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1 of 2 = = = = = = = =====çÑÑáÅÉ=çÑ=íÜÉ=j^vlo= UMM=ãìåáÅáé~ä=ÇêáîÉ= = = = = = = Ñ~êãáåÖíçåI=åã=UTQMN= = = = = = = =====ERMRF=RVVJUQPM=Ñ~ñ= = = = Äç~êÇëLÅçããáëëáçåë= = = Personal Information (Please print or type) Name: Home Phone: Home Address: City: E-Mail: Fax: Business: Business Phone: Business Address: City: Other Information: Do you live within the City limits? Yes No Do you hold a public office? Yes No If yes, Office held: Are you employed by the City? Yes No If yes, position: Are you related to an employee of the City? Yes No If yes, who: Have you served on a City Board or Commission? Yes No If yes, Board/Com. name: When: Potential Conflict of Interest: Are you currently engaged in the management/ownership of any business enterprise that has a financial interest or is presently doing business with the City of Farmington? Yes No If yes, please provide details: City Boards/Commissions Indicate your board/commission choice below. If more than one, please rank by preference. Administrative Review Board Airport Advisory Commission Animal Services Advisory Commission Cable & Communications Commission Capital Improvements Advisory Commission Citizen Police Advisory Commission Community Relations Commission Electrical Code Advisory Commission Library Board Lodgers’ Tax Advisory Board Metropolitan Redevelopment Agency Commission Oil & Gas and Geologic & Eng. Hazards Advisory Committee Parks, Recreation, and Cultural Affairs Commission Planning & Zoning Commission Public Utility Commission ---PAGE BREAK--- 2 of 2 Qualifications (Briefly describe specific expertise, abilities, or qualifications that would be beneficial to the board.) Education: Qualifications: Experience: Other information you feel is relevant to the appointment you seek: *You may attach a resume and/or additional documentation to supplement this information. I understand that any false, incomplete, or misleading information given by me on the application is sufficient cause for rejection of this application. I understand and agree that any such false, incomplete, or misleading information discovered on this application at any time after appointment to a Board or Commission may result in my removal. I also understand that all Board and Commission appointments are for voluntary, uncompensated services. Additionally, if appointed, I am representing that I am able to attend regularly scheduled meetings and otherwise am able to fulfill the duties as a member of the Board or Commission. Applications are submitted to the Mayor of Farmington when vacancies occur and are effective for two years from the date of completion. Appointments to City of Farmington Boards and Commissions are made at the sole discretion of the Mayor and confirmed by the City Council; as such, this application may be utilized and referenced by the Mayor in making appointments. By submitting this application, I declare the foregoing facts to be true, correct, and complete and authorize a criminal background check should the Mayor deem it necessary. I understand that this application, when submitted to the City of Farmington, will become a public record and will be subject to review and copying by members of the public under the terms of the New Mexico Inspection of Public Records Act. Date Applicant’s Signature ---PAGE BREAK--- CITY OF FARMINGTON BOARDS & COMMISSIONS Administrative Review Board Meetings: First Thursday following the first Tuesday of each month, 6:00 PM The ARB consists of five members, each of whom must be a resident of the city. These members shall serve staggered terms of two years each, and the chairman shall serve one year terms. The ARB has delegated authority to carry out the functions and duties delegated to it and, to the extent of such duty, is designated as a planning authority pursuant to State Statute; a zoning authority to hear appeals pursuant to State Statute; and a board of appeals under the provision of the Fire Code. Airport Advisory Commission Meetings: Third Wednesday of each month, 4:00 pm The AAC consists of five members and one alternate, all of whom shall serve staggered terms of three years each, and cannot serve more than three consecutive terms. The purpose of the Airport Advisory Commission is to advise the Mayor and City Council upon all phases of the operation and maintenance of the Four Corners Regional Airport. Animal Services Advisory Commission Meetings: To Be Determined The Animal Advisory Board consists of seven members, all of whom shall serve staggered three year terms. One member shall represent the San Juan Animal League, one member shall represent the Humane Society of the Four Corners, and one member shall be a veterinary professional. The only criteria for the other four members shall be that they have an interest in animal issues. The purpose of the Animal Advisory Board shall be to advise the Mayor, City Council and the Parks, Recreation, and Cultural Affairs Director upon all phases of the operation and maintenance of City of Farmington animal services, including the Animal Shelter and Animal Control. Cable and Communications Commission Meetings: As needed, on call The Cable and Communications Commission is comprised of three members who live within the city limits and serve two year terms. The commission shall review and approve basic cable rates as authorized by federal law and the Federal Communications Commission. In addition to these duties, the commission shall advise the City Council on all matters pertaining to cable television and communication services within the City. ---PAGE BREAK--- Capital Improvements Advisory Committee Meetings: As needed, on call The Capital Improvements Advisory Committee is composed of five members. Two members must be representatives of the real estate, development or building industries and all members serve staggered three‐year terms, and cannot serve more than three consecutive terms. The CIAC is an advisory committee only, whose recommendations are not binding on the City. The committee assists the City in adopting land use assumptions; advises the City in the implementation of a capital improvements plan; recommends development impact fees; and assists the City in complying with the requirements of State Statutes. Citizen Police Advisory Committee Meetings: Third Tuesday of January, March, May, July, September, and November at 7:00pm The Citizen Police Advisory Committee is composed of seven members. All members shall be residents of the City of Farmington, with the exception of one member who may reside outside the city limits but within San Juan County, and who has significant ties to the city. All members shall never have been convicted of a felony and shall not hold such office or position that will create a conflict of interest with the faithful discharge of their duties. These members shall serve three year terms. The purpose of CPAC is to encourage a citizen‐police partnership by fostering positive police‐community relations and by maintaining police services commensurate with the expectations of the community. Community Relations Commission Meetings: The first Monday of each month at 4:00 pm The Community Relations Commission consists of nine members and six ex‐officio members who are appointed by the Mayor and confirmed by Council. The majority of all members should live within the city limits. The nine voting members will serve staggered terms of two years each. The purpose of the CRC is to set standards for positive community relations dealing with cultural diversity, fairness, integrity and respect to all people. Electrical Code Advisory Commission Meetings: Second Tuesday of months of February, May, August and November, 1:30 pm The Electrical Code Advisory Commission consists of seven members. Three members shall be licensed electrical contractors, one member shall be a licensed journeyman, one member shall be a professional electrical engineer, one member shall be a licensed architect, and one other member shall be appointed at large. They shall serve staggered three year terms. It is the duty of the electrical code advisory committee to review the city electrical codes, to recommend changes or amendments to the electrical codes, and to assist the city electrical inspector and the city building inspector. ---PAGE BREAK--- Library Board Meetings: Third Tuesday each month, 3:30 PM The library board will be composed of seven members, one of which may reside outside the City limits. Members shall be appointed for terms of four years, not to exceed more than two consecutive terms. The library board is responsible for the proper administration of the affairs of the public library. Lodgers Tax Advisory Board Meetings: Required by State law to meet once a year. The Lodgers Tax Advisory Board shall consist of five members, two of which shall be owners or operators of lodgings within the city that are subject to the lodgers’ tax imposed pursuant to Chapter 8, Article 12 of the City Code. Two members shall be owners or operators of industries within the city that primarily provide services or products to tourists, and the last member, who is a resident of the city, shall be appointed to represent the general public. They shall serve staggered terms of two years each. This board serves in an advisory capacity to the Mayor and City Council. This board shall advise and make recommendations to the City Council upon the expenditure of funds and also advise upon advertising, publicizing and promoting of tourist attractions and facilities in the city. Metropolitan Redevelopment Agency Commission Meetings: Third Thursday each month, 4:00 PM The MRA is a five member board with members serving staggered three year terms. This agency assists the City in the development and implementation of the redevelopment plans for the Downtown MRA (Metropolitan Redevelopment Area) and other future Metropolitan Redevelopment Areas that may be established by the City. The Agency formulates and administers metropolitan redevelopment plans for Metropolitan Redevelopment Areas established within the City pursuant to State Statute. Oil & Gas & Geologic & Engineering Hazards Advisory Commission Meetings: As needed, on call The Oil and Gas Commission consists of four members. One member is a municipal employee who serves with voice but without vote, and who serves indefinitely until replaced by the Mayor. The remaining members shall serve staggered four year terms. One member is a professional geologist, one member is a professional petroleum engineer and one member has expertise in any area of the oil and gas industry. The members must reside in the Four Corners area. The purpose of the Oil and Gas Commission shall be to advise the Mayor, City Council, Planning and Zoning Commission, and the City Manager on the following: the drilling and maintenance of oil and gas wells within the city limits; zoning matters pertaining to oil and gas wells; matters pertaining to oil, gas, natural resources and other mineral interests; and any other matters pertaining to natural resources and the oil and gas industry as may be appropriate. ---PAGE BREAK--- Parks, Recreation & Cultural Affairs Commission Meetings: Third Thursday each month, 7:00 PM The PRCA Commission consists of eleven members who are all residents of the city, with the exception of one member who may reside outside the city limits. All members serve staggered terms of three years each. This Commission makes recommendations to the Mayor, City Council, City Manager, and the Director of the Parks, Recreation, and Cultural Affairs Department, concerning the development, maintenance, and acquisition of properties for PRCA facilities. The Commission makes recommendations regarding rules for the use and care of the public parks and department programs of the city. They set admission fees, and annually they review and comment on the operation and capital budget for the department. Planning & Zoning Commission Meetings: Each Thursday following each 2nd and 4th Tuesday of each month, 2:00 PM The Planning and Zoning Commission consists of nine members who are residents of the city. The members are appointed from professional and occupational groups within the city, who will provide administrative, legal, and technical expertise in the areas that fall within the jurisdictions of the Commission. Members serve staggered two year terms. The Commission primarily acts as legislative advisory review commission to the City Council. They advise and submit recommendations to the City Council on matters submitted to it. The Commission may, in the interest of the public welfare and to assure compliance with this UDC, establish conditions of operation, location, arrangement, and construction of any use for which approval is recommended. Public Utility Commission Meetings: Third Wednesday each month, 3:00 PM The board consists of ten members and one liaison from the City Council. Members shall be competent persons in residence in the district they represent, and shall serve three year terms. The duties for the PUC are subject to the approval and adoption of such rules and regulations by the city council, the board shall recommend general rules and policies of the municipal electric utility system, water and wastewater.