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HomeMy Public PortalAboutCrossing Guard Carolyn HulionCONTRACT FOR SERVICES THIS CONTRACT, made and entered this day of 40.1 , 2019 between the CITY of Crestview, hereinafter called CITY andCG•rolynv fC01/61) hereinafter called SCHOOL CROSSING GUARD for a period of the remainder of the 2018 / 2019 and duration of the 2019 / 2020 school year, unless terminated by either party. WITNESSETH: WHEREAS, the CITY Council has directed the Police Department to establish and implement a School Crossing Guard Program. WHEREAS, incumbent CITY personnel resources cannot provide the manpower required to implement this program. WHEREAS, it is deemed prudent, wise and beneficial for the CITY to utilize the services of local residents that possess the capacity to function in a part-time contractual work environment. NOW, THEREFORE, THE PARTIES HERETO AGREE AS FOLLOWS: ARTICLE I The SCHOOL CROSSING GUARD shall be responsible to provide services for the CITY to wit: 1. To ensure the safety of children and pedestrians crossing the streets and highways at designated intersections and/or school crossings. 2. To be on the crossing at the prescribed times and not to leave the crossing unattended unless in an extreme emergency. 3. Compliance with uniform regulations with respect to attire, equipment and appearance. 4. Providing their own transportation to and from the assigned crossing. 5. Maintaining an accurate record of arrival, departure and any unusual occurrences on the assigned school crossing. 6. The immediate notification of the Police Department in the event a person is injured or a motor vehicle accident occurs. 7. Operates communications devices as directed by the Chief of Police. 8. Operate CITY owned equipment as directed by the Chief of Police. 9. Possess a valid Florida Driver's license. 10. Display and employ tact, firmness and communication skills with the public and department members. ARTICLE II GENERAL REQUIREMENTS OF SCHOOL CROSSING GUARD 1. Provide services on a scheduled basis, determined by the Chief of Police: 2. Accept the sum of $30.00 daily paid each Friday; CITY shall not withhold or match Social Security, Federal withholding tax or any other amount requested by SCHOOL CROSSING GUARD; IRS Form 1099 to be provided at the end of a taxable year. 3. Attend any required training sessions. 4. Receive direction and supervision from the Chief of Police or his designate. 5. Agree to be evaluated by written documentation on CITY evaluation forms as required. 6. Arrive punctually for work and be properly attired. 7. Acknowledge the fact that should a vacancy occur within the regular CITY workforce, training achieved under this contract is one of the basis whereby SCHOOL CROSSING GUARD may enhance his/her selection opportunity notwithstanding personnel and procedures of Crestview, Florida currently in effect. 8. Provisions of this contract may be amended by either party subject to written notification and agreement by the other party. 9. The sum per day is $30.00. I`ll ir I �( 9t� SCHOOL CROSSING GUARD SIGNATUR, Executed and witnessed our hands and seal this e; v day of Notary Public (SEAL) Imo',e5t-Pei Fr t O CpD 3 Sol►#4,24d — NOTARY PUBLIC (Printed) �.�e I ( 2019. J.B. Whitten Mayor Elizabeth M. Roy City Clerk Date S Date CITY OF CRESTVIEW Office of the City Clerk P.O. Box 1209 Crestview, Florida 32536 APPLICATION FOR EMPLOYMENT "AN EQUAL OPPORTUNITY EMPLOYER" Position Applied For: ::S L,\y 01 CA—n5 s't PERSONAL C-Du aC Dale: ©11.4) 5 / / 1 Full Name: (L i I r o f i I, h /- Last First M.I. r Address: r^if-� n H,j iv `Ref , Street Address Apartment/Unit # City e re.64- v 1 e.0 State Zip Code { c �JYI Phone: (Q so ) `.:239 g •-- ©'eo ep E-mail Address: A LI t O A 4, ( Fn.l( G r rva.1.i I• C Date Available: � O 6) Social Security No.: 24, -- i % —61 ( 00 J Are you a citizen of the United States? YES NO If no, are you authorized to work in the yi $, U.S.? l � Have you ever worked for the City of Crestview? YES NO If yes, � r o SS t nC 9wkr" d R.6 o Lt.} when? 2 ye 6tr5 430 I/ Are you related to anyone working at the City of CrestviewilaQ YE If yes, give: Relationship: 5i 5'le_C ( n Low) Have you ever been convicted of any offense against the law, or pleaded guilty, nolo contendere (no contest), or had adjudication withheld, or entered a court sponsored program, or forfeited collateral, or are you now under charges for any offense against the law? You may omit: (I) Traffic Violations, (2) Parking Violations; and (3) any offense committed before your 181 birthday which was finally adjudicated in a Juvenile Court or under a Youth Offender law? YES n N If yes, explain M eawmia (Rev01si List any special skills, software or abilities that would qualify you for this position. Please submit copies of any valid professional or occupational license(s), registration(s) or membership(s) relevant to the position. For example: Florida Certificate in Water/Wastewater Treatment; Florida Professional Engineering Registration; etc. Please list three professional references, other than relatives who have knowledge of your work experience and/or education. Full Name: Ng le_ I�pis,nson Relationship: I //�� LArr rt4 aiipe.rUfs�r Phone: ( ISO ) 4.702-�1(1,5 Occupation`/ )1/54/ del- ML1ltGrAc�s / i �� kte4j5 t Address: O 'nr) __ , / J Full Name: ao %�) e_ tije L 5 I, 'Relationship: P I cdl C]/ Xl e it Gl 1 r Occupation: C C-Cl C' h ar /1,40u t Ee -1 C* l )) j Phone: ( (65a ) �`^9' g '- 6, � s -3-61, cc- 5 -1-J j e c„,) Address: r P / ,`Y e"' / x, R„, C._- n NI; Full Name: e 4--3 Pr,�1 I, 1C{ Ctn. Relationship: r y-; e,t'1 d Occupation: "Re IL) re 4 — Br id3J tt )0.4 Phone: (ESD ) S20--(0/9 Address: %l /Dar •PLI Lp . C4._.4-iLe_LJ EDUCATION High School: Cre_34'1Jjti1.) /.4i Address: l._(CS•-i'oi,e_ta) !- f, From: c l t j l To: / 9 J O I Did F„ YNO Degree: 0, p (� you graduate? V College: Address: From: To: Did Degree: you graduate? In t Other Training: Address: IIRHR012 (Rev012) Employer: ';ontrac--'c`al -Por ,/V kir zyt1y mz_05 Phone: (go )&o3 j3Ltts. Address: Supevisor: ha)C kOt-irlSC5/\ Ending Salary: $ Job Title: e_Xl C i t E. r Starting Salary: $ Responsibilities: Pic {: uo, A5�e-I kble � lie_/, ue_r ije (,�s,P a toed From: B 995 To: CCLtffen °i Reason for 1 Leavin : S'�f l t76�<inc+ May we contact your p evious supervisor for NO J a reference? U/ 1 Employer: 3; ) lu e r not rw--5 0-(0 n d a Phone: ( (AS-o) A j / •- tJJ o /o q, Address: e stid I n Pit Supervisor: Pr 1,-/ McN _rt f( Job Title; -) i nr, Starting Salary: $ 2 ,7 D 4 r Ending Salary: $ / / r 6 3 A r L/lSelf Responsibilities: i ea_ r,V C "jgZ01)S From: iota rigb To: (p� 4- Reason for 5�`.� spy oc[ Leavitt : r CPJ t rti�.SS May we contact your p evious supervisor for YES j�JLtS ,5�f�.ea C fig re AH r (, t or Rect.) a reference? (—I v Employer: Phone: ( ) Address: Supervisor: Job Title: Starting Salary: $ Ending Salary: $ Responsibilities: From: To: Reason for Leavin : May we contact your p evious supervisor for a reference? ti n If you are eligible for veteran's preference, please provide form DD-214 at the time of the application. Check the appropriate block if you are claiming veteran's preference: 1. A veteran with a service -connected disability who is eligible for or receiving compensation, disability retirement, or pension under public laws administered by the U.S. Department of Veteran's Affairs and the Department of Defense, or 2. The spouse of a veteran who cannot quality for employment because of a total and permanent disability, or the spouse of a veteran missing in action, Captured, or forcibly detained by a foreign power, or 3. A veteran who has served on active duty for one day or more during a wartime period, excluding active duty for training, and who was discharged under Honorable conditions from the Armed Forces of the United States of America, or 14. The unmarried widow or widower of a veteran who died of a service -related disability. 5. Any Armed Forces Expeditionary Medal is qualifying for veteran's preference. The Global War on Terrorism Expeditionary Medal is qualifying for veteran's preference, provided the individual is otherwise eligible. NOTL: Under Florida law, preference in appointment shall he given by the sloth to those persons included in 1 and 2 above, and second to those persons included in 3 and 4 above. Fan applicant claiming veterans' prefe owe for a vacant position is nut selected, hetsbe may file a complaint with the Department of Voter:up Affairs, ILO. Box 31003 St. Petersburg, Florida, 33731. A complaint must he tiled within 21 days of the applicant receiving notice of the hiring decision made by the employing agency or within 3 months of the date the application is filed with the employer if no nonce is given. kS hllttlRal2 (Rev 0TO APPLICANT'S CERTIFICA-flON AND AGREEMENT: CERTIFICATION: I certify that answers given herein are true to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of my employment, I understand that False or misleading information given in my application: interviewts) or any part of the employment process may result in my discharge, I understand that if offered employment with the City of Crestview, I will be required to provide proof of eligibility to work in the United States and will be required to abide by all City of Crestview rules and regulations. AGREE:I-IEN'TS: 1 am furnishing my Social Security Number on a voluntary basis with the understanding that law or regulation does not require such. I have been advised that the City or Crestview will utilize this number only to facilitate the location of my records in order to conduct background investigations. PHYSICAL EXAMINATION: I understand I must take and pass a physical examination before the decision to hire me is complete. I understand that the physical examination will include a drug screening test. Any illegal or unprescribed controlled substance which shows in my test results will cause my immediate disqualification for employment with the City of Crestview. DRUG FREE WORKPLACE: I understand and agree that the City of Crestview is a drug free workplace. The City of Crestview may conduct drug screenings for: Job applicant testing, routine fitness for duty testing, reasonable suspicion testing, post accident and injury testing, follow-up testing and return to duty testing. Disclosure Statement; By this document, the City of Crestview discloses to you that various reports may be obtained for employment purposes as part of the pre -employment background investigation and at any time during your employment. I understand that these reports will not be used for any propose other than employment. Please sign below to signify acknowledgement or this disclosure and authorization for the City of Crestview to request copies of such reports. Upon termination of employment, 1 understand the City may hold my final paycheck until a final accounting is made for any City of Crestview property in my custody, or any monies owed the City of Crestview. Applicants needing accommodations to complete this application should contact the City Clerk's Office — payroll Division at 682-1560 ext. 268. Thank you for your interest in the City of Crestview. Because of the volume of applications the receive each day, we are unable to contact applicants unless they are selected for intervieovs, vISCr OUR WFBSITE FOR AVAILABLE OPENINGS: www.citvorcrestview.oro FOR OFFICE USE O.\LY College Transcripts Driver License DD314 (military discharge) _ With School Diploma`GED Certificate State Certiticmions Received by Datetsk Incomplete _ Position applied Date sent to Department - - - Depurtmem EMPLOYMENT APPLICATION SUPPLEMENT To: Applicants for Employment The Uniform Guidelines on Employee Selection Procedures require records to be kept by sex and the five race/ethnic categories defined by the Equal Employment Opportunity Commission. The Uniform Guidelines on Employee Selection Procedures have been adopted as final rules by the Equal Employment Opportunity Commission, the Office of Personnel Management, the Department of Justice, the Department of Labor and the Treasury Department. The City of Crestview City Clerk's Department has adopted safeguards to insure that the records required are only used for appropriate purposes within the Payroll Division. The information requested below is needed to satisfy Federal Equal Employment Opportunity reporting and research requirements. This information will NOT be used to evaluate your application and will be filed separately. Although the following is not mandatory, it is requested to aid the City of Crestview in its commitment to Equal Employment Opportunity. It is unlawful for an employer to fail or refuse to hire any individuals or deprive any individual for employment opportunities because of race, color, religion, sex, national origin, age, marital status, or disability. Applicants who believe they have been discriminated against may file a complaint with the Florida Commission on Human Relations, Building F, Suite 240, 325 John Knox Road, Tallahassee, FL 32303. (Please print) [Name: an on p ast First Mi Date: eD s:2/ // / g Birth Date:D495 Sex: Male h Zip Code: a 2-3 a Veteran: Yes ear (')/� Please check the box next to the ethnic group you belong (select only one): Social Security Number: 26 / / / DO H./ Female No American Indian or Alaskan Native (the original people of North America and who maintain cultural identification through tribal affiliation or community recognition) Asian or Pacific Islanders (the original people of the Far East, Southeast Asia, the Indian Subcontinent of the Pacific Islands) Hispanic (all persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin regardless of race) Black (not of Hispanic origin) VWhlte (not of Hispanic origin) HRHIta 13 iltev 0121