Item 10AAGENDA ITEM # l0A
APRIL 13, 2009
CITY OF ATLANTIC BEACH
BOARD MEMBER REVIEW COMMITTEE
April 9, 2009, 5:00 PM
AGENDA
Call to Order
1. Approval of the minutes of the BMRC meeting of January 8, 2009.
2. Discuss and review applicants for the Code Enforcement Board listed below and
make a recommendation. (There is one current vacancy and one upcoming
vacancy.)
Applicants for the Code Enforcement Board
A. Veda Bernstein- current alternate (5:10 pm)
B. Jonathan Daugherty (5:30 pm)
C. Elizabeth Eilers (5:50 pm)
D. Maria Mark (6:10 pm)
E. Rita Boni (6:30 pm)
F. Nicholas Dodaro (6:50 pm)
3. Other Business
Adjournment
AGENDA ITEM # ] 0
APRIL 13, 2009
0
.y
.~
O
U
.~
C
N
c
~O
Q
Q.
Q
C
t0
U
00
a~
...
E
O
C
O
Q~ N
O ~
N ~
E
M E
N v
V ~
~ ~
of _~
a-
O ~
N ~
O a~
O v
O ~
N v
.C 7
N-~'
~ o
~~ ~
C ~
V ~
~ V
' C
~ rN+
~ Q
a ~
d
dd
C ~
i~+
3
L O
L
1-
N_
d
.~
d
N
7
~+
~~.+
~ ate,,
~ a
z
o
~4+
_ ~
m ,r Z
L
0
F-
_E
d'
.~
m
N
rn
7
~+
~~+
'a ~
~ a
z
°~~'~`o
+~+ ~ ~
~ _
,,,, Z
1- Q.
E
L
d'
M
.4+
V
.~
N
H
7
.b+
~N.+
~ a
Qz
L
L d
_ }r
,+,, Z
frL~
- L_
F- ~Q.
E
E
d
~.+
M
3
.ai
d
.~
d
N
N
7
y.+
'a~
.+
m a
z
L
V ~ 0
= C
d ~,, Z
O Q
Z
Z
Z
Z
_ ~
0
~ ~
0
0 ~
~ ~
0
~
~' N N ~
N ~
N W
~ `
~ ~
~- ~
~ .
~ ~
r
E
Q
F
W M M M M i,
~ r ~ ~ H
w
E "`
m
E
d
+ N
'~
~ ~
~
3 °' ~ °'' ~
~ w ~ ~
N ~ w
z. r' ~ r" R
w
`
d
C
~
C
~
~
~
C
~ ~
~
N
~ ~ ~ ~
N d
V
,~ ~
~ ~
'rr
V
~ > > > > ~
a+ V U U
N Q Q Q Q (%~
N
E
t6
Q
N
C
.~
m L
N ~ ~ N
~ ~ O ~
m
O (' ~
,n ~ a =
t ~ ~
U W D Y
CITY OF ATLANTIC BEACH AGENDA ITEM # l0A
APRIL 13, 2009
CODE ENFORCEMENT BOARD
3 year terms; 3 consecutive term limit
Meet in Commission Chambers 7:00 p.m. Second Tuesday odd numbered months
NAME& ADDRESS EXP.DATE POSITION BUSINESS HOME PHONE
PHONE
Juliette Hagist 9/30/2011 Member 249-2821 249-9983
1763 Park Terrace East (2°d term)
Atlantic Beach, FL. 32233
Richard L. Ouellette 9/30/2010 Member 249-0264
1060 Seminole Road (2nd term) 697-6180 (cell)
Atlantic Beach, FL. 32233 dickouel@bellsouth.net
Ray Martin 9/30/2010 Member 241-3372 I;Zavdmartin(a'comcast.net
2263 Barefoot Trace (lgt term)
Atlantic Beach, FL 32233
Ron Pendleton 9/30/2011 Vice Chair 246-8746
1825 Live Oak Lane (2°d term) Ron.Pendleton~r~comcast.net
Atlantic Beach, FL. 32233
Carl Russell 9/30/2010 Chair 246-4130 246-4130
812 Ocean Blvd. (3rd term) C l ER~a~bellsouth.net
Atlantic Beach, FL. 32233
Mamie W. Hurd ~ 9/30/2009 Member 247-5647
720 West 14th Street (3rd term)
Atlantic Beach, FL. 32233
Barbara Weiss ~' 9/30/2009 Member 247-0935
1049 Little Cypress Key (2°d term) ENVCFW(a~COMCAST. NET
Atlantic Beach, FL. 32233
Veda L. Bernstein 9/30/2010 Alternate 610-5927 242-8159
680 Sailfish Drive msveda2000(awahoo.com
Atlantic Beach, FL 32233
Alen Sherrer Code 247-5855
Enforcement
Officer
Susan Gorman Secretary 247-5810
Suzanne Green Prosecuting 280-8770
4300 Marsh Landing Blvd. #203 Attorney 285-8839 (fag)
Jacksonville Beach, FL. 32250
Alan Jensen City Attorney 246-2500
935 N. 3rd Street 246-9960 (fag)
P.O. Bog 50457
Jacksonville Beach, FL. 32240
Revised 10/21/08
AGENDA ITEM M ] OA
APRIL 13, 2009
Y
v
d
t
V
W
7
~+
N
N
t0
J
rn
O
N
0 0 0 0 0 0 0 0 0 0 0 0
L L L L L L L L
O O O
~ ~ ~ ~ ~ ~ ~ ~ ~ Z Z Z
00o rnrn
O O
~ ~ p ~ ~
o rn rn
~ O O
D ~ ~
C r r r r r r O r r r r 0 0 0 O O O O r r O r r
O r r 0 r r r r 0 r r r r 0 0 0 O r r r r r r r r
'++ O O r 0 0 0 0 0 0 ` O O O N N N N O O O O O O O O
` N N N N N N N N N N N N N~~ ~ N N N N N N N N
•~ (O '~t ~ j O o0 0) '~i' C~ O 00 0 ~?' O f~ 0O 'd• M f"7' M
r r~ N r r r~ r r r r~ N` N r N N r r N r r
X ~ ~ N ~ ~ ~. ~ O ~ ~ ~ ~ r r r p ~ ~ ~ ~ ~ ~ ~ ~
W N r r M M r r M M M r r r r r M N N r r N r r
d
^ U
~ Q
3 ~ ti ~o ~ ~ ti ~~ ti m o 0 0 ~
U°o .,.., Qo 00o U Q
'~ l`0 N t~0 f`6~~y NNQ UN ONNN ^NNN tB~ C~ co N
O C C C CCON C`-~,, `'~M CM(~,d~' OMC~7M ~Z 0 C C
~ O N ~ C O N N N N N~~~ O
N r O~ M r r r r ~ j ('7 C7 M N
N ch ~ ~ N ~''~
J M U ch r ~
M
.-,.
O
O
a0+ (h
!0 N
0 O I` i` I` r
~ 00~ 000000- OOOM~N X00000 :000
y.. ~~(O -rpOOMO ON~rNr r0~O~'d• QOtn~
v ~~ N N~ N~ O~ ~ M ~ ~ ~ ~ ~~ N N `` N~ ~
N r r M (h r r (h M r O M N N r r, N r r
O r r r O
N
Q N
N
O
r
c
o ~oZ'; cooa~m~ moa~?'-cv~ o•°voi~''mcu Noce
~ N cyo c,cn•c cs~ N._ N ~ co N v~~.. w~.,_.
Q Y ~ ~ Q.'~Z N~ c ~Z NYQ co cgs N N~ ~ Nlr
~"' ~W voi .=~OWY+~ W `~ _ N ~ aZW ~ OW ~
O ~• ~O O Z'ui ~ cp_+: O O
Z ~W~ m~W m m~WW ai ~ UUD~Wm OWfA
m o o °'
~'
O'
O
N aoi m ai m a°~i a°~i
~_
M E E~ E E E
s ~~~ -a-o-a-vv-o 0 0 0 0 0 0
H E ~ E c`o m` c`o Lm c`o c`u UUUUUU
tII ~ E E E 0 0 0 0 0 0 :~ ~ Z~~~
m o 0 o m m m m m m 0 0 0 0 0 0
~ UUU ~~'o-avv c c c c c c •~•~•~•~•~•~ ~vv
w- c6 co m co m m a~ a~ a~ m a~ a~ v v -v -a -a v m cu co
o c ~ ~ ~ m°m°m°m°m°m° QQQaQQ aaaa¢a m°m°m°
~ ~~~ -cccccc 000000; vci~ci~~ ccc
c~ ~ tr~~ mma~ma~a~ ma~a~ma~a~ ~ay~~a/~~a/~~ay~~a/~~a/~ 000
E ~~~ m a~ a~ a~ a~ a~ ~oo~oo ~s~s~s~s~s~s m ~mj ra
C ~ LU•. {U.. L L L L (A M (n (A M (A ~ Z
N O ~ N N O ~O O ~O ~O O L' ~` ~` ~' ;~' ;~' 'C 'C ~ ~ 'C ~ vOi voi voi
U V ~~~ c c c c c c ~~~~~~ Q Q Q Q Q Q 0 0 0
~ W W W W W W ~~~~~~ U U U.
L L L L L L
~ ~ ~ >
~a `m `m cLo a-oa-oaa-oav E E E E E E ~..=•_..~=.•.. 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 '~ ~~~~~
Q m mmm UUUUUU UUUUUU UUUUUU ~~~~`-
O
r
O
O
(0
a
AGENDA ITEM # l0A
APRIL 13, 2009
C
'd o
d
~.+ ~+ r
y C
w
C
a+
C
..+
C
t+
C
w+
++
c
~,
c =
d m O Gyf d d d y
~ d y
a Q
~
a`
a`
a`
a`
a
a` ~
a
,~
W
= O
r
~ M
A
C
C
C
C
G
~
C
~
~ d y d d d d d
O~ y tfJ NJ y N1 y y
o x
~ w ~ a a a a a a
0
::
::
::
::
::
s y o
o ~ c c c c c c c c c c c c c c c
~
M
01
d
d
d
d
d
d
d
d
d
d
d
G7
G1
d c
d c
d
t
L O y
d N!
d y
d y
d fA
d y
d y
d (p
G1 y
d y
G1 W
d V!
G1 y
d NJ
d Hl
d y
G1 y
d
~
~ x
~ L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a L
a
o mw
s
..
::
::
::
F a w
C
~ °
O
.r+
c
++
c
a+
C
~,,
w
=
.,.+
~
~..
c
~+
c
~+
~+
++
..+
y ~
++
~+
++
~+
~.+ E
O
N =
M
d
d
d C
y
d
d
d
d c
d c
d C
d C
d N
UJ L C
d C
G7 C C
y y
y c C
d c
d c ~
d O
y
d
L
y
y
L
y
d
L
y
~
y
d
L
y
d
L
N1
d
L
y
d
L
N!
d
L
y
d
L
y
d
L
y
G~
L
t4
(,)
C
~
y
d
L
y
d d
y
~
y
d
nS
() y
y
,Q
W
d
to
d d
y
Q G
3
~a ~ c. a a a a a a a a a a a a o ~ n L
a a L
n a L
a L
a '
a ~ c:
c
~ w z o
z . , o
z o ::
,~
, z
~ ~ a
, ~ w
d N 4 _ c ~ C
C = ~ G d y C C C C d C C C C d C
~ M y ~ d d d d d ~ y d d d d d
G1 O!
~'
i
s
~
~
~
~
a
~
~
i
~ a
~ : a a a a a a a a a d a
~ ~ w ~
a -~ c c ~
_ .. .. .. .. .. .. .. ~
°~
~ U
~ V
R
c
c c o V V
a ~
~ p o
m O
:
~ w w ~ w ~ w ... ~ .~ .r ~ t.
d N N N N y N N N d d d ~
~ t
~? d y
a m y
~ °' L ~ ~ ~ ~ ~ ~ y
~ y
Q ~ N
~
Q a a a a a a a a a a a a a a a a
a ~ =
o ~ ~w
m
~ do
~ r
m
~ o
:
r..
c
~
c
~
c
w
c
..~
c
~,
c
.+
c
~.,
c
~
c
..,
c
w,
~
c
.~
c
~
c
w
c
w.
L
C
Y..
M
~~
d
y
d
y
d
U!
d
y
d
y
d
y
d
y
d
VJ
G1
V!
d
y c
y
y
C~
y
d
y
d
y
d
y c
d
y
c
w a
~, Q- m
a` m
a` d
a` m
aL m
a` ,c
a
a ~
a L
s ~
a a~ m
` L ~ L
d
x
W
a
a
a
a
a
a
O v
V ~
- O
!E N T'
O +~+
c ~'+
C *+
C ++
C ~+
C w
C w
C ~+
C ,fir
C ~+
C ++
C r.+
C a+ ~+
=
C ~+
C
C
E y
~ M
~
d
d
y
d
y
G1
f/J
d
y
d
UJ
d
y
d
y
d
y
d
N1
d
G1 C
G1
d
d c
d
d
d C
d C
y C
d
. ~
, ~
_ ~
d
L
d
L
d
L
d
L
d
L
d
L
d
L
d
L
d
L y
G1
L y
d
L y
~ y
d y
"'~ y
d
y
y HJ
i VJ
~ y
i
_ L Q. a
a
a
a
a
a
a
a
a
a
a
a
a L
a
a L
a
a
a
a
a
a
v ~
c
w
m
0
0
0
0
0
0
0
0
D ~
, O
N N
, O
N N
~ N
~ O
N O
N O
N O
N O
N O
N N
, O
N O
N 0 ~
, N N N O N N N N
~
.
C-- C
14 L
R L
C.
~ Q
as C
ea ~
G
t~'0 ~
~ ~
~ ~
Q ~
R L
e0 ~
~ ~
~ ~
d
O ,
~ L
tv
y N
~ ,
s?.
p ~
~ ~
e0
~
,,
C~ ~ ~ a, ~ N ~ .
Q' 2 '~ ~f a
i
/) ~ ~ e
~ ~ y Z y ~ .
~ ~ y Z ~ ~
r O r r O O~ O! r- r G~ r w ~ O O r O
r N r r r r O r
(A8/14/06 12:05 FAT 9042493292 CDB
CITY C1F ATLANTIC BEACH
BOARD /COMMITTEE MEMBER APPLICATION FORM
~~ubirni -1-iea~-
Please check (~ beside each Board or Committee that you are applying to serve on: PY~ ~f lgrQ~{
(A summary of each bo;trd/committee is available on page 2 of this form.) ~`''~~
~` Code Enforcement Board CJ Commututy Development Board
CJ Pension Board of'I'rustees ^ Tree Conservation Board
D Cultural Arts and Recreation Advisory Committee
APPLICANT'S NAME: ~ Q~` ~~
ADDRESS: li9 ~-~ ~~ ~ ~1-1 ~~1 I
DAYTIME PHONE: ,~~~ n ~ ~ ~~ ~'-r
E-MAIL ADDRESS: t1~SJ ~l~:Ts e•~W1
AGENDA ITEM # IOA
APRIL 13, 2009
+ f
~~C~
EVENING PHONE: ~~~ ~4~ ~~c5
FAX: '~
Please provide a brief explanation of your interest or any special qualifications you have in this field and
your reasons for wishing to be appointed to this board/eommittee.
Please return completed form to
Donna L. $ussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
Please explain any employment experience, board/committee experience, and/or community volunteer
experience relative to thc; boardlcommittee applying for.
08/14/06 22:05 FAJC 9042493292 CDA AGENDA ITEM # l0A
APRIL 13, 2009
-.,
Veda !. Bernstein ~Uf~wp. .
680 Sailfish Drive ~ n 3/ ~ ~ ~
Atlantic Beach, F! 32233 ~~;~
904-242-8159 Home 904-610-5927 CeU
August 14, 201)6
City of Atlantic Beach
Board/Committee Member Application Form
Response to (questions on Application:
I have been privileged to be a resident of Atlantic Beach since 1992. I have
worked at the beaches for as many years, I graduated from Jacksonville
University in 2(103 with a Bachelors of Generll Studies, Cum Laud. My
employment history has been steeped in business administration and accounting.
My ability to fa:us on details, as well as the long term residual effects of
decisions made today, would be a welcome addition to the Code Enforcement
Board. I look forward to a challenging and rewarding commitment working for
the residents o1' Atlantic Beach.
As Head of Household and a single parent my volunteer experience has been
limited as 1 spent my time working full time and giving my daughter a secure,
safe and loving home. At this time my daughter is a sophomore at Stanton
College Preparatory High School, and as she will tell you, it is time for me to "get
a life." I would like to spend my free time helping my community become
recognized as a model for other communities. Z live in the "Royal Palms"
neighborhood and I anticipate a lot of changes in ownership in the up coming
Y~m• We havf: in place a wondertul mix of rnsidential and commercial land use
and I would likes to keep that balance and hopefully ensure that my daughter and
other future residents of Atlantic Beach feel the same way.
I look forward t~~ the opportunity to glue back to my community
AGENDA ITEM # l0A
APRIL 13, 2009
CITY OF ATLANTIC BEACH
BOARD !COMMITTEE MEMBER APPLICATION FORM
Please check (~ the box beside each Boazd or Committee that you are applying to serve on. If you check more than
one, please rank your interest in each board /committee by order of priority.
(A summary of each boazd/committee is available on page 2 of this form.)
Code Enforcement Board ~ Community Development Board
- Pension Board of Trustees _ Tree Conservation Board
Cultural Arts and Recreation Advisory Committee - Board Member Review Committee
DATE: ~ I 1 O APPLICANT'S NAME: J do a (~ ~Lo ~'
ADDRESS: ~ U !~!/ .6/ s C Us S-~~ 1 ~~~/1 ~`~ c CG. [.
y~y~ / r ~ _
DAYTIME PHONE: /y`l - ~b p - b ~ j~' EVENING PHONE: Sa Nt ~'
~Q ~ •/
E-MAIL ADDRESS: /arn~1 G+'L ~ r • ~NL FAX: ~~Q
Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons
for wishing to be appointed t/o this boazd/cammittee.
!/~ /l ~~taU h ._._L ~ ~ /~X Ct ~O/j1/ylFj"'Cic~ J G/~~/
o P~' Gr/ ~r///~
P~ G-G ~ C U ~ u ~ /UdH7 ClJ /yJ/ilri , • , ~ /~/~ ~ ~~i 6 l~Ni
L-~ , ~~~r.~~l//l9 ~~i CPC ,/~ t~i~~ ~~.C)n l ~do~ ~Gv~i~~wnP~'s ,-: ~~,. ~a.~/ ~.~ ~. ~~~ ,~ i6,v~
i
Please return completed form to
Donna L. Bartle, City Clerk, S00 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: This application will expire two (2) years after date of submittal.
1
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the boazd/committee applying for.
AGENDA ITEM # l0A
APRIL 13, 2009
CITY OF ATLANTIC BEACH Received
BOARD / COMMl'TTEE MEMBER APPLICATION FORM
Please check (~) the box beside each Board or Committee that you are applying to serve on. If yoAN heck m~ than
one, please rank your interest ineach boazd /committee by order of priority.
(A s/ummary of each board/committee is available on page 2 of this form.) Onb. d City c~sdc
/ Code Enforcement Board 1~ Community Development Board
/ Pension Board of Trustees ~_ Tree Conservation Boazd
Cul#u~-al Arts and Recreation Advisory Committee ~ Board Member Review Committee
DATE: ~ -' /'G -- f> `' APPLICANT'S NAME: ~~/z,q..~3 ~ 7` ~ `7'• ~ ~ / G ~. ,e S
ADDRESS: 3 ~ y TH,N~ r ,9 ~ ~~ ,~,~ 3 ~
DAYTIlVIE PHONE: ~p cf - ,~ 4/ g' ~ 3o y EVENING PHONE:
E-MAIL ADDRESS:
FAX:
i'lease explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the baazdlcommittee apglyin for.
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: This application will expire two (2) years after date of submittal.
1
Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons
for wishing to be appointed to this board/committee.
AGENDA ITEM # l0A
APRIL 13, 2009
~o~~~o~
CITY OF ATLANTIC BEACH
BOARD /COMMITTEE MEMBER APPLICATION FORM
Please check (~) beside each Board or Committee that you are applying to serve on:
(A summary of each boardlcommittee is available on page 2 of this form).
Code Enforcement Boazd ^ Community Development Board
^ Pension Board of Trustees ^ Tree Conservation Board
^ Cultural Arts and Recreation Advisory Committee
APPLICANT'S NAME: Maria Deese Mark
ADDRESS: 1148 Linkside Drive Atlantic Beach FL 32233
DAYTIME PHONE: 707-3584
EVENING PHONE: 249-4094
E-MAIL ADDRESS: mariadmark(c~gmail.com
FAX: 247-5433
Please explain any employment experience, board committee experience, and/or community volunteer
experience relative to the boazd/committee applying for.
With over 20 years experience as a professional paralegal I believe my legal experience is an excellent
complement for the Code Enforcement Board My skills set include utilizing conflict resolution and critical
thinkine processes to analyze complex issues so that solutions can be identified and implemented A great deal
of my tob encompassed listening to clients with empathy and understanding and then workin>r toward finding
amicable solutions.
Please provide a brief explanation of your interest or any special qualifications you have in this field and your
reasons for wishing to be appointed to this boazd/committee.
I believe I have the experience integrity obiectivity and tenacit~quired to carry out the duties and
responsibilities as amember of the Code Enforcement Board Moreover my legal experience provides a solid
foundation of reseazclung and understandmt~ the statutes and ordinances which overn our City thus ensuring
the health, welfaze and_safety of our citizens I have been an Atlantic Beach resident since 1987 and I have a
deep affuuty for the quali of life we've developed and enjoyed as a citizen and as a community. It would be
mY honor to serve on this Board and I respectfully request m~appointment be considered
Please return completed form to
Donna L. Bussey, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
AGENDA ITEM # l0A
APRIL 13, 2009
CITY OF ATLANTIC BEACH JAN 2 i 2009
BOARD / COMIVIITTEE MEMBER APPLICATION FORM
Please check (~ the box beside ~,ch Board or Committee that you are applying to serve on. If you che~ck~mor~eyth n
orie, please rank your interest in each board /committee by order of priority.
(A summary ofeach board/committee is available on page 2 of this form.)
Code Enforcement Board Community Development Board
Pension Board of Trl~stees _~ Tree Conservation Board
_ Cultural Arts aiid Recreation~Advisory Committee ~ Board Member Review Committee
DATE: ~ (5~ D J APPLICANT'S NAME:
1 'l`
ADDRESS: ~_~ ~ /a- t ~. ~t S ~~ ~2
/ l 1 tT-(~ ~~ il//~ -
~'l
. 3a-a3 3
DAYTIlVIE PHONE: (~'~~} ~- ~ ~, _ ~~ -~' ~ `~ tt
.~
E-MAIL ADDRESS: lam, 13vn/~ 6~ pNJC~ fiST~ Ntz f
EVENINGr PHONE: ~~ G~ Y~f~ ~ ~~f f .
FAX: (~~) ~-a-' ~~ '~ f / ~f-`1
Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons
for wishing to be appointed to this board/committee.
Please return completed farm to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: This application will expire two (2) years after date of submittal.
Please explaim any employment experience, boatd/committee experience, and/or community volunteer experience
relative to the boardJcommittee applying for.
AGENDA ITEM # ] OA
APRIL 13, 2009
CITY OF ATLANTIC BEACH
BOARD /COMMITTEE MEMBER APPLICATION FORM
Please check (~) the box beside each Board or Committee that you are applying to serve on. If you check more than
one, please rank your interest in each board /committee by order of priority.
(A summary of each board/committee is available on page 2 of this form.)
_2_ Code Enforcement Board _1 Community Development Board
Pension Board of Trustees Tree Conservation Board
Cultural Arts and Recreation Advisory Committee _ Board Member Review Committee
DATE: _03/20/09_ APPLICANT'S NAME: Nicholas R. Dodaro
ADDRESS: 373 12th Street
DAYTIME PHONE: 904.253.0293 EVENING PHONE: 904.249.4349
E-MAIL ADDRESS: ndodaro(cr~,crucialcarejax.com FAX: 904.854.7912
Please explain any employment experience, board/committee experience, and/or community volunteer experience
relative to the board/committee applying for.
_I am the founder of Crucial Care. My experience in innovating health care and building a new business has
propelled my growth as a leader. I am the physician volunteer for the American Red Cross (NE Florida division) and
serve on the disaster management team. This has reinforced my skill at working with teams in complex situations.
My peers and colleagues, in noting my abilities, have nominated me for a position on Leadership Jacksonville of
2009.
Please provide a brief explanation of your interest or any special qualifications you have in this field and your reasons
for wishing to be appointed to this board/committee.
_My interest is in participating in my community. I love Atlantic Beach, and I want to be a part of the leadership
teams that keep it special. My special qualifications are my supreme attention to detail, my ability to listen, my
commitment to hard work, and my integrity.
Please return completed form to
Donna L. Bartle, City Clerk, 800 Seminole Road, Atlantic Beach, FL 32233
PLEASE NOTE: This application will expire two (2) years after date of submittal.
1
AGENDA ITEM # l0A
APRIL 13, 2009
Nicholas R. Dodaro, MD, FACED
373 Twelfth St.
Atlantic Beach, FL 32233
Home: 904-249-4349
Cell: 904-253-0293
Email: ndodaro n yahoo com / ndodaro(~crucialcareiae com
Professional Positions
December 2006 -present Crucial Care
Chief Medical Officer /Owner
November 2004 -present University of Florida / Shands Jacksonville
Emergency Medicine Residency Program
Teaching Attending
December 2004 -present Baptist Hospital System
Jacksonville, FL
Staff Emergency Medicine Physician
July 2001- December 2004 McLeod Regional Medical Center
Florence, SC
Staff Emergency Medicine Physician
Certifications
Diplomat American Board of Emergency Medicine
Fellow American College of Emergency Physicians
Medical Training
Residency 1998 - 2001 Emergency Medicine
University of Florida HSC, Jacksonville
Internship 1997 -1998 Internal Medicine
Georgetown University, Washington, D.C.
Education
Medical School 1993 -1997 Tulane University
New Orleans, LA
Doctorate of Medicine (M.D.)
Undergraduate 1989 -1993 Tulane University
New Orleans, LA
BS Environmental Biology
High school 1985-1989 Catholic High School
Baton Rouge, LA
Leadership
President: Qualified Emergency Group, PA
Graduate: Leadership Development Program (Dr. Harold Resnick) - 2007-08
Chairman; Physician Recruitment (ERG) 2005 - 2007
Chairman: Pharmacy and Therapeutics Committee (McLeod) 2003- 2004.
1 of 2
3/20/2009
AGENDA ITEM # l0A
APRIL 13, 2009
Participation:
Volunteer: American Red Cross Disaster Services Team (Jacksonville, FL 2006 -present) -
Team Physician
Member: Physician Leadership Committee for the Emergency Dept (McLeod).
Member: Chest Pain Center Development & Implementation Team (McLeod).
Member: Hospital Vision and Mission Statement Development Committee (McLeod).
Professional Organizations
American College of Emergency Physicians.
American College of Physician Executives
Duval County Medical Society.
Florida Medical Association.
Florida College of Emergency Physicians.
Personal
Date of Birth January 20"', 1971
Status Married to Cathy
Children Ian (4 y.o.)
Gia (2 y.o.)
Hobbies Computer Technology.
Travel.
Art.
References
Available upon request
1 of 2
3/20/2009