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<br />AUG. 4, 2006 3; 30PM Wl Bun E R NO, 6535 P. 6 9C <br />. ' . Page 5 <br />. <br />~ <br /> <br /> <br /> <br />PLEASE LIST THREE PERSONAL AND/OR PROllESSIONAL REFE:RENCES: <br /> <br />333 Twin Dolphin Drive, Suite 230 <br />Jeff I~a Redwood City, CA 94065 peA (650) 802-8668 <br />Name Address Occupation Phone <br /> <br />1017 Middlefield Road <br />Ec Everett Redwood City, CA 94063 City Manager (650) 780-7301 <br /> <br />Name Address Occupation Phone <br /> <br />1017 Middlefield Road <br />Barb Pierce Redwood City, CA 94063 Mayor (650) 368-6246 <br />Name Address Occupation Phone <br /> <br /> <br />I understand that this application is a public document and its contents will be disclosed upon reques~ and any <br />misrepresentation or deliberate omission of a material fact in this application may be justification for refusal or <br />tennination of appointment. I also authorize persons knowledgeable of the information stated herein to give any <br />additional information Ie d. my qualifications and character, I hereby release said persons from any liability <br />for any damages whats er g this information. <br /> <br />8/1/06 <br /> <br />Date <br /> <br />The Political Reform Act of 1974 requires all govemment agencies to adopt a Conflict of Interest Code which <br />designates the positions within an agency which make or participate in making governmental decisions which <br />may forseeably have a material effect on any finanoial interest. Members of Redwood City boards, committees <br />and commissioDB, by virtue of their positions, make or participate in making decisions which may affect their <br />financial interests and who therefor must disclose these interests on the Fair Poliiical Practices Commission <br />Form 700 - Statement of Economic Interests of Designated Employees, The Form 700 is a public document <br />and its contents will be disclosed Upon request. <br /> <br />Please mail or deliver your application to the City Clerk Department, 1017 Middlefield Road, Redwood City <br />CA 94064 or fax: to 650-261-9102. If you downloaded this application) you may e-mail the completed <br />application to phowe@redwoodcitv.org. Deadline for applications is 5:00 p.m., Friday, March 17,2006. <br /> <br /> <br /> <br />How did you hear about this year's recruitment: <br />_ newspaper <br />_ utility bill insert <br />_ city website <br />friend <br />_ neighborhood newsletter <br />_ other <br /> <br /> <br />2006 <br />