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HomeMy Public PortalAboutCrossing Guard Harry TomlinCONTRACT FOR SERVICES THIS CONTRACT, made and entered this 23 day of APn'( , 2019 between the CITY of Crestview, hereinafter called CITY and kkri".1 TO01 %11/ 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. SCHOOL CI OSSING GUARD Executed and witnessed our hands and seal this 9"3 day of Notary Public (SEAL) ifirriesied `ZIre Cp)) f5 ScNe,'�� NOTARY PUBLIC (Printed) 2019. . Whitten Mayor Elizabeth M. Roy City Clerk Date Date np`.ry z Employment Application Form Applicant Information Full Name: Tomlin Harry C Last Address: 162 Villacrest Dr Phone: First M.L Date: 2/19/2019 7:03:12 PM Street Address CRESTVIEW ApartmenVUnit # FL 32536 City 650-687-7922 E-mail Address: State hctomlin@cox.net ZIP Code Date Available: 02/20/2019 Desired Salary: gopen Position Applied for: SCHOOL CROSSING GUARD (Contract Position) Are you eligible to work in the United States? Have you ever worked for this organization? Have you ever been convicted of a felony? If yes, explain: Full Part Time Time Employment Desired? Hours of work (per week) desired? 10 (Number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, and sentence(s) imposed) Education High School Clarksville High School College Faith Covenent Theologica Other Address: Did you graduate? Clarksville, Tennessee YES NO © ❑ Degree: Address: Palm Harbor, Florida Did you graduate? Address: Did you graduate? None YES NO El Degree: Bachelor of Christian Min YES NO Degree: Previous Employment Company: Address: Job Title: Crestview Police Department 201 Stillwell Blvd, Crestview,Fl Chaplain Starting Salary: $0 Responsibilities: Volunteer chaplain for department. Spiritual and emotional care. Phone: 850-682-3544 Supervisor: Mark Broadhead/758-2029 From: 08/16 To: N/A Reason for Leaving: Still employed YES No May we contact your previous supervisor for a reference? © ❑ Ending Salary: $ 0 Company: Address: Job Title: Crestview Mennonite Church Phone: 850-682-2212 385 E. Cobb Ave, Crestview,Fl Pastor Responsibilities: Pastor congregation Supervisor: Dave Landis (251-294-3014 Starting Salary: $ 0 Ending Salary: $ 0 From: 11/14 To; N/A Reason for Leaving: still employed YES NO May we contact your previous supervisor for a reference? © ❑ Company: Phone: Address: Supervisor: Job Title: Starting Salary: $ Ending Salary: $ Responsibilities: From: To: Reason for Leaving: YES NO May we contact your previous supervisor for a reference? ❑ ❑ Military Service Branch: U.S. Air Force Rank at Discharge: Master Sergeant From: 1962 To: 1985 Are you currently in the Armed Forces? YES NO References Please list three professional references. Full Name: Sam Kinnison Relationship: Friend Company: Crestview Police Department Address: 201 Stillwell Blvd, Crestview, FI Phone: 850-305-7831 Full Name: Bob Grappone Company: Okaloosa County Sheriff Office Address: 416 Whirlaway Ct, Crestview, FI Relationship: Friend Phone: 850.240-0686 Full Name: Ben Martin Jr Company: Martin Landscaping Relationship: Friend Address: 5570 Tom Page Ln, Baker, Florida Phone:. 850-537-8447 Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment. I understand that the company may require me to successfully complete a pre -employment drug and alcohol test as a condition of employment and that continued employment may be based on the successful completion of similar tests. I understand that the company may as part of the hiring process request an investigative consumer report from a third party entity or agency including information concerning my character, general reputation, personal characteristics, credit records, and mode of living. I may make a written request to the company to provide me with additional information regarding the nature and scope of any such report. I understand that employment with your company is at Sr and nothing in the interview or hiring process, this application, or your company policies are intended to create an employment contract between myself and the company. Employment may be terminated by either party at any time for any reason with or without notice. Signature: Electronically Submitted Date: 2/19/2019 7:03:12 PM Para informacion en espanal, visite www.consumedinance.gov/learnmore o escribe al Consumer Financial Protection Bureau, 1700 G Street N, 61!, Washington, DC 20552, A Summary of Your Rights Under the Fair Credit Reporting Act The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, faimess, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records), Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552. • You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment— or to take another adverse action against you — must tell you, and must give you the name, address, and phone number of the agency that provided the information. • You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"), You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if: • a person has taken adverse action against you because of information in your credit report; • you are the victim of identity theft and place a fraud alert in your file; • your file contains inaccurate information as a result of fraud; • you are on public assistance; • you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.eov/learnmore for additional information. • You have the right to ask for a credit score. Credit scores are numerical summaries of your credit -worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender. • You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance,gov/learnmore for an explanation of dispute procedures. CITY OF CRESTVIEW P.O. DRAWER 1209, CRESTVIEW, FLORIDA 32536 PHONE fP (850) 682-1560 FAX k (850) 682-8077 Acknowledgement and Authorization I acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION and the SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT AND REPORTING ACT and certify that I have read and understand both. I hereby authorize the obtaining of "consumer reports" and investigative reports" at any time after receipt of this authorization and, if I am contacted for employment, throughout the term of my contract. I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service buueau, employer or insurance company to furnish any and all background information requested by any consumer reporting agency acting on behalf of the company. I certify that the information provided is true and complete to the best of my knowledge and agree that a facsimile ("fax") or photocopy of this authorization shall be valid as the original. I agree to receive all communications regarding any consumer report or investigative consumer report as may be required by the Fair Credit Reporting Act or such other state or local laws via email at your designated email address. _ Oklahoma, Maine, Minnesota and California applicants may obtain this consumer report by checking this line. California applicants only: For consumer reports, which were not obtained by a consumer reporting agency, by checking this Tune you waive the right to obtain a copy of this report. If unchecked, you will receive this report within seven (7) days of the employer receiving it. California only: for reports obtained by Southeastern Background Services LLC, California applicants also may review the file Southeastern Background Services LLC maintains on you during normal business hours, upon submitting proper I.D and paying fees associated with making copies of those files. In the State of California, a new Disclosure and Authorization/Release of Information form is required each time a subsequent Consumer Report/Investigative Consumer Report is going to be requested. The nature and scope of the consumer report or investigative report is the procurement of reports such as consumer credit, criuninal records, civil records, driving records, employment verification, education verification, professional License verification and others. Applicant: Signature Date Printed Name Email Social Security Number Date of Birth Driver's License Number State of Issuu<nnce Address