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08-12-19 Handout D. BartleNaxid vu:+ ) s &r ) CITY OF ATLANTIC BEACH Slat / 11 BOARD / COMMITTEE MEMBER APPLICATION FORM Please check (V) the box beside each Board or Committee for which you are applying. Board Member Review Committee (BMRC) Cultural Arts & Recreation Advisory Committee (CARAC) Pension Board of Trustees (PBOT) — Police DATE: APPLICANT'S INFORMATION: FIRST NAME: ADDRESS: Community Development Board (CDB) Environmental Stewardship Committee (ESC) Pension Board of Trustees (PBOT) - General LAST NAME: CELL PHONE: HOME PHONE: PRECINCT/DISTRICT: E-MAIL ADDRESS: Please explain any employment experience, board/committee experience, and/or community volunteer experience relative to the board/committee applying for. Please provide a brief explanation of your interest and your reasons for wishing to be appointed to this board/committee. I will be available to interview after 5:00 p.m. on the following date. September 12, 2019 O September 18, 2019 PLEASE NOTE: This application will expire two (2) years after date of submittal. Please return completed form to Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233 Rev. 7-26-19 Page 1 of 2 STANDING COMMITTEESBOARDS: Additional information can be found at www.coab.us) Board Member Review Committee (BMRC) This committee consists of five (5) members and meets on an as -needed basis. The committee reviews applications and makes recommendations for the appointment and reappointment of members to the city's Boards and Committees including CARAC, CDB, ESC and some PBOT positions. The BMRC does not make recommendations regarding BMRC membership. Cultural Arts and Recreation Advisory Committee (CARAC) Meets at 6:00 pm on the first Tuesday of March, June, September and December. This committee consists of seven members and one alternate who are appointed by the City Commission and who serve three-year terms. The duties and responsibilities of the committee include: Develop plans, promote and support programs and projects to bring the benefits of recreation to the citizens of Atlantic Beach; Recommend a calendar of special events; Evaluate and advise the City on the effectiveness of programs; Evaluate and make recommendations on assignments or requests made by the City Commission or City Manager; and Evaluate and make recommendations to the City commission on requests for City funding for special events, art projects, and recreation programs. Community Development Board (CDB) Meets at 6:00 pm the third Tuesday of each month. The board consists of seven members and one alternate who are appointed by the City Commission and who serve three-year terms. Applications for Variances, Uses -by -Exception, Comprehensive Plan amendments, rezonings, and several other types of applications are considered by the CDB. The board makes final decisions on Variances and Uses -by -Exception and forwards recommendations to the City Commission on Comprehensive Plan amendments, rezonings, and several other types of applications. The City Commission makes a final decision on these requests. Environmental Stewardship Committee (ESC) Meets at 6:00 pm on the second Wednesday of each month. This committee consists of eleven (11) members who are appointed by the City Commission and who serve three-year terms. The purpose of the committee is to study and make recommendations to the City Commission and City staff with respect to the City's (a) Maritime forest; (b) Parks and open spaces; (c) Beautification of public and private spaces; and (d) Environmental stewardship; and to act as a motivating and coordinating body to encourage joint public and private participation in promoting these purposes. The Environmental Stewardship Committee appoints members from its committee to serve on a Tree Subcommittee which consists of three 3) members and one alternate member. The subcommittee members are authorized to review tree permits submitted to the City. General Employees' Pension Boards of Trustees (PBOT-G) & Police Officers' Pension Board of Trustees (PBOT-P) Meets quarterly or as scheduled. The City has two pension boards, one for police officers and one for general employees. Each board consists of five members. Knowledge of investments preferred. The boards are responsible for the general administration, management, and oversight of the operation of the retirement system. CONFLICT OF INTEREST" NOTICE: Part III of Chapter 112, Fla.Stat., is the Code of Ethics for Public Officers and Employees. This Code defines "conflict" or "conflict of interest" to mean a situation in which regard for a private interest tends to lead to disregard of a public duty or interest. Fla.Stat. §112.312(8). The intent of this Code, in part, is that public office not be used for private gain. Fla.Stat. §112.311(1). A "conflict" or "conflict of interest" is something that would result in a special private gain to an individual, usually a special financial benefit. An appointed member of a committee of the City of Atlantic Beach will most likely be subject to the provisions of the State Code of Ethics. Disclosure of any potential conflict of interest should be made as soon as possible in the appointment process. While it may be difficult to anticipate a conflict of interest that could arise during future committee meetings, those known or anticipated initially, including those which others might perceive as a conflict of interest, should be disclosed during the appointment process. STATEMENT OF FINANCIAL INTERESTS FORMS: Please Note: Members of the Community Development Board and both Pension Boards of Trustees are required to file Form 1 -Statement of Financial Interests. Rev. 7-26-19 Page 2 of 2