Fort Walton Beach Council agenda — 02-28-06 ‎(workshop)‎ — reading text

QPfPCf2~ t,,;: /:;- h'J //? IJ~ rR c. I~ t- p I, . L. z w III:! J ,~i",? I(),Crl/llt ' Employer Name - rt,t' t- O.4- Ah.l Dates of Employment ( qq II) -kr.) :: i) AlA- Address 9\11~- PRp~'-k;,.., Ar1 ~~ bAIl.+. c,. Tx. 75~ Phone No o 5.d () () - .. J ,; s:J ~( () Supervisor' s Name 12.cL,A-~d 01 i!..- Salary (Beginning & Ending) $'~ g,. /' Position Held f1" fP;c/ '/Ajrl ".. I 14cc- I - - ( P~ / F~) 1 "')') 5 .)pI iE DutieslResponsibilities , 11AA, p 2 F Jt> iN II ~ Afj I{ ~ LU Yeco 2cl Employer Name U l'JhIA^, J GO.t>~) 1 LQ "" fA,Alf Dates of Employment Iqq~-- lC}q (p AI. ,01" 4,:;)/ DAIIA~ y.. AI,A " ( Address'!!)/, 75.dD I Phone No Salary (Beginning & Ending) J. 97. . Cf)fJ ,",' j 35'"': il") {)( Supervisor' s Name G/i- 1'2y A IIp',..) Position Held f,::+- s 117.1 Rk _1'^ I"j Ac ~,I--Part(/ ~ Reason for Leavin~ r''WCtd'' 5iA'b/ t (' 0,-f' u::> 4rJ.; I R bl, j, . lJ,J . rl..),,)), / , DutieslResponsibili~ es C 2 "'. A /./; d, ~ i- i c' 1 I Q.cJ I,"'; .... .. J J " ~. J ' I' V -,' UJ I I- Please include any additional information that you think would be helpful to us in considering you for employment. U c:( LL J c( Z 0 l- e Q C STATEMENTS OF AFFIRMATION AND AUTHORIZATION AFFIRMA nON AUTHORlZAnON I understand that any employment offer will be contingent I authorize and consent person, finn, company, to every corporation, governmental agency, medical facility or practitioner, upon the successful completion of a pre- placement medical association, court, school, college, university or institution having examination and background investigation. As a part of the control of any documents, records and other information pertaining City' s requirement for a work force free from drugs, the pre- to me, to furnish such information, upon request by The City of placement medical examination will include a drug/alcohol I do also authorize the National Personnel Fort Walton Beach. test. Records Center and/or Anny/Navy/ Marine/ Air Force/ Coast Guard To the best of my knowledge all infonnation on this or their reserve components, to release infonnation in their files application is true and correct. I understand any false about me to the City or its authorized agents. statements, representations, or failure to disclose pertinent This Authorization will serve as a release of any and all infonnation is sufficient cause for dismissal from the City' s infonnation and for this purpose a photo copy shall be considered employment if hired. I understand that an employment is not an offer of an original and valid. I have read and fully understand the contents of this statement of employment contract and that either the City or I may Authorization" . terminate the employment relationship at any time. JlI':J/~ If 1'3/ S- Date Date If eligible, which Veterans' Preference category are you claiming? Please indicate number from Veteran' s Preference Category fonn) FOR OFFICE USE ONLY - APPLICANT PLEASE DO NOT WRITE IN SECTIONS BELOW Human Resources De artment Hirin Date Application Entered Date Applicant Interviewed Postcard Receipt Applicant' s Status (please check appropriate box) Log Book [] S Applicant selected Entered by (initials) N Did not show for interview I Insufficient applicable experience Q Does not meet minimum qualifications Forwarded to M Better matched candidate was chosen R Job was offered but rejected Department B Not best qualified Comments: Date Returned Filed by Interviewer' s Initials 02/ 17/ 2006 07: 39 9403497206 FMS PAGE 02 Management antI Budget * 215 E. McKinney * DeJfto1f, Taas 76201 940) 349- 8320 * DFW MetrQ ( 971) 434~2259 * Fax (94fJ) 349- 7206 MEMORANDUM Date: August 6, 2004 To: Deloitte & Touche LLP From: William Michael Rodgers, Chief Accountant Re: Impact Fees This memorandum documents the assessment and collection of the City of Denton' s water and wastewater impact fees. A copy of the ordinance is attached