgmation. The applicant agrees to release and hold,harmless the City from all claims in " to the verAcatio infor nation:contalned herein. All information provided is considered public pursuant to the Texas'm nfo on Act. i Signature Date;SIMM k ROBERT A.KEN9NS 605 West Highland Street Southlake,Texas 76092 817-424-3169(Home) 214880-9781 (Office) 817-715-1169(Cell) E-mail: bobkemins@yahoo.com Professional 2002-Pmseat United States Department of Justice Tax Division Dallas,T.X. Trial Attorney(Southern Criminal Enforcement Section) Sole Taos Division Criminal Trial Attorney with a POD outside of the Washington,DC area. As suck I am the face of the Tax Division to United States Attorney's Offices throughout the Southwest United States. i 2000-2002 United States Department of Housing and Urban Development Experience Office of the Inspector General-Howing Frmd Initiative Task Force Arlington, Texas Trial Attoraey/Special Assistant United States Attorney(Northern District of Texas) Chief Legal Counsel to a 30 member congressionally mandated task force consisting of special agents and senior auditors. My primary function is to approve ar decline cases for prosecution and thea to lead and coordinate the investigative effort_ The ultimate goal is to successfully investigate and prosecute those who papetreft high dollar fraud against HUD through the use of all applicable criminal statutes,investigative agencies and techniques- 1991-2000 echniques_199f-2000 United States Departmerkt of Justice Tax Division Washington,D.C. Trial Attorney(Southern Criminal Enforcement Section) My primary function as a trial attorney was to review cases of proposed charges to be brought under Titles 26 and 18 of the United States Code involving income tax offenses. 1 also litigated numerous cages around the United States. Notably, I was a member of the Department of]ustice's Bank Fraud Task Force located irk the Northern Judicial District of Texas. 1 also aided is the prosecution of several members ofthe self-proclaimed"Republic of Texas"sovereignty movement. This assignment led me to become knowledgeable with the numerous anti-government and and tax movements operating in the Southwestern part of the United States and their techniques oftax evasion. My final year at the Tax Division was spent as the coordinator of"abusive"trust prosecutions,both domestic and ofbhom. The Assistant Attorney General of the Tax Division who requested that I oversee the Division's overall strategy in combating this method of tax evasion appointed me to this position. I also worked closely with the Criminal investigative Division of the IRS to make sure there was a cohesive prowcution/investigative strategy and that these cases I which frequently contained overlapping targets were investigated in a way that j maximized the potential to bring the strongest case in the best venue. 1983-1991 United States Navy Judge Advocate General's Corps I i During this period I hold a number of billets,which included being a prosecutor and defense counsel at the Naval Legal Service Office in Norfolk,Virginia. I was also a legal and legislative assistant to the lnSWtor General of the Navy. I was an appellate counsel and then a Special Assistant United States Attorney in the District of Columbia. Education 1980 BA.Dowling College,Oakdale,New York 1983 J.D.New England School of law,Boston,Massachusetts Bar Memberships Supreme Judicial Court of Massachusetts United States Court ofMilitary Appeals Federal District Court for the District of Massachusetts Awards Received Numerous Tax Division Outstanding Attorney Awards,including 2013 IRSCI Chiefs Award Honorary 1RSCI Agent 1991-1999 Numerous IRS/CID Certificates of Appreciation from CID agents and management 1991 Joint Services Commendation medal(awarded by Secretary ofDefense) 1988 Navy Commendation Medal(aww ded by Secretary of the Navy) 1986 Navy Achievement Medal(awarded by Judge Advocate General of the Navy) Also entitled to wear the National Defense Service Medal I i r 1Yf REG- � SOUTHLAKE SEP 2 8 2015 OFFICFrt t,�� �,���,��� � � _�� ���q�p���►t�o^�o�tM�s�s s���uc�r N �� ��.����:��� ��� ,, 6 tom/ Name: v a Address: (-S0 S- - h2a4-A '-'e _h, C111 E-mail Address: (-A9 ~v�� Home Phone: ?kLq9/—/ Cell Phone 40 Work Phone: _ Occupation: Employer: Are you a resident of Southlake? Yes 0 No Length of residency:Inil Are you a registered voter? Yes 0 No Voter registration number; 4.Lo � Do you, your spouse or your employer have any financial interest, directly or indirectly, in matters that might come before the Board and Commission to which you seek appointment? =Yes k No If yes, explain: Do you, your spouse or your employer have any financial interest, directly or indirectly, in the sale to the City of any land, materials, supplies or service? Q Yes No If yes, explain: t�t� � _•__�os.-f�:M m-"'""`+E�z•.r ,�z - lb��r^- r.-r� ..r,,.,-co'�a�- - -c� �' 'r' � = 1 � I C� Building Board ofAppeals Parks and Recreation Board Community Engagement Committee Planning and Zoning Commission Community Enhancement and Development Senior Advisory Commission Corporation Board of Directors Southlake Arts Council 0 Crime Control and Prevention District Board Southlake Parks Development Corporation Library Board EM Zoning Board of Adjustment Metro ort Teen Court Advisory Board `� S1 °��,,,'.x.ct r^' a s r�---r1,,�-:xcra� v. .oe fs .�a.�r�yyrr�1 `'�,s� � .. rF- S� ' r"Ltr i s } x#a�'� r'Y. fie' a e U0 y s�$,r 1 Y } i'VLav��r,e »'� 'c y _ .t...,� � ` V Education: High School Coll e -Cou a Study: 4 d, Other-explain M A What is your ccup do l experience? l ° Area CITY OF SOUTHLAKC IN ,�.,,���� j,��_ -.'• w r_' M t •':��,..:.>f»`'�-l l.t l,5v�. ' �:s�z ':...;y i..E.:.,.c':. � � '. �f l ,A Please speafy mend flnre dtie and dates ardor empCoyment with all Boards,Comm�ss�ons.Carparat<ons, on-fes Ent 'esencies,aro er ntihas on any r other gav ent Board or Commission at you have held. Additional information may be a ed. aJ- ayz AA 7 wn i F AL R-P,k It;f IV I i Are you involved in any community activities? �g �nlErn n Please attach a brief narrative outlining our interests and aualificatioras for seeking appointment. You may also add a resume or additional information. Please ch ec b , if res be attached: What do you h pe to accomplish by servin o bo dor commission? 7A�. 9 What els ould you like to tell us about yo elf? ..6Z—Z 41 A7 CZAP�tl Zlzl�)r , (j U Board nd Commission members are rep re ntatives of the ity of Southlake: Is there anything in your past that would be harmful or embarrassing to the City of Southlake? Completed forms maybe delivered to the City Secretary's Office, Town Hall, 1400 Main Street, Suite 270, Southlake, Texas 76092, faxed (817) 748-8270, or e-mailed Ioayne@ci.southlake.tx.us. Applications are kept on file for a period of one (1) year. After that time it will be necessary to reapply and update the information herein if you wish to be considered for appointment. By signing below, you;certify that all information on this form is represented accurately. The applicant further authorizes the City Council, or its designee, to verify any information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information provided is considered public pursuant to the Texas Public In ation Act. Signature: ' Date: � o S i CL f � y 01 0 Nc m l N p c0 CL FrD sum. 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Z ° z N o 0 - C N 19 CD N X € Cr o' m CD o °, o (D X\ c _ o � •V O � ru M� 7y - , i 1 fi � m s �Cel 3 a- CL c 3 0 or ILS o o f7 0 i I i i 4`r At INi, V. �MIZ" Y*' :: ..a: m.:' r m t E.t v O r a le- - }- u G }+M ' R, A�- Ell% W M NW V P.A im wf� ID ja KZ MI 4 .0, p"I" R, jo xpiD 9 S its J'' Ofta ppi P'O W V-6- �'k� w tas I %MW:W 0 s a r;� Kll r-::. -ip MEAN 0-1 NS� - am- g� U3 "H AM, "gY Al? v A 10. syr_ �Am ;KIP nu% 4 mW ,rx ko Aff V ZZ- A Nwv�', 09M.", All �g NEIN,- m 5 ME- F-R", ak, Aa 'MY 1�"L 57 W:I.. 'MM Al"la: g Zd -'s"hSWO v Er yr -4 w WO 10, "jp 0 M Rmf .1 I ME maw-i� 57 M 406 -5, 4we e4 AB 10 MI. % M W -5,440. i W.In 452 ;2 9 �� d1�tNt Texas Department of Health �oE1�1r 1100 W49491h sheet Aue&,'re 7675"199 s�xasr.�nr� Mry b, 1998 Doctor John M,Kutch Ndionai Health Service Corps 1301 Yang 5treek 10th Floor,IRSA 1 Dallas,Test 757,E Dar Doctor Kutch: On beb s f of till of us at the Tares Depaltttlent of Health who imwn and worked with you over the pag Ye►we wish you the very bei,upon your re nQnt from tlro United States Public Halth Service. Yaw tireless farts to MOM& and improve the health of£chow Tmm have certainly had a pQ&z4 bnOA. you have acquired►used,aad-spplW a scholar's knowledge of the various Selds aty�our�.Y.arra leaving behurd a noble legacy of dedicdon and devotion that will long be ref wjared.We cormnced and congratulate:YOU for your leadership and service to the people of Tocas and die Texas DepNUrA t ofHealth Sincerely, Lee A Laney Program Specialist Comde Berry,Dura*w P&kUy'Can Provider Placemnent Program Prnnery Care Provider Placement Now= � ty Odented Primary Cara Bureau of Communith►Oriasked Primagy Care B�neatl of con Ays Emp"ad apRA3 ►rw P f E i E RECEIVED SOUTWLAKE APR 2`6 2016 OFFICF-z OF CITY Si=CRFTARY ,b !Name: ' V Address: 2oo _ � _ E-mail Address: cid 0 6L 2.9ma twrri — Home Phone: Cell Phone: 20 Work Phone:- 9112M-0200 Occupation: Employer; �` Are you a resident of Southlake? f5�1 Yes_0 No Length of residency,._deny:_ 2y rs Are you a registered voter? --ayes No Voter registration number Ltka Do you,your spouse or your employer have any financial interest,directly or indirectly,in matters that might come before the Board and Commission to which you seek appointment? ❑Yes ErNo If yea,explain: Do you,your spouse or your employer have any financial Interest,directly or indirectly,in the sate to the City of any land, materials,supples or service? Yes ITNo If yes,explain: leas 'in icatts,�►aurtap . to r� rum ,n � i 1 g Building Board of Appeals Parks and Recreation Board Community Engagement Committee �_ Planning and Zoning Commission Community Enhancement and Development Senior Advisory Commission Corporation Board Southlake Arts Council Crime Control and Prevention District Board Southlake Parks Development Corporation Library Board Zoning Board of Adjustment Metropo - rt Teen Court Advisory.Board. - --- - P Education: High School College-Course Study: © Other-explain r ,2<444u*. - What Is your occupational experience? 0=2ic as ,r amot d*naan . lmmdd nn s;f J)c ~ U Areas of interest I i r i SOUTHLAKE PfBVi41]S i3 d urr, g ; j } Da' '�� - y v�r3 1 - r Lam' Tid �s.3iA"«�-eu' '— v S y� E` ~ '' �\�'q e�� ,�.. tk Y 4 . 2{F ,y ,�*-` ••F. gYO1Wi1 ji"O1n111f11�1IS � ' ~. a� NEW"membership ao glue tltle and .GndW employmai'WRn ail UMMS.Commiaaions.: — fele.NarProRt�MElles,AgeneFea ar other£nttl{es on airy otlw govemm m Board or Coesnta km that you have held, AddklorW Infamatlon may be attached. Q r Ocotilh RdvKw4w3 Bjsooiv�ft-t 6"of OZrRa*ol`s Trw;Arar- , bond Mtmbcr Are you Involved in any community activities? `( t3 ' U 31a +h nreoni2� �..1 ,adan�an�Jl-,}fib �a x 1k:N?_ ne WHO ay" (so nhad� 1 Reason seekin apPlease aaLch a brief narrative outlining r interes ndu life ion for seeking appointment. You may also add a resume or additional information. Please check box,9 resume attached i4 What do you hope to accomplish by serving on a board or commission?ksisi is ST" CWV'At,e QPQIjih_ Qaxbrnrt f11i 5► scc Ag, aLOA(.r; c xltist c-Lo:sim+doMao Board and Commission members are representatives of the City of Southlake. Is there anything in your past that would be harmful or embarrassing to the City of Southlake? DO I I Completed forms may be delivered to the City Secretary's Office,Town Hal, 1400 Main Street, Suite 270,Southlake,Texas 78092, faxed (817) 748-8270, or emailed IaavneCcs?ci.southlake.tx.us. Applications are kept on file for a period of one (1) year. After that time it will be necessary to reapply and update the information herein If you wish to be considered for appointment. By signing below, you certify that all information on this form is represented accurately.The applicant further authorizes the City Council,or its designee, to verify any Information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information provided is considered public pursuant to the Texas Public Information Act. Signature: � 1Dn Date: i i I Gina Cannova-Phalen I Professional Education , APPRAISAL INSTITUTE Expert Witness in Litigation 2016(McSissock) Cost Approach 2015 Sales Comparison Approach 2015 General Appraiser Income Approach,Part I,2014 General Appraiser Income Approach,Part 112014 USPAP,2014 General Appraiser Report Writing and Case Studies(2014) 't MESA COMMUNITY COLLEGE -Mesa,AZ Basic Appraisal Principles,2013 Basic Appraisal Practices,2013 I i ARIZONA SCHOOL OF REAL ESTATE AND BUSINESS—Scottsdale,AZ Mastering Unique and Complex Properties,2013 Statisctics,Modeling,Finance,2013 ARIZONA STATE UNIVERSITY—Tempe,Az I Bachelors in Business,Supply Chain Management, 1997 Certified Purchasing Manager,C.P.M. 1997-2005 Professional Organizations IRWA--International Right-of-Way Association 2014-Present CREW Fort Worth—Commercial Real Estate Women, Communications Committee Co-Chair 2016-Present Appraisal Institute 2016-Present I I 9320 S.Lakeshore Drive Tempe,AZ 85284 (602)510-3900 gdphalen@gmail.com Page 2 I Gina Cannova-Phalen 200 King Ranch Road*Southlake,TX 76092* (602)510-3900 gdphalen@gmail.com Profile F E Self-motivated,anaylytical business professional with a Bachelors degree in Business and real property appraisal experience. A variety of successful,versatile business experiences including profitable small business entrepreneurship.Thrive in fast-paced,challenging environment. Always eager to expand job roles and learn new i skills.Excellent project management skills. f. SkAs Summary E ♦ Real Property Appraisal ♦ Market Analysis ♦ Supply Chain Management Research/Analysis ♦ Accounting ♦ Business Development ♦ Project Management ♦ Sales&Marketing ♦ Freelance&Report Writing ♦ Team Leadership ♦ Basic HTML Design Professional Experience • Research,property inspection,market analysis and development of opinion of market value for real property ♦ Assist in trial preparation for eminent domain hearings ♦ Design and implement business plan for new business using market analysis ♦ Establish successful LLC with a strong on.-line presence and increasing sales year after year ♦ Leadership as President of non-profit PTA overseeing the expenses,income&volunteer base with$40k i budget and 30-+events ♦ Freelance writing for newspapers and national magazines regarding sun safety and health • Establish professional relationships with vendors and customers ♦ Design websites and manage social media marketing for small business ♦ Reconcile invoices with vendors i Supply chain management for retail sun protective items,electronics circuit boards and computer wholesale i ♦ Treasurer for Ocotillo Homeowners Association,—present budget at HOA meetings,approve$2.6 million dollar budget and monitor expenses and income statements in partnership with HOA Management Company ♦ Coordinate or oversee major fundraisers and community events for non-profit organizations Professional History `i O'BRIEN REALTY ADVISORS- Eminent Domain/Commercial Real Estate Valuation Analyst 2014—Present i LANDPRO VALUATION—Researcher/Appraiser —Mesa,AZ 2014 j SELL&ASSOCIATES—Researcher/Appraiser —Tempe,AZ 2013-2014 SUNSATIONAL STYLE,LLC.—President/Founder-Tempe,AZ 2007 to 2014 BRIGHT BEGINNINGS PTA—President—Chandler,AZ 2012 to 2014 DESERT SUN CHILD DEVELOPMENT CENTER-President,Board of Directors—Chandler,AZ 2005-2013 OCOTILLO HOMEOWNERS ASSOCIATION—Treasurer,Board of Directors—Chandler,AZ 2006-2008 VARIAN ELECTRONICS—Production Control Analyst-Tempe,AZ 1998-2001 MICROAGE COMPUTERS—Team Lead,Purchasing Analyst,Business Systems Administrative Assistant,Human Resources Assistant—Tempe,AZ 1994-1998 i i i s i i f RECEIVED 1 �1JT'6�-ILAKE i 19 APR 2 5 2016 Name: Michael J. Smietana .Address:603 Stratford Drive, Southlake TX 76092 E-mail Address: al'Smie@vedzon.net Home Phone: Cell Phone:214-505-9499 Work Phone: 213-312-6579 Occupation:Engineer Employer:Army and AF Exchange Service Are you a resident of Southlake? [z] Yes No Length of residency:8 years Are you a registered voter? Yes _a No Voter registration number: 117795021 Do you,your spouse or your employer have any financial interest,directly or indirectly,in matters that might come before the Board and Commission to which you seek appointment? []Yes ®No If yes,explain: Do you,your spouse or your employer have any financial ingest,directly or indirectly,in the sale to the City of any land, materials,supplies or service? QYes WlNo If yes,explain: II Building Board of Appeals " Parks and Recreation Board Community Engagement Committee i Planning and Zoning Commission Community Enhancement and Development Senior Advisory Commission Corporation Board Southlake Arts Council Crime Control and Prevention District Board s Southlake Parks Development Corporation Library BoardSao Zoning Board of Adjustment Metroport Teen Court Advisory Board Now= I EMS Education: ❑ High School 15-L College-Course Study: BS--Civil Engineering, MBA, MS ❑,Cather-explain j What Is your occupational experience? Resume attached I Facility investment, land development Areas of Interest i I i *.T"--%) SOUThyr LAKE Y • W geraciea,,or er dhw govaa m d Board ar Commieslan chat you have held.AddEwW inlbmwlon n"be aged. Currently serving on Zoning Board of Adjustment. Would like to continue,or serve in another Capacity as the city desires. I i i i I i I Are you involved in any community aches? i i Please attach a brief narrative oullinina your interests and aualifncadons for seeking appointment. You may also add a resume or additional Information. Please check box,if resume attached As What do you hope to accomplish by serving on a board or commission? a reared�ln�ry o l lily 9ift �`to ` """'n'� By serving on a board, I can serve my community in a seftiess way without any personal agenda other than to make Southlake great. 35 years experience in facilities! _. 1 Board and Commission;members are representatives of the City of Southlake. Is there anything in your past that would be harmful or embarrassing to the City of Southlake? No Completed forms may be delivered to the C' Secretary's P y City ry* Office,Town Hail, 1400 Main Street, Suite 270, Southlake,Texas 76092,foxed (817) 748-8270, or e-mailed IPaynef%ci.southlake.tx.us:. Applications are kept on file for a period of one (1) year. After that time it will be necessary to reapply and update the information herein If you wish to be considered for appointment. By signing below, you certify that all information on this form Is represented accurately.The applicant further authorizes the City Council, or its designee, to verify any information.The applicant agrees to release and hold harmless the City from all claims incident to the verification rmation contained herein. All information provided is considered public pursuant to the Texas Public Information 000, Signatu o�Z Date: " /y I I i i I MICHAEL J. SMIETANA, P.E. ' 503 Stratford Drive Mobile:.(214)505-9499 Southlalce,TX 76092 E-mail: afsmie@verizon.net Work:(214).312-6579 i PROFILE Proven.management.professional with 30 years of leadership ecperience.developing comprehensive progran and directing complex multi-million dollar projects in a highly dynamic environment. Results producing.leader with expertise directing all aspects of operations,administration,finance,and human resources for civilian and military organizations. Intuitive supervisor with strong interpersonal and communication skills. PROFESSIONAL E d ERiENCE VICE PRESIDENT,REAL ESTATE DIRECTORATE,Amey and.Air Force ad W Service,Dallas TX 2008.-present • Leads.500 associates in planning;:designing,constructing,maintaining and;evaluating<facility investnnent&for worldwide organization supporting the DoD with annual sales of$913. Responsible.for strategic:capital investment portfoliovalued at$250M annually. MISSION SUPPORT GROUP COMMANDER,Hurlburt Field FL 2006.-2W8 • Led;.multi-disciplined-organization of 18.00 miljitarylcivilian persmnel providi ng.;services for.13,000 peoplelincluding security,communications,humanresources,contracting,logistics, facilities, infrastructure,and base.development i HOUSING DIVISION.CHIEF,HQ Air Force,Office of the.Civil Engineer,Per►tagora Washington DC 2005-2006 � • Supervised Ditrision of�36 military,civilian air►dcontract,pWfessionakin developing the$11.2�`liillion.Air Force:Hotisj= program,to include military family housing;.privatized housing,dormitories:and master planning i SENIORMILITARY ASSISTANT,Assistant Secretary, . of the Air Force(SAFfIE),Pentagon,Washington DC 2M-2005 .. • Formulated..strategies/advised assist SECAF on multi-dimensional-initiatives,impadmg domestic/Idtenrcatianal policy SQUADRON CONIlVIANDER,::345 Civil Ftgaeer Squadron;McGuire AFB,;Ni 2flI12-:20E14 + Led organization of`550 employees°providing£achy/engineer:services for 9;000 baspopulace: f]pecatetllvn'atntained infrastructure supporting 8 flying squadrons,1,000#acilities,3,QW hot si tg uxa its and central:heatplants: HOUSING.BRANCH CHIEF,I-IQ Air Combat Command,Langley AFB,VA 1998 2002 SQUADRON COMMANDER,886,Civil.Engmeer Squadron,Wright Paterson AFB,OH 1996-1998 EXLCUrIVE SERVICES CHIEF,HQ Air Force,Office of the:Civd Engineer.Pentagon,Washington DC 1993-1996 ENGINEER OFFICER,Base-level engineer assignments four bases 1982-1993 EDUCATION I M.S.,National Resource Strategy,Industrial.College of the Armed Forces,Ft McNair,Washington DC,2002 M.3-k,University of Wdst Florida,PensacAk FL,1990 B.S.,Civil Engineering,State University of New York at Buffalo,1982 LICENSES AND AFFILIATIONS -Minnesota Professional Engineer,#26921 -Society of American Military Engineers f li r RECENED CITY OF SOUTHLAKE MAY - 9 2016 OFFICE OF CITY SECRETARY Name: ronell smith Address:208 donley court E-mail Address: ronell@roneiIsm ith.cm Home Phone: 817-991-2006 Cell Phone.817-991-2006 Work Phone: Occupation:marketing strategist Employer:RS SS Are you a resident of Southlake? M Yes No Length of residency:2 Are you a registered voter? M Yes No Voter registration number:1191187528 Do you, your spouse or your employer have any financial interest, directly or indirectly, in matters that might come before the Board and Commission to which you seek appointment? Dyes [z]No If yes,explain: Do you, your spouse or your employer have any financial interest, directly or indirectly, in the sale to the City of any land, materials, supplies or service? ❑ Yes F71 No If yes, explain: 5 Building Board of Appeals Parks and Recreation Board Community Engagement Committee iF Planning and Zoning Commission Community Enhancement and Development Senior Advisory Commission Corporation Board Southlake Arts Council Crime Control and Prevention District Board Southlake Parks Development Corporation Library Board Zoning Board of Adjustment Metro ort Teen Court Advisory Board i f Education: Z High School Q College-Course Study: Biology/psychology El Other-explain What is your occupational experience? 15 years of marketing and communications fishing, hunting, guns, fitness and nutrition Areas of Interest: r CITY OF j SOUTHLAKE ease spectly membership and gnre true and dates,an or employment wnn an boaros, ommissions, orpo ons, on- es, gerrcies,or o eW.,,.ny other government Board or Commission that you have held. Additional information may be attached. ZBA-2015 Citizen's Academy-2015 Active in supporting the teachers, staff and kids in Carroll ISD. Supporter of Southlake PD and FD CLASS Are you involved in any community activities? Please attach a brief narrative outlining your interests and qualifications for seeking appointment. You may also add a resume or additional information. Please check box, if resume attached What do you hope to accomplish by serving on a board or commission? Helping to make an amazing community � better in some small way. I Board and Commission members are representatives of the City of Southlake. is there anything in your past that would be harmful or embarrassing to the City of Southlake? no Completed forms may be delivered to the City Secretary's Office, Town Hall, 1400 Main Street, Suite 270, Southlake, Texas 76092, faxed (817) 748-8270, or e-mailed Ioavneaci.southlake.tcus. Applications are kept on file for a period of one (1) year. After that time it will be necessary to reapply and update the information herein if you wish to be considered for appointment. By signing below, you certify that all information on this form is represented accurately. The applicant further authorizes the j City Council, or its designee, to verify any information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information provided is considered public pursuant to the Texas Public Information Act. Signature: [i ` Date:05=09=16 . I crry OF RECEIVED SOUTHLAKE a APR 2 5 2016 i Name: Lloyd Summy Address:594 Garden Ct Southlake, TX 76092 Email Address: Iloydsummy@hotmaii.com Home Phone: Cell Phone.817-925-2979 Work Phone: Occupation: Psychologist Employer:Summy Family LLC Are you a resident of Southlake? [z] Yes No Length of residency:8 years Are you a registered voter? 7 Yes No Voter registration number:41062500 Do you, your spouse or your employer have any financial interest, directly or indirectly, in matters that might come before the Board and Commission to which you seek appointment? ❑Yes O.No If yes, explain: Do you, your spouse or your employer have any financial interest, directly or indirectly, in the sale to the City of any land, materials, supplies or service? ❑ Yes ❑� No If yes, explain: } 1 Building Board of Appeals -14 Parks and Recreation Board Community Engagement Committee Planning and Zoning Commission Community Enhancement and Development _. Senior Advisory Commission Corporation Board Southlake Arts Council Crime Control and!Prevention District Board _,3 Southlake Parks Development Corporation Library Board _-ZL Zoning Board of Adjustment Metroport Teen Court Advisort AdvisorBoard mom Education: ❑ High School II College-Course Study: Psychology LiOther-explain What is your occupational experience? I work with children and adults with mental disabilities. The betterment of our social and physical enlvornments. Areas of Interest: i r I CITY Or SOUTHLAKE I W. -Mrs ip an give a an aPan, r amp oymen w e 11okamWommissions, n ons, on- rof En es, genc�es,or other government Board or Commission that you have held. Additional information may be attached. Lakewood and Long Beach Ca worked as a member on various boards such as the airport and harbors, Also, on boards dealing with the infrastructure of the city. Are you involved in any community activities? Active member in the Elks Masonic Lodge, and Scottish Rite, and their hospital and community activities. Please attach a brief narrative outlininci your interests and qualifications for seeking appointment. You may also add a resume or additional information. Please check box, if resume attached What do you hope to accomplish by serving on a board or commission? Board and Commission members are representatives of the City of Southlake. Is there anything in your past that would be harmful or embarrassing to the City of Southlake? Nothing I am aware. The agencies I work for do background checks monthly for morals and fraud with the state and attorney generals offices. i I Completed forms may be delivered to the City Secretary's office, Town Hall, 1400 Main Street, Suite 270, Southlake, Texas 76092, faxed (817) 748-8270, or e-mailed Inayne@ci.southlake.tx.us. Applications are kept on file for a period of one (1) year. After that time it will be necessary to reapply and update the information herein if you wish to be considered for appointment. By signing below, you certify that all information on this form is represented accurately. The applicant further authorizes the City Council, or its designee, to verify any information. The applicant agrees to release and hold harmless the City from all claims incident to the verification of information contained herein. All information provided is considered public pursuant to the Texas Public Information Act. Digitally signed Signature: Lloyd SummJ Dats:201604.251115251u-05'00Date:04/25/2016