qnee’zea 9etn - henderson · 2017-05-25 · qnee’zea 9etn under pen ity of perjury, i swear or...

12
City of Henderson Appointment to Fill City Council Ward II Vacancy To be considered for the Council Ward II appointment, this interest form must be completed and returned to the Office of the City Clerk no later than 5:00 p.m., Thirdy,Máy 25, 2017, with the following: CITY C’ r P.K C Supplemental Questionnaire CITY or C Statement of Interest (attach a separate sheet describing why you are seeking appointment) LU! t o Affidavit of Residency (must be signed in front of City Clerk) City of Henderson residency for the past 12 months prior to the close of appilcation date (05/25/2016) Ward II residency for at least 30 days prior to the close of application date (04/25/2017) C Notice of City Council Meeting and Acceptance of Personal Service Form C Attachments (e.g., resume, personal and/or professional references, if applicable) Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE: Upon submitting this form, all information will be considered public information pursuant to Nevada Revised Statutes. RETURN FORM IN-PERSON TO: city of Henderson, city clerk 240 Water Street, Henderson, NV 89015 702-267-1400 office A RoaTh anti dowe Name: cell Phone: DAVID F KALLAS 702-245-6172 Home Phone: Work Phone: Fax: 702-245-6172 N/A 702433-8759 Email address: [email protected] Address: city/state: Zip: 1407 FOOTHILLS VILLAGE DRIVE HENDERSON NEVADA Length of residency in Ward II: Length of residency in Henderson: 4 YEARS 25 YEARS Mailing address UI dWferenr than above): city/State: Zip: Employer/Occupation/Employment Status: UNEMPLOYED/RETIRED Are you currently or have you previously been employed by the city of Henderson? NO. Do you have any relatives within the third degree of consanguinity (see chart attached) currently employed by the city of Henderson? If yes, provide the name and relationship of all relatives currently employed by the city of Henderson. NO. Have you served In the Branch: From: (year) to (year) Type of Discharge: U.S. Military? NO. Have you ever been convicted of a crime? If so, please explain. NO. application are true and correct.

Upload: others

Post on 14-Apr-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

City of HendersonAppointment to Fill City Council Ward II VacancyTo be considered for the Council Ward II appointment, this interest form must be completed

and returned to the Office of the City Clerk no later than 5:00 p.m., Thirdy,Máy 25, 2017,

with the following: CITY C’ r P.KC Supplemental Questionnaire CITY orC Statement of Interest (attach a separate sheet describing why you are seeking

‘ —appointment) LU! t

o Affidavit of Residency (must be signed in front of City Clerk)

• City of Henderson residency for the past 12 months prior to the close of appilcation date (05/25/2016)

• Ward II residency for at least 30 days prior to the close of application date (04/25/2017)

C Notice of City Council Meeting and Acceptance of Personal Service Form

C Attachments (e.g., resume, personal and/or professional references, if applicable)

Qnee’zea 9etn

Under pen Ity of perjury, I swear or affirm that the statements made on this

App cant’s Signature Date

PLEASE NOTE:Upon submitting this form, all information will be consideredpublic information pursuant to Nevada Revised Statutes.

RETURN FORM IN-PERSON TO:city of Henderson, city clerk240 Water Street, Henderson, NV 89015702-267-1400 office

A RoaTh anti dowe

Name: cell Phone:

DAVID F KALLAS 702-245-6172

Home Phone: Work Phone: Fax:

702-245-6172 N/A 702433-8759

Email address:

[email protected]: city/state: Zip:

1407 FOOTHILLS VILLAGE DRIVE HENDERSON NEVADA

Length of residency in Ward II: Length of residency in Henderson:

4 YEARS 25 YEARSMailing address UI dWferenr than above): city/State: Zip:

Employer/Occupation/Employment Status:

UNEMPLOYED/RETIRED

Are you currently or have you previously been employed by the city of Henderson?NO.Do you have any relatives within the third degree of consanguinity (see chart attached) currently employed by the city of Henderson? If yes,provide the name and relationship of all relatives currently employed by the city of Henderson.

NO.Have you served In the Branch: From: (year) to (year) Type of Discharge:U.S. Military? NO.Have you ever been convicted of a crime? If so, please explain.

NO.

application are true and correct.

Page 2: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

City of HendersonAppointment to Fill City Council Ward II Vacancy

5p€emeaat ZceueeonnaaePlease list all of your professional and civic affiliations:

- ___________________

ASSOCIATION OF FORMER INTELLIGENCE OFFICERSGANG INVESTIGATORS ASSOCIATION OF AMERICALABOR AND EMPLOYEE RELATIONS ORGANIZATIONPOLITICAL CAMPAIGN CONSULTANTS, MANAGERS AND CANDIDATESASSOCIATION OF STATE LOBBYISTSFORMER POLICE OFFICERS IN BUSINESSEMPLOYMENT LAW AND LABOR CONSULTANTS OF AMERICA

What is your schedule availability? Please explain.

I AM AVAILABLE AT THE PLEASURE OF THE HENDERSON CITY COUNCIL AND THE CITY OFHENDERSON ADMINISTRATIVE STAFF.

Do you or any relatives within the third degree of consanguinity (see chart attached) currently have anycontractual relationship with the City of Henderson or other government agency? Please explain.

CHELSEA N KALLAS- DEPUTY ATTORNEY GENERAL FOR THE STATE OF NEVADA.EVAN A KALLAS- POLICE OFFICER LAS VEGAS METROPOLITAN POLICE DEPARTMENT.

A Rac, 73 Cdt Io..e

Do you currently hold other elective or appointive positions? Please explain.

NO.

Page 3: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

City of HendersonAppointment to Fill City Council Ward II Vacancy

Scft€enseaat %ae4eeonnaaeHave you ever been terminated by an employer? If yes, please explain.

NO.

Have you been subject to any disciplinary action? If yes, please explain.

1. RECEIVED AWRIUEN REPRIMAND IN 1984.

Have you ever been the subject of civil litigation or judgment? If yes, please explain.

I HAVE NEVER BEEN THE SUBJECT OF A JUDGEMENT!I HAVE BEEN ONE OF A FEW SUBJECTS IN A FEW CIVIL LITIGATIONS WITHIN THE COURSEAND SCOPE OF MY OFFICIAL DUTIES AS A POLICE OFFICER WITH THE LAS VEGASMETROPOLITAN POLICE DEPARTMENT.

Please attach your statement of interest.

Page 4: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

,j7fl7?To: Henderson City Council and Administrative StaffFrom: David F KallasSubject: Henderson City Council Ward 2 VacancyDate: May 25, 2017Dear City Council and Administrative StaffPlease let this letter, and the required attachments, serve as my notice to you that I would like to be consideredfor appointment to the vacant Henderson City Council position to represent the residents of Ward 2 ofHenderson, Nv.As my records will indicate, I have been a resident of Southern Nevada since 1979 and have lived in Hendersonwith my wife and children since 1992.Prior tD moving to Henderson my wife and I lived in the SouthWest part of Las Vegas. At the time a veryunderdeveloped area of Clark County. When our children became of school age we had a significant decision tomake as to where the would go to school and be raised. We quickly decided on Henderson because of thequality of the schools our children would attend, Bartlett, Greenspun and eventually Green ValleyHigh School. It is without doubt the most significant family decision we ever made and are grateful that wedecided to call Henderson our home.Through the years our family has been an active member of the community both in the academics of our publiceducation system and in all the extra-curricular activities Henderson has to offer. During those years Ivolunteered as a member of the Legacy little League Board of Directors and the Henderson National JuniorBasketball Board of Directors. Our daughter spent time in High School working for the Henderson Parks andRecreation Department while I volunteered as a member of the Henderson Parks and Recreation Board.Needless to say our entire family is community oriented and believe in doing what’s in the communitiesbest interests. This is evidenced by the 30 years my wife spent as a Social Worker for our community, the 30years I spent as a Police Officer for our community, including representing our public employees and theirfamilies as a representative in Carson City. Our children have carried on with being Public Service advocates asboth a Police Officer and Deputy Attorney General for Nevada. The best way to look at it is that Public Service isin our DNA and I would like to continue that service as the residents representative of Henderson’s Ward 2.My commitment to the residents of Ward 2 and all of Henderson is best seen by my recent decision to withdrawfrom all my activities and all my ownership of The Apothecarium, A Medicinal Marijuana Establishment. Thoughmy continued involvement would have been a financial benefit to me and my family, the thought of being ableto go back to work in the Public Sector, helping out residents and employees while providing leadership skills tothe benefit of all far outweighed any financial reward!

Thank you for taking the time to review my submission and thank you for all the work you do!

Da F Kallas

Page 5: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

DAVID F. KALLAS

1407 FOOTHILLS VILLAGE DR. HENDERSON,NEVADA 89074

D1225K(äMSN.COM ‘702-245-6172

WORK EXPERIENCE

December 2014-May 2017

Owner

The Apothecarium Medicinal Marijuana Establishment

702-245-6172

Januatv 2012-December 31. 2016

Director of Government Affairs! Labor RelationsFindlay Toyota

7733 Eastgate Road

Henderson, Nv. 89011

702-566-2000

Responsible for all Government Affairs issues related specifically to FindlayToyota and the Findlay Auto Group of Dealerships. This includes Licensing,Zoning and Legislative Issues, at both the local and state levels, that impactthe Auto Group. Oversee, in conjunction with Ed O’Bannon, all LaborRelations issues such as Health Cam Program Evaluation, EEOCCompliance, Policy Manual Updates, Employee/Employer work place issues,etc.

Januaw 2011 to June 2011

Ls,gis/a/ive Carnpazgn Maua,ger/ Consu/taztNevadans for Nevada Public Employee Coalition

P.O. Box 751510

Las Vegas, Nv. 89136

702-286-9390

Responsible for day to day implementation and consultation of groupsLegislative strategies, representing their members which included theapproximately 100,000 active and 40,000 retired Public Employees and the70,000 Public Employees entitled to participate in the provisions of NRS 286.Included the creation and distribution of printed material through organizedwalks and mail, radio ads and lobbying of Legislative and Executive Branchmembers as it relates to Public Employee Groups. Group includedPoilce/Firefightersifeachersfsocial Workers/Corrections Officers/State and

Page 6: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

County workers. Pdmaiy focus was on issues affecting the group’s CollectiveBargaining Rights and Retirement System (NVPERS) during the 2011Legislative Session. Successfully defended maintaining CollectWe Bargainingrights and Defined Benefit Retirement program for existing and future publicemployees.

August 2010 to November 2010

Con,gressional Poll!ical/ Campargn ConsultantThe Affiance for Retired Americans

815 16” Street NW Fourth Floor

Washington, DC 20006

202-637-5399

Aigiist 2010 to January 2011

President! Polifical/Lçgislative ConsultantSouthern Nevada Conference of Police and Sheriffs

9330 \VLake Mead Blvd Las Vegas, Nv. 89134

702-384—5174

Prepared and submitted Bill Draft Requests (BDR’s) from 2003 through 2010for submittal to the Nevada Legislature that benefitted Police and CorrectionsOfficers throughout the State of Nevada. Testified in front of LegislativeCommittees about BDR’s submitted on behalf of SNCOPS and on any thatmay impact irs members and other Nevada Officers. Assisted SNCOPSparticipants with legislative issues during the 2010 °Special Session AssistSNCOPS endorsed candidates with Nevada based campaign activities andadvise group on issues that may affect them during the 2011 legislativesession.. Provide strategic plans for endorsed candidates campaigns toaugment SNCOPS goals and objectives.. Interviewed and recommendedendorsement of Political candidates supportive of Law EnforcementLabor/Personnel and Enforcement Issues Interviewed and recommendedendorsement of Judicial candidates who supported equal, objectiveapplication of arrest/evidence and sentencing procedures.

August7, 1979 to September 18.2009

Las Vegas Metropolitan Police Department

Las Vegas, Nv. 89101

702-828-3111

From 1979-1990 I worked in the LVMPD Patrol Division as a Patrol Officer,Field Training Officer; Street Narcotics Officer and Original Member of theDepartments “Gang Enforcement Unit’From 1990 to 2001 1 was assigned as a Detective working in the CriminalIntelligence Section of the Organized Crime Bureau participating in dual rolesas both an investigator and undercover detective. From1998-2001 I wasassigned to the units Undercover section working strictly covert operationsfrom covert locations both intra and interstate and frequently with federalagencies from which security clearances were obtained.

Page 7: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

From July of 2001 until retirement in September of 2009 I was assigned to ourdepartment “Rank and File” Labor Organization for Police and CorrectionsOfficers, the L VPPA, as both its Executive Director and Director ofGovernmental Affairs after being elected by a majority vote of themembership.Responsible, in conjunction with current E/D Chris Collins and current/formerExecutive Board members, of organizing and increasing membership fromapproximately 990 out of 2000 commissioned officers in 2001 to todayscurrent membership of approximately 2600 commissioned officers.

Police Officer/Detective/AdministratorJOB DUTIES

January007-September 2009Detective/Director of Governmental Affairs Las Vegas Police ProtectiveAssociation• Responsible for all political activities,

• Political candidate interview, endorsements and campaign strategy,

• Legislative lobbyist 2001, 2003, 2005,2007,2009,2007 Special Session, 2008Special Session and 2010 Special Session

- Compose and submit all Bill Draft Requests

• Compose and submit Bill Amendments related to the activities andresponsibilities of the 2800 rank and file police and corrections officers of theLVMPD and officers of North Las Vegas, 1-lenderson, City of Las Vegas,Clark County School District Police and all Nevada Law EnforcementTestify in front of Legislative committees regarding Law Enforcement issuesand on behalf of all Public Employees related to Public Retirement Systemand Collective Bargaining.

March 1. 2001- December 31. 2006

Detective/Executive Director Las Vegas Police ProtectiveAssociationSupervise office staff including 2 administrative assistants, I paralegal, 2attorneys and 5 frill time officers

Responsible for the day to day operations of the Association on behalf of 2600police and corrections officers and its 25 officer Board of Directors

Annual Budget oversight$3-4,000,000.00

Implementation and oversight of $22,000,000.00 health and welfare planElvulE hearings/elections/legislative changes

Labor/Management headngs

Arbitrations/Civil Utigations

Employee representations/Internal Interviews

Negotiation of collective bargaining agreements 1994,1997, 2001, 2005,2009

May 1991- Tune 2001

Page 8: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

Detective Criminal Inteiigence Section ofOrganized CrimeBureauResponsible for all intelligence gathering and disseminating information relatedto individuals and groups involved in organized crime activity includinghomeland security issues, domestic terrorism, extortion, murder for hire, creditcard fraud, prostitution, arson, white slavery, illegal gambling, gaming workcards, key employee investigations, gaming fraud, narcotics trafficking, politicalcorruption, NCAA Compliance assistance, case submittal and presentation,wiretaps, search warrants and arrest warrants as both an investigator and“undercover” officer. Acquired various Governmental clearances, whileproviding dignitary and diplomatic protection in conjunction with the U.S. SecretService and F. B. I.

• Department Of Energy Top Secret Security Clearance

• FBI Top Secret Security Clearance

• Department Of Defense Field Training Contact

• Department Of State Dignitary Protection Training

• Federal Law Enforcement Center Specialized Training

• 80 hour Advanced Instructor Training School

a In-Service Training Course Instructor

• Certified Defensive Tactics Instructor

Jan 1991-May 1991

Detective Vice Detail Vice/Narcotics SectionResponsible for investigation and suppression of prostitution related activityincluding solicitation, pandering, white slavery, extortion and coercion.

October 1989-December 1990

Police Officer Patrol DivisionDay Shift Patrol Officer responsible for activities in the Southeast AreaCommand.

March 1988- September 1989

Gang Crimes Officer Special Enforcement DetailResponsible for identif’ing gang members in both covert and overt operations,preparation and execution of search/arrest warrants, organize/develop andmaintain filing system for identification. Clark County School District Liaisonfor gang related issues.

October 1983- March 1988

Police Officer Patrol Division

Swing Shift Patrol officer responsible for activities in the Northwest Area

September 1980- September 1983

Field Training OfficerResponsible for the training and evaluation of newly academy graduated PoliceOfficers in the “Field Training Program”.

Page 9: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

August 1979- August 1980

Police Officer Recruit/Trainee Participated in 3 mo,ztb Police Academyand subsequent Field Trainins Prosram as a ‘New Hire” officer.

Philosophy:

Going through the Police Academy in 1979 one of the things that wasemphasized about the job of a Police Officer was the enormous amount ofdiscretion we had when dealing with other people and the impact thatdiscretion could or would have on peopl&s lives. As I progressed throughmy career I realized that all people have discretion in their daily lives, maybenot as impaciful as that of a Police Officer, but discretion none the less.People can choose to do the right thing or the wrong thing and do everyday.The difference, I believe, between me, the people I associate with andothers is the choices we make every day and the consequences andoutcomes of those choices. People can choose to do whatever they wantbut I, my family, my friends and the people I svth with work and live by thebelief that no mailer what anyone else chooses we choose to do the “rightthings”, work harder; help improve our and others lives when we can and tryand be betted!

BOARDS AND COMMISSONS

LVMPD Employee Benefit Trust

Police Protective Association Representative Sept. 2012-‘ODecembet 2016Governance and Fiduciary responsibii4yfor all investment decisionsfor MetroRetiree Health Care Funds in the amount of329,000,000.00.

Nevada Public Employees Retirement System Board

Gubernatorial Appointment December 2002-July 2010Governance and Fiduciary responsibility For all investments decisions,contribution rates, benefits, etc. for 106,000 active and 39,000 retired membersof Nevada Public Employee Retirement System valued at $22,000,000,000.00.

Executive Board Member Nevada State AFL-CIO

.4sisust 2006- September2009

Henderson Parks and Recreation Department

CYfy C’oundfl Appointment Jufy 1999- January 2006Responsible for advisory decisions and recommendations related to all Parks andRecreation issues in Henderson.

EDUCATION AND TRAINING:

BACHELORS OF SCIENCE 1978 FRAMINGHAM STATE COLLEGE1974-1976 Massasoit Community (bilege CdminalJustice Major

Page 10: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

References

Honorable Brian Sandoval Governor ofNevada775-624-7129State Senator Richard “Tick” Segerbiom702-279-3896kState SenatorJoyce Woodhouse702-498-8302United States Marshal Chris Hoye US Marshal for State ofNevada702-610-9009SheriffDouglas Gsliespie(Retfred) Las Vegas Metropolitan Police Department702-812-0013SheriffBill Young(Re&ed) IT for Security Station Casinos702-810-0002ProfessorJohn Cummings College ofSouthern Nevada702-510-1112SheriffJerq Keller IT Secuthy(reilred)of Wynn Resorts International702497-5355Detective Stacy Rodd Asst Director ofSecurity Cosmopolitan Hotel/Casino702-698-7000Lt Wayne Petersen Director ofSecurity Bishop Gonnan High School702-810-0014k

ADDITIONAL REFERENCES UPONREQUEST

Page 11: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

Nonpartisan Office City of Henderson, State of NevadaAffidavit of Residency and Qualification

,4daoct DAVID F KALLAS

Applicant for the Office of City Council Ward II

Subscribed and sworn to before me thisth

oftheyear °I7

.A F!ace Th Call tda.ie

STATE OF NEVADA, COUNTY OF CLARK

For the purpose of having my name placed on the list of interested candidates for the appointment of

DAVID F KALLASCity Council Ward II, I, the undersigned

____________________________________,

do swear or affirm

under penalty of perjury that I actually, as opposed to constructively, reside at

/VO M2-t4dZin the City of Henderson, County of Clark, State of Nevada;

that my actual, as opposed to constructive, residence in Ward II began on a date at least 30 days

immediately preceding the date of the close of filing (06/20/2017) as an applicant for this office and

that my residence in the City began on a date at least 12 months immediately preceding the date of

the close of filing (07/20/2016) as an applicant for this office, in addition to any other requirements

required by law; that my telephone number is 76i 2Ø’ 6/7.2 , and the address at which I

receive mail, if different than my residence, is

_______________________________________________

that I am a qualified elector pursuant to Section 1 of Article 2 of the Constitution of the State of

Nevada; that if I have ever been convicted of treason or a felony, my civil rights have been restored

by a court of competent jurisdiction; and that I will qualify for the office if appointed thereto.

Sig ture —

__________

_;j ‘)Xnze A R

____ __

if appointed, designatiSWf name to appear on certificate of appointment d cff the mon of ‘U’ S

N Address (optonai—’ N co her rs tho’tt±ed to administer an oath

Page 12: Qnee’zea 9etn - Henderson · 2017-05-25 · Qnee’zea 9etn Under pen Ity of perjury, I swear or affirm that the statements made on this App cant’s Signature Date PLEASE NOTE:

City of HendersonAppointment to Fill City Council Ward II Vacancy

Itetice q e€, ea ve€,Agd Aeeefrtaace cij Pe’zaonat Sewece 9o’un

NOTICE OF CITY COUNCIL MEETING AND WAIVER OF FURTHER WRIHEN NOTICE.

NOTICEIn connection with this application, and pursuant to NRS 241.033, the Henderson City Council mayconsider your character, alleged misconduct, professional competence, or health at a special meeting onJune 15, 2017. The meeting will begin at 10:00 am and will be held in the Henderson City Hall, City CouncilChambers, 2405. Water Street, Henderson, NV 89015. City Council meetings are public meetings, and youare welcome to attend. Notice of the City Council meeting will also be posted on the City of Hendersonwebsite: . As a courtesy, we will send you a copy of the agenda(s) to the emailaddress provided in this application.

WAIVER OF FURTHER WRflEN NOTICEI acknowledge that I am voluntarily waiving my right to receive a separate written notice by personalservice or certified mail pursuant to NRS 241.033(2)(a) and NRS 24L034(1)(b), as applicable, of the timeand place of the City Council meeting(s) at which my application to fill the vacant City Council Ward II seatmay be considered, and I have been notified of my right to receive such written notice. By signing thisform, I am not forfeiting my right to attend or for my application to be considered during this meeting.

I understand lam voluntarily waiving my right to additional written notice of the meeting(s)described above.

C)7J

_____________

Applicant’s Signature Date

SIGN FORM IN-PERSON AT:City of Henderson, City clerk2405. Water Street, Henderson, NV 89015702-2671400 Office

ACCEPTANCE OF PERSONAL SERVICE.

I hereby accept personal service of this Notice of City Council Meeting at Which my application to fill thevacant Cliv Council Ward II seat may be considered.

J-)LC2di)t-.

Date

SIGN FORM IN-PERSON AT:city of Henderson, City Clerk240 Water Street, Henderson, NV 89015702-267-1400 Office

n

A floes ? Colt do-s

Pri ted Name ,—P1tic) V ..Th U J2PAn/ [

Title Dht’e