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AnyfurtherinformationyouwouldliketheCityCounciltoconsiderorthatyoufeelisrelevanttotheappointmentor <br />reappointmentyouareseeking.:Iknowwhatittakestobalanceabudget. <br />IunderstandthatinformationprovidedinthisapplicationmaybedistributedbytheCitytothepublicincluding,butnot <br />limitedto,beingpostedontheCityofRosevillewebsite.IagreetowaiveanyandallclaimsundertheMinnesota <br />GovernmentDataPracticesAct,oranyotherapplicablestateandfederallaw,thatinanywayrelatedtothe <br />disseminationtothepublicofinformationcontainedinthisapplicationthatwouldbeclassifiedasprivateundersuch <br />laws.IunderstandthatImaycontacttheresponsibleauthorityfortheCityofRosevilleifIhaveanyquestionsregarding <br />thepublicorprivatenatureoftheinformationprovided.:Yes <br />OccasionallyCitystaffgetsrequestsfromthemediaorfromthepublicforwaystocontactCommissionmembers.The <br />Commissionrosterisperiodicalymadeavailable.PleaseindicatewhichinformationtheCitymayreleasetosomeone <br />whorequestsitorthatmaybeincludedontheCommissionroster.UnderMNStatute§12.601.subd.3(b),eithera <br />telephoneorelectronicmailaddress(orboth)whereyoucanbereachedmustbemadeavailabletothepublic.Please <br />indicateatleastonephonenumberoroneemailaddresstobeavailabletothepublic,andfillinthecorresponding <br />informationinthebelow.:HomePhoneNumber <br />HomePhone: <br />WorkPhone: <br />CellPhone: <br />PreferredEmailAddress: <br />dunderstandthestatementsonthisform,andIherebyswearoraffirmthatthestatementsonthisform <br />Ihavereadan <br />aretrue.:Yes <br />AdditionalInformation: <br />Formsubmittedon:1/16/201312:28:47AM <br />2 <br /> <br />