agenda item# palm beach county board of …pbcgov.com/pubinf/agenda/20121016/6c1.pdf · ii. review...

PALM BEACH COUNTY

BOARD OF COUNTY COMMISSIONERS

BOARD APPOINTMENT SUMMARY

Agenda Item#

=============================================----------------======= Meeting Date:

Department:

Submitted By:

Advisory Board Name:

OCTOBER 16, 2012

PLANNING, ZONING & BUILDING

CONTRAC::TORS CERTIFICATION DIVISION

CONSTRUCTION INDUSTRY LICENSING BOARD

==============================================================------------I. EXECUTIVE BRIEF

Motion and Title: Staff recommends a motion to approve: A.) Appointment of two (2) new members and B.) Re-appointment of two (2) current members to the Construction Industry Licensing Board (CILB)

A.) Appoint Donald Sharkey

Edward Lynch

B.) Re-appoint John Desnoyers

Stanley Goodman

Summary:

Seat# Requirement Term 2 Electrical Contractor 10/16/12-9/30/15

11 Building Contractor 10/16/12-9/30/15

Seat# Requirement Term 9 Engineer 10/16/12-9/30/15

14 Consumer 10/16/12-9/30/15

Nominated by Comm. Burdick Comm. Abrams Comm. Marcus Comm. Vana Comm. Aaronson Comm. Burdick Comm. Abrams Comm. Marcus Comm. Vana Comm. Aaronson Nominated by Comm. Burdick Comm. Abrams Comm. Marcus Comm. Vana Comm. Aaronson Comm. Burdick Comm. Abrams Comm. Vana Comm. Aaronson

The Construction Industry Licensing Board was established by Special Act, Chapter 67-1876, Laws of Florida as amended. The Special Act and subsequently Florida State Statute sets forth the membership of the Board, which consists of fifteen (15) memhers. The above named members have been recommended by the International Association of Electrical Inspectors (IAEI) (Mr. Sharkey); the Associated Builders of America Inc (ABC) (Mr. Lynch); and the Florida Engineering Society (FES) (Mr. Desnoyers). Mr. Donald Sharkey was nominated to replace Mr. Nelson Dozier who is unable to continue to serve. Mr. Edward Lynch was nominated to replace Mr. Ezra Saffold who resigned. The Florida Engineering Society recommends the re-appointment of Mr. John Desnoyers to complete a second term. Mr. Stanley Goodman has also expressed a willingness to continue serving the board. The nominations represent the seats for an Electrical Contractor, a Building Contractor, an Engineer and a Consumer Member as cited in the Special Act and F.S. § 489.131 establishing the Construction Industry Licensing Board. Memorandums were sent to the Board of County Commissioners on September 10, 2012 advising of the vacant position; No other nominations were received. Countywide (SF)

Background and Justification: The membership of the construction board consists of 15 members: two (2) general contractors, one (1) member of the following categories; building; residential; electrical; plumbing; HARV; roofing; swimming pool; architect; engineer and a building official. In addition, F.S. § 489.131 requires that we have three (3) consumer representatives. The Board is to establish qualifications and competency of contractors that work within the County. The Board also provides for the testing and licensing of these contractors and is empowered to discipline licenses. The Cl LB has 14 member,, seats currently filled and a diversity count of White: 12 (85. 72%) Black: 1 (7.14%) and Hispanic: 1 (7.14%). The gender ratio (male: female) is 12:2.

Attachments: 1. Board Appointment Forms. 2. Recommendation from the International Association of Electrical Inspectors (IAEI), the Associated

Builders of America Inc (ABC), and the Florida Engineering Society (FES). 3. Resumes for Mr. Sharke,, Mr. Lynch, Mr. Desnoyers, & Mr. Goodman. 4. Special Act (excerpt regarding membership composition)

~::::.;.ended Bz~:,cii~t~--0:Jl&//z_ ===========

Legal Sufficiency: ~ J- tr"7 /0 ( d--{ (:)., Assistant County Attorney Date

II. REVIEW COMMENTS

A. Other Department Review:

Department Director

REVISED 06/92 ADM FORM 03 (THIS SUMMARY IS NOT TO BE USED AS A BASIS FOR PAYMENT.)

2 H:\CILB-BOARD\BOARD.APPOINTMENTS\2012\BDAPPT.MAR.DOC

BOARDS/COMMITTEES APPLICATION CHECKLIST This form must be completed by Staff and accompany the Board Appointment Item

Proposed BCC Date: 10/16/12

Applicant's Name: Donald G Sharkey

Dept/Division: Contractors Certification/ PZB

Board/Committee Name: Construction Industry Licensing Board of PBC Purely Advisory [ ] Not Purely Advisory [X]

# Description

1. Is Part I fullv completed and correct? . • .. . · ..

2. Is Part II fully completed? 3. Bioqraphv or resume included? 4. Is Aoolicant a Palm Beach Countv resident? a. If "No", please explain:

5. Did Applicant disclose felony conviction? a. If "Yes", did staff review information? b. Based on review, does staff recommend Aoolicant for consideration? C. Please explain:

6. Did Applicant disclose contractual relationship(s)? If "Yes" complete Questions "a" and "b" below: If "No" skip to Question 7:

a. Board/Committee provides regulation, oversight, management

List Each Contract(s) Identified in Application or policy setting recommendations regarding the contract identified

(Check if "Yes")

b. Does Department Recommend Waiver and/or Disclosure ?,· •<(i,,;i >(: <(;;.;.;;.,. " ..•......... . '

.. : : . 7. Is Part Ill completed?

Completed by: Kurt Eismann (Print Name)

Department Head: Rebecca Caldwell (Print Name)

.. ',; . · ... /) /1

~r:2 -,

Yes

X

X X X

X

Board/Committee provides NO regulation, oversight, management or policy setting recommendations regarding the contract identified

(Check if "Yes)

Yes

. · • .. '

X

.. ~

To be completed by Administration if Staff answered "Yes" to Questions 5 or 6:

Administration (Initials): ____ _ Date: ____ _

Failure to complete this Checklist and/or incomplete Board Applications

will be returned to the Department

No N/A

: .

X X

X

X

Waiver Disclosure Required Required (Yor N) (Y or N)

No N/A X

· ... . . .·

Date: 9/2 ✓/4<

PALM BEACH COUNTY BOARD OF COUNTY COMMISSIONERS BOARDS/COMMITTEES APPLICATION

The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further,please attach a biography or resume to this form.

Section I (Department): (Please Print)

Board Name: _C_o_n_stnl_c_ti_on_In_d_u_stry--"--_L_ic_en_s_;_in__,g"'-B_oa_r_d_o_f_P_al_m_B---'-ea-'-c_h_C_o_u_n__.ty'----- Advisory [ ] Not Advisory [X]

[X] At Large Appointment or [ ] District Appointment /District #: __ _

Term of Appointment: 3 ----- Years. From: 10/16/2012 To: 9/30/2015

Seat Requirement: Electrical Contractor Seat #: ----------------------- 2

[ ]*Reappointment or [ X ] New Appointment

or [ to complete the term of Due to: [ ] ---------- resignation [ ] other

Completion of term to expire on:

*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: __ _

Section II (Applicant): (Please Print) APPLICANT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: Sharkey Donald G First Middle Last

Occupation/ Affiliation: Electrical Contractor / International Association of Electrical Inspectors (IAEI)

Owner[~' Employee [ ] Officer [ ]

Business Name: Current Connections Inc

Business Address: 1620 Hill Ave

City & State Mangonia Park, FL Zip Code: --~----'------------ 33407

Residence Address:

_J~v...,r,...::."'-: .... -l.....,"C.-=-..,...f' ___ r:_-1c_. ________ Zip Code: City & State

Home Phone: ----------- Business Phone: (561) 863-0010

Cell Phone: _(.,_5_6 ___.1 )_5_1_2-_02_1_7 _____ Fax:

Email Address:

Mailing Address Preference: [vjBusiness [ ] Residence

Have you ever been convicted of a felony: Yes ___ No v If Yes, state the court, nature of offense, disposition of case and date: ____________________ _

Minority Identification Code: [ ] Native-American

Page I of2

[«·t\1ale [ ] Female [ ] Hispanic-American [ ] Asian-American [ ] African-American [?J.-eaucasian

I

Section II Continued:

CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. Ifthere are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code:

Contract/Transaction No.

Ex: (R#XX-XXXX/PO XXX)

Department/Division

Parks & Recreation

Description of Services

General Maintenance

(Attach Additional Sheet(s), if necessary)

OR G NONE

10/01/11-09/30/12

All board members are required to read and complete training on Article XIII, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.

By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

1,./ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

l vi By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

• Applicant's Signature: A lcril Q i(J(/l,.t,,i a)rwd Name: 'Lhn Q l c\ :,bn r \.( <" l(Date: . f'>o · ;;.,o · 1 l.

Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.

Return this FORM to: Janeth Cervera, Contractors Certification Division

2300 N. Jog Road, Ste. 2W-61, West Palm Beach, FL 33411

Section III {Commissioner, if applicable):

October 16, 2012 Appointment to be made at BCC Meeting on:

Commissioner's Signature: U 1 <....kif-::,; 08-11 I?~ i::1 Date: -----J¼,.._,./_,1 ..... ·,t-/_,@.c=..._.I_L-=-=·-~ I

Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/0 I /20 I I


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach ·a biography or resume to this form.


Board Name: _C_o_n_stru_c_ti_on_In_d_u_stry_.___L_ic_en_s_in_,g.,_B_oar_d_o_f_P_alm_B_ea_c_h_C_o_u_n_.ty'----- Advisory [ ] Not Advisory [X]



Seat Requirement: Electrical Contractor ----------------------- Seat#: 2


or to complete the term of ---------- Due to: [ ] resignation [ ] other





Occupation/ Affiliation: Electrical Contractor I International Association of Electrical Inspectors (IAEI)

Owner [v],.,..,. Employee [ ] Officer [ ]



City & State _M_a_n""'go_n_i_a_P_ar_k--'-, _F_L __________ ziiCcide: 33407

Residence Address:

J ._r q: -i -c:, r f:-L Zip Code: -~T'. ~~~-----'---------City & State

Home Phone: ----------- Business Phone: (561) 863-0010

Cell Phone: (561)512-0217 Fax: (56l)'f°.Ho·~-.5~f~O

Email Address: de, n G l°A, ~r r ·e,,., + c: .c~ n (\ e .. d-; C"! o .e., , . o e..+ Mailing Address Preference: [v(Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No v,... If Yes, state the court, nature of offense, disposition of case and date: ---------------------


Page 1 of2

[/,y'Male [ ] Female [ ] Hispanic-American [ ] Asian-American [ ] African-American [,¼Caucasian

---------------- ---- ----------


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code:



Department/Division

Parks & Recreation


General Maintenance


OR [Z] NONE

10/01/11-09/30/12


r.-.:1 t...:::J By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach

County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

-..,,,,. By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ ., 20 __

I vi By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

I: - , ./! J;, !J'\P/2 *Applicant's Signature: ",rvi( O t/._ h-ccW,tt{J. (,p-mted Name: r)-~r·in l d _e:iho c½'.e\fDate: E:~ · ?-£)· i L




Section III (Commissioner, if applicable): ,,-----.____

Appollltmontto be mado~C Moetinijl:~' ~@ Commissioner's Signature: lAJtt=- J--\t}~ /

October 16, 2012


Page 2 of2

Revised 08/01/2011


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach ti biography or resume to this form.

Section I {Department): (Please Print)

Board Name: _C_on_s_tru_ct_io_n_In_d_u_stry_,_L_ic_en_s_in_.g"-B_oa_r_d_o_f_P_al_m_B_ea_c_h_C_o_u_n--"ty ____ Advisory [ ) Not Advisory [X)

[X] At Large Appointment or [ ] District Appointment /District#: __ _




or [ to complete the term of ---------- Due to: [ ] resignation [ ] other



Section II {Applicant): (Please Print) APPLICANT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: Sharkey Last

Occupation/ Affiliation:

Business Name:

Business Address:

City & State

Residence Address:

City & State

Home Phone:

Cell Phone:

Email Address:

Donald G First Middle

Electrical Contractor I International Association of Electrical Inspectors (IAEI)

Owner ["1:.1/ Employee [ ] Officer [ ]

Current Connections Inc

1620 Hill Ave

Mangonia Park, FL Zip Code: -----~----------- 33407

J ✓' n ,· -~ -c., f' r::-1, Zip Code: ?;, ~1..:Vl ~:~• -~r, "-=--~~---.-----'--------- ~--=-~---'-==------------------- Business Phone: ~(5_6_1~) _86_3_-_00_1_0 __________ _

(561) 512-0217 Fax: ~-'---------- (561) ~j w:;;;~. 5 ~80

Mailing Address Preference: [-,,,,f'Business [ ] Residence

Have you ever been convicted of a felony: Yes ___ No \./ If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page 1 of2

[t:r'Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American [q-Caucasian


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.



Department/Division

Parks & Recreation


General Maintenance


OR 0 NONE

10/01/11-09/30/12



.,,,,.. By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

[2J By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

• Applicant's s;guature: A fr,/ Ii Q 1{f :tfl, Jl),yr.ted Name: u-.n a i cl ,':bo rk ""ljDate: 6 -"'~o . 1 z Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.




Appointment to be made at BCC Meeting on: October 16, 2012

Commissioner's Signature: ~ '/(_ /;:; .e..,.;f ~ hKL Date: '1 / 1'"6{I ?--. , . Co-ivv~. t.-o--~ ~YlA.JGLv~ 1

Pursuant to Florida s Pubhc Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/01/20 I I


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach a biography or resume to this form.


Board Name: _C_o_ns_tru_c_ti_on_In_d_u_stry_.__L_ic_e_ns_in_,g"'--B_o_ar_d_o_f_P_a_lm_B_e_ac_h_C_o_u_n~ty'------ Advisory [ I Not Advisory [X)


Term of Appointment: 3 Years. From: 10/16/2012 To: 9/30/2015 -----



or to complete the term of Due to: [ ] ---------- resignation [ ] other






Owner ['-1"" Employee [ ] Officer [ ]



City & State _M_a_n.,..go_n_i_a_P_ar_k_,_, _F_L __________ Zip Code: 33407

Residence Address:

City & State _J__,.....,""1pl"""-'-; ...... ·\....,,'C..""--'-r---.,_Fl--'-'-.-------- Zip Code:

Home Phone: ___________ Business Phofle: ___,,_(5_6_1,_) _86_3_-_00_1_0 __________ _

Cell Phone: (561) 512-0217 Fax: (561) '2:,tp':1;). 5 ~f,O Email Address: doo @ux:c M± a,n o e..c±i c,a ~, o e .. .+ Mailing Address Preference: [v(Business [ ] Residence

Have you ever been convicted ofa felony: Yes___ No v If Yes, state the court, nature of offense, disposition of case and date: ---------------------


Page 1 of2

[ ] Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American [ ] Caucasian





Department/Division

Parks & Recreation


General Maintenance


ORD NONE

10/01/11-09/30/12



✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on ------~ 20

B By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

• Applicant's Signature: I,. 6ta 1,LlJ.,6,1,~ted Name: rbn a Id .:::bo r:kel/Date:1:,- ?:,0- I 2




Section III {Commissioner. if applicable):

• . October 16 2012 Appomtment to be made at,X-C Meetmg on: ____ ' ,

Commissione,'s Signanrre: ~/ ~ Date: 9 ft is' /2 "7__ ., -........:__ I I Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/0 I /20 I I




Board Name: _C_o_ns_tru_ct_io_n_In_d_u_stry--"-L_ic_en_s_in_,g.,_B_oa_r_d_o_f_P_alm_B_ea_c_h_C_o_u_n_.ty ____ Advisory [ ) Not Advisory [X)



Seat Requirement: Seat#: -----------------------Electrical Contractor 2


or to complete the term of ---------- Due to: [ ] resignation [ ] other






Owner ['-1/ Employee [ ] Officer [ ]



City & State _M_a_n....,g'-on_i_a_P-'ar_k..,_, _F...;,L __________ Zip Code: 33407

Residence Address: •.•• ·-:1 ,,, ,.. '· -l .·-1 ·i-:- D.. - • 1. , .... · ~-, * t? t...,.,. • - _:Jj _ , ~ ~

J t' .-, . ,l .,,. ,, .f-'.--.. Zip Code: -~ ........... i .J=•~t-'---"' .... "-# '"--....---·-·--------

City & State

Home Phone: ----------- Business Phofie: (561) 863-0010

Cell Phone: (561) 512-0217 Fax: ~-~--------Email Address:

Mailing Address Preference: [·\,,f'Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No v .. If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page I of2

[ ] Male [ ] Hispanic-American






Department/Division

Parks & Recreation


General Maintenance


ORD NONE

10/01/11-09/30/12



v,,. By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ ., 20 __ .

I vi By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

• Applicant's Signature: ,1 {r'i),(Q {f,.;J.j). l ~)rted Name: 'Q-,no l cl .:bt:i rk <'!/Date: ·E:, · ",O · I l




Section III (Commissioner, if applicable):


Commissioner's Signature: /1i ~----._- Date: /tr-tf dZ--Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/01/2011

BOARDS/COMMITTEES APPLICATION CHECKLIST

This form must be completed by Staff and accompany the Board Appointment Item


Applicant's Name: Edward J Lynch

DepUDivision: Contractors Certification/ PZB


# Description

1. Is Part I fullv completed and correct? . ·. ~ . ·. Y. ,,:;l1l. > 7

;}:\ \. • c:· •: ' " / '·

' ',, ·,v,'.: .. .: .·

2. Is Part II fully completed? 3. Biography or resume included? 4. Is Aoolicant a Palm Beach Countv resident? a. If "No", please explain:

5. Did Aoolicant disclose felony conviction? a. If "Yes", did staff review information? b. Based on review, does staff recommend Aoolicant for consideration? C. Please explain:


a.

List Each Contract(s) Identified in Application

Completed by: -K=u~rt-E-is~m~an'--'-'n"'-------(Print Name)


Board/Committee provides regulation, oversight, management or policy setting recommendations regarding the contract identified

(Check if "Yes")

Yes

X

X X X

X


(Check if "Yes)

Yes


Administration (Initials): Date: ____ _

I

I



No

X

X

Waiver Required (Y or N}

No

"

N/A

:

X

X

Disclosure Required (Y or N}

N/A X

Date:~C....,


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further,please attach ii biograph for resfl'fJ'le to this form.


Board Name: _C_o_n_stnI_c_ti_on_In_d_u_stry......,,__L_ic_e_ns_in.....,g"'--B_o..:,.._ard_o_f_P_a_lm_B_ea...:...c'-h_C-=--o'-u_n~ty'--___ Advisory [ ] Not Advisory [XI


Term of Appointment: 3 Years. From: 10/16/2012 To: 9/30/2015

Seat Requirement: Building Contractor Seat#:


or [ to complete the term of ------------ Due to: [ ] resignation [ ] other



Section II {Applicant): (Please Print) APPLICANT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: Lynch Edward James First Middle Last

Occupation/ Affiliation: Building Contractor / Associated Builders and Contractors Inc. Florida East Coast Chapter (ABC)

Owner [ ] Employee [ ]

Business Name: DeLeon Industries LLC

Business Address: 6453 W. Rogers Circle, Ste C4

City & State Boca Raton, FL

Residence Address: 8584 Wendy Lane E

City & State West Palm Beach, FL

Home Phone: Business Phone:

Cell Phone: (561) 445-3139 Fax:

Email Address: [email protected]

Mailing Address Preference: [0 Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No V If Yes, state the court, nature of offense, disposition of case and date: ---

[ ] Female

Officer [ ]

Zip Code: 33487

Zip Code: 33411

(877) 425-9235

(877) 630-6095


[""Male M'Hispanic-American [ ] Asian-American [ ] African-American [ ] Caucasian

Page 1 of2


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions· to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.



Department/Division

Parks & Recreation

Descnption of Services

General Maintenance


OR~ NONE

10/01/11-09/30/12



✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 ~

By,; signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

'Applicant's Signature: &J,u.l'.l,J_ & ~ Printed Name: tbWl\,t,/) :r LVll»I I S/2. Date: f,-30 - /}





Api,oll1tment to be ma~CC Meeting on: . r

Commissioner's Signature: Utt: /3 µA cl .t---( October 16, 2012

Date: <;Jc /2 &. . /,RO lcb-, I I


Page 2 of2

Revised 08/01/2011

PALM BEACH COUNTY BOA.RD OF COUNTY COMMISSIONERS BOARDS/COMMITTEES APPLICATION

The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please qttach il biography or res"(lme to this form.


Board Name: _C_o_n_stru_c_ti_on_In_d_u_stry__.__L_ic_e_ns_in---'g"'--B_oa_r_d_o_f_P_a_lm_B_ea_c_h_C_o_u_n__.ty'------ Advisory [ ) Not Advisory [X)



Seat Requirement: _B_u_il_d_in_.,.g,_C_o_n_tr_a_ct_o_r ________________ Seat#:

[ ]*Reappointment or [ X ) New Appointment

or [ to complete the term of Due to: [ ] resignation ------------ [ ] other




Name: Lynch Edward James First Middle Last


Owner [ ] Employee [ ] Officer [ ]



City & State Boca Raton, FL Zip Code: 33487


City & State West Palm Beach, FL Zip Code: 33411

Home Phone: Business Phone: (877) 425-9235

Cell Phone: (561)445-3139 Fax: (877) 630-6095

Email Address: deleonindustr•[email protected]

Mailing Address Preference: [vf Business [ ] Residence

Have you ever been convicted of a felony: Yes ___ No \I If Yes, state the court, nature of offense, disposition ofcase and date: _____________________ _


Page 1 of2

~Male l¥f Hispanic-American






Department/Division

Parks & Recreation


General Maintenance


OR~ NONE

10/01/11-09/30/12


By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach County Code of Ethics, and I have r.-!ceived the required Ethics training (in the manner checked below):

✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ ,, 20~

AND

~ By) signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

• Applicant's Signature: &J,m;J_ & ~ Printed Name, EbWAt-1) :r l,..'J;l,'l>f I se Date: 1:,-30 - I 2 Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.




ppointment to be made ~C Me~tin~n A · @ October 16, 2012

Commissioner's Signature: atµ U-- BbfM8. _J____ Date: _9H/_,!_,1'-+/--l-1_..i'-------------Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public. Revised 08/0 I /20 I I

Page 2 of2


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Fur.ther, please {ltta'Ch a ~iogfaphy or res411J1i to this form.


Board Name: _C_o_ns_tru_ct_io_n_In_d_u_stry~L_ic_en_s_in~g~B_oa_r_d_o_f_P_al_m_B_ea_c_h_C_o_u_n~ty ____ Advisory [ ] Not Advisory [X)


Term of Appointment: Years. -----3 From: To: 9/30/2015 --------10/16/2012

Seat Requirement: Building Contractor Seat#:






Name: Lynch Edward James Last

Occupation/ Affiliation: First Middle

Building Contractor / Associated Builders and Contractors Inc. Florida East Coast Chapter (ABC)

Owner [ ] Employee [



City & State Boca Raton, FL


City & State West Palm Beach, FL

Home Phone: Business Phone:

Cell Phone: (561) 445-3139 Fax:

Email Address: [email protected]

Mailing Address Preference: [vj Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No V If Yes, state the court, nature of offense, disposition of case and date: ---

[ ] Female

] Officer [ ]

Zip Code: 33487

Zip Code: 33411

(877) 425-9235

(877) 630-6095


lYtMale M'Hispanic-American [ ] Asian-American [ ] African-American [ ] Caucasian

Page 1 of2




Ex: (R#:XX-XXXX/PO XXX)

Department/Division

Parks & Recreation


General Maintenance


OR 0 NONE

10/01/11-09/30/12

All board members are required to read and complete training on Article XIII, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment 'prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.

By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach County Code of Ethics, and I have r.:ceived the required Ethics training (in the manner checked below):

✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ ., 20~_

AND

0 B)1) signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

*Applicant's Signature: &J,,a:,,J!_ & ~~ Printed Name: 1,/)WI\Jtb :r k.V'-1'.>11 se Date: €,-30 -12 Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.





Commissioner's Signature: ~£J?e3-~ fc-ll Date: Cf/ I fs'/t ;2 C,o \/\. · It..~ 7': (Ylo.-/Lt!-U 5 1 ' Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/01/2011


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach a biography.or resµme to this form.


Board Name: _C_on_s_tru_ct_io_n_ln_d_u_stry_.__L_ic_e_ns_in__.g"--B_oa_r_d_o_f_P_a_lm_B_ea_c_h_C_o_u_n~ty,______ Advisory [ ] Not Advisory [X]


Tenn of Appointment: 3 Years. From: 10/16/2012 To: 9/30/2015 ----- --------

Seat Requirement: Building Contractor Seat#: ---~------------------- 11


or [ to complete the tenn of ____________ Due to: [ ] resignation [ ] other




Name: _L.._yn_c_h ____________ Ec:.:.d_w_ar..c:.:d ___________ J_am_es __________ _ Last First Middle





City & State Boca Raton, FL Zip Code: 33487


City & State West Palm Beach, FL Zip Code: 33411

Home Phone: Business Phone: (877) 425-9235

Cell Phone: (561) 445-3139 Fax: (877) 630-6095

Email Address: deleonindustri:.:[email protected]

Mailing Address Preference: [v1 Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No V If Yes, state the court, nature of offense, disposition of case and date: _____________________ _


Page 1 of2

[ 1 Male M"Hispanic-American





Ex: (R#XX-XXXX/PO XXX}

Department/Division

Parks & Recreation


General Maintenance


OR 0 NONE

10/01/11-09/30/12

All board members are required to read and complete training on Article XIII. the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.

By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach County Code of Ethics, and 1 have r~ceived the required Ethics training (in the manner checked below):

✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 ~

BY,i signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

•Applicant's Signatu,e: ~ & ~ Pdnted Name: !cl'iWAt-0 :r L'f'X>l I SR- Date: f,-30 - /2 Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.




Appointment to be mad~l/lfl,

Commissioner's Signature: _ 'I,//(~

October 16, 2012


Page 2 of2

Revised 08/01/2011


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attad, a

• biography tJ.r res~me to this form.


Board Name: _C_o_n_stru_c_ti_on_In_d_u_stry..........__L_ic_e_ns_i__,ng"'--B_o_ar_d_o_f_P_a_lm_B_ea_c_h_C_o_u_n_,,ty'---- Advisory I ] Not Advisory [X)



Seat Requirement: _B_u_il_d_in_,,g ..... C_o_n_tr_a_ct_o_r ________________ Seat#: H






Name: Lynch Edward James Last


Business Name:

Business Address:

City & State

Residence Address:

City & State

Home Phone:

Cell Phone:

Email Address:

First Middle Building Contractor / Associated Builders and Contractors Inc. Florida East Coast Chapter (ABC)


DeLeon Industries LLC

6453 W. Rogers Circle, Ste C4

Boca Raton, FL Zip Code: 33487

8584 Wendy Lane E

West Pahn Beach, FL Zip Code: 33411

Business Phone: (877) 425-9235

(561) 445-3139 Fax: (877) 630-6095

[email protected]

Mailing Address Preference: [yf' Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No V If Yes, state the court, nature of offense, disposition of case and date: ___ ------~------------

Minority Identification Code: [ J Native-American

Page 1 of2

[ 1 Male M' Hispanic-American

[ ] Female [ J Asian-American [ ] African-American [ ] Caucasian




Ex: {R#XX-XXXX/PO XXX)

Department/Division

Parks & Recreation


General Maintenance


OR~ NONE

10/01/11-09/30/12


By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach County Code of Ethics, and I have r~ceived the required Ethics training (in the manner checked below):

✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20~_

A@

~ By:, signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State of Florida Code of Ethics:

• Applicant's Signature: &J,a,-uf. & ~ Printod Name: fhWI\Jtb :r L'/i1)04 I se Date: f,-30 - I 1 Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.




Appointment to be made at BCC M~eting on: October 16, 2012

Commissioner's Signature:_-,;1-~h-~-.---,-,,.,,...-~_-_,_· ------"--- Date: --J./'---"'~'-----+{_-__,J'----?--____ _ Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/01/201 I

BOARDS/COMMITTEES APPLICATION CHECKLIST

This form must be completed by Staff and accompany the Board Appointment Item


Applicant's Name: John Desnoyers

Dept/Division: Contractors Certification / PZB

Board/Committee Name: Construction Industry Licensing Board of PBC Purely Advisory [ ) Not Purely Advisory [X)

# Description Yes

1. Is Part I fullv completed and correct? X .··

2. Is Part II fully completed? X 3. Bioqraphv or resume included? X 4. Is Applicant a Palm Beach Countv resident? X a. If "No", please explain:

5. Did APPiicant disclose felonv conviction? a. If "Yes", did staff review information? b. Based on review, does staff recommend Applicant for consideration? X C. Please explain:


a. Board/Committee Board/Committee

provides regulation, provides NO regulation, oversight,

oversight, management management or policy List Each Contract(s) Identified in Application or policy setting

setting recommendations

recommendations regarding the contract regarding the contract identified

identified (Check if "Yes") (Check if "Yes)

Yes b. Does Department Recommend Waiver and/or Disclosure

. 7. Is Part Ill completed? X

Completed by: Kurt Eismann ~a~ (Print Name)


/ - -•.


Administration (Initials): ____ _ Date: ___ _



No NIA

.

X X

X

X

Waiver Disclosure Required Required (Y or N) (Yor N)

No N/A X

.

Date: 9.b-£ £ i.


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach a biography di'resumltii this form.


Board Name: _C_o_ns_tru_c_ti_on_In_d_u_stry~_L_ic_e_ns_in_,g"--B_oa_r_d_o_f_P_al_m_B_ea_c_h_C_o_u_n~ty ____ Advisory ( ] Not Advisory (X]

[X] At Large Appointment or [ ] District Appointment /District #:

Term of Appointment: 3 ----- Years. From: I 0/16/2012 To: 9/30/2015

Seat Requirement: Engineer Seat#: 9

[ X ]*Reappointment or [ ] New Appointment

Due to: r ] resignation otter L or to complete the tem1 of


*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: _,.....o __ Section II (Applicant): (Please Print) APPLICANT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: Desnoyers Last


Business Name:

Business Address:

John First

Engineer/ Florida Engineering Society (FES)

Owner [

SAFE

6625 Miami Lakes Drive

Employee [ ]

Middle

Officer [ ]

City & State _M_i_am_i L_ak_e_s,'-F_L ___________ Zip Code: 33014

Residence Address: 4075 NW 7th Court

City & State

Home Phone:

Delray Beach, FL Zip Code: -~--~----------- 33445

Business Phone: ------------ (305) 779-8597 Cell Phone: (56 l) 927-7105 Fax: -"'-~'---------- (561) Email Address: i [email protected]

Mailing Address Preference: [ ] Business )>(Residence

Have you ever been convicted of a felony: Yes___ No~ If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page I of2

"M'Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American ~aucasian


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions. to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and · transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.


Ex: {R#XX-XXXX/PO XXX)

Department/Division

Parks & Recreation

OR


General Maintenance

NONE

10/01/11-09/30/12

All board members are required to read and complete training on Article XIT1, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found · on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going. ~By signing below I acknowledge that I have read, understand, and agree to abMe by Article XIII, the Palm Beach County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

ls_ By watching the training program on the Web, DVD or VHS By attending a live presentation given on------~ 20

_0-.. By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State f rida Code of Ethics:

Date: Any questions and/or concerns ding Ar(cle X , the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www. almbeachcoun ethics.com or contact us via email at [email protected] or (561) 233-0724.

Return this FORM to: Janeth Cervera, Contractors Certification Division 2300 N. Jog Road, Ste. 2W-61, West Palm Beach, FL 33411

Section III (Commissioner. if applicable):

October 16, 2012 Appointment to be made ~C Meeting on:

Commissioner's Signature: w l4_l;-lt:.) Bu d~c Date: __ __,c;'-J/'--'--1=.:L"'---1--/-=a,..,o"'-·_,_/__,Q.__==---,~ Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public. Page 2 of2

Revised 08/01/2011

I I,

" I


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach. a biography o,:res~ml,:tothisform.


Board Name: _C_o_n_stru_c_ti_on_In_d_u_stry--"-_L_ic_e_ns_i_,ng"'----B_o_ar_d_o_f_P_a_lm_B_ea_c_h_C_o_u_n_.ty'----- Advisory ( I Not Advisory (X)

[X] At Large Appointment or [ ] District Appointment /District#: \

Term of Appointment: 3 Years. From: 10/16/2012 To: 9/30/2015 -----Seat Requirement: Engineer Seat#: 9

[ X ]*Reappointment or [ ] New Appointment or [ to complete the tem1 of Due to: r ] resignation ] otter L


*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: _..;.o __ Section II (Applicant): (Please Print) APPLICANT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT



Business Name:

Business Address:

John First


Owner [

SAFE


Employee [ ]

Middle

Officer [ ]

City & State Miami Lakes, FL Zip Code: ----~'------------- 33014


City & State

Home Phone:

Delray Beach, FL Zip Code: -----"-__ __.__ __________ _ 33445 ____________ Business Phone: (305) 779-8597

Cell Phone: (561) 927-7105 Fax: ----'--'------------ (561) Email Address: j [email protected]


Have you ever been convicted ofa felony: Yes___ No A If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page 1 of2

~Male [ ] Hispanic-American



CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions. to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. lfthere are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.


Ex: <R#XX-XXXX/PO XXX)

Department/Division

Parks & Recreation


General Maintenance 10/01/11-09/30/12

All board members are required to read and complete training on Article XITI, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going. ~By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach .. County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

,&_ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

a By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine · Amendment & State f rida Code of Ethics:

·, *Applicant's Signature: , .:f f b r;;i;rJo1(;C,£ Date: °( / 1o f tz-. >Any questions and/or concerns ~Qrding Art;cle X , the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www. almbeachcoun ethics.com or contact us via email at [email protected] or (561) 233-0724.


Section III (Commissioner, if applicable): · . . October 16 2012

. Appomtment to be made atee~ Meetmg i\ I ' Commissioner's Signature: ~ltJJLt: ~ Date: -~--+---l_1 __ \~t~{ ______ _ Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public. Revised 08/01/2011 Page 2 of2


,,·.:,

The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach a biography or resumisto this form.


Board Name: _C_o_ns_tru_c_ti_on_In_d_u_stry......__L_ic_en_s_in__,g"--B_oa_r_d_o_f_P_al_m_B_ea_c_h_C_o_u_n_..,_ty ____ Advisory I I Not Advisory (X)

[X] At Large Appointment or [ ) District Appointment /District #:

Tenn of Appointment: 3 Years. From: 10/16/2012 To: 9/30/2015


[ X )*Reappointment or [ ] New Appointment or to complete the tem1 of Due to: [ ] resignation otter Completion of term to expire on:

*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: __ o __ Section II (Applicant): (Please Print) APPLICANT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT



Business Name:

Business Address:

John First

Engineer I Florida Engineering Society (FES)

Owner [ ]

SAFE


Employee [ ]

Middle

Officer [ ]

City & State Miami Lakes, FL Zip Code: ----~------------ 33014

Residence Address: 4075 NW 7th Court City & State

Home Phone:

Delray Beach, FL Zip Code: --~-~~----------- 33445

Business Phone: ------------ (305) 779-8597 Cell Phone: (561) 927-7105 Fax: ~-~--------- (561) Email Address: j [email protected]


Have you ever been convicted of a felony: Yes___ No A If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page I of2

~Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American }<tfaucasian

I


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions.to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.



Department/Division

Parks & Recreation


General Maintenance

NONE

10/01/11-09/30/12

All board members are required to read and complete training on Article XIH, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going. ~By signing below I acknowledge that I have read, understand, and agree to abid~ by Article XIII, the Palm Beach County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

K_ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

g_ By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State f rida Code of Ethics:

.:ff. b b ~rJi}j(s(L> Date: . Any questions and/or concerns ~ding Art:cle X , the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www. almbeachcoun ethics.com or contact us via email at [email protected] or (561) 233-0724.




Comm;ss;oner's s;gnature: ~ ,Ii: he.T~ fiAL- Date: "I /1'41 '>-• > • • • tt. ~/'-e.,J,'\ . ~0--U .s / Pursuant to Florida s Public Records La==t may be reviewed and photocopied by members of the public. Page 2 of2




Section I (Department}: (Please Print)

Board Name: _C_on_s_tru_ct_io_n_In_d_u_stry__,__L_ic_en_s_in_,g._B_oa_r_d_o_f_P_al_m_B_ea_c_h_C_o_u_n~ty ____ Advisory ( I Not Advisory [X]

[X] At Large Appointment or [ ] District Appointment /District#:




or to complete the tem1 of Due to: [ ] resignation [ ] ott.cr


*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: __ o __




Business Name:

Business Address:

John First


Owner [

SAFE


Employee [ ]

Middle

Officer [ ]

City & State _M_i_am_i _L_ak_e_s,'-F_L ___________ Zip Code: 33014

Residence Address: 407 5 NW 7th Court

City & State

Home Phone:

_D_el_ra_,yc,_B_ea_c_h,.._, F_L ___________ Zip Code: 33445

Business Phone: ------------ (305) 779-8597

Cell Phone: (56 l) 927-7105 Fax: ~~~--------- (561)

Email Address: j des no ye r s@c om cast.net


Have you ever been convicted ofa felony: Yes___ No A If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page 1 of2

'M"Male [ ] Hispanic-American



CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions_ to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.



Department/Division

Parks & Recreation

OR


General Maintenance 10/01/11-09/30/12

NONE


~By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm Beach County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

K By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

g__ By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State f •rida Code of Ethics:

Date:

Any questions and/or concerns rding Art\:;le X , the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www. almbeachcoun ethics.com or contact us via email at [email protected] or (561) 233-0724.




. . October 16 2012 Appomtment to be made at BCC Meetmg on: '

Commissione,'s Signature:~~~ Date: ijrrk// z_ Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/01/2011


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further,please attach a biography or, r'esiime'to this form.


Board Name: _C_o_ns_tru_c_ti_on_In_d_u_stry~_L_ic_en_s_in_,g"-B_oar_d_o_f_P_al_m_B_ea_c_h_C_o_u_n~ty ____ Advisory ( ) Not Advisory (X)

[X] At Large Appointment or [ ] District Appointment /District#:



[ X ]*Reappointment or [ J New Appointment or [ to complete the tem1 of Due to: [ ] resignation [ ] otter Completion of term to expire on:

*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: --"'O __




Business Name:

Business Address:

John First

Engineer I Florida Engineering Society (FES)

Owner [

SAFE


Employee [ ]

Middle

Officer [ ]

City & State _M_i_am_i L_a_k_e~s,'-F_L ___________ Zip Code: 33014


City & State

Home Phone:

_D_el_ra"""y_B_e_a_c_h,.__, F_L ___________ Zip Code: 33445 ____________ Business Phone: (305) 779-8597

Cell Phone: (561) 927-7105 Fax: __,___,__ ________ _ (561) Email Address: j [email protected]

Mailing Address Preference: [ ] Business J><Residence

Have you ever been convicted of a felony: Yes ___ No A If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Pagel of2

'M'Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American }<If aucasian

I I


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions. to this prohibition include awards made under sealed competitive bids, certain emergency and sole source purchases, and · transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.


Ex: <R#XX-XXXX/PO XXX)

Department/Division

Parks & Recreation

OR


General Maintenance

NONE

10/01/11-09/30/12

All board members are required to read and complete training on Article XITI, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going. ~By signing below I acknowledge that I have read, understand, and agree to abid_e by Article XIII, the Palm Beach County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

K By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

g_ By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State f rida Code of Ethics:

Date: Any questions and/or concerns i!fding Art;cle X , the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www. almbeachcoun ethics.com or contact us via email at [email protected] or (561) 233-0724.




Commissioner's Signature:_--.,1--rp-J;t,,t;,.,.~=---__.-~2._,...,-;.=• .,.-:.,9--'-"-::::::::::.::.:::::_--_'--_ Date: __ _,./_6...__-_{~_-_I_~ ____ _ Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public. Page 2 of2

Revised 08/01/201 I

BOARDS/COMMITTEES APPLICATION CHECKLIST This form must be completed by Staff and accompany the Board Appointment Item


Applicant's Name: Stanley Goodman

Dept/Division: Contractors Certification / PZB


# Description

1. Is Part I fully completed and correct?

2. Is Part II fully completed? 3. BioaraohY or resume included? 4. Is APPiicant a Palm Beach County resident? a. If "No", please explain:

5. Did Aoolicant disclose felony conviction? a. If "Yes", did staff review information? b. Based on review, does staff recommend Applicant for consideration? C. Please explain:


a. Board/Committee provides regulation, oversight, management

List Each Contract(s) Identified in Application or policy setting recommendations regarding the contract identified

(Check if "Yes")

b. Does Department Recommend Waiver and/or Disclosure

7. Is Part Ill completed?

Completed by: Kurt Eismann (Print Name)


,1

#tl ,

Yes

X

X X X

X


(Check if "Yes)

Yes

X

____,


Administration (Initials): ____ _ Date: ___ _



No N/A

X X

X

X

Waiver Disclosure Required Required (Yor N) (Yor N)

No N/A X

Date: 1&, /41


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. F'urther;please:attach, a hiograpliyt,r.MsumelQ thisjd'rm;'


Board Name: _C_o_n_stru_c_ti_on_In_d;_u_stry__.__L_ic_en_s_in_,g.,_B_oa_r_d_o_f_P..:.alm __ B_ea_c_h_C_o_u_n_.ty'----- Advisory [ ) Not Advisory [XI


Tenn of Appointment: Years. -----3 From: To: 9/30/2015 --------I 0/16/2012

Seat Requirement: Consumer Member ----------------------- Seat#: 14

[ X ]*Reappointment or ( ] New Appointment

or to complete the term of ------------ Due to: [ ] resignation [ ] other


*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: _ _._O __


Name: Goodman. Last


Business Name:

Business Address:

City & State

Residence Address:

n/a

Owner [

n/a

n/a

n/a

Stanley First

Employee [ ]

-----------------7130 Via Genova

Zip Code:

· City & State

Home Phone:

_D_el_r__,ay~B_ea_c_h,_, F_L ___________ Zip Code:

_(~5_6_,1)~6_3_8_-8_9_2_2 ______ Business Phone: n/a

Cell Phone: ~ F~ n/a ------------Email Address: stand o t l [email protected]

Mailing Address Preference: [ ] Business [ ) Residence

Middle

Officer [ ]

n/a

33446

Have you ever been convicted of a felony: Yes___ No -JL-If Yes, stat.e the court, nature of offense, disposition of case and date: ____________________ _


Page I of2

['A Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American p4 Caucasian


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awm-d:; made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations

' regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.



Department/Division

Parks & Recreation


General Maintenance


OR[Z] NONE

10/01/11-09/30/12

All board members are required to read ancj ~.9mplete training on Article XIII, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.


✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

[ZI By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State f Florida Cf/de o/thics:

* Applicant's Signature· J/.F,A,HP'V- ~ Printed Name: ~5---'--rfJ_fv._l.u_t __ c;_o_,..1_P_ffl_.A_µIDate: i/3o)1 Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.



Section III (Commissioner. if applicable):

October 16, 2012 Appointment to he mad~ Meeting on:

Commissioner's Signature: t -J/;, ~1.,u:/_, .:11t';, Date: 9j; :i_ /t1._o , 2. "" Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public. Revised 08/01/20 I I

Page 2 of2


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. Thisforrrz MUST. BECO~PLETED IN FULL. Answer "none" or "not applicable" where appropriate, Further,piease attack a bivgraphyir,ri¢suitlelQ thisfor~


Board Name: _C_o_n_stru_c_ti_on_In_d_u_stry--"---_L_ic_e_ns_in___,g.,__B_o_ar_d_o_f_P_al_m_B_e_ac_h_C_o_u_n~ty'---___ Advisory [ ] Not Advisory (X]


Term of Appointment: 3 Years. From: 10/16/2012 To: 9/30/2015

Seat Requirement: Consumer Member ----------------------- Seat#: 14

[ X ]*Reappointment or { ] New Appointment


Completion oftenn to expire on:

*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: --=-0 __

Section II (Applicant}: (Please Print) APPLIC4NT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: Goodman, Last


Business Name:

Business Address:

n/a

Owner [

n/a

n/a

Stanley First

Employee [ ]

City & State _n/_a _______________ Zip Code:

Residence Address:

· City & State

Home Phone:

Cell Phone:

Email Address:

7130 Via Genova

Delray Beach, FL

___,_(5_6_1 ),_6_3_8_-8_9-'2..::.2_______ Business Phone:

_n/_a ___________ Fax:

standot l [email protected]

Mailing Address Preference: [ ] Business [ ] Residence

Zip Code:

n/a

n/a

Middle

Officer [ ]

n/a

33446

Have you ever been convicted of a felony: Yes___ No ~ If Yes, stat~ the court, nature of offense, disposition of case and date: ____________________ _

Minority Identification Code: [ T Native-American

Page 1 of2

r;4 Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American p4 Caucasian


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awitrd::; made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government ancl you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.

Contractffransaction No.

Ex: (R#:XX-XXXX/PO XXX)

-------·--·--

Department/Division

Parks & Recreation


General Maintenance


OR[ZJ NONE

10/01/11-09/30/12

All board members are required to read ancj i;gmplete training on Article XIII, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.


✓ By watching the training program on the Web, DVD or VHS By attending a live presentation given on 20 __ ------~

understand and agree to abide by the Guide to the Sunshine





Appointment to be made October 16, 2012


Page 2 of2

Revised 08/01/201 I


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Further, please attach a biography or resume ti> this form;


Board Name: Construction Industry Licensing Board of Palm Beach County Advisory [ ] Not Advisory IX]



Seat Requirement: Consumer Member Seat#: 14


or [ to complete the term of Due to: [ ] ------------ resignation [ ] other


*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: ---0 __

Section II (Applicant): (Please Print) APPLIC4NT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: _G_o_od_m_an_, ___________ St_a_nl_e,t._y ______________________ _ Last First Middle

Occupation/Affiliation: n/a -----------------------------------

Business Name:

Business Address:

City & State

Residence Address:

City & State

Home Phone:

Cell Phone:

Email Address:

Owner [

n/a

n/a

n/a

Employee [ ]

-----------------7130 Via Genova

Zip Code:

_D_e_lr....,ay~B_ea_c_h.,_, _F_L __________ Zip Code:

(561) 638-8922 Business Phone: n/a

n/a Fax: n/a

standot l [email protected]

Mailing Address Preference: [ ] Business [ ] Residence

Have you ever been convicted of a felony: Yes___ No ~'j.. __

Officer [ ]

n/a

33446

If Yes, state the court, nature of offense, disposition of case and date: ____________________ _


Page 1 of2

r,4 Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American p<1 Caucasian


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awiird:.; made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government anct you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.

Contractffransaction No.


Department/Division

Parks & Recreation


General Maintenance


OR [Z] NONE

10/01/11-09/30/12

All board members are required to read an<) ~gmplete training on Article XIII, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.palmbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.

By signing below I acknowledge that I have read, understand, and agree to abide by Article XIII, the Palm County Code of Ethics, and I have received the required Ethics training (in the manner checked below):

/ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

Beach

read, understand and agree to abide by the Guide to the Sunshine





: . October 16 2012 Appomtment to be made at Bf f ~1)f;. on~ '

Commissioner'sSignature: ~~ Date: 9Jg/tz. Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2

Revised 08/01/2011


The information provided on this form will be used by County Commissioners and/or the entire Board in considering your nomination. This form MUST BE COMPLETED IN FULL. Answer "none" or "not applicable" where appropriate. Ji'urther;;pl~ase attach a biograplif otreSllme tQ fhisjorm.


Board Name: --'Cc...::o_n_stru_c_ti_on_In_d....:.u-=-stry~..:...L..:...ic-=-e....:.ns....:.i2ng"'-=B-=-o-'-'-ar....:.d_o_f_P....:.a---'lm:c:...::..B-=-e.:::.cac-=-h:..._C::..co:..._u'-n--'-'ty'--___ Advisory ( ] Not Advisory (X]

[X] At Large Appointment or [ ) District Appointment /District#: __ _

Term of Appointment: Years. -----3 From: To: 9/30/2015 --------10/16/2012

Seat Requirement: Consumer Member Seat#: -----"-=----------------- 14

[ X ]*Reappointment or [ ) New Appointment

or to complete the term of ------------ Due to: [ ) resignation [ ] other


*When a person is being considered for reappointment, the number of previous disclosed voting conflicts during the previous term shall be considered by the Board of County Commissioners: _ _..a-0 __

Section II (Applicant): (Please Print) APPLIC4ivT, UNLESS EXEMPTED, MUST BE A COUNTY RESIDENT

Name: Goodman, Stanley Last


Business Name:

Business Address:

City & State

Residence Address:

· City & State

Home Phone:

Cell Phone:

Email Address:

n/a

Owner [

n/a

n/a

n/a

7130 Via Genova

Delray Beach, FL

First

Employee [ ]

~(5_6_1)~6_3_8_-8_9_2_2 ______ Business Phone:

n/a Fax: ------------stand o t [email protected]

Mailing Address Preference: [ ] Business [ ) Residence

Have you ever been convicted ofa felony: Yes___ No __ _

Zip Code:

Zip Code:

n/a

n/a

Middle

Officer [ )

n/a

33446

If Yes, state the court, nature of offense, disposition of case and date: ____________________ _

Minority Identification Code: [ JNative-American

Page 1 of2

['f.i Male [ ] Hispanic-American

[ ] Female [ ] Asian-American [ ] African-American ~ Caucasian


CONTRACTUAL RELATIONSHIPS: Pursuant to Article XIII, Sec. 2-443 of the Palm Beach County Code of Ethics, advisory board members are prohibited from entering into any contract or other transaction for goods or services with Palm Beach County. Exceptions to this prohibition include awiird:; made under sealed competitive bids, certain emergency and sole source purchases, and transactions that do not exceed $500 per year in aggregate. These exemptions are described in the Code. This prohibition does not apply when the advisory board member's board provides no regulation, oversight, management, or policy-setting recommendations regarding the subject contract or transaction and the contract or transaction is disclosed at a public meeting of the Board of County Commissioners. To determine compliance with this provision, it is necessary that you, as a board member applicant, identify all contractual relationships between Palm Beach County government and you as an individual, directly or indirectly, or your employer or business. This information should be provided in the space below. If there are no contracts or transactions to report, please verify that none exist. Staff will review this information and determine if you are eligible to serve or if you may be eligible for an exception or waiver pursuant to the code.



Department/Division

Parks & Recreation


General Maintenance


OR[ZJ NONE

10/01/11-09/30/12

All board members are required to read ancj ~9mplete training on Article XIII, the Palm Beach County Code of Ethics, and read the Guide to the Sunshine Amendment prior to appointment/reappointment. Article XIII, and the training requirement can be found on the web at: http://www.pa1mbeachcountyethics.com/training.htm. Keep in mind this requirement is on-going.


/ By watching the training program on the Web, DVD or VHS By attending a live presentation given on _______ , 20 __

~ By signing below I acknowledge that I have read, understand and agree to abide by the Guide to the Sunshine Amendment & State f Florida Cie o/thics:

* Applicant's Signature· / Afi'hlP/,"'-' ~ Printed Name: .,_}..:..._11-J_/ll._t_li,:;_f __ G_o_o_p_tn_.A_JDate: ik/,1 Any questions and/or concerns regarding Article XIII, the Palm Beach County Code of Ethics, please visit the Commission on Ethics website www.palmbeachcountyethics.com or contact us via email at [email protected] or (561) 233-0724.




Appointment to be made at BCC Meeting on:

/p ·-f'-7T) ;,,. .,..., ,- . • • , l-z;,,-- ' C Comm1ss1oner's Signature: y-c ~

October 16, 2012

Date: / lJ .,,.. t/ - / 2-, Pursuant to Florida's Public Records Law, this document may be reviewed and photocopied by members of the public.

Page 2 of2


2012 OFFICERS

ERIC WASSER PRESIDENT

GLEN LABONTE 1st VICE PRESIDENT

STEVE NAUMANN 2nd VICE PRESIDENT TREASURER

DAN PRATER SECRETARY

BOARD OF DIRECTORS

VINNY BURDO CHAIRMAN

ELLIS BAIRD LEONARD DEVINE DAVE HOLT JAKE LEAHY DEBBIE NUTTER BOVELL RICHARDS KARL SWIERZKO

HONORARY MEMBERS

TIM VAN FOSSEN LEONARD DEVINE

International Association of Electrical Inspectors

Kurt Eismann,

Southern Section * Florida Chapter PALM BEACH COUNTY DIVISION

Director Contractors Certification Palm Beach County 2300 North Jog Road West Palm Beach, FL 33411

Re: CILB / PBC Nominations

Dear Mr. Eismann,

The Palm Beach County Division of the International Association of Electrical Inspectors, IAEI, received your letter, requesting a nominee to fill the vacancy for an electrical contractor on the Palm Beach County Construction Industry Licensing Board.

At our August 21, 2012 meeting, after a short discussion, the members voted to support our well respected and longtime member, Donald G. Sharkey. Don is the qualifier for his local electrical contracting business, Current Connections, and has been in business in PBC for 28 years. We know Don to be very conscientious and knowledgeable of the Codes, along with a good common sense approach to issues. We also know that he previously served with distinction on the CILB.

This Division of IAEI does not know anyone else that we could recommend more to serve on the PBC CILB.

On behalf of the PBC Div. IAEI

Dan Prater Secretary PBC IAEI

P.O. Box 174 Jupiter, Florida 33468-0174

Associated Builders and Contractors, Inc.

Florida East Coast Chapter

Chairman Clay Fischer

Woodland Construction Co., Inc.

Chairman Elect Scott R. Moss

Moss and Associates

Immediate Past Chairman Randall Lebolo

Lebolo Construction Management, Inc.

First Vice Chairman George Cuesta

Cuesta Construction

Second Vice Chairman Jesus Vazquez

Facchina Construction of Florida, LLC.

Miami-Dade Council Chairman Antonio Obregon

Formrite Construction, LLC

Space Coast Council Chairman Felix Perez

Woodland Construction Co., Inc.

Directors

Carlos Ardavin Jr. Matrix Construction Group, Inc.

John Bennett Coastal Construction Group

Bill Bower Southeast Mechanical Contractors

Alberto Fernandez ANF Group, Inc.

Clinton Glass Balfour Beatty Construction

Chris Kennedy Suffolk Construction Co., Inc.

Casey K Lee DynaServ Florida, Inc.

Roy F. MacRobert Supermix/Superblock/Superpaver

Russell P. Nash William R. Nash, Inc.

Bill Parker lnSource, Inc.

Bernard Paul-Hus Hypower, Inc.

John Scherer Guld Building LLC

Brian A. Wolf, Esq. Smith, Currie & Hancock, LLP

Alternates

Juan Bauza Cellucrete Corp.

Monica Manolas CEMEX

Mike McWilliams SimplexGrinnell, LP

President and CEO Peter M. Dyga

ABC Florida East Coast Chapter

August 17, 2012

Kurt Eismann Director- Contractors Certification and Code Enforcement

3730 Coconut Creek Pkwy., Suite 200 Coconut Creek, FL 33066

Phone 954.984.0075 Fax 954.984.4905 www.abceastflorida.com

Palm Beach County Department of Building, Planning and Zoning 2300 North Jog Road West Palm, FL 33411-2741

Dear Kurt,

On behalf of Associated Builders and Contractors Florida East Coast Chapter, I proudly recommend Edward J. Lynch, Sr. for the vacant seat on the Construction Industry Licensing Board of Palm Beach County. We believe that Edward would be a fantastic

addition to this very important effort.

Mr. Lynch meets the requirements for this position based on the following: - He is currently a resident of Palm Beach County and has been since 2000 - He is currently licensed in the State of Florida #CGC1509578 - The License is in his name - Since 2005, Mr. Lynch has been actively engaged in construction in Palm Beach

County.

Associated Builders and Contractors Florida East Coast Chapter is the largest commercial construction association in Florida. Representing the interests of member companies from Key West to Melbourne, we truly are the Voice of Commercial Construction. We would be thrilled to have our member, Edward Lynch, represent us on the Palm Beach County CILB. Additional and pertinent information is enclosed.

August 24, 2012

Palm Beach County Planning, Zoning & Building Attn: Kurt Eismann - Director Construction Industry Licensing Board 2300 N Jog Road, West Palm Beach, FL 33411

Dear Mr. Eismann:

Florida Engineering Society

The Florida Engineering Society endorses Mr. Jean-Francois (John) Desnoyers, PE of Delray Beach, Florida, for re-appointment to the Construction Industry Licensing Board. Mr. Desnoyers is a highly qualified, accomplished and dedicated Licensed Professional Engineer and has been a member of the Florida Engineering Society for over 9 years. I am confident that, if reappointed, he will continue to serve the Board with the same degree of commitment and focus.

Thank you for your consideration of Mr. Desnoyers to this important Board position and I hope you will not hesitate to call me if you need further information.

Sincerely,

Frank H. Rudd Executive Director

125 S Gadsden St PO Box 750 Tallahassee, FL 32302-0750 850-224-7121

Fax: 850-222-4349 E-mail:[email protected] Web site: www.fleng.org

Current Connections, Inc. 1620 Hill A venue Mangonia Park, FL 33407

(561) 863-0010 Donald G. Sharkey (561) 863-5380 Fax

Vitae

Donald G. Sharkey President

Professional Certifications

State ofFlorida EC-0001253 August 1991

Palm Beach County Journeyman J-12358

July 1979

Professional Organizations

Association of General Contractors (AGC)

Board Member 1996 to 2008 Treasurer 2004 to 2008

Construction Industry Licensing Board

of Palm Beach County 1997-2003

Independent Electrical Contractors, Inc

International Association of Electrical Inspectors

Electrical Council of Florida

IEC Forum Group # 11

SUMMARY OF QUALIFICATIONS AND EXPERIENCE

Mr. Sharkey formed Current Connections, Inc in 1984, and has over 35 years of experience in the electrical industry. Specializing in commercial, industrial and institutional construction and renovation, projects include schools, nursing homes, public facilities, airport buildings, country clubs, storm water facilities, and marine projects.

KEY PROJECTS

• Polo Club of Boca Raton-Additions to an existing 75,000 sf clubhouse facility resulting in a 167,000 sf finished product. Included new tennis and golf pro shops, spa and fitness areas, indoor racquetball courts, and underground parking garage and larger, updated dining and bar areas. Boca Raton, FL Weitz Golflnternational, LLC. $2,955,000.

• Jupiter Hills Country Club--New construction of a 42,000 sf two-story clubhouse. Tequesta, FL. Weitz Golflnternational, LLC. $ 763,954.

• Palm Beach County 1916 Historic Courthouse Restoration West Palm Beach, FL. Hedrick Brothers Construction Co. $2,147,796.00

• Old Port Cove Marina North Basin-46 Slip Mega-Yacht Marina North Palm Beach, FL. The Murphy Construction Co. $1,251,122.00

• Old Port Cove Marina South Basin - 144 Slip Mega-Yacht Marina North Palm Beach, FL. The Murphy Construction Co. $2,770,000.00

• Palm Harbor Marina - 180 Slip Mega-Yacht Marina West Palm Beach, FL. Leisure Resorts, LLC. $3,020,537.00

• Port of Palm Beach-Refrigeration Power Station, Riviera Beach, FL. Port of Palm Beach. $ 500,940.00

• WPB V AMC Parking Deck - 400 space parking garage addition. Riviera Beach, Fl. The Clement Group $329,921.00

PROFESSIONAL HISTORY

• 1984-Present Current Connections, Inc

President. State certified electrical contractor specializing in commercial, institutional and industrial construction from St. Lucie to Miami-Dade Counties.

• 1976-1984 - Employed by various local electrical contractors in the capacities of General Foreman, Job Foreman, and Superintendent on residential, commercial, institutional and industrial projects throughout Palm Beach County.

Objective:

Edward J Lynch, Sr. 10269 Trianon Place

Wellington, Florida 33449 561.445.3139

Appointment to the Palm Beach County Construction Industry Licensing Board.

Experience:

2004 - Present

2001- 2002

2000- 2001

1995 - 2000

1993 -1996

1989 -1993

Education:

1983 -1987

DeLeon Industries, LLC (President, CEO) Construction Consulting, Construction Management, General Contractor, Electrical Contracting, Federal Contracting

International Interests, Inc. (President, CEO) Construction Consulting, Construction Managements, General Contractor, Program Management Telecommunications

Qserve Communications, Inc. (President, NE Operations) Construction Consulting, Construction Management, General Contractor, Program Management

DeLeon Industries, Inc. (President, CEO) Construction Consulting, Construction Management, General Contractor, Electrical Contractor, Tower Contractor, Excavation Contractor, National and International Program Management Telecommunications

R & L Electrical Contracting (CFO) National General Contractor, National Electrical Contractor, Construction Management

JRJ Contracting, Inc (COO) General Contractor, Construction Management, Telecommunications Construction, Commercial Construction

Drew University Major: Economics with Business Management Emphasis Minor: Spanish and Computer Science

Resume

Education

Registrations

Professional Affiliations

Professional Specialties

Professional History

2011

1993-2011

1991-1993

,,/\ .. E. SCIENTIFIC APPLICATIONS IN FORENSIC ENGINEERING LLC

Jean Francois Desnoyers, P .E.

Associates of Arts, Broward Community College, 1981 Bachelor of Science in Engineering, Florida Atlantic University, 1984 Masters of Science in Engineering, Florida Atlantic University, 1987 emphasis on structural, geotechnical, corrosion, and environmental engineering.

Florida Professional Engineer, PE 47885 Certified Special Inspector of Threshold Buildings, License No. 1060

Palm Beach County Construction Industry Licensing Board American Soils and Foundation Engineers Florida Engineering Society Florida Institute of Civil Engineers American Society for Civil Engineers American Council of Engineering Companies

Geotechnical, subsurface soil investigations and recommendations, determination of soil bearing capacity, foundation design, demucking, test pits, pressure grouting, vibroflotation, and dynamic compaction. Special inspection of reinforced masonry, structural steel, foundation systems, framing, drywall, and roofing systems. Threshold inspections of foundations, elevated slabs, exterior wall systems, light gage metal framing, metal decking, bolted and welded connections, columns and beams, and fire proofing.

Senior Civil/Geotechnical Engineer Scientific Applications in Forensic Engineering, LLC (SAFE) Miami Lakes, FL

Vice President of Engineering GFA International Delray Beach, FL

Principal Engineer Corrtech Consultants Inc .. Boca Raton, FL

Scientific Applications in Forensic Engineering. LLC • 6625 Miami Lakes Drive, Suite 417 • Miami Lakes, FL 33014 Toll Free: 877-711-2027 • Phone: 305-779-8597 • Fax: 305-777-3802

www.safe4claims.com

1988-1991

Brief Professional Biography

- ----~- - ~----

Engineering and Inspection Manager Florida Testing & Engineering Inc. Fort Lauderdale, FL

Mr. Desnoyers has extensive experience on projects involving soil investigations for land and marine foundation assessments, shallow and deep foundation design, rigid and flexible pavement design. His experience in threshold and special inspection includes low and high rise buildings of residential and commercial construction. His experience in construction materials testing includes the management of hundreds of projects involving earthwork quality control, building materials QA/QC and roadway construction testing.

Representative Project Experience

Senior Engineer for Geotechnical Projects:

• Geotechnical investigation for hi-rise and low-rise buildings in South Florida including: Las Olas City Center, Stiles Tower, Sunrise Harbour, Boca Resort and Club, Hard Rock Hotel and Casino, St-Regis Hotel, Coral Springs Automall parking garage, City Furniture Main Office/warehouse.

• Geotechnical investigation for thousands of single and multi-family residential structures in South Florida.

• Geotechnical investigation for bridge projects- Fort Lauderdale, Fl. Bridge# 865712, Castle Harbor Isle drive, Bridge# 865713, Fort Royal Isle, Bridge# 865729, East Las Olas over Himmarshee Canal, Bridge# 865770, Laguna Terrace, Bridge# 865773, West Lake Drive over Lucille River, Bridge# 865774, West Lake Drive over Mercedes River, Bridge# 865775, South Ocean Drive, Bridge# 865778, Harborage Isle Drive. Mr. Desnoyers was responsible for borings, laboratory soil classification and corrosion testing, field and laboratory testing procedure, and evaluation of subsurface rock and soil conditions.

Senior Engineer for Low and High Rise Structures:

• Consolidated Rental Car Facility -Ft. Lauderdale/Hollywood lnt'I Airport, 4.5 Million S.F .Parking Garage • Las Olas City Centre, Fort Lauderdale - 20+ story high rise • Stiles Tower, Fort Lauderdale - 20+ story high rise • Espirito Santos, Miami - 30+ story high rise • Las Olas Centre, Fort Lauderdale - 15+ story high rise • Sunrise Harbour, Fort Lauderdale - Twin 15+ story high rises • Boca Resort and Club, Boca Raton - 200+ million dollar expansion project • 2700 Singer Island, Singer Island - Twin 20+ story condominium • Resort at Singer Island, Singer Island - 20+ story hotel/ condominium • Hard Rock Hotel & Casino, Hollywood - 15 story hotel, 300K sq ft casino/conference, 7 story parking

garage • 900 Biscayne , Miami - 60+ story condominium • St. Regis Hotel, Fort Lauderdale - 20+ story hotel • Brickell Financial, Miami - 40+ story office building • Marlins Stadium, Miami - 37,000 seat covered baseball stadium

Page2

. . . . -·~ ,,: ·--~-~-· _ _,_·. :·:. :

Objective

Stanley Goodman 7130 Via Genova

Delray Beach, FL 33446 (561) 638-8922

[email protected]

Reappointment to the Palm Beach County Construction Industry Licensing Board

Education Queens College - Associate in Applied Science Western Illinois University - Bachelor of Arts University of North Carolina at Wilmington - Elementary Education Licensure (Post Retirement)

Relevant Experience Palm Beach County Fair Housing/Equal Opportunity Board Construction Industry Licensing Board of Palm Beach County, three years Board of Directors of Alliance of Delray Residential Associations, (a non-partisan civic association) five years Delegate to the Alliance of Delray Residential Associations, eight years President, Villa Borghese Home Owners Association, two terms Chairman and member of various committees at Villa Borghese Received award from NC Governor's office for volunteer work with children Board of Directors several synagogues Board of Directors Family Services, Wilmington NC Vice Commander Post 766 Jewish War Veterans, South Brunswick, NJ

Employment Experience JCPenney Company Inc. Corporate Office 6501 Legacy Drive, Plano TX 75024 May 1968 - June 1993

Division Control Manager - Retail and Catalog Children Division and Family Shoes Division.

Forecasted and presented to top management projections of all measureable factors. Developed and monitored training for all pertinent issues. Coordinated and was in charge of special projects, analyses and committees that supported company objectives. Evaluated monthly performance and issued reports projecting future performance. Developed production schedules for suppliers.

United States Air Force May 1958 - May 1962 Aircraft Control and Warning , Osan Korea, Trained Korean Air Force Servicemen. Using flight plans, identified aircraft called in by radar sites. Unidentified aircraft resulted in action by fighter jets. Lockport NY, monitored air traffic

Personal Married to wife Dorothy 52 years. Three daughters, six grandchildren

BOARD MEMBER QUALIFICATIONS

Chapter 67-1876, Section 3 (B) To be eligible for appointment each contractor member shall be:

(1) Actively engaged in the construction business in Palm Beach County and have held a certificate of competency in his name and have been so engaged for a period of not less than 5 consecutive years immediately before the date of his appointment, and be a resident of Palm Beach County. The Architect and Engineer member shall be licensed in the State of Florida and be a resident of Palm Beach County.

(2) Each member of the Board except the Building Official shall hold a valid certificate issued by this Board or the state of Florida in addition to have the qualifications required in subsection (8)(1) above.

CONSUMER MEMBER QUALIFICATIONS

FS. § 489.131 (CONSUMER REPRESENTATIVES)

(10) No municipal or county government may issue any certificates of competency or license for any contractor defined in s. 489.105 (3) (a)-(o) after July 1, 1993, unless such local government exercises disciplinary control and oversight over such locally licensed contractors, including forwarding a recommended order in each action to the board as provided in subsection (7). Each local board that licenses and disciplines contractors must have at least two consumer representatives on that board. If the board has seven (7) or more members, at least three (3) of those members must be a consumer representative. The consumer representative may be any resident of the local jurisdiction who is not, and has never been, a member or practitioner of a profession regulated by the Board or a member of any closely related profession.

agenda item# palm beach county board of …pbcgov.com/pubinf/agenda/20121016/6c1.pdf · ii. review...

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