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2019 Ward III City Council Application <br />Page 2 of 4 <br />I LI Cityi <br />Om Louisville <br />COWRADO • SINCE 1878 <br />4) DISCLOSURES: <br />Have you ever been convicted of a felony offense, embezzlement, bribery, perjury, <br />solicitation of bribery, or subordination of perjury? ❑ YES IR NO If yes, list for <br />each case: (1) date of offense; (2) charge; (3) jurisdiction; (4) court name and (5) <br />disposition: <br />Per the City Charter Sections 3-3 (c) & (d) any person who seeks election or appointment <br />to the office of Councilmember, and who has been convicted of any of these offenses, she <br />disclose the same in writing under penalty of perjury. <br />A conviction includes being found guilty of, a plea of guilty to, a plea of no contest or nolo <br />contendere to, or the receipt of a deferred judgment or deferred sentence for, any of the <br />offenses listed above, but does not include any conviction for which the records have been <br />ordered expunged or sealed. <br />5) Do you or a company you work for or own do business with the City of Louisville? <br />0 YES ONO If Yes, please explain below: <br />• It is the policy of the City Council to make appointments to the citizen boards, <br />commissions, committees, and task forces based on the needs of the City as well <br />as the interests and qualifications of each applicant without discrimination based <br />on race, color, national origin or ancestry, gender, religious convictions, <br />disability, age, or sexual orientation. <br />• Anyone applying to this position is subject to a background check. <br />• All information on this application is public record and may be released for public <br />review. <br />• If appointed, City Council attendance rules state members may miss no more than <br />six (6) regular meetings in any twelve (12) month period. <br />• This appointment will expire in November 2020. The appointee will be eligible to <br />run in the November 2020 election for the remaining one year of this term. <br />• If you have questions about the application or the application process, please <br />contact City Clerk Meredyth Muth (MeredythM@LouisvilleCO.gov or 303.335.4536). <br />4 <br />