Loading...
HomeMy Public PortalAboutPRR 17-2555I ROBERTS, REYNOLDS, irw- LA W WY E R 5 BEDARD & TUZZIO, PLLC LAURA E. BEDARD OANNA P. CLEMENT ABSYJ. GOLDMAN SHELLI A. HEALY ANDREA G. AMIGO JEFFREY W. HURCOMB STEPHANIE W. KAUFER BRITTANY H. JACOBS MARGUERITE F.CHARLSON NICHOLAS S. MADSEN SHANNON L MARIBONA JASON B. VRBENSKY- Board Certified Construction Law KRYSTAL KOZMA KEITH R. HEDRICK VANESTI E. BROWN LINDA M. BERNS SCOTT A. KANTOR ALEX B.C. ERSHOCK JORDAN H. LEWIS Gulf Stream Police Department 246 Sea Road Delray Beach, FL 33483 Celebrating 30 Years of Excellence GEORGE P. ROBERTS, JR. Of Counsel LYMAN H. REYNOLDS, JR. Board Certified Civil Trial Lawyer BENJAMIN L. BEDARD Board Certified Civil Trial Lawyer GERARD A. TUZZIO 470 COLUMBIA DRIVE -SUITE C101 WEST PALM BEACH, FL 33409 TELEPHONE(561)688-6560 FACSIMILE (561) 688-2343 RRBPA.COM May 30, 2017 Re: Broberg v. City of Boynton Beach, et al Our File No.: 15-414 Dear Records Custodian: PARALEGALS KATHRYN L. REEVES JENNIFER G. WHITTALL MICHELLE L SMITH REBECCA K. DAVIS TIFFANIE T. WALLEN LINDA J. FRIEDMAN ELLEN KUZNIEWSKI JESUS DELAROSA PLEASE REPLY TO: WESTPALM BEACH Pursuant to the Florida Public Records Act, § 119 Fla. Stat., please provide us with a copy of the following records in your possession, within seven (7) days of the date of this letter: Any and all applications, background screening, interview results, interview panel notes, physical and mental screening results, offers of employments, declinations of offers of employment, or any other such documents related to the application for employment submitted by Leif Broberg, whose date of birth is and the last four of his social security number are Please contact our office to advise of any cost associated with reproducing said records so that prompt payment or reimbursement can be made of associated copying costs in accordance with relevant statutory provisions. If any privilege or exemption from disclosure is asserted, you must comply with the provisions of § I 19.07(2)(a) Fla. Slat, by promptly stating the specific exemption asserted, in writing, and excise only that portion of the document over which the privilege is asserted and produce the remainder of the document(s). WEST PALM BEACH, FL • FT. LAUDERDALE, FL • FT. MYERS, FL • JACKSONVILLE, FL Gulf Stream Police Departmem Broberg v. Boynton Beach. el al May 26, 2017/Pg. 2 Thank you for your prompt attention and assistance in this request. Should you have any questions or need additional information, please do not hesitate contact my paralegal, Rebecca Davis, at the phone number listed above. Respec Ily submitted, L For the Firm LHR, Jr./rkd/kjl WEST PALM BEACH, FL 6 FT. LAUDERDALE, FL 9 FT. MYERS, FL a JACKSONVILLE, FL TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA Delivered via e-mail June 8, 2017 Lyman H. Reynolds, Jr. [mail to: lreynolds@rrbpa.com] Re: GS #2555 (Broberg v. City of Boynton Beach, et al - Our File No.: 15-414) Pursuant to the Florida Public Records Act, 119 Fla. Stat., please provide us with a copy of the following records in your possession, within seven (7) days of the date of this letter: 1. Any and all applications, background screening, interview results, interview panel notes, physical and mental screening results, offers of employments, declinations of offers of employment, or any other such documents related to the application for employment submitted by Leif Broberg, whose date of birth is and the last four of his social security number are xxxx. Please contact our office to advise of any cost associated with reproducing said records so that prompt payment or reimbursement can be made of associated copying costs in accordance with relevant statutory provisions. If any privilege or exemption from disclosure is asserted, you must comply with the provisions of 119.07 (2)(a) Fla. Stat., by promptly stating the specific exemption asserted, in writing, and excise only that portion of the document over which the privilege is asserted and produce the remainder of the document(s). Dear Mr. Reynolds [mail to: lreynolds@rrbpa.com]: The Town of Gulf Stream has received your public records request dated June 2, 2017. You should be able to view your original request at the following link: http://www2.gulf-stream.org/weblink/0/doc/111332/Page1.aspx Please be advised that the only responsive records to your request for “Any and all……. documents related to the application for employment submitted by Leif Broberg” are the Town of Gulf Stream Application for Employment materials submitted to the Town by Mr. Broberg himself. There are no other records responsive to your request. If you still desire a copy of what Mr. Broberg submitted to the Town, we can provide you with an estimate of the cost to review the materials submitted, redact the information provided by Mr. Broberg that is exempt under the Public Records Act, and provide you with those materials. If we do not hear back from you within 30 days of this letter, we will consider this request closed. Sincerely, Reneé Rowan Basel As requested by Rita Taylor Town Clerk, Custodian of the Records TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA Delivered via e-mail June 15, 2017 Lyman H. Reynolds, Jr. [mail to: lreynolds@rrbpa.com] Re: GS #2555 (Broberg v. City of Boynton Beach, et al - Our File No.: 15-414) Pursuant to the Florida Public Records Act, 119 Fla. Stat., please provide us with a copy of the following records in your possession, within seven (7) days of the date of this letter: 1. Any and all applications, background screening, interview results, interview panel notes, physical and mental screening results, offers of employments, declinations of offers of employment, or any other such documents related to the application for employment submitted by Leif Broberg, whose date of birth is and the last four of his social security number are xxxx. Please contact our office to advise of any cost associated with reproducing said records so that prompt payment or reimbursement can be made of associated copying costs in accordance with relevant statutory provisions. If any privilege or exemption from disclosure is asserted, you must comply with the provisions of 119.07 (2)(a) Fla. Stat., by promptly stating the specific exemption asserted, in writing, and excise only that portion of the document over which the privilege is asserted and produce the remainder of the document(s). Dear Mr. Reynolds [mail to: lreynolds@rrbpa.com]: The Town of Gulf Stream has received your public records request dated June 2, 2017. You should be able to view your original request at the following link: http://www2.gulf-stream.org/weblink/0/doc/111332/Page1.aspx The Town notes that you have indicated that you would like the Gulf Stream Application for Employment materials submitted to the Town by Mr. Broberg. After spending 15 minutes on your request, the Town now estimates that to fully respond to your request will require approximately an additional half hour of administrative support at $38.54 per hour, the labor cost of the personnel providing the service, per Fla. Stat. § 119.07(4)(d). If the costs of producing these documents will exceed your deposit, the Town will provide you with an initial production of responsive records and an estimate for the production of any additional responsive records. If the costs of production are less than the deposit, the Town will provide you with the responsive records and a refund. (1/2 hour @ $38.54) = Deposit Due: $19.27 in cash or check. Upon receipt of your deposit, the Town will use its very best efforts to further respond to your public records request in a reasonable amount of time. If we do not hear back from you within 30 days of this letter, we will consider this request closed. Sincerely, Reneé Rowan Basel As requested by Rita Taylor Town Clerk, Custodian of the Records TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA Delivered via e-mail July 24, 2017 Lyman H. Reynolds, Jr. [mail to: lreynolds@rrbpa.com] Re: GS #2555 (Broberg v. City of Boynton Beach, et al - Our File No.: 15-414) Pursuant to the Florida Public Records Act, 119 Fla. Stat., please provide us with a copy of the following records in your possession, within seven (7) days of the date of this letter: 1. Any and all applications, background screening, interview results, interview panel notes, physical and mental screening results, offers of employments, declinations of offers of employment, or any other such documents related to the application for employment submitted by Leif Broberg, whose date of birth is xx/xx/xxxx and the last four of his social security number are xxxx. Please contact our office to advise of any cost associated with reproducing said records so that prompt payment or reimbursement can be made of associated copying costs in accordance with relevant statutory provisions. If any privilege or exemption from disclosure is asserted, you must comply with the provisions of 119.07 (2)(a) Fla. Stat., by promptly stating the specific exemption asserted, in writing, and excise only that portion of the document over which the privilege is asserted and produce the remainder of the document(s). Dear Mr. Reynolds [mail to: lreynolds@rrbpa.com]: The Town of Gulf Stream has received your public records request dated June 2, 2017. You should be able to view your original request at the following link: http://www2.gulf-stream.org/weblink/0/doc/111332/Page1.aspx Thank you for your deposit of $19.27 by check #77509 for the public record request described above, received by the Town on July 21, 2017. The Town is providing you with responsive records, which have been redacted pursuant to Fl. Stat. § 119.071, and can be found at the link above. As previously noted, the only records responsive to your request were records submitted to the Town by Mr. Broberg. We consider this request closed. Sincerely, Reneé Rowan Basel As requested by Rita Taylor Town Clerk, Custodian of the Records TOWN OF GULF STREAM APPLICATION FOR EMPLOYMENT POLICE DEPARTMENT SUPPLEMENT Because of the nature of law enforcement work, applicants for positions within the Gulf Stream Police Department are required to submit additional information. The following application supplement and reference forms must be completed in addition to the general application for Town employment. All information provided is subject to verification. The submission of false or misleading information will be cause for cancellation of the application process or dismissal of an applicant who has been hired. PERSONAL INFORMATION Name (Last, First and Middle) 69,03F -2v LES � 'E',o ► K Present Home Address (Number, Street, City, State and 71P Code) How long have you lived at your present address? -- Pe-CSEK7T Ido `?(c4es Home Telephone Numbe : C Current Business Telephone Number: Social Security Number: — Date of Birth: Height: .3 Weight: 07S5 Sex: I. Are you a citizen of the United States ............................ Native Born () Naturalized ( ) Yes No ( ( ) If Naturalized, where? 2. Do you currently possess a valid driver's license? Driver's License number and state: Yes o ( ) 3. Do you currently possess additional driver's license from any other U.S. state or territory, or the District of Columbia. ................................... .............. If your answer is "Yes," give the additional driver's license number(s) and state(s). Yes() No 4. Has your driver's license ever been suspended or revoked? . If your answer is "Yes," have your driving privileges since been restored? . If Yes (&6o ( ) Yes ( KNci ( ) your answer to the first question is "Yes," attach a separate sheet of paper with a complete explanation. 5. Have you ever been refused a driver's license? ....... If your answer is "Yes," attach a separate sheet of paper with ­a complete explanation. Yes() No 6. Have you ever received a traffic citation, other than a parking ticket? ...................... "Yes," Yes (Io ( ) It your answer is attach a separate sheet of paper with a complete explanation. 7. Do you have any outstanding, unpaid summons for any parking violations? .................. "Yes," Yes() No If your answer is attach a separate sheet of paper with a complete explanation. PERSONAL INFORMATION (Continued) =youen convicted of, had adjudication withheld, plead guilty or no contest to any offense other than ations?......................................................... Yes() No "Yes," attach a separate sheet of paper with a complete explanation. 9. Were you ever the subject of any military discipline proceedings? ......................... Yes No ( ) if your answer is "Yes," attach a separate sheet of paper with a complete explanation. placespf.residence over the past:five (5 years, from the most recent to the earliest. Indicate the month r beginning and ending residence at each location. Be sure to include the complete address (street or nt number, street name, city, state, and ZIP code. Use a separate sheet of paper if necessary. 717065ikmilk- ;D;Q,J '7e0 t - PR�Sfee�rT 11. Do you drink alcoholic beverages? ................................................ Yes (eNo ( ) Have you ever been arrested for driving while under the influence of alcohol? ................ Yes() No( ver used, tried, experimented with, or ingested in any way, and/or sold any narcotic drug, bed barbiturate, amphetamine, cocaine, marijuana, hallucinogen, or other illegal dsubstance?....................................................... Yes /No ( ) rently use any narcotic drug, non -prescribed barbiturate, ne, cocaine, marijuana, hallucinogen, or other illegal or controlled substance? ....... Yes () No LHaveyou ver been arrested for possession, use or sale of illegal drugs? ................... Yes() No [13. During the course of your duties as a sworn police officer, it may be necessary for you to lawfully take a human life. Is there anything in your background, education or beliefs that would prevent you from carrying out thisduty?................................................................... Yes() No If your answer is "Yes," attach a separate sheet of paper with a complete explanation. D et o Ce L-i cC j s E- S u s Pf-n7 o iLb 19l �5�50..� iNSoQ9Nc.e�, NOT'��IC{j! ♦p.N (Q . `i 2AC�IC. c..iTi9�o•� S( �ct7t/J Lo Co -7 MPhJ -20 MPH ZDA)f, l4 SCo (J,4 U iC P or_ IC E A4 115 r1,-jE- q AWOL. 01SPoSI-riary wFIS pi5G4,9rZ6C b4,f&S;4IP PlIf QS O n1 A L.. -_7r- N t'-oiLr2l'+ATIOAJ 19, Som �l2F.Pvt4 , f'2 ! P,q2 q M,E.o I Iy, pAovt-}rrr2 STv7E� ly . DAGf-ASCj) CCAfTi n.A-crO ILI. (,- 5oN / sruor.� r )c -I. / w1�Fc NUVZS�- /L46De^v0&ELkUCe7 IL -i. QfvrJ j g o s s ib m.Tw t-,9 l 7- 3 o -- S r g3 -i1 nI") J.9 -7H C: -I s�Ne�sE /� Mf�a.1 C.F3� �xPr�-4sS ( ci, M+CNH/�L iAJSS/ b RaoT�-K2-�• L#W l9 -a?- by 1a9 NW ? 3 �d qv>: PL5l.1TF,rDN FL. 3331? if wm,#0Ce?- ,RAl0bldi� i%47'O4�JL-7- ✓L,gu-) '7--13,.30 0 CkA s Pn a CE- ofc.- c r j uc k.MPL,o4M£Ajri- LACY-�,�oUNp 3, SES+n�oc_E POLIC£ fJCPt9Q-r.-70%! PQM S�2 `N 449PLAChrr0N AeV&L*- o� Pouc-t- oGf'ac 2 pos rrtotil 3.60 Q t4 Pour, a A2, -r fPPLiCITTro-) ©nD CAPiAt/JS PO$I iiON 3, C-LoQ,LOA ! !SN 91\33) L.Jcc�LL �� CoNU42Sr¢TJ j4PP4.ICA7tt:�N xiJ PQnb(Z zSS ��Ql I, ,11 May 17, 1991 To Whom it May concern, Leif Broberg was employed by the Sundance Saloon. from January of 1991 through April of 1991. He was responsible for cleaning the entire club during the day and at night he worked security. He was very reliable, 'loyal and conscientious about everything lie did. His eagerness to please and do a good job was commendable. All other employees lilted Leif very much. He worked, on an average, 50 hours a week. I feel Leif would be :'an asset to any employer he chose to work for: If any further information .is needed, please contact Paula A. Royce at the Sundance Saloon, '.;20937 W. Rt. 176, Mundelein, Il., 60066, 708-999-0858. S/incerely, ;:Paula A. Royce h:Operations Manager 9 To whom it may concern; In:"the..short time that LIEF BROBERG has been employed by th'R he has been dependable and hard work- ing` He seems to enjoy a challenge and has never complain- ed.„about his work load. His duties consist of barbacking and security work.idr. Broberg has been a tremendous asset in .:helping keep the peace in our generally violent atmos - tmos-phere.'To ph er e .'Toreiterate, if you need a hard working,depend- able'and intelligent person,with a willingness to learn. Hire5LEIF BROBERG. v can be of any further assistance please do hesitate to call me.(581-9523). ;. Sincerely, zMY � wry rf: DAN SHAW t; General manager l` 0 PERSONAL INFORMATION (Continued) 14. List all members of your and, if applicable, your spouse's immediate family. For each person give their name, address, relationship and date of birth. Include parents, step-parents, foster parents, guardians, brothers, sisters, children and step -children. Attach an extra sheet of paper if necessary. fy' o-rs4ck CoNST* ,qA-e*, ReogyLeb 171871-mmw,480D, lsx0HgTC4Xfi Ct (W_7"it+*4 L-&0NH2aD �2f}JIL8203�z� b POt lGfc :arJSFE1�bi2 �/dnI Of2HNC.tCco POUCH ey¢,oT**R_ GUN.)„),g2 820GIrr-eb a—f 1 - So P.0.110X a?a wtcK.C^�3uet,, /4 g53sg )4De5eAZ Sic.-rCR TE14R•r 3fc.'(LL> 8-(42-5i P.O. GCK a7 C7 10►e,IL.fJ(3ueb RZ. SS3S`t3 Ho2SfL r-2,�r.� 51s-rCZ L;o21AJoA PO C_*_ SceL-fA^ MILITARY BACKGROUND 1. Have you ever served in a military organization of the United States? ....................... Yes ( No ( ) If your answer is "Yes," attach a copy of Form DD -214. 2. Are you currently a member of a reserve force of a military organization of the United States, or are you a member of a state National Guard unit? .................................................... Yes () No If your answer is "Yes," attach a separate sheet of paper with complete details. 3. Are you currently registered with the Selective Service System? ............................ Yes ( No ( ) EMPLOYMENT BACKGROUND 1. Have you ever been discharged or asked to resign from a job for any reason? ................. Yes ( ) No If your answer is "Yes," attach a separate sheet of paper with complete details. 2. May we contact your present employer concerning your job performance? .................... Yes ( No ( ) If your answer is "No," at what point during the application process may we contact them? 3. Have you ever applied for a law enforcement position with another agency? .................. Yes ( No ( ) If your answer is "Yes," attach a separate sheet of paper with complete details, including the status of the application(s). REFERENCES Attached are.forms to be supplied to your education, employment and personal references. Forms are required from all past employers and schools, and from three people who have known you for at least five years but who are not related to you and are not past employers. Additional forms may be copied or obtained from Town Hall. Print or type the name and address of the reference and your name at the top of the form, and complete and sign the Release section. Do not have the forms completed by the reference. Return them with your application and the Town will distribute them during the background investigation conducted as part of the application process. 70 CERTIFICATION I swear or affirm that this supplemental application contains no misrepresentations, falsifications omissions, or concealment of material fact, and that information provided by me is true and complete tc the best of my knowledge. I am aware that statements made by me on this and other applications arc subject to investigation and -verification. I also understand that prior to my selection for h position, I ma} be required to submit to a polygraph examination, and that I will be under an obligation to disclose completely and -fully my -.medical history. I also understand that I will be required to submit to a drug and/or alcohol screening test as a part of the selection process: L authorize ,the appropriate medical authorities to ielease the results of any tests and examinations conducted on behalf of the Town of Gulf Stream. I authorize my former employers lo. furnish their records of -my service. This includes all information they may have concerning me, whether on record or not I also release them from any liability for any damage in -providing this' information. I further understand that if the answers to the questions on this and other applications and documents prove to be false, I will be dropped from the selection process. If already hired, I wfll be subject to immediate dismissal. STATE OF FLORIDA COUNTY OF PALM BEACH The foregoing instrument was acknowledged before m(jeonthis p - day of by who has produced as identification and who did take an oath. � 16 lam e Signature of NcAary Punt Name: I -VC <Yitle: My Commission Expires: (SEAL) �M1gp y MICHELLE JONES .r • t Gv ,NOTARY PUBLIC ��'• ' ` STATE OF FLORIDA Canm# FF170336 0 6�� Expires 11/6/2018 TOWN OF GULF STREAM APPLICATION FOR EMPLOYMENT An Equal Opportunity Employer 100 Sea Rokf ,, - ' Gulf Stream, Florida 33483 (407) 276-5116 (PLEASE PRINT PLAINLY IN BLUE OR BLACK INK) PERSONAL INFORMATION Date: Name.(Last) - (First) ..-(Middle) Social Security Number ARZI;f—Qb Let;:: 1EeLK - Mailing Address City, State and ZIP Code Telephone Number Florida Driver's License Number 8rot 6 - 5a5 - G?" 410q CDL( ) Operator Are you a citizen of the United States or a registered alien? ...................... . . . . . . . . . . . . . • , , , , • , . , , , , ... , ... , yes (1KNo ( ) Have you ever been convicted of an offense against the law or forfeited colateral, or are you now under charges for any offense against the law? You may omit traffic violations for which you were fined $30 or less, and any offense committed prior to your 21st birthday that was finally adjudicated in a juvenile court or under a youthful offender law ................................................... Yes () No While in the military, were you ever convicted by a general mutt martial ............................................ Yes() No If the hnswer is "Yes" to any -of the above, give details below. For each offense, show the dale, charge, place, court, and action taken. Attach extra sheets of paper if necessary. NOTE A cogviction does not automatically lftean you will not be hired. _ .. . . Have you ever been employed by the Town of Gulf Stream before? If so, givtes of employment: t-1 R Do have for you a relative currently working the Town? .... Yes () No (W) Relative's name and relationship: ( EDUCATION CIRCLE HIGHEST. GRADE COMPLETED - Grade School 1 2 3 4 5 6 7 8 High School 1 2 3 4 College 1 2 3 4. Graduate 1 2 3. 4 Schools Name/Address Major Did you Degree Yeai ' graduate? Graduated High School ar GED tasfSiF�.N Nlbli SGHOO L c1L C ,, 5 ��'7 College Ce Aro1uN 17T Ccf_LA S No g - Graduate School, Vocational School S rJ-C', 1 210L1Jl/JU - Other Training 'C..IViI.� C.RIv�NFt�ic.¢iyir>'i` - • ' .. Y(fis �1. (�-70 JOB INTEREST Position Applied For: - ', bf.11, wO0'e/ C?r-c • • �R Date you can begin: �P�•J�i ^_� Salary Desired: Will you accept: Temporary Work Yes (v)" No () Part -Time Work Yes e"No ( ) MILITARY SERVICE RECORD Were you in the G^^Unit�e^dSates Armed Forces? Yes (INo () If'Yes," what branch? All',r� Dates of Duty. —T3/ 3 to -7' '��c( Grade at Discharge: r — 3 Type of Discharge: J-10,QofC List duties in service, including special training received: _ =N1 AAIiL�/Y1RnJ t Snt,�t�L. 19-z�sz Il147o L%/l�l� .92Mo2� SPECIAL SHILLS, APTITUDES and OTHER QUALIFICATIONS List details of all skills, aptitudes and other qualifications that you feel are relevant to employment. Typing Speed: words per minute Shorthand wpm Speed Writing wpm Office machines you can operate efficiently: ✓l7 o S r F:4K i [ARS YKA0, C D"Wl PU i&YL Machinery or heavy equipment you can operate cllciently., 0%.D 1% C—)(, C.1(. l 03 C,$ r 11 L-) u- 0 0"z- Scholarships, fellowships, honors, etc., you have received: F0 V OF— Trr-Pf�2'9-j f- rl' &OZt,'fbt4► aos SVR-�'hC$- 1LJo C)/J* C0.1464T JHONo2 4L-Og20 $ , Speak Read Write Foreign languages Excell Good Fair Slight Excell Good Fair Slight Excell Good Fair Slight I Special qualifications and skills (licenses, certificates, memberships in professional organizations or societies, etc.): Fo(, voctc�c-sl��car� !b-9o-Ooa-oas�(�ooflS, fl�.ry/2�r � 5ukalomsceolc-c ,4t?fin as Y11r,82s 2CsPb(Vj0CC, CPQ Ariz G i Srz2 j2r9)A.)10b copiLfrivT. REFERENCES (Excluding former employers and relatives) Name and Occupation Address Phone Numbers (Day and Evening) 1.0%42Y f. S65-.. 2.pru4Je 12 - tIL� A�o�T 4 CDP Y,4c447-e,-,)g DO. HPi Sob dVPowao 510 1 5a3- a 40 s. A2o� v�C r l i o 4Ni OEX Ulf— PRESENT AND PRIOR EMPLOYMENT List below all present and past employment, beginning with your most recent. All spaces must be completed. A resume may be submitted, but it cannot substitute for completing the questions below. Do not answer a question below with "see resume." Name and Address of Company and Job Title: S$-'QbE9r-rT l Starting Last Type of Business: Hired r t.I G- -1{ ComMr9rJ,0&R- Salary Salary �i�"GP/JJ O`�afl(�oQn1To/J I r— -r2-s,rot�.tb S69-bFA� 11.00 Month/Year 1✓7-p gl k*- 4nr— A C R t46.61) uNt STEeoluEs N S Describe the work you did: Su P4eo S *- Name and Title of Supervisor May we co act your resent/most recent a ]oyer at this time? Left PO L t � CJ �/ c-s-2 $ �O� Yes (W No ( ) If"No,"when? TlL9t�fcO 01=►'tCf'ZS -711-2 07 /�iO Month/Year AS " j��Wl�a11�� pEb IU LI 0 - - /Oo C�9S t'w3oE6E(,tul_lo elep one: p ff IC Cale_ . CAP f{I /J Reason for Leaving: j ),111 S 1-4 CiD Q,p P COnJ R9,^T R-n] Oi:T 1'aw pkp C-1)NDyz4t,"r; Name and Address of Company and Hired Job Title: Starting Last Type of Business: CA(xp&^j jY e- L43a2 Salary Salary t-- -r Cote s-reuc-rionl 10 _/ W t -1 . oo -z-00 L�gQ NE a N9 R Month/Year yl(L F-T L9004404tdc_ rL. Describe the work you did: Name and Title -3333(l Left (3U1 t-0 J"JO n'lk-S of Supervisor Mont car K-rMt'e LCI) Telephone: 15- -5-f3S1YS Sup*��tsa✓L Reason for Leaving: (�-I /L(n JJ 8C)y ntTO,-% 6fAC-H PD LLCM_ Name and Address of Company and Hired Job Title: Starting Last Type of Business:�y �1 U /09 CRQOEQ tLfl3ae Salary Salary -1,00 MMt�C GpAJSi2UCTt0/&l (0.00 !S,rl0 5 W 3fp �-T• 0,SUSE Montb/Year 1412 14 /Z Describe the work you did: Name and Title V'L. 333 GoNS*4Ue-'r�o� Go�1PA�r Left BU t LD bi0,7/ S of Supervisor 6 ,90 P,gUL Month/Year t��s Teleph3b-& w-1-11- 053 F0Wn1 Reason for Leaving: 14cc iLP 7 FLS j p eo"C*. 142C,4DEl" o Additional copies of the inserted page for PRESENT AND PRIOR EMPLOYMENT may be made by the applicant.or requested from Town Hall, as necessary. Occasionally the format of an employment application makes It difficult for an individual to adequately summarize his or her complete background or the characteristics he or she can bring to the position under consideration. Use the space below or attach additional sheets of paper to provide any additional information necessary to describe your full qualifications for the position you are seeking. Thank you for completing this application and for your interest in employment with the Town of Gulf Stream. Your application for etttployment will be maintained by the Town as an active file for a total. of three (3) months from the date it is submitted. PLEASE READ CAREFULLY APPLICANT'S CERTIFICATION AND AGREEMENT Employment at Will: Nothing on this application is intended to create or imply a contractual relationship; if hired, the employee understands that employment is at will, i.e., is not for any specific time period 'pr -duration, and can be terminated with or without reason at any time. While employment policies or procedures may change from time to time, only a written agreement signed by. the Town Mar ager can change an employee's at-willstatus. Probation Period: I understand that my position with the Town is temporary during an introductory period of employment. My employment may be ended during or at the conclusion of the probationary period for any lawful reason without recourse. Physical Examination: I understand that I must take and pass a physical examination, before the hiring process Is complete. Statement of Aoalicant: I authorize my former employers to furnish their records of my service. This includes all information they may have concerning me, whether on record or not. I also release them from any liability for any damage in providing this information. Certification: I agree that any false or misleading information supplied by me will be cause for canceling the application process. After my Hiring date, it may cause my dismissal from employment with the Town. I have answered all the questions on this form completely and truthfully. I understand that this application must be fully completed end that incomplete applications will be rejected. I certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I authorize the Town of Gulf Stream to make any investigation of my personal history. Applicant'sSignature: Date: a'ag- a0 i 7 UNSIGNED APPLICATI NS WILL NOT BE CONSIDERED etkuc.,q -r' 0,-3 /,9002mss OL6" SC HOoL L -41 6H ScH&oL_ /3.00 5w t 3f07N flLoE• h'J LAv e�At f?L.3333r GOIL�I�� (32oWAer� GOe"fp7uNii`? GOU-O-c"t.. 3s -•O1 Ir IQOLE 9,0• Day.�.. c'c...3331Y V a f1TlONAL Sc•NuoL. S L 1 /CY?tn�t.i1(� S rrre- 14SAUV sc41VjoMfr,- .201°1 NwtS,fL*-• rT.L9���p9L& �L•333t1 O' ►'�- t_t v fi c-�? C. ¢w��o� c E✓h g S� F,r�40E �+t }� D 2 . 14,9U,9nvn)?l , r:LdA33 3 PRESENT AND PRIOR EMPLOYMENT (Continued) Name and Address of Company and wed Job Title: Starting Inst v't 1 � 1 SalarySalary Type of Business 89 SCC- 5.5c) 001 L- MI- ear S.so 42 N2 Q,t3(p r*w a 1 C:. svaelsE Describe the work you did: Name and Title NL.333aa Nlg�7eWf3 Left -:r0 i of Supervisor DRQ '-J 139 Month/Year sNA� Telephoa Reason for Leaving 9 CC pT Fc i o PpLtt ¢C 4G4 M Name and Address of Company and Hired Job Title: SLc.L5rc i T y i4 N O Starting Salary Last Salary Type of Business / �� . rl�¢iN7fcN9nJG� �' 7.00f% $Un10,9Nc-VL S,9 .oe,a Month/Year d2 y+?uNOiE h t 7 �L, te006(� Describe the work you did: Name and Title of Supervisor N t bt+TCL.�3 Left CWfLcx-x6 P1evL4 91 Gtfr>fNEO //3Ui`IDinJIJ MonthlYear 20 YGIE yMANfiV�r 2 Telephone �� -9L/9-0�g Reason for Leaving: f i U rZ ATF 0 '10 9L DA k d/t+ Name and Address of Company and Hired Job Title: Starting Salary Last Salary Type of Business:j.�NT✓Zq �/ 1057 497 U.9. 4ev' " `l Month/Year n,ed:Hc T in cwt Describe the work you did: Name and Title :r^j0i2*-c'r rr 12-F— of Supervisor Left yW;7 iVTJP-L> f WAQ'fF V SM9i[y IDA1JAJY Al2M 5 '4o -,V1 0 (Lkk . 1301 SC. -0Q Month/Year 60,11PA�N Coit s1^W4D e1S tR N r Telephone 1J t� q_l U fi e— S Reason for Leaving: 4D! SC K d� oYL /j/3 C o ND t o NS Hired Job Title: e G i o'e Starting Sn1a'S Last Salary Name and Address of Company and Type of Business �p(L Err ; tG% OFi g lQ 7 S OP(c¢l*Tt ^l L7 Month/Year 14A- I5 LAuO£AD/1tE Describe the work you did: Name and Title tjQf!�£9U `f of Supervisor (1-37-31) . ! !$ �%� Left ktv 4vIP.vtk tM gQ0iPmfw OP�Q9�t2 �l� MonthlYear foGA?roNar_ SGrd�iJ�- St rrt i or/S ,� VY14,NiNb 5!L- �157yve, 02 Telephone: pS- SaIt Reason for Leaving: �5 O t�/ �F-t% n11 L t ! 2`f U. S' 1�rv;q L) F©LE AUTHORITY FOR RELEASE Florida Department of OF INFORMATION CJSTC Law Enforcement (Background Investigation Waiver) q� 58 Incorporated by Reference in Rule 11B -27.0022(2)(a), F.A.C. To: Concerned Person or Authorized APPLICANT'S NAME: Stec) Representative of Any Organization, /, LAST FOUR DIGITS OF SOCIAL SECURITY NUMBER: AGENCY REQUESTING BACKGROUND INFORMATION: Having made application for certification or employment as a law enforcement, correctional, or correctional probation officer within the stale of Florida, I hereby authorize for one year, from the dale of execution hereof, any authorized representative of a Florida criminal justice agency or a Regional Criminal Justice Selection Center bearing this release to obtain any information pertaining to my employment, credit history, education, residence, academic achievement, personal information, work performance, background investigations, polygraph examinations, any and all internal affairs investigations or disciplinary records, including any files that are deemed to be confidential andlor sealed. I also authorize release of any criminal justice records of arrests, citafions, detentions, probation and parole records, or any police reports or other police records in which I may be named for any reason, including any files that are deemed to be juvenile and confidential. I hereby direct you to release this Information upon the request of the bearer, whether In person or by correspondence. I further authorize the bearer to make copies of these records. This release Is executed with the full knowledge and understanding that these records and information are for the official use of a Florida criminal justice agency or Regional Criminal Jusfice Selection Center In fulfilling official responsibilities, which may Include sharing the records or information with other criminal justice agencies, Regional Criminal Justice Selection Centers or the State of Florida or release to third parties as may be required by Florida public records laws. I hereby release you, as the custodian of such records, and employer, educational insfitution, physician, hospital or other repository of medical records, credit bureau or consumer reporting agency, including its officers, employees, and related personnel, both individually and collectively, from any and all liability for damages of whatever kind, which may at any time result to me, my heirs, family or associates because of compliance with this authorizalion and request to release information, or any attempt to comply with it A copy of this farm will be as effective as the original. I hereby authorize the National Records Center, SL Louis, Missouri, or other custodian of my military record to release information or copies from my military personnel and related medical records. Including a copy of my DO 214, Report of Separation, or other official doaamenls from the United States Military denoting discharge status or current active military status to: Section 768.095, F.S., filed Employer Immunity from Liability, disclosure of information regarding former or current employees stales: An employer who discloses information about a former or current employee to a prospective employer of the former a current employee upon request of the prospective employer or of the former or current employee, is immune from civil liability for such disclosure of its consequences, unless it is shown by dear and convincing evidence that the information disclosed by the former or anent employer was knowingly false or violated any civil right of the former or current employee protected under chapter 760, Florida Statutes. Pursuant to Sections 943.134(2)(a) and (4), F.S., Chapter 2001-94, Laws of Florida, disclosure of information Is required unless contrary to state or federal law. Civil penalties maybe available for refusal to disclose non -privileged legally obtainable in flon. Applicant's Signature Date Applicant's Address OATH Pursuant to Section 117.05(13)(a), Florida Statutes STATE OFACC) '-A Q COUNTYOF CC1�U`C1 'l -7F :1Lh STAT[ OF FLORIDA Personalty Known ElOR Produced Identification '' ; • CamnrH PF170336 ° vCE 141 Type of identification Produced � — Expires 11/6l201 S Effective: 819001 Pursuantto Original— Employing Agency toff Commission -Approved Revisions: 12116110 Sections 943.134(2)(a) and (4), F.S. Form Effective Date: 312D13 ITEMS NEEDED TO BE INCLUDED WITH APPLICATION - Application must be signed and dated (Last Page) -Authority For Release of Information (Background Investigation waiver) CJSTC form # 58 (Signed and Notarized.) - Copy of Florida Drivers License -Copy of Social Security Card -Copy of Birth Certificate -Copy of High School Diploma or GED -Military Background if Yes Copy of DD -214 -Minimum of Six (6) Personal References Excluding Former employers and relatives. To Expedite the Background process Please include address, zip code and Phone Numbers fixed streAm POLICE DEPARTMENT M-1 JOHN HASELEY LIEUTENANT TFL: (561)278-8611 246 SEA ROAD • GULF STREAM. FL 99489 DMER LICENSE CLA,3$ E c R616 -526 -674C -I -ft LE7 CMK "- ow. SEX. M SAPP DRMW Leif erg Whose Sig, tification Appears h OTitle of R4 W PolE'"V nt!1.16 CAM . .............. TOS MUUBIA HAS SEEN GVAeUSHfv M ip LEIF E BRObERG t- T IT" F•,rm N,.. V5 f-Ia(iM L,.ul prlwr.rr Nn. WISCONSLN STATE BOARD OF HEALTH 955 CERTIFICATE OF LIVE MRTII .•t. 1•LA 1'!: __ O—, �IRTH - --- —_^ I II -SI -Al. R}:NI UE:\/!: OF MOTIIF.H t%% heft J•.rt- .httlivri) a t'OUNTY s. STATE ,L•. COUNTY' _Kenosha _.___ _ _ Hiaconsin _ rn ha VILL.AGt❑IIF HI:AL, NAME TOWN Sii 1'1:rkL. PITY NS111P) [lox r CITY O and \:FI1(FinandName$atm In+rrtSame Kenosha c. A.%6 TA1.(Ifi ' NOT m hmpnal a inebtunon, lire Garel 1-:41111 If beat... n) d. %lailinr Address Include at rrr•t and clq• INT1Tl•TiOF Kenosha MemrialHospita R. le Box 6.50 A c. (Lilt) SCtHi'.tYP .._ .—.- +1•arx3--___ __.. _.h-LlltddlV_.. .. —�___. _.._. _ __ _ _.___ ._._ . ..- NA (T)'pa or Print) Leif Frik 1 SES 5a. This if irlh "'� Triplet G 151, If Tw'inur-rn Flet ,Thea t'h tld) on ....... ............ ir ....... .. ..... I . 7. FATHEH•S a (First) 4 -Meddle) c. 1L.ast) FELL NAME: iAionsrd Stuart Brobers _ F. ACE OF FATRI:R RL:ALOCCL'PATION UIRTHi'LA (•E 151-1- a b+run Orvntryl las L'oreman i lab i:IN IIOF AUSINfiSS OR INDUS' 19. cement VF:AH� an �t finisber 44 Zemon COSletructiOn 11 MOTHER'S a. (First) 4. (build UQ _ _ C. (Last) M41UE19 NAME Angeline DeSalw _ _ _ �gpPrence 1't. AUF UY NUTH EIt i I1. UIRT11PLACElvalr •a larva Mills) Ila. CSUALUCCUPATIUS i lib. KIND OF DC9INES5 UR 1NP1.'S• 34 1 F. a R< Romelmker ISS PARENT: I I certif)that it.. informs- 15b. Signature of one or parents. rrr ret'. tion tr. I•.me 1.11 Is ror- Is ibis M1lrth recordn n•-t In mt- n.yt krnw"•dgn Constance Broberg / Inrebp rerh tlwf 7y ;Ea ?P;NATL'RE 166. 16 U. AlTF.NItA NT AT BIRTH l U (l D UTIB R IScedf3': Ibis r;'ild um• Zorn l P A Capelli •'- ' afire 'm fhr -lair ! above. ADDRESS IGd. UANEU stared 116c 11/8/6TE�•:O 7 1400 -75th St. - _ l :. DA TF RECD DS—LOCAL tt. t t is no•a.a•, ,..... ., .- - 11/9/67 Inuise korkert! Dep• RFALT11 ANU J1E1'It-At, SECTIUN (CVNF'I UI:NTIAL) IThia h,., if n Nt':4•P he ai.•,d oat for .•arh bir::,l i loraffiarb Reif 01111E (gmnitu DOD E QTertifits T4at Cric 3Brobrrg 4aiiing satisfurforilU rompleftb all requirentents of Infu anh simbarbs for high sr4col grabuntion as prgorribeb bg the L$tatp �varb of Fburatim nub the ,Vistrirt $rhool Pourb is 4trtbg iduarbeb this bg order of the Profuarb Cmut Pishid $rhovl Potts June 14, 1987 GULF STREAM POLICE DEPARTMENT EMPLOYEE REFERENCE SUPPLEMENT NAME and OCCUPATION ADDRESS PHONENUMBER and Evening) 5*_BR.+c+C 9/KE v /oo fc. (3oY ron� BFAc+� Powr-Cz S e6f-ynli f3�aD•BoYN'7a.�/3 u -J + 3 NAW -Y 4SPEr-j6&1f (00bW.(3LO*-kfCleoa Cr9 I2ivtQA P,Q 3 `0. R+�oea B iC+J � �A1^) cNICI�, 2fL.4+2fi-b I NJA-;j & UQMY 300 W. qrc r+cqu/L G+EviENq�.r; o nAYP.4. 0�' �9�' �3£AcN rL 334tYy m� Qom' K 5Lio w Pkjp-Kq ST. co-.riaac oe L4,r,--W9 irL 33 &a S�oi - 9s�-ss59 PoUb i �cso>_KE.Q. (oil r,�_ iecoE(Z91_ OLJN(rf- i�oo0 EF}2 Jdw� 6oP•n'onJ3f�cu 3 3,� P/gTiZIC.e guJ,rK�.J l3EACJ1 PCL CE 0Lr-GI C.fr 4e_ I�l.�:�.,ISG� .^^"v* -4 R. 33y3 y mi",vu- 'ecc-Yc.2 /00 St -9 2c90 �vo��L.>; pi',�+C.rtrL �uL,r"STn�rJ^� ��• 33453 To�1� /Y),gL)KO /00 Sou%(•i r'-EDI:Q9l_ C'o,s2,icToe 130Y✓,2w 69Z -y 3 ,pi -43e- 39gS 3oHn7 PO -Cc -C a0d(.7 cc -"4 KEP. O2 r+Aaac+9C. '90o+so4. 8oC4 C4ro/N 33y9jS W41fft!•ICATo(34 ...,.. 'v.n,.:�.4 ,. .. .... _...... . TES- fiftEASE OR DISCmmr•.r• A1L111A•1CI•Ivr m rry 1. NAME, (Lafl f f , I t I,. ��—r ), UL'I•Al11MCN1, CUIdI•UNCNT� DIIANCII—"�-�—�-• °' 3. SOCIAL SECUIII'fY BROBERB LEI�a, liRMY/ftA No. 4.4. CIlnOE, 11AT ! 1 4.1). PAY CItAUE PV1 !A�. LT4�• ' EL S. OM ATC Of UUIfn (YYM(1D) L. Ill SE I1VE OIILIG AM UAl'L' TE 7.4. PLACE Of EryT� N1jQ'(1CTIVE OUt'Y YUaf I:III MUnt _- +irt Cw4111 UY fl 3,6 llulv1 Uf M.CO1to AI TIME OI FNIRY (City JIIJ IIJIV, UI MIAMI FL I {� �Sa �{,1 11YY,ti/,:•I :' addn•M MIU. 11) umlplely If " u.G %IWIull mil IIC SCPnIM FO Irjut�'�M�� W WC TRAODC TCh,P .'!: Ff11'LT I_NrIY VY 11111'•1 O. COMMAND TO'Ly�jjGN :TRANSFCIIpCD 111. SOLI COVLIInGC� nano NA',W`11"I+,Y,jt7:� nmounc S YVuh) MonNdO_ U_a ylU— �NR_U___— . 11. PRIMARY SPEC,IALTW( F( nYlnbet, fie and Y2ari mLl Amn(hi in Specialty. Lrr?dffjOA. m _ -12lCO ILL) OI' SfIIVICL ipwirlrofoneQ(.0(!yTNC Pvllua I1C10 INDIREO-pi,FZ Ei INFMN--1 YRr-2 I•IOS// NO11•IINB FOLCQ B%�°ii " i, my. nla wI, Urle If,,%Paned ii ilv.: i.laa, u n i•Dnod lU9 07 -U%__� JIill :1f ,' _<wvi a i�i.d•r��.I� i.ulrV wlYuu —I- _ ri t ----1•, I_ 0 L1U_.- LLQ_-.- .:., �('.: !1•"1.S.tll.l � uU:• a-. I;ilai I'n I'i� 4�eliwr-5W vice _ . _ ......... - Dick— BuL­ LIL1 IUB_•__ • ,Ili,�.lA>y1JL7' _ _ ..._ 1. Imn•4u 5vlvnv ..__ "--._ 's of, —_ .___--- i ��fW{{ylppp� +f�: •. iA11LJ1�'u _� t•.� Dri vHc _nrl r(p Qrl Ii.y t b IIL'<LVU UOLL• ul Itiy Glade ,1r• n.: T]. OCCOMTIONSC'ME•g(1u1IS1l 1AOGES, CITATIONS AND CAMPAIOIY IIWnONS AVVMUI to Uli AUTNUIU/EO (,Vt penudl of IVIWrv) ARMY `•IERVICE1R H1jR0VEXPERT OMI-IPIC(ITION DAUGtE I•IORTfIR//;PIAkP::hIUO'1'C•I'< OUAL11-IcnTTON 9110M 311C...h'ADEMIARKS, •SIGAjI�4gfjL•IrICAT! ON MOGE R1FLIE, N-lE,//Nrrl'HUaU liOLL.OWS 14. MILITARY EDUC/t (0f•Ir-fCOWrO title, nuulbvt u( w+vki, end month al,d Yvai cu..Vdewd) IWDTIiEI'T I'IF2El�x(�IRfdB7RYMAN, 13 W ri, APR OD//IQOTH1NCi f-0L1,0W11, IS...N, Illu IL. DAYS AEEIIu1.0 ISAVC PAIDI vel(MNfCOCIIT19Hg%j!STANCC PADCMM r 1.r9, If. M(MY(II WAS YN0Y1040 COMPLt Tf DENIAL IAAMINAIIUY MlU All AYMNUNNIAII UINIAt SINNIII ..HU 1111AIIAINT WIIIIIN YII IIAY1 YIIIWI IU 41 YANAl111U V, hu 1R. BLOCK 6, PE ' P-1�BB0205-BBO217//EXCESS LEAVE 142 DAYS, 090216 090707//140THING FULLOW, {N lI ice. ;tV I loll," I t 1i � ai,'11 19.a. M)JUNG of;( Pf1MT!Oli Iu1(lude !IP COUT) Irw 1, IvLU1111 IILLAIIVE (Ndfllt• ,,INI ndJfYff • in(tudv hp iudr) RTT7 •' i I_i'INYIifll:uy F'L 3:;32'; fe. 4I[ML(x N[Ou[fTS COEYS U,n Uf VIf A;fAlkf T.•, 21. SIGNATURE Q EPAIIA1 CU 1(r 31 UI'I ILIAL AU1II,DII1r10 �IJ. flYPCLiI �f� Vfade. I'll, Jlld II!N•''u(vJ J�}�( ,np��E�{IG•.5 Ytht�^sYvl•,' , �'SfrF.t. AM I'll iHkl'•fl:i:1�N �EIIRI. YCIPlf.(tyrC,.,',•+y ,CI' fl9 •• G N • SPECIAL AWAY10IIAL INFORMAI'10N (rut mr br .wdoufseed agunpLa Only) 73. TYPE OF SEPA (f 24. CIIAIu,unl UI tflIVICI UudHdv upUlad1JJ DIDCHARGr jt ((!1�( UIM01 1AUNONAULL CONUITIONO (CIENERAL) 25. SCPAIlAT10N>A1I,T#PPITY,(?L. N. ,I rllnh nue CUUt I 1. IUu:IRY iuut _AR ICFri 30 311. NAIIItAIIVE REq 1�±�FOIL SEPARATI014 FOR THE BOBO.,t�ifi@l;RV10E; __ 39. until 0f 1'1M 40{tVVIING TIDS P(IRUDUNDff< IV-11.B.C. 7/2t 090102-41)U?U:1 m.1.uMuhl nlyui,lG Lw•r a OO f unn a14, •NQVt U Ihvnum .•durum .n. vin,n. I.' - CHARACTERIZATION OF SERVICE CHECKLIST FOR ADMINISTRATIVE DISCHARGE ACTIONS A member's record of current enlistment of current period of service will be carefully screened for data which would have a bearing on the final de- cision as to type of discharge certificate to be awarded. ATSB-SB F,0,P u 4939 lR,plan. USAARMC fwm 4979, Oct 84 Whkh my b. uwd) 1 Grade, Last Name, First Name, Middle Initial, SSN) SPC PCF. 2 .7,03: US?A019'C, !liFcT IQ80%,, ;:Y 40121-52.J.S 3:'0502 Unit ITEM NO ACTIONS REMARKS 1. Length of time served in the enlistment or period of service. 2 Y 1 days 2. Promotions and dates thereof. PV2 - 360E37_8 3. Reductions, if any, and dates thereof. Where there has been a reduction, the specific reason should be listed. 4. Whether there is a record of time lost, 890102 - 1190205 and if so, whether due to AWOL and/or confinement or other reason. 5. Whether there has been disciplinary action under Article 15, UCM7, and if so, list the specific offenses which resulted in such action. 6. Whether there have been any convictions by court-martial, and if so, note offenses, findings and sentence, and any subsequent actions in the case. 7. Favorable communications or recommenda- tions for the member. l� ATSB-SB F,0,P u 4939 lR,plan. USAARMC fwm 4979, Oct 84 Whkh my b. uwd) 1 8. Derogatory data, other than article None. 15 actions and courts-martial 9. Citations and Awards. (This may also ASR include personal decorations received. during prior service). 10. Where derogatory data has been revealed, Mone make note of whether there is evidence or other indication of successful rehabilitation. H. Medical or other data meriting consideration in the medical I`• evaluation. REMARKS: t -Signature of Unit Commander T RRY L - BURMS ct"P, r1w COtVANDING IA 4M4),NmMKn -Aw WM e WI a zw N a h Y " � � " a,, �' LAWTON CHILES GOVERNOR STATE OF FLORIDA JAMES T. MOORE, COMMISSIONER FLORIDA DEPARTMENT OF LAW ENFORCEMENT THE COMMISSION ON CRIMINAL JUSTICE STANDARDS AND TRAINING Hereby awards to LEIF E. BROBERG BASIC RECRUIT CERTIFICATE CERTIFICATE OF COMPLIANCE LAW ENFORCEMENT OFFICERS 668 HOURS For having fulfilled the requirements for training as prescribed in Chapter 943 of Florida Statutes M L416 „_ MARY OU RAJCHEL, CHAIRMAN CRIMINAL JUSTICE STANDARDS AND TRAINING COMMISSION MAY 14, 1992 eA4- JEFFREY VJEFFREY W. LONG, DIRECTOR DIVISION OF CRIMINAL JUSTICE STANDARDS AND TRAINING 16-90-002-02 CRIMINAL JUSTICE STANDARDS AND TRAINING COMMISSION CERTIFICATE ISSUANCE LOG PSR416 : 6/03/92 COURSE TITLE: CERTIFICATE OF COMPLIANCE COURSE SEQUENCE NUMBER: 16-90-002-02 SOC -SEC -NUM LAST NAME FIRST NAME BROBERG LEIF PAGE# : 28 RECRUIT LAW ENFORCEMENT I ENDING DATE DISCIPLINE ORI E 5/14/92 FT LAW FL0500300 Boyn-lcn 8eacb, PCU-ife Depcti-17nev)fi o(oIis�z I HEREBY ATTEST THE ABOVE CERTIFICATES WERE RECEIVED ON IF APPLICABLE. PLEASE RETURN ANY CERTIFICATES FOR INDIVIDUALS WHO DID NOT SUCCESSFULLY COMPLETE THE PRESCRIBED COURSE OF INSTRUCTION OR WHERE DELIVERY IS NOT POSSIBLE. TRAINING DIRECTOR/COORDINATOR NUMBER OF CERTIFICATES PRINTED 1 I ci w tA tA 9 " (D O - %����; til �� _ _ate " 1 1 �� 1 ' " " lb / 1 \ " L " \con L:l Es M�f N e W Off``\ O Q7 T mV�\ S V IN I rn n � Or IU 4 �\ N I E V aqm Z �mmmmmmm����,�mmmmmmmmmm�mm��mmm aaaaaaaaaaaaaaaaaaaaaaaaaaaamuu c o a a c v a m m m m m m m m m m m m 0 m m m is m 0 a m m 0� m m m m m m m m raD�m m m m m m m m m m m m m m m m m m m m m m as Q a'e do w no w' w' w oa a as as w ma as vo w Da w' ao w' oa Da w' as as va as as aD Z m 3 m zi; Z m O m 9 W O N M n y D T C m 0 0 `- c �3 3 m u, 1I�m m 0 m O in c n o -fDi K o e' vO N n ra m n� n n T g m o- w ° .m. or O A p 5 -� 3 Da m m m m O m n 7 Ln G n V1 w S -� _S --pp w n O rr a '_'f CL ^1 m O° x m O d i y m 0 oi' ���� ° w �+ n m O n m 9 aha ' m> > Bi m a= N y m m C1 q Q° v O 2 0 0 G o w o s b D �^ 3 vii m w 'm 4.. "' m omi -{ i a p N m m O T --1 ° m c^ 3 n N D N > > O C � H O �. w vmi w •tea rNa c m � o m � w m m N 3 O � 4a ° � y al — � n a 0 m 3 m N N 5 r N C 2 O c IA n m 7 2 N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 rrrrrrrf+ N W m m Of pl Ol Qf Ol N ap W V V N N N N N O Y �D A 0 0 Y 1p {p A Y O °� N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N m p o o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 p 0 0 0 0 Y N \ O O Oi N � O N r W O OD W W m m m m 0 L � L � v � � � •OD •m0 S � � L � � 'm0 � 'OD "m0 � 'm0 '09 'm0 10/1 'O 'WO V •mD � v v o v o v v v v v v v v v o v v v v v v v o o n v v e v o s n m O 0 m � \ Fa tD N O F+ N W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W l l 1 1 o 1 1 1 �{ 1 'l 0 0 0 0 0 0 m t 0 0' o m m m m m m m m m m N Q C' a• c o' [r Q a• p' v a a' v C• ar 6 Q of �' Ir Q m m m m m m m m m m m m m m m m m m m m 03o�ola3aowoca'av'oaom m m onwo'aa'owaaw'aaw'ww03mooa'oa m"Ro a Rao z d 3 m m m m m m m Fo ro ia � �a m m m m m T T T T T "F T T 1� �/i 1� � T "'1i T '9i •-li T T T T T M T •�Ii �� '� � yj yj Z d 'o o D m oii o v O Si as 0 n v+ n 1 'n W O Z 2 W -n i m z< n 3 3a �• vii c `�° m m o>>> m am m n n m a c m m f a z nto m an d 0-4 L7�a < m arD tW0 �D D " d -mi, d E � `� N d' D p It x m �' a m to `da m a -1 m e m s m. m ID.a, N m m O 3 v w o f v 1 0 � rte, w �• v S m o o w m .mN. n o' °� A a ._. W X,3 _R. C d d 9 o: n d Q' n 3 o O H w a o o = m o m yo C N � at) fNp N � N 2 O C n m 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o a o 0 0 0 0 o m \ \ - \ W b V V V V J V 1 \ � \ N N \ W Y Y Y Y W W \\ of Q� Gl N. �I �( J �! t0 W F+ O t0 i-+ m a_ N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Nm V V V V W W W lO w lD l0 (p to tp w w w w w O O O O O O o O N Y N Y O d r+ m N W W v v W o W v m Wm o W o W v W v W o W v W v W o W o W v W v W v W v W v W v W v W v W o W v W v W v W v W o W v W v s n d D 7 W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W o a o o '0 0 0' o' o o 'o 'o 0 0 B o' o' o o' 0 0 0' o 0 0 0 0' 0 d m m m m m m m m m m m m m m m m m m m m m fb m m m m m Cm waoa3w'a'vvD�oaaoD3wwvuD�m�a'oo3aaoawD3a3wa aw'aaaa W'ww' m 3 m m m m m m m m rn m m i—D m m i—D 1D m m m �D m i—D nr m m 9 m �D 1ft `T T 1i T 'a�h Z m 3m' p m z of r C C c c o D f1 A A f7 �'• a n m p �c y m D 3 s 3 m O v L m ... CL '1 U G T p _ @ 7 » 'W-� N p� N j' (\j 3' 3w 00 z e w o m m c 2 O O n m' C -n to 5l a O W a. w' z s 0 -o 'm 03 m S O O Si E 0 0 O m' °° \ T N 2 H_ w 0 m o 3 m m w m m m ro 0 0 = w m O O m 0 m o m • 3 $ d m o c m 13 m 7n Li m N N cr N O =i 3 3 Do m m W 0 " w 0 m 1 50 0 on a0 .Z y O OQ C a C CL m E A W {JI N N N A A N A !+ H �+ H �.. N W N W W N N N VI Q X O C Vl A m f m 0000000000000000000000000000000 040000OOO000OOOOOOO0000OO00000 �'' O �-'' �-` 4•` F, N P.+ N N N A A A A 0o0ooOOo000000o0o\00NN 0NNWN 0000yNON.1 ppNOWN N0WNO 0NONW N0ONA 0NNAD 0ANON 0NOWO 000000 0 0 0 0 0 0 0 0 0 0 0 00 0 0 00 0A 0 0 0 0 0 mDW V V V V V V V V V V V V V O m .r m N W� W W W W W V W W W W W W W W W W n W W MWWEP W W W W W S W W W W W W W 3 o o v o o o o o a o W W W W W 0 0 p 0 0 0 0 0 v 0 v O o v v o v v 3 o o o o o W v v v v o v 0 0 d m m n m -O' A l 1 1 1 Z 1 1 1 Z 1 1 1 O O a 0 a 0 0 0 0 a 0 c 0 0 0 0 0 0 0 p p O 0 a 0 0 0 0 0 a 0 0 m m m m m N m W m ry m N m mm m m m m fD fD m to m wo'awa'awwa'oo o3 v3 o3 a3 al o3 aawwaa o3 vo v3 oa a a'o a a3 a a3 a oa a w m 3 m m m m m r m m m m m m m m m m m m m m m m m Z a o m o m m G C m? C C C C C r r r_ N o p N m N m c Q Q. a d �dp a a o 3 eD a o a d _ C O D D w m 0 o 9 3 3 N c N 3 a o m c N m N W CL -pig m m n O< j m Oa o m Si x 'D 5 3 m w v= m m m m Oa �» w 0 m umi :3� ani -". O o O m m O 7 N N N N N w N Y i 1- i+ 1+ m N N N N N H 1 F+ " N F F W N w F N N 2 O C 7 A ro 7 ti m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 W W W W W W a to 14 Ip N N N N F-+ N N A DD 00 00 O O O N W W\ W N N H N N N N W\ N tp `tp N N N tp N 1+ N O Ol Q� Ql Ol A A A O Vl N N N N N N {Jf V� V V d N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N m 0 0 0 0 0 0$ 8 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N N N N N N N N W IOi! A a a A O d m N m m m m W m m m W m m m m m m m m W W W m m m W m W m m W m W O O O D O O O O D O O O O O O O O O O O O O O p p 0 0 0 0 0 0 0 � g = T_ N O 4 r N O Ln H 0 a 0 0 0 0 m W lP lA W W m W lD W �mmommmmomf7mm(OT ����gg aDaaaas o3waom�ww' ma3v3vao3 t3 ad R3 a3 w' m m m m egm v3 o3 o3w'o3v3wo3woac3wvo ro'o3 m r r r r r r 3 'yl T z n CL m _ K m a $ m o > =� 3 O d fel w m o+ m m w 7 N .S :S d d m m n � T ro m � C n h m m O _ -I a N O O C � N = y m CL g a tb m t1 2 O c m _ W W A N to m V 00 o N J.- N O O O O O O O O O O O O O O O O o O p m \ \ \ \ \ \ \ \ \ ~ W (n O V d A In m V "' �+' \ \ \ \ N N O lD l0 w lD lD lD lD tD tD to to [D lD tD tD to t0 lD to t0 IO N 4\+ l\+ 1\+ pN N N N pN lQ� N lb lb 1p W 00 W co W W W 00 W tD tD to to to W W tD to tD to t0 tD O O Op O G O tD tp l0 lD lO W lD tD tD O tD lWo to lWO LD O o O O O O i i i i O d N W CO W W Om�mwmm N v O v ro < W d O v v o? 'D '7 V '07O W W W m m tv O t7 p t7 0 o t7 o G W W W W ca a)m 0 0 0 0 C v o O o o O C 0 d o 0s m d O tD N O to Ln i i i i v m m r' W W m W m W W W m m W m m W m m m m OJ m m m m m m m m m Z l l '7 1 l 1 l l "l Z Dry ll 1 1 1 1 O O O O O O O a O D 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 m m m m m m m m m cr m m m m m w w' 03 as al w oma 4 mi m www' w tm www a� w o3 a'o tm w' w' 03 w w' m 3 m i—D FD m m �D m fo �o �o fo' fn' mr m � � in !n �o �n m � m � m �o m �c' m '—'• Z d N n a c D O n n o Q A r r r r C c C C C C C O f, Q- m m c. c. mm �' a an d M a o a o 0 o mm O n G ' �e n = m z m< f° m m m M. Z 5 =i � r 2 D y m m m 9 an @ N 63 m ms 4 a 0 0 3 > p a o o>> DQ N DC m Dl o > m 3 0, 3 N N N m n aqa tt � � m m k o 1 3 w m 0 NJ 1. y W m — 3 n O- O 0 3 tT O -O Oma O O A A ca m m N a N N m Y d Y N N Y Y m Y N N H Y N N d m O C N n m rt c A m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N W\ Y Y N\ N\ Y Y N N\ N N lJ W Y Y N N N W N Y N 0 A W O Y O �! W O1 N W A A N W Y O W O m !n V Of lD Y Oa m m m \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ N N H Y Y Y Y N Y N Y Y Y Y N i+ m lY0 �•+ lYD IYO lYp Lo to w w w Y m tD m tD tD tD tO tO tD tO tD m m m lD lO N N N W W W A A. to ? loll Ln Ln Ln Cto to to il V V V V V V V V V V OODD O0D OODD coo Y N N \ N \ Oa rm-r La m N N � m m m m m m W m m m m .� m m w m m m W T m m m m m W m m m m m m m m m W m m m m W to m m O p 0 m m m O W m n v o o o o o v v v v v v v v v< p< v -o v< v v n p 0 0 0 0 0 0 p 0 0 0� O p» p p p ti p p 0 0 6 E O [ot O W 7 7 m m m m m m m m O CD N a) 7 S � � t Z O LT' L 0 LL P4 H P M 5 i LEIF ERIK BROBERG • • leifo l5(rt11,*mnil mm Summary Highly dedicated, experienced and professional career law enforcement supervisor with 25 years of service, with a focus on community policing. Considered a highly -effective manager and leader that has always been able to easily motivate and inspire subordinates. Has been in a supervisory position for over 14 years. Prefers challenging work and enjoys working in a team environment. Qualifications / Skills Supervisory experience Communication Reliable Proven leadership skills Observant Perceptive Active listener Positive attitude Problem solver Attention to detail Adaptable Trustworthy Education Lively Law Enforcement, Havana, FL November 9990, lam Enfotrement Certification Broward Community College, Davie, FL 1988 Western High School, Ft Iauderdale, FL Graduated 1987 Experience Boynton Beach Police Department, Boynton Beach, FL Sergeant/Acting 97ateb Commander • Responsible for supervision of 12 road patrol officers 2002-2016 • Prepared and presented reports used to evaluate officer performance • Identified opporttmities for training and enhanced productivity • Planned, conducted, and adjudicated internal investigations on minor disciplinary infractions • Scheduled officers' time off and vacations to ensure minimum staffing levels were met • Managed police and civilian personnel in the creation and execution of major events for the city • Under supervision, platoons outperformed entire department in self -initiated arrests, motor vehicle stops, and proactive crime prevention activities • Active watch commander for Uniform Services. Commanded day and night shift patrol squads performing duties as a lieutenant BOyntOn Beach P011Ce Department[ Boynton Beach, FL 20042005 Training Sergeant/Field Twining OffrarPmgr= Qvi&flarar • Coordinator for 12 PTOs and numerous recruit officers upon police academy graduation • Researched and developed training lesson plans for personnel • Maintained files and records of department police • Preserved documentation and training records for each police officer Boynton Beach Police Department, Boynton Beach, R 1992-2002 Road PatmlOf fcer/FTO/Commmmity Bike Patrol Q*w • Protected life and property • Responded to emergency and non -emergency calls for service • Reduced fear of crime in city through effective patrol techniques • Publicly praised by department for community policing • Trained new recruits on proper department policies and procedures • Problem solving using community policing philosophy United States Army 1988-1e89 Infantry soldier and meipmry commander' Perron! driver Commendations • Four meritorious service awards • Two police duty metals • One combat award • Officer of the Month numerous times I am also proud to be affiliated with Adopt a Cop USA, in which police officers mentor at -risk children, helping them leam bow to make positive choices with positive consequences.