CITY OF BURBANK APPLICATION FOR APPOINTMENT TO CITY BOARD, COMMISSION OR COMMITTEE Burbank Glondale Pasatena Aiport Aushorty ‘Name of Board, Commission or Committee Mr /Ms Mrs Name. Dave Golonski a 5 fray “Tey 2p code 91505 phonestes, 818-843-2048 cot Phone 818-434-5873 x Resident of Burbank for 27 Years Burbank Registered Voter: Yes X_N. EmailAddress: golon@uolcom ALL INFORMATION IS A PUBLIC RECORD AND WILL BE POSTED ON THE CITY'S WEBSITE. **pursuan to BMC Se. 21-407 n person sll be eligible tobe @ member of any Board, Commission, or Committee ‘established bythe Burbank Municipal Code unless he/she san elector of, and actully lives inthe City. Eestion: scH0oL MAR ‘GRADUATION DATE & DEGREE UC Berkeley Computer Science 19848. UC Berkeley Poitical Economy of Natural Resources| 1984 BS. Additonal Pertinent Courses oF Training Other Pertinent Sil, Experience or Interests: Employment information Prevent Occpaton: -PropertyManagement name offen: Self Erployed voce: 218-049-2046 ‘Telephone: ‘Specify current or prior service on a City Board, Commission or Committee: 1992-2013 Burbank City Council Rev, 1-17-14 rllappucanr’s name: Deve Golonski Listcommunty acti in which you ate involved ‘Burbank Coordinating Councl Hay Basket Program, Vice Chalman, LOSSAN Rall Coir Agency (LA Metro appoinige) ‘you at related 0 any Cy of Burbank employee(s) please state ther name(s relationship), and departments). you ae not elated toa City of Burbank employee, please put NIA N/A Confit of interest: Rules of law and ethics prohibit members from participating in and vating on matters in which they may havea direct oF Inairectcontct of interest Incivang 2fnanell interest. Ae you aware of any potentat conc of interest which may ‘develop from your occupation or financial holdings in elation to your responsibil as a member of the Board ‘Comimision or Commies to which you seek appointment? YES NOX Ifyou answer yes, ona separate sheet of paper explain in detail any potential confcs inthe same manner as required by the For Politeal Practices ommision’s Statement of Economic Interest (Form 700}. (you shuld have any questions about thie matter or need further information as i relates to your situation, please advise the City Clerk prior to ‘ulitting your applicatn) ‘convitons: Conviction ofa felony or misdemeanor will not necessary result in automatic disqualification ofthe position to which vou have volunteered. However, falure to give complete and accurate information may be grounds for rejection of your {pplication or removal from office. The ity of Burbank may conser the nature, date, and cumstances of the offense {or which you were condcted 3s well as whether the offense is relevant to the duties ofthe Board, Commission, or Committe to which you ae appiin, ‘As an adult (age 18 or over) and within the last ten years, ave you ever been convicted (including a pea of gly or 90 ‘contest which resulted ia 2 criminal conviction placed on probation (iter formal or cout probation) placed on parole, forfeited bal or paid afr for a violation of any law except for any infractions including traffic? (00 NOT include any ‘misdemeanor convictions for marjuana-telated offenses that are more than two years ol, misdemeanor convictions that have been expunged, oF any convictions that were dismissed afer completion ofa diversion program.) Yes x No ‘Within the lat ten years were you required to register under the provisions ofthe Sex Oflender Registration Act (Penal Codie § 250, et sea)? yes x___No Ifyou answer yes to ethe- question, please describe the type of offense, date, place and sentence or fine imposed on 3 separate page of pape. ‘Are you cutently on bal rleased on your ovm recognizance for 2 misdemeanor or felony cae that spending trl? es xno If you answer yes, on a sesarate page of paper please describe the type af offense and ate that the matter has been st fort. 1¥ you answered yes to any of the above questions on convictions, please schedule an appointment with Live Scan (218.238.5340) to submit ingerprins for erminal story verification. Page 20f3,appucanr’s name: Dave Golonski FIRST choice for Board/Commision/Commitee appointment: Burbank Glendale Pasadena Aiport Authority ‘Deze any qualcations experience, and education, 35 well as any technical or professional background you may have clave tothe duties of ths poston What ae your goals In serving on this Dosrd/Commisson? Committee? [Served for over 15 years on the Burbank City [Council airport subcorwmitee. ‘My goal in serving on this Authority would be to help the Airport find a path forward with anew replacement terminal and use of the additional property on the B-6 site that wil gan the support of the community. believe | could help the Authority succeed in what | believe is a sincere effort on their part to being respectful and good neighbors in the Burbank community SECOND choice for Board!Commision/Committe appoint ‘Deserbe aay qualications, experience, and education, a wellas any technical or professional background you may have relatve tothe duties ofthis poston. What are your goals in serving on this Baard/ Commision] Committee? PLEASE NOTE THAT THIS APPLICATION IS PUBLIC INFORMATION AND IS AVAILABLE ON THE CITY'S WEBSITE. ‘neve certify that the formation contained inthis application and any accompanying documents is true and correct to ‘Signatire of Applicant ‘You are encouraged to attach addtional pages, enclose 2 coy {you feel may assist the Cty Counc inthe evaluation of your of cy ‘when compte mails original to: 42/15/2014 py of your resume or submit supplemental information which application. lee ofthe Gt Clerk of Burbank East Olive Avenue, Burbank, California $1502 age 3.03CITY OF BURBANK APPLICATION FOR APPOINTMENT TO CITY BOARD, COMMISSION OR COMMITTEE ‘Name of Board, Commission or Committee ens. Nae Bel Thomas handler Toa Ft Tides ee Adres Zip Code 91505, Phonees._Cell ccenphone 747-439-7100 Resident of Burbankfor TONS Years Burbank Registered Voter: Yes No mall address: homes belt7@gmaiicom ALL INFORMATION IS A PUBLIC RECORD AND WILL BE POSTED ON THE CITY'S WEBSITE. **Pursuantto BMC Sec. 2-107 no person shal be eligible tobe a member of ony Board, Commision, or Committee estobshed bythe urbonk Municipal Code unless he/she san elector of and actualy ives inthe City. Education: ‘scHOOL MAIOR “GRADUATION DATE & DEGREE University of Maryland Business Administration 3 years “University of Colorado, Business Administration ‘semester ‘Additional Pertinent Couses or Trinng: RealEstate and Appraisal courses ‘ther Pertinent Sil, perience or interests: 25 years of Banking and Economic Development, Army Aviat Aiport Manager “Employment information: Present Occupation: ___ Semietired Name of Frm dress: Telephone: ‘pect current or prior service ona Cty Board, Commission or Committee:_Please See: non-profit page and leter ftom the Ciy of Harrisburg, Pennsyivania Rev, 117-14 pele~arpucanr’s ame: Thomas C. Bell First Presbyterian Church of Hollywood Us community actin whlch you ar involved: you are related to any ity of Burbank employes, plese state the name(s) relationships), and departments). If you ae ot related to ty of Burbank employee please put N/A N/A Confit of intrest: Rules of aw and ethics prohibit members from participating in and voting on matters in which they may havea direct oF Indiectconfct of intrest including a nancial interest. Ate you aware of any potential coflets of interest which may develop from your eccpation or financial holdings in relation to your responsbltes as a member of the Board, ‘Commission or Committe towhich you Seek appointment? YES. NO If you answer yes, ona saparate sheet of paper explain in deta any potenti conf in the same manner as requires by the Fai Political Practices Conimision’ Statement of Economic Interest (Form 700}. (you should have any questions about this matter or aed farther fformation asi relates to your situation, please advise the City Clerk prio to Submitting your applicaton) Convictions: Conviction ofa felony a misdemeanor will not necessarily result in automatic disqualification ofthe position to which you have volunteered. However, allure to give complete and accurate information may be grounds fr eeection of your Application or removal om office. The Cty of Burbank may consider the nature, dat, and circumstances of the offense for which you were convicted as wel as whether the offense is relevant to the duties ofthe Board, Commision, oF ‘Committee to which youare applying ‘Asan adult age 18 or over) and within the last ten years, have you ever been convicted (nluding a plea of guity or no contest which resuted ina criminal conviction, placed on probation either formal o court probation), placed on pale, forfeited bal or paid afin fora violation of any law except for any infractions including traffic? (DO NOT include any ‘misdemeanor convicios for mariuana-elated offenses that are more than two years ol, misdemeanor convitions ‘hat have been expunged, or any convictions that were aamseed after completion af diversion program] Yer x No ‘atin the lst ten year were you required to register under the provisions of the Sex Offender Registration Act (Penal Code § 280, et. sea 7? ves x No Ifyou answer yest either question please describe the type af offense, date, place and sentence or fine Imposed on 2 separate page of pape. ‘Are you currently on ba or leased on your own recopnzance fora misdemeanor o felony case that i pending tal? ves No If you answer yes, ona separate page of paper please describe the type of offense and date thatthe matter has been set fortra. 1f you answered yes to any ofthe above questions on convictions, please schedule an appointment with Live Sean (815.238.5340) to submit fingerprints for erminal history verfeation.arpucanrsname: TomasC.Beh RST choke for oad mmislon/Conmite appointment: Burbank Glendale-Pasadena Airport Authoriy ‘Describe any qualieatons, experience, and edveation, az | What are your goals in sersng on hs Board Commission” ‘well as any technical or profersonal background you may | Committe? have relative to the dts of ths poston Agata Cary Commision oe Boao Werk effectively wit he 3 ols tbuld a Samanta Ae gor Art ey replacement trminal and wodk vith allnecessary sates Fo et ans and viable entities forthe constructon ey haga on ents Any enhancement and cmplton of te proposed iene Scary Povonkin vo Coo, case, | EQN! Intermodel Transporalon Centers motors dnreteoHecthysCamnin | Do whats necessary to asist in making Burbank unnnnneenemine a ‘stop premier transportation hub and go to jexthation ‘SECOND choice for Board/Commission/Committee appointment: ‘Describe any auaications, experience, and education a5 | What are your Boas a sering on tis Baard/Commisson] ‘wall as any technical or professional background you may | Committee? have elitive tothe dutes of tis positon PLEASE NOTE THAT THIS APPLICATION IS PUBLIC INFORMATION AND IS AVAILABLE ON THE CITY'S WEBSITE. "hereby cently thatthe nformation contained inthis application and any accompanying documents is true and correct to tie best of my knowledge, January 2, 2015 Senate of applicant bate You are encourage to attach ational pages, enclose a copy of your resume or submit supplemental information which you feel may assis the Cty Counc nthe evaluation of your application, ‘When completed mai/ubmit orignal to: Office of the city Clerk ity of Burbank 275 EastOlive Avenue, Burbank, California 91502THOMAS C. BELL | “Email: thomas.<.bell17@gmail.com Cal (717) 439-7300 Executive Profle Senior Executive with substantive business development expertise in creating public private partnerships. Innovative leader with an exceptional financial acumen used to leverage finances to bring projects to closure. Proven successes ‘throughout career in sigficantly increasing funding for and promotion of economic development projects. Effective ‘communication and collaborative sls use in forging relationships. ‘Areas of Effectiveness “Senior Executive Leadership 1 Strategie Planning/imatementation 1 Malti Pubic Private Partnerships (Community Revitalization Development ‘Business/Community Ventures» Renewable Energy Development Mortgage Srokerage/Lending, = Public Speaker/Precenter Government Banking/Afairs © Regulatory Compliance Project Management Grant Review/Weiting Executive Career ‘CHANDLER RESOURCES, LLC, Mechanicsburg, PA 2012 t0 2014 Business Development Consultant Responsible for introducing UGI Performance Solutions to °C Level” members of Fortune SOO companies. Assemble and ‘manage UGI Performance Solution team fr specific energy opportunities inclusing major mechanical retrofits, controls, ‘rves lighting, et. with specifi focus on ste power generation with solar and combined heat and power. ‘Guide Sales people through the sales process, Evaluate Energy Conservation Measures and assembles varius scenaios/options for customers, Review and exp financing options with customers and guides them to a decision ‘Work with egal counsel tough the terms and conditions evaluation process DEPARTMENT OF ENVIRONMENTAL PROTECTION, Harrisburg, PA 2008 to 2012 Executive Director of Penasyvania Energy Development Authority (PEDA) 2008 to 2012 {an independent public authority whose mission isto finance clean, advanced energy projects in Pennsyvana including solar energy, wind, low-impact hydropower, geothermal, biomass, landil gas, fue cells, and combined heat and power.) ‘+ Oversawa staff of 30 and the design and management ofall PEDA's financial programs + Represented PEDA to the pubic, the state legislature and the financial and eneesy communities + Participated in stategic development meetings to attract investment and energy development to Pennsyvani + irectly interacted with Secretary to formulate policy for the advancement of Governor's energy policy goals, covering the areas of financial and economic development of energy technology deployment in Pennsylvania “+ Create the Energy Development Implementation Plan for Soard and Commonwealth's energy policy/strategy “Generated 2,000+ jobs by leveraging projects worth $89 milion in grants nto $750 millon in private funding, | Serve alto as the Director ofthe Pennsylvania Sunshine Solar Program that provided $100 milion in ebatesto help fund solar electric (solar photovolae, of PY) and solar hot water (solr thermal) projects fr homeowners and small businesses in Pennsylvania ‘9 Wrote program guidelines, policies and procedures. (© Approved and certified over 750 contractors fr istaling projects equaling 92 MWS. ‘© Increased grid connected photovoltaic capacity in Pennsylvania by 945% within fist year in ob Local Government Laizon and Community Revitalization Coordinator (2008 to 2009) ‘Supported 15 SouthCentral PA counties to provide services to developers, economic development agencies and local government officials 10 facilitate the submission and review of environmental plans and permit applications for community revitalization and economic development projects. SUSQUEHANNA LENDING GROUP, Camp, PA 2005 10 2008, President, Morteage Broker ‘Started up and marketed services ofa new mortgage brokerage firm, + Developed a funding mechanism for affordable housing programs with non-profits and PHEA + Closed $2 milion in Conventional, VA, FHA, and Sub-Prime Loans.Thomas ¢.Bell~ Page 2 NC Ban, Mechanicsburg, PA 20018 to 2005 Vice President, Government Banking "+ Cultivated and managed banking partnerships with government agencies across a seven-county region with fll responsiblity forachieving all income generation and portolio growth targets. Initiated relationships with state, county and municipal governments, public school districts and authorities. Consulted with government customers to devise integrated total service solutions ‘Advised customers of multile investment programs, lending oppertunities and cash management strategies ‘Coordinated investment, borrowing and daly Banking services on customers’ behalf. ‘Conducted annual account reviews to ensure 100% customer satisfaction and identily new opportunities. urs Ba, Hacrisburg, PA 1994 to 2002 Senior Vice resident, Community and Economic Development (ED) + Oversaw all facets of housing, community infrastructure, downtown renewal and economic development Initiatives for PA, MD and DE + Managed corporte portfolio of qualified investments including community/economic development loans, equity limited partnership transaction and low income housing/comprehensive tx credit programs. + Established al plices and procedures te govern economic development programs and regional offices, + Monitored the review and analysis of funding applications and the oversight of funded projects. + Represented fest Bank on several professional/community and non-profit Boards, + Managed rtical partnerships wth various government, regulatory agencies and economic development groups. {created and managed mult-milion dolar community partnerships to reultalae distressed neighborhoods in PA. + Leveraged PA's Department of Community and Economic Development tax programs to gain additional local state and federa funding, Manan Derantivent oF HOUSING aN ConDMUNTY DevtLoPMenT, Crownsyille, MD 1993 to 1994 [Administrator for Development Finance “> Oversaw staff ant intial review, underwriting and loan processing functions fom initial application to final Closing to suppor low to moderate multifamily renal housing projects. + Worked withthe Community Development Adminstration, local government officials, and city agencies to ensure that al procedures, standards and programs were i full compliance with regulations statewide 4 Establzhed standard underwriting erteia/reference manuals to ensure consistent quality in project evaluation. + Administered Federal Home/Tax Credit programs on behalf ofthe State of Maryland. {Financed more tan 2,837 units in FY1993 by utilizing $100 milion in bond issues. Fins Bacar ves Hus, Beverly Hills, CA 1984 to 1993 Vice President/Major Loan Division “= Oversaw staff ard the Majr Loan Division including underwiting, document preparation and appraisal Education + Graduate of Leadership Harrisburg, 1997 + Course work at Gradate School of Public fais, UNIVERSITY OF MARYLAND Business Administraion, UNIVERSITY OF MARYLAND Military = US. Army (6 years) Captain, Helicopter Plot ‘Board Affiliations + Chairman and member of numerous non-profit and for profit Boards, References and Board Membership Uist are Available Upon Request‘Board Affiliations both Non-Profit and For Profit Thomas C. Bell ‘My broad experience as. board member to many non-profit organizations and community action centers while cepresentng financial institutions included expert councl, budget preparation, writing by- Jaws, and helping to secure funding from outside sources. ‘As chairman of rug Free Pennsyvania (AG Mike Fisher was heavily involved) I partnered with Senator Jake Corman to spearhead a legislative issue that became Senate Bill 413. This bil increased fines fom {rug and alcohol violations which a turn helped support Drug Fee Pennsyvana’s mission. In alton, atthe request of Hacisburg city’s mayor (Steve Reed |, while Chairman ofthe Board ofthe National Ci Wer Museum, was aked to take the addtional position of Executive Director. (the then ‘current drector‘ook gravely il). n establishing cost cutting measures | was able totum the museum into profitable satus forthe fist time sine its inception Below ia st of for profit (P) and non-profit (NP) boards | was affiliated with fr many years Past Board Afilations 2008-2012: Board Member, Susquehanna Area Regional Airport Authority 2004-2010: Board Member, American heat Asociation of Central Pennsyvani. (NP) 20042008: Board Member, arrsburg Senators Baseball Club. (Chair Audit Committee) (P) 2003-2009: Board Member, South Central Workforce Investment Board. (Chai Finance Committe) (NP) 2003-2008; Board member, Pennsylvania Association of tatino Organizations. (Finance Commitee) (NP) 2001-2004: Board member, Lancaster laner Cty Group. (NP) 2000-2007; Chatman and foard member, National Civil War Museum, (NP) 11998-2003: Fourding Member, Pennsyvania Community Development Bank Operational Comittee. (P) 11998-2003: Fourding Board Member, Tri-County Housing. (NP) ‘This was not resume building a! Wasa very ative board memberOffice of the Mayor ‘The City of Harrisburg Me) Sort Seems arriburg, PA ITOLAST® Stepnen Knee December 11, 2009 Mr. Thomas Bell 512 South Market Street ‘Mechanicsburg, PA 17085 Dear Mr. Bell: [As this Administration comes to an end, I wanted to extend to you my personal and this City’s — most sincere appreciation for the service you have provided the City of Harrisburg, ‘The various Boards and Commissions that are a part of or associated w play an absolutely critical role in their respective functions. the city “Those who have been in board service for an extended period, especially those whose longevity involves service in the 1980"s and into the 1990's, know well the ety that ‘we inherited and the devasting effects that hud been visited upon Harrisburg from decades ‘of precipitous decline. When we first began, our City was listed as the second most distressed in the Nation ~- having suffered massive loss of population, businesses, jobs, tax base and, worst ofall, hope and confidence for this future. “The city that exists today is vastly different than the one that once existed. Harrisburg, ofcourse, faces current challenges, as with every American city, but today’s issues pale in comparison to the conditions and circumstances that once confronted this City a eity that was afraid ofits own future, ‘Through arduous effort, nt only has the City’s capacity to function been extensively increased, but arguably one of our greatest successes has been in creating and building the civie and institutional capacity of the Harrisburg community and region. Literaly thousands of projects resulted from our efforts, with this City many times, specially in the earlier days, serving in the very unconventional role of being the developer or the catalyst to make things happen.Mr. Thomas Bell Page Two ‘The roleof our Boards and Commissions has been critical during al this time. Many have bees the instances when a Board or Commission's action and partnership have been a critical snd enabling factor to bringing progress to fruition. ‘Whether involved in Board or Commission service fora short or long time, you can take pride in your contributions to Harrisburg by your public and other service. You can take pride in the gains and progress ofthis era. Please accept the enclosed Distinguished Publie Service Award as my way of saying ‘to you, now and for the future, my gratitude for your abiding commitment and service to this City. May you know success and good health in all that you do. With warmest personal regards, Lam Stephen R. Reed Mayor EnclosureMay i, 2008, Mr. Thomas C. Bel S128, Market Stect Mechanicsburg, PA Dear Mr Bell: Attheir meeting of May 1, 2008, the Cumberland County Board of Commissioners moved ‘unanimously to appoint you to the Susquehanna Area Regional Aisport Authority (SARAA) Board as a representative for Cumberland County. Your appointment will expire January 05, 2013 ‘We very much appreciate your willingness to undertake this responsibility Sincerely, Chiet Ceri DMibrs co: Camille SpringerBren ‘One Terminal Dive Mialeton, PA 17057 Aui.com ee December 23,2016 Vitor i Director of Pubic Aas and Communications Burbank Bob Hope Alport 2627. Hollwnod Way Re: Thoma: Bell Letter of Recommendation ‘ear Mr. Gilt Pease accep this correspondence as letter of recommendation for consideration of Me. Thomas Bell asa member ofyour port's board of crectors. In shor, offer my hiehest posible recommendation forMe Bel "have served onthe Susquehanna Ares Regions Apart Authority (SARAA) since 2006, and am the incumbent Vice Char ofthe Board of Directors, Me. Bland served onthe SARAA Boor together during my itl thre (3) yeas unt he relocated and wae no longer a eident of an eae ‘municipal forGoard service. Mr, Blf's background and experienc in community and econeric development was an excelent sition to our board, a we transtioned from a sngestate owned and ‘operated apo into 2 municipal authority sponsible or the operations of fur ()sirprts, one of ‘which san inte national aiport (MDT, a premier general vation fcity (XY), end two smaller regional arports(GRA & FCRA In particular, Mr. els expertise was celled upon regulary when the former terminal t MOT was closed, and anew facty was erected the fst nthe nation that met all ‘ofthe pos 9/1: security standards which was an arduous, complex and challenging projet to tere Inadaiton to We. Bas outstanding service to the Board of biretors,he was akey member ofthe Boar's Airport Development Commitize which promulgated the Authors Master Plan and served 3s the oversight cemmittee for the Authority's marketing staff and efforts, Me el dolzately served the SARAA Board and hs contebtlons were ways above and beyond any reasonable expectations, For the foregoing reasons, high reeermend Mr. Bll for service on your Board of Directors and assure you that his tlents, competency a abies wl bean invaluable asset to your staff, cstomars and faites Please fel re to contact me at your convenience, for any ational assistance may provide, stephen 8 bh Vie Chaman sblibhast vernon net Ph: 717 576.525518 Circle Drive Carlisle, PA 17015 December 12, 2014 Leter of Recommendation ‘Thomas C. Bell 4140 Warner Boulevard #12 Burbank, CA 91505 “To Whom i May Concer: I served with Tom Bell on the Susquehanna Area Regional Airport Authority (SARAA) for several years. I was always impressed with his depth of knowledge of airport ‘operations as wel s his ally to understand the business side of eunning airports. SARAA operates four airports, one with international service. I've always known Tom to have good information to add to any discussion, He knows his \way around an airport. He would be an asset to your board Donald S. Geistwhite, Jr. Board Member Susquehanna Area Regional Airport AutvorityCITY OF BURBANK APPLICATION FOR APPOINTMENT TO CITY BOARD, COMMISSION OR COMMITTEE a. ~Guenparé-Vasarénia flapoat joer s "Name of Board, Commission oF Committee M5 rs. came Abams Ray - (as rt) aves, recat Giso, pronenes. GIF. SST. 2S) cenrmone LIS - 12-6 574 Resident of furbankfor (© Years Burbank Registered Voter: Yer No emaindires: LAO RHC 2be Cons ALL INFORMATION IS A PUBLIC RECORD AND WILL BE POSTED ON THE CITY'S WEBSITE. **Pursuant to BMC Sec 2-1407 no person shllbe eile tobe @ member of eny Bord, Commision, or Committee established by the Burtank Municipal Code unless he/she ison elector of ond actualy ves in the hy Fuaton: { ‘SCHOOL (GRADUATION DATE & |__| ensoumranom anor | Prsuc Sencar Ee | eenenar Eo | 12-14-1953 ieee eee eee ere | ra lass Adaitional Pertinent Courses oF Training: Other Pertinent Skis, aperence orinterests: A@esrY 7 Commun icHTe AAD Wlenviaze. HAVE Boker ELECTED ro LEADERS jesrri: rex, z pzariec! oe mpoyment ermatin preset occupation (Ze a Esreare Consents Sevices are Fe 2 Ease le sddess: 12. Severe Dé Bvesanc CA Goop Teleohore: BI SE T-E3Zy Spec current or pir sence on City Board Commision or Commitee: 26/2, = Peeves? Com, Rev, 17-4 Pe ofAPPUCANT'S NAME: Kat Lows Lsrcommuniy actitesinwhichyousreimohee: Woonesyey Univ. Bye sranin Mipedice denez. Boe sank Seaer fmeroes — thuerge Taiezers ¥youare related to any City of Burbank employees), please state ther name(s, relationships and departments. yovarertrctd io cyt aurank aly, pase pe NA v/a Conflict of interest: Rules of law and ethics prohibit members fom partipating in and vating on matters in which thay may have aarct or indirect confit of intret including» Financial intrest. Are yon sare of any ptentil cnc of interact wich ny ‘develop fom your occipation of financial holdings in relation to your respansibties as a member of the Board, Commssion or Commie to which you seekappointment? YES NO Hf you answer yes, on a seprate sheet of paper expan in detaany potential conflicts inthe some manner as required by the Fair Political Practices Commissions Statement of Economic interests (Form 700). (you should have any questions about tis matter or ad further information at i relates to your situston, please aevise the City Clerk pier to ‘using your appcaton) ‘convictions: {Conviction ofa felony cr misdemeanor wil aot necessary result in automatic disqualification ofthe position to which you have volunteered. Sawever,falure to give complete and accurate information may be grounds fr rejection of your pplication or removal fom ofce. The Cy of Burkank may consider the nature, date and creumstances ofthe offense for which you were concted as well a2 whether the offense is relevant to the dts ofthe Board, Commission, of Committe to which you are apoyng. ‘Asan alt age 28 oF ever and within the las ten years, have you ever been convieted including plea of guilty or no ‘contest which esulted na criminal conviction} placed on probation father formal or cour probation, paced on parole, forfeited bl. or aid 3 fie for vltion of any lw exept for any infractions including tafe? (00 NOT include any misdemeanor convictions for marjuans-relsted offenses that are more than two yers old, misdemeanor convictions ‘that have Been expunged, or any convictions that were dismissed ater completion ofa dversin program) Yes No ‘icin te ast ten yeas were you required to register under the provisions ofthe Sex Offender Reistration Act (Penal Code $250, sea)? yer no tyouanewer yes tether question, please describe the typeof offense, date, place and sentence or ine imposedon 3 separate page of paper. [Are you currently on bal or released on your own recognizance fora misdemeanor or felony case thats pending tia? ves re if you answer yes on separate page of paper please describe the typeof offense and date thatthe matter hasbeen set for a if you answered yes to any ofthe above questions on convictions please schedule an appointment with Live Scan {818.238 S2un}t9 hm freerrnts for erminal stow vetieaion Page 20F3APPLICANT'S NAME: —_—_ [ARST choice for Boerd/Commisson/Commitee appointment: Describe any ualicatio, experiance, and uation a | Wha are your goal ih sonra on ths Boa] Common? ‘wel ean technical or fofesional background yournay | Committe? have lative tothe duties of his poston, Lenpcitswy ExPcKiEnce To mace THE Merer BBILITY Te (meTiVATE | Meee PRer/THBLh, AMD AND CommurtenrTe. heunpece Fon THE — Taaewine FUsLe Star many YeAns FLYING IN AND oT oF Buna HULPORT —Somerimes 2 Times A weer SECOND choice for Boari/Commisson/Committee appointment: Describe ony aualicatans, experiance, and eaeaton as | What are your goals Srungon Ts Bora Commisson] well asany technical or professional Background you nay | Commitee? have relative tothe duis of hs position PLEASE NOTE THAT THIS APPLICATION IS PUBLIC INFORMATION AND IS AVAILABLE ON THE CITY'S WEBSITE. | hereby ceri thattheinformation contained inthis application and any accompanying documents rue and corect 0 the bet of my knowleaie LULL sae nye Signature of Applicant Date ‘You ae encouraged to sttach ational pages, enclose 3 copy of your resumeor submit supplemental information which ‘you tee may asst the ty Counelinthe evaluation of your appieaton. When completed maisubmit original to Office of the ct clerk 275 East Ove Avenue, Burbank, California 91502 age ofRay Adame Blography Ray Adams worked for a Burbank Real Estate Broker ~ Paul, White Carnahan (PWC) from 1964 to 1970. He joined the Burbank Association of Realtors in 1964. November 1970, Me. Adams left PWC to work for First California Title as afield representative inthe Burbank area, In May 1971, he was promoted to Vice President Sales Manager, In 1972 he joined Safeco Title ag Vice President Sales Manager and in 1973 became interested in the home warranty business. His enthusiasm for warranty was 0 great that he left Safeco ttle and started his own warranty company in 1975, His first warranty office was located at 99 B. Magnolia Blvd, Burbank and Buyers Home ‘Warranty Company (BHWC) is stil located in Burbank at 550 N. Third Stret. ‘Since 1976 Mr. Adams has worked closely with both the California Association of Realtors anc the National Association of Realtors in developing the concept of home ‘warranty coverage. In addition, he was instrumental in seiting standards followed by the industry. In 1978 Mr, Adams served as a member of an advisory group that helped draft the home warranty legislation ~ signed int law that year ~ giving the California Insurance Commissioner comprehensive regulatory jurisdiction over home warranty ‘companies. Jn 1984, Mr. Adams participated in the formation ofthe Home Warranty Association of California and was subsequently elected is first president. He served as President for ‘two additional terms in 1988 and 1999. As President he worked closely with the Department of Insurance, organized real estate and the home warranty industry to improve and strengthen the financial requirements of home warranty companies. For the last 30 years he has continued to serve asa liaison between the home warranty industry and the Califomia Association of Realtors. He formed the Texas Warranty Association hich was incorporated in October 1999. In addition, he serves asthe liaison to the [National Heme Warranty Association coordinating the efforts ofall industry associations, ‘The objective isto improve consumer protection a it relates to a realestate transaction, Until August 31, 2007 Me. Adams was President of Buyers Home Warranty Company (BHWO), BHWC is. leader in the home warranty industry. The service center, located ‘in Burbank, serves most states 24 hours/? days and currently employs 75 people, ‘Mr. Adams and his wife Bonnie have been marred for 48 years. They have two children and cight grandchildren. Mr. Adams was born in London, England, is a United States citizen, and has lived in California since 1962. His son Ed and wife Dianne reside in ‘Burbank wih their four children. Ea is President of HISCO Home Warranty. His «daughter Denise and husband Doug reside in Colorado Springs with thet four children, Denise and Doug were missionavies in Siberia,‘Burbank Resident: [lived in Burbank forfour years (1962 to 1966). 1 built a new home in 2006 and moved back to Burbank. Since 1974 Ihave had a business address in the vty. The ‘companies Ihave owned and operated were: © Action 76, tn. Pacific Cal West * Old Republic Home Protetion Company * American Home Shield Buyers Home Warranty Company Political Activities: Joh Garamendi, Lieutenant Governor Mike Antonovih, County Supervisor ‘Community Activities: Police Community Relations Couneil—LAPD-—Foothill Division, 1970 Kiwanis, 1968— 1974 Sunland Chamber of Commerce, 1966 ~ 1970 (President 1969) Sunland/Tujunga Jaycee, 1966 to 1972 (President 1967)CITY OF BURBANK APPLICATION FOR APPOINTMENT TO CITY BOARD, COMMISSION OR COMMITTEE "Name of Board, Commission or Committee M/s vr Nan Dyson Paul John tar Fisiy daly Residence Ades ZipCode 91508 _—_Phone:Res. cellphone 818 371 9516 Resident of Burbanktor 23 Years Burbank Registered Voter: ves YE8_ Wo ‘eMail Address: Pauldyeon@yahoo com ALL INFORMATION IS A PUBLIC RECORD AND WILL BE POSTED ON THE CITY'S WEBSITE. **Pursvant to BMC Sc.2-1-407 no person shal be eligible to be « member of any Board, Commission, or Committee established bythe Burbonk Munk! Code unless he/she lon electr of, and actualy ives in the hy. eatin: ‘SCHOOL MAIOR “GRADUATION DATE & DEGREE Gity of London College ‘Transport, Law, Economics 4971 BA Equivalent King Edward VI Guildford UK GCE A Level 1968 Adana Pertinent Courses oF Training Other Petinent Sil, perience or interest: year caeerin anspor ncaa operations Passongor rll advocss. Overt millon mies ai avel Employment information: Present Occupation: Retired Business Owner Name of Frm Ades: Telephone: Specty current oF prior service ona Cty Board, Commision o Common: HBN8P6r Rev, 117-14 ry Pa NOESsorvcans name; Patil Dyson - President, Ral Passenger Associaton of Califor st community actives which you ae ined: you are related to any ty of Burbank employes please state thel name(s), relationships), and department). Hf YoU are not related to a ity of Burbank employee plese put N/A Confit of interest Rules of law and etis prohibit member from partipating in and voting on mater in which they may have a director Inarect conte of interest incuding a inania nteret. Are you aware of any potential conics of interest which may ) Eomersay& Mie School iron Counselor, >) Burenk HoghbaoodLeadertp roam 1. To understand the mission of our Senior [Citizen Board and its workings 2. To explore improvements that can be made 50 thatthe Board can: successfully accomplish its mmission, work effectively, and provide better 3. To serve as an Advisor tothe City Council regarding the improvements needed at the Senior Citizen Board PLEASE NOTE THAT THIS APPLICATION IS PUBLIC INFORMATION AND IS AVAILABLE ON THE CITY'S WEBSITE. ‘hereby cetitythat the information contained inthis appiation and any accompanying document itr and correct to ‘the best of my tonedge igetre oF APD yo 62014 Date ‘ou are encouraged to sttach aaltional pages, enclose copy of your resume or submit supplemental Information which you les may asst the Cty Counal inthe evaluation of your application. ‘when completed mai/ssbt orignal to (Office of the city Clerk {iy of Burbank 275 East Ove Avenue, Burbank, California $1502 Page 3.003