City Council Agenda and Packet 2019 02 26 SP

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2019 Board and Commission General Application Page 3 of 4 Please note: LCity,/ Louisville COLORADO • SINCE 1878 • All Board and Commission members serve without compensation. • Anyone applying to a Board or Commission is subject to a background check. • The City may reject an applicant for any lawful reason. An appointed Board or Commission member may be removed during his/her term of office for cause as defined in the City Charter and Resolution No. 16, Series 2009. Reasons for rejection or removal from office include, without limitation, where a background investigation reveals an arrest, conviction, or pending charges for a criminal offense (excluding minor traffic violations). • All information on this application is public record and may be available for public review. I certify the information in this application is true and complete. I understand false statements, misrepresentations or omissions of information in this application may result in rejection of this application. The City is expressly authorized to investigate all statements contained in this application and, in connection therewith, to request a criminal history. I consent to the release of information about my ability and fitness for volunteer assignment by employers, schools, criminal justice agencies, and other individuals and organizations to investigators, personnel staffing specialists, and other authorized employees of the City of Louisville, and release all parties for all liability for any damage that may result from furnishing such information. In the event that I am selected to serve on a City of Louisville Board or Commission, I agree to comply with all of its ordinances, rules, and regulations. I fully understand and agree to provide my services to the City of Louisville as a volunteer in a voluntary capacity and that I will receive no compensation or benefits for services provided. I understand that I am NOT insured by the City of Louisville Worker's Compensation Insurance and NOT covered by any Accident Medical Insurance Policy while I am a volunteer with the City of Louisville. I authorize that all necessary first aid steps may be taken as prescribed by qualified personnel. I grant full permission to use any photographs, videotapes, recordings or any other record of my volunteer participation as a Board or Commission member. The City will provide any applicant who is rejected as a result of a background investigation information on how to obtain the report and contact information for the reporting agency. Determinations to reject an applicant as a result of the criminal background investigation report are final. 14