HomeMy Public PortalAboutCrossing Guard Bruce DwyerCONTRACT FOR SERVICES
THIS CONTRACT, made and entered this a3 day of 4R-0 , 2019 between the CITY of
Crestview, hereinafter called CITY and 'Blru 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 $30.00.
. l Y02__
--'8-6HOOL CROSSING GCIARD
Executed and witnessed our hands and seal this c33 day of�n�1 2019.
Notary Public
(SEAL)
5:
FTLt-0 Cp N4,`
NOTARY PUBLIC (Printed)
J.B. Whitten
Mayor
Elizabeth M. Roy
City Clerk
-4/7
Date
3_-9-i�
Date
CITY OF CRFSTVIEW
Office of the City Clerk
P.O. Box 1209
Crestview, Florida 32536
APPLICATION FOR EMPLOYMENT
"AN EQUAL OPPORTUNITY EMPLOYER"
Position Applied For: ,Sc A001-- rj 0,5,5` 6;(1 /2/ )
PERSONAL
Date: ` /Z
e /
Full Name: DLL)yPrz_ 0,2Wie- C/
Last First kl.1
Address: /C/ S:j/7/2� Z 96/e_
C�
Street Address
Aparonent/Unit #
02-e5/ I/.1eP/ P% ?,36'
City(L3`0
Since Zip Code
Phone: 4/ i
) 7/0- _��
//,•, 1/ ,
E-mail Address: Cw%yf/'��� yjy+��L . (,Zy
Date Available:
i7`2..//5e
Social SecurityNo.:
y{�/Zl/CP
%a-,-,/,• c297—C"____
Are you a citizen of the United States?
YES
NO
If no, are you authorized to work in the jam$ J IO,
yJ
U.S.? I I �f
Have you ever worked for the City of
Crestview?
YES
NO
If yes,
when?
J
Are you related to anyone working at the
City of Crestview
YES
If yes, give: Relationship:
n
it
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: (1)
Traffic Violations, (2) Parking Violations;
and (3) any offense committed before your
le birthday which was finally adjudicated
in a Juvenile Court or under a Youth
Offender law?
YES
n
N
If yes, explain
ruaixoiz
I Iiev 012)
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.
poe9ce 0940e�r2,4-22rz 2S t%_; /cam` /1%9thr,Vj�iv(.942- >:
�T 0/2chfr . porgy
F0//7/92 F%4- /0»ce 1/2.-e///72, Ca/4 59,--
A yen -
Please list three professional references, other than relatives who have knowledge of your work experience and/or
education.
Full Name: i�/�67 ��% /�
Relationship: �/e'x acr ��,,
Occupation: ChA,ty
Phone: r74 d/24
�((7
Address: {�i 27(: � /�//e%-(/.�/fi z) 7, /%4 yryA4,
/
Full Name: 157�j,4) C9-G/777-47 -
Relationship:
6.Q�7/'/�/a?J�
Phoney: 374 --/7M
Occupation: �OL//,�� (�,
/4�1d)
n/6 Address: r 5774.2r
/ 42 (2,641;e6 2, /, �� 7":76I �
Full Name%/-30/� c.,7- jcJjyt/l�
Relationship:
j92,(74€1,29
Phone: (,_76 95{y4,,rr
, Aiij- 7eRIT% di,
Occupation:. J6 7?�
J
Address: lit( vI-1( .5/904)7 Cr /92r (n9r./9i0
EDUCATION
High School: 4596/P59t///qh
Address: ye42,a%/-sf%5:- fyf-
From:
�Wer
To:
1 9 % /
Did
Degree: G•e, VC_41%--
you graduate? )(
College: izetiao (,62,9.7
Address: Ci���))%on- , /41—
From:
871
To:
1973
Did
YN
Degree: f 9f 4UC-(i
you graduate? n
Other � %
Training: �%(7 N/jj,/ / {�/ �'L'I /»1' n,� Y- Address:
i
HIU412012
(Rev012)
J >>
Employer: 6 fi
12r- (1,-�/ e
Phone: b0 ) 87‘ - -/7t%D
,Lf q
Address: L.5—gp gy7 3 %/ear /q'If,/'/%) w 147
Supevisor: s� �/9//ll
Job Title:
,,dui
Staru g Sa�ry: $ ///).-
Ending Salary: $ ✓2/9
VOL ?/
Responsibilities: /SSVe,, /2K/, i,*1 4 //�s�1/9t�/ 74/ grase �je�
From:
� % 7
To:
//
d i
Reaso fgr �J / / /��
Leavin /`j e.„%z � 62//. --
May we contact your previous supervisor for a reference?
?
YES
NO
�4,
Employer: �,1)e . /,i�4 ive,5764/. 6,,,:d��;
Phone: ( 261,) 32,0-2-537
Address: ,5790 17thMAC/
��7�
Supervisor: �j//� Je-
L-e ar
-- //
/6th
Job Tit1019-/Cf//�/X
Starting Salary: $ 2y Pe2
/�
/
Ending Salary: $ Qe7fi1/jr3-
/
Responsibilities: "ea-n2/--W /9//%9470-� a .g),"7 7.-5 Of)/22,9�j14)13 / `
From:
ZOO
To:
01 7
Reason for
Leavin : �erige ',
May we contact your previous supervisor for a reference?
YES
NO
Employer: Us �1//tty
Phone: ( 3/90) 9%f [far
Address: / 9'�i 2--
fiir�/ll% 7 ,,y,, , f'��N l 9e�
Supervisor:
Job Title: �jt/}yGG /)(�jjq y % -e(;,`ij Starting Salary $ i POO fl?irl
Ending Salary $ y0 (% r
Theinbeka-OP F/eer )1051'/�-e - ;J
Responsibilities: Fefi /ni 34j24- ,j
From:
/�,��
To:
2,�%()
Reason for // n� /
Leavin T/
May we contact your previous supervisor for a reference?
YF$
�Q
u
�
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:
Pa 11- A veteran with a service -connected disability who is eligible for or receiving compensation, disability
4 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 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
ement, or pension under public laws administered
4. The unmarried widow or widower of a veteran who died of service -related disability.
N5. Any Armed Forces Expeditionary Medal is qualifying for veteran's preference. The Global War on Terrorism Expeditionary Medal is qualilying
for veteran's preference, provided the individual is otherwise eligible.
NOTE: Under Florida low, preference inappointment shall be given by the stale to dnrze persons included in I and 2 above, and second to those persons included in 3 and J abuse. Iran applicant claiming poems'
preference for a vacant position is not selected, he/she may file a complaint with the Department of Veterans' Athirs, P.D. Box 31003 St. Petersburg, Florida, 33731. A complaint must be filed within 21 days of the
upplicun receiving notice ()Hie hiring decision made by the employing agency or within 3 months of the date the application is tiled with the employer Woo notice is given.
.2164-K21
HRHR01'_
(Rev 013)
.APPLICANT'S CERTIFICATION AND AGREEMENT:
CERTIFICATION: I certify that answers given herein are true to the best of my knowledge. L 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:
interview(s) or any part of the employment process may result in my discharge. 1 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.
AGREEMENTS:
L 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 of Crestview will utilize this number only to facilitate the location of my
records in order to conduct background investigations.
PITYSICAL 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 n drug free workplace. The City of
Crestview may conduct dntg screenings for: Job applicant testing, routine fitness for duty testing, reasonable suspicion
testing, post accident and injury testing, follow-up testing and retum to duty testing.
Disclosure Statement: By this document, the City of Crestview discloses to you that various repots 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 put -pose other than employment. Please sign below
to signify acknowledgement of this disclosure and authorization for the City of Crestview to request copies of such
reports.
Upon termination of employment, I understand the City may hold my final paycheck until a final accounting is
made for nny 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 fur 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 Interviews.
VISIT OUR WEBSITE FOR AVAILABLE OPENINGS: www.citvofcrestview.nrg
FOR OFFICE USE, ONLY
_ College Transcriplt _ Drive' License
tligh School Diploma/GED CenEleate State Certifications
Received by Date(,): -
Incomplete
Position applied -
DD214 (mititivy discharge)
- Dafa cant ai,Doparunent -. _ Depanmeat
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:
Du)yeiz f7rv(2i
Last First Mi
Date: 312g) J
Social Security Number: -,:a5 i/- 99?.5"
Birth Date:. ///I//Ol rJ // Sex:
Zip Code: 7---7 , ) (42
Veteran:
Male
Yes
Please check the box next to the ethnic group you belong (select only one):
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, Cerium! or South American, or other Spanish adhtre or origin regardless of race)
r I Black (not of Hispanic origin)
$ I White (not of Hispanic origin)
HRHI5112
(Rev 012)
PORT 9AcIIAAD
March 19, 2019
CITY OF PORT ORCHARD
POLICE DEPARTMENT
Geoffrey C Marti, Chief of Police
54.6 Bay Street, Port Orchard, WA 98366
Voice: (360) 876-400 •:Fax: (360) 876-5546
police@cityofportorchard.us
www.cityofportorchard.us
Any Law Enforcement Agency
Re: Bruce Dwyer
To whom it may concern,
I would like to take this opportunity to provide my personal and professional recommendation
for Bruce Dwyer as a volunteer for any police agency.
I have worked with Bruce for the past six years and have observed his personal dedication to
his position with the City of Port Orchard Police Department as a volunteer. I have always
found him to be helpful, responsive and extremely competent.
I have always had complete confidence in his ability to tackle any assignment and achieve
outstanding results. This is a product of being resourceful, intelligent, determined, and
professional.
Mr. Dwyer's work history meets the highest standards and 1 believe he is capable of using the
vast skills he possesses to achieve and enhance any law enforcement's volunteer program.
Sincerely,
Geoffrey C Mrt1
Chief of Police
Port Orchard, WA
HICIY IIrIu,Y l!UN runruaco
bAhtWAHL) I I. _ RENDER FORM
CERTIFICATE OF RELEASE OR DISCHARGE FROM ACTIVE DUTY
1. NAME (Last, First, Middle)
DWYER, BRUCE CHARLES
-4a.. GRADE;. RATE OR RANK
2. DEPARTMENT, COMPONENT AND BRAN
NAVY' -USN
b. PAY GRAD•
E
7a. PLACE OF ENTRY INTO ACTIVE DUTY
JACKSONVILLE, FL
5. DATE OF BIRTH (YYYYMMDD)
19521106
CH 3..SOCIAL SECURITY NUMB
263 I; 17 I, )923
6. RESERVE OBLIGATION TERMINATION DA
M'YYMMDD) NA
6a. LAST DUTY ASSIGNMENT AND MAJOR COMMAND
NAVHOSP LEMOORE, CA. 93245
b. HOME OF RECORD AT TIME OF ENTRY (City and state, or complete address If lox
MELBOURNE,FL
b. STATION WHERE SEPARATED
PSD NAS LEMOORE, CA. 93246
aCOMMAND TO WHICH TRANSFERRED
NRPC, NEW ORLEANS, LA. 70149
11. PRIMARY SPECIALTY (List number, title and years and months in
specialty. List additional specialty numbers and titles involving periods of
one or more years.)
HM-8452 ADVANCED X-RAY TECH-14YRS/01MOS;
HM-8404 FIELD MEDICINE TECH-09YRS/041MOS;
9595 HAZARDOUS MATERIAL CONTROL MANAGEMENT
TECH-08YRS/08MOS.
X X X
X • X X
X X X
X X
13. DECORATIONS, MEDALS, BADGES, CITATIONS AND CAMPAIGN
RIBBONS AWARDED OR AUTHORIZED (All periods of service)
NAVY/MARINE CORPS ACHIEVEMENT MEDAL; JOINT
MERITORIOUS UNIT AWARD; MERITORIOUS UNIT
COMMENDATION(2); NAVY GOOD CONDUCT MEDAL(6);
NATIONAL DEFENSE SERVICE MEDAL(2); ARMED
FORCES EXPEDITIONARY MEDAL; HUMANITARIAN
SERVICE MEDAL; SEA SERVICE DEPLOYMENT
12, RECORD OF SERVICE
10. SGLI COVERAGE N(
AMOUNT: $250,000.00
YEAR(S)
MONTH(S)
DAYI:
a. DATE ENTERED AD THIS PERIOD
89
b. SEPARATION DATE THIS PERIOD
c. NET ACTIVE SERVICE THIS PERIOD
05
"`MAR`
d. TOTAL PRIOR ACTIVE SERVICE
4:
0.
:".12
e. TOTAL PRIOR INACTIVE SERVICE
f. FOREIGN SERVICE
Oi
?Is9
'00
g•
SEA SERVICE
h. EFFECTIVE DATE OF PAY GRADE
0
00
•• DEC :•
-
+:27
14. MILITARY EDUCATION (Course title, number of weeks, and month.
year completed)
RADIOLOGIC TECHNOLOGY SCOL-54WKS-FEB91.
X
3
16a. MEMBER CONTRIBUTED TO POST-VIETNAM ERA VETERANS' EDUCATIONAL ASSISTANCE PROGRAM
b. HIGH SCHOOL GRADUATE OR EQUIVALENT
16. DAYS ACCRUED LEAVE
PAID NONE
x
i<
YES
YES
17. MEMBER WAS PROVIDED COMPLETE DENTAL EXAMINATION AND ALL APPROPRIATE
DENTAL SERVICES AND TREATMENT WITHIN 90 DAYS PRIOR TO SEPARATION
YES
SERIAL 43077 04-575=SAN. BLOCK 13 COLS4I RJBBON(2); GLOBAL WAR ON T.ERRORISWERVICE MEDAL .
COAST GUARD3SPECIAL OPERATIONS SWRVICERIBBON; U S C * GLiARD•MERITORIOU UNIT
^COMMENDATION. EFFECTIVE DATE OF,TRANSFER TO FLEE1 RESBRVB $TATUS' 2bOS.MAI UI3 'SJECTTO ACT'Ll
,OUTYRFCALLBY,,SECRETARIbFTHENAVY. ,.;;, -
-the ingYonaliari` ig4Led herein is sublacf'to eeropMer'tlatG• hg yttt le7 the Depvtrnentot`Defense or,ders
with any 9( affOted Federal or>nan Fe'deralaget
P d arldtodetormmaellgibPot„ llify 04torr•onTlnuedm ,Copliance Wlth,Th y:Ocibrerr{ants'ofa€eJbetfef Ypragram.
E ARATION(/nc/udaZlPCodeJ. b ,NEARESTRELATIVE(61dnwhi. a bitess Inghiii& lPCode
SUSAN IZI t!R.11.45 S„EOUOIA AVE ,
LEMOOILE CA 9314
19a MAILINGADDRES5.AFTERS P
1145 SE(�UOIAl� VE
LEMOORE CA 93245°
20; MEMBERS;REQUESIS,COPY6 BESENTTO: ; CA • _ DIRECTOR OF VETERANS•AFFAIRS
SIGNATURE OP EMBER BEWG S PARATED •': 22,
23: TYP
. T,RANSFERRE
:T�HORIZED T
IG ame, f a ttleandsignaturel
BY R: D OIC'
SPECIAL ADDITIONAL INFORMATION (FcW itss by authorized agencies bnlyl' _
24. CHARACTER OF SERV(CE.dncrude upgrades)
D TO'FT'T ET RESERVE ' HONORABLE
25 SEPARATION,AUTHORITY
.' MILPERSMAN 1830`<040.
26.'(4ARRATIVE'REASON FOR SEPARATION
SUFFICIENT'•SEltVICE^FOR•RETIREMENT
29: DATES OF TIME: LOST DURING THIS PERIOD GlYYYMMDD)
41,-HONE^ۥ :i `
DD FORM'214 FEB:2000
wpTF wHsmiow _
SEPARATION CODE
37 ;REENTRY CODE
3ampinBEF.tRuESTS COP
PREVIOUS EDITION. IS OBSOLETE.
SERVICE