AGREEMENT FOR CONDUCTING IN CONJUNCTION SPECIAL GENERAL ELECTION - MUNICIPAL ELECTION MARCH 11, 2014AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
CITY OF CLEARWATER SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS — MARCH 11, 2014
WHEREAS, the City of Clearwater has requested the assistance of the Office of the
County Supervisor of Elections (Supervisor) in conducting its General Election; and
WHEREAS, the Supervisor is agreeable to providing such assistance to the City subject to
the following conditions, considerations and agreements arrived at between the parties;
IT IS HEREBY AGREED AS FOLLOWS:
GENERAL PROVISIONS
The election is to be conducted under any applicable ordinances of the City and all sections of
Chapters 97 -106, Florida Statutes (the State Election Code). It is understood that the Supervisor
is in charge of the election, and that the County Canvassing Board is responsible for canvassing
the election (no cost to the City). The City may have a designated representative in the
canvassing board room. This designee may only serve in an "observer" capacity and may not
participate in the canvassing of the election. The County Canvassing Board will determine
whether a recount is required and advise the City. The County Canvassing Board will certify the
election results and will provide a certificate of election and a conduct of election report to the
City (ONE certificate of election and conduct of election report will include all elections held on
the same day). These documents will be provided to the City after the County Canvassing Board
certifies the official election results.
The Post - Election Audit may not begin until the canvassing board has certified the official
election results. The City is responsible for the costs associated with conducting an annexation
election (mapping annexation areas, reassigning addresses, and mailing new voter registration
cards).
The City is responsible for the costs associated with any legal action or contest of election arising
from its election. The City, the Supervisor of Elections and the County Canvassing Board agree
that the County Attorney's Office will represent the Supervisor of Elections and County
Canvassing Board in any legal action concerning the canvass or certification of the election.
Page 1 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
It is understood that the provisions of this contract are based on current state law, and if any
changes in election law or to the Supervisor's County election schedule should occur during the
period of this agreement, those changes will supersede the terms of this contract where
applicable.
The City will provide the Supervisor with the current City definition /boundaries (which
includes ALL current annexations) no later than 5:00 p.m., January 10, 2014. It is the
responsibility of the City to ensure the Supervisor has the current definition /boundary
information so all eligible voters can participate in the City's election. The City agrees that NO
changes to the City definition /boundaries will be made effective between 5:00 p.m., January
10, 2014, and Midnight, March 11, 2014.
This contract must be signed by the City and received by the Supervisor no later than the ballot
language deadline of 5 p.m., January 10, 2014.
The Supervisor will certify to the City the number of registered voters for this election
approximately 10 days prior to the election.
SPECIFIC PROVISIONS (City of Clearwater)
CITY CLERK:
PHONE:
FAX:
ELECTION DAY CELL PHONE:
ADDRESS:
ELECTION TITLE:
ELECTION DATE:
VOTER REGISTRATION DEADLINE:
ROSEMARIE CALL
(727) 562 -4092
(727) 562 -4086
(727) 224 -2351
112 Osceola Ave., Clearwater, FL 33756
Special General Election
March 11, 2014
February 10, 2014
BALLOT INFORMATION (Scott Kirby 464 -6641)
o Final Ballot Language is due no later than 5:00 p.m., January 10, 2014 and must include all
opposed candidate oaths and resolutions and /or ordinances with ballot questions.
o All ballot language must comply with Florida Statutes [101.161(1)] and the Uniform Ballot
Rule (1S- 2.032).
o Using the Ballot Language Submittal Forms — Complete required information. Include
information and Candidate Oaths for ONLY qualified opposed candidates in ballot order,
Page 2 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
and all Charter Amendments /Referendum Questions with SIGNED /APPROVED
Ordinances /Resolutions including numbering for ballot order.
o Scan and Email ballot language to Scott Kirby at skirby @votepinellas.com by the final ballot
language deadline.
BALLOT LAYOUT /PRINTING (Marc Gillette 464 -4958)
o The Supervisor is responsible for creating the ballot (ballot layout will comply with Florida
Statutes and the Uniform Ballot Rule).
o The City is responsible for approving the City's portion of ballot.
o Precinct ballots will be printed by the Supervisor. The Supervisor will bill the City 22 cents
per ballot card (includes shipping charges) if the City's portion of the ballot creates an
additional ballot card.
o Provisional Ballots (minimum of 25 ballots per precinct) will be printed by the Supervisor.
The Supervisor will bill the City 22 cents per ballot card if the City's portion of the ballot
creates an additional ballot card.
o If the City requires a ballot change after ballots are printed, the City is responsible for
additional costs.
CANDIDATE AUDIO RECORDING (Scott Kirby 464 -6641)
o The deadline for candidates to record their names and office titles for the audio ballot is
5:00 p.m., January 17, 2014. It is the responsibility of the City to notify City candidates of
this deadline. Candidates must call (727) 453 -3293; a voice message will prompt the
candidate to record his /her name as indicated on the Candidate Oath and the office for
which the candidate is running.
MAIL /ABSENTEE BALLOTS (Martin Munro 464 -6788)
o The Supervisor will bill the City 22 cents per ballot card, if the City's portion of the ballot
creates an additional ballot card, used in the initial mailing.
o The Supervisor will bill the City 40 cents per ballot card, if the City's portion of the ballot
creates an additional ballot card, used in daily mailings.
o The City will be billed for additional postage if the City's portion of the ballot creates an
additional ballot card.
Page 3 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
o The deadline for mailing military/overseas mail /absentee ballots is January 25, 2014. [F.S.
101.62(4)(a)]. Tentative Mailing Schedule for military /overseas ballots: The week of
January 20, 2014, no later than January 25, 2014.
o Domestic ballots must be mailed no earlier than February 4, 2014 and no later than
February 11, 2014 (F.S. 101.62(4)(b)1.
o After the initial mailings, ballots will be mailed daily as requests are received up to the
fourth day prior to the election. The deadline to request a ballot be mailed is 5:00 p.m.,
March 5, 2014, the sixth day prior to the election. [F.S. 101.62]
o Duplicate and Test Ballots will be printed by the Supervisor; the Supervisor will bill the City
40 cents per ballot card if the City's portion of the ballot creates an additional ballot card.
LEGAL NOTICES (Nancy Whitlock 464 -7493)
o The Supervisor is responsible for publishing the canvassing board meeting schedule.
o The Supervisor is responsible for creating the Sample Ballot and publishing it in a
newspaper of general circulation. The City is responsible for the advertising costs
associated with publishing their portion of the sample ballot ad. The Supervisor will bill the
City for the City's portion of the sample ballot ad.
o The Supervisor is responsible for mailing any necessary polling place change notices, one
per household, and publishing the list in a newspaper of general circulation.
o If the City is conducting a special election or special referendum election, the City is
responsible for any additional notices required by Florida law. The City is responsible for
any notices required in its charter or by ordinance.
Page 4 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
TESTING BALLOT COUNTING EQUIPMENT (Marc Gillette 464 -4958)
o The canvassing board will certify test results of the ballot counting equipment and the
Supervisor will file the election parameters with the Division of Elections. The Supervisor
will publish the canvassing board meeting schedule. The canvassing board meeting
schedule is:
DATE
MEETING TIME
ACTIVITY
February 19, 2014
9:00 a.m.
Pre - election test of precinct optical scan equipment and
mail /absentee and provisional ballot optical scan equipment
[F.S. 101.5612]
March 3, 2014
9:00 a.m.
Second test of absentee /provisional ballot optical scan equipment
[F.S. 101.5612]; Canvass mail /absentee ballots (no earlier than 15'h
day prior to election) [F.S. 101.68(2)1
March 4 —10, 2014
9:00 a.m.
Canvass mail /absentee ballots [F.S. 101.68(2)]
(Meetings If Necessary)
March 11, 2014
9:00 a.m.
Canvass mail /absentee ballots [F.S. 101.68(2)]
7:00 p.m.
Election Day processing
Release unofficial results (does not include provisional ballots and
10 -day overseas mail /absentee ballots)
March 12 —14, 2014
9:00 a.m.
Canvass provisional ballots [F.S. 101.048] (Meetings If Necessary)
March 15, 2014
9:00 a.m.
Deadline to file Unofficial Election Returns with State (does not
include 10 -day overseas mail /absentee ballots) [F.S. 102.141] No
later than Noon of the 4th day after election (Meeting If Necessary)
March 16 —19, 2014
9:00 a.m.
(Meetings If Necessary)
March 20, 2014
9:00 a.m.
Deadline to file 2nd Unofficial Election Returns with State (if
necessary) [F.S. 102.141] No later than 3 p.m. of the 9th day after
election (Meeting If Necessary)
March 21, 2014
9:00 a.m.
Deadline for Receipt of 10 -day overseas mail /absentee ballots
[Rule 1S-2.013; F.S. 101.6952] No later than 10 days from the date
of the election (Meeting If Necessary)
March 22, 2014
9:00 a.m.
(Meeting If Necessary)
March 23, 2014
9:00 a.m.
Deadline to file Official Election Returns and Conduct of Election
Report with State [F.S. 102.112] Noon on the 12th day after election
[F.S. 102.141] (Meeting If Necessary)
March 24 — 26, 2014
9:00 a.m.
(Meetings If Necessary)
o All Canvassing Board Meetings Will Take Place At: Election Service Center, 13001 Starkey
Road, Largo
Page 5 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
EARLY VOTING (Martin Munro 464 -6788)
o Early Voting will be March 1, 2014 — March 9, 2014
Early Voting Locations
Election Office - County Courthouse
315 Court St., Room 117
Clearwater, FL 33756 -5190
Election Service Center
13001 Starkey Rd.
Largo, FL 33773 -1416
Election Office — County Building
501 First Ave. N.
St. Petersburg, FL 33701 -3726
Days /Times of Operation
o Monday- Friday: 10 a.m. — 6 p.m.
Saturday and Sunday: 9 a.m. — 5 p.m.
o Early Voting ballots will be printed by the Supervisor; the Supervisor will bill the City 40
cents per ballot card if the City's portion of the ballot creates an additional ballot card.
MAIL / ABSENTEE BALLOT DROPOFF LOCATIONS (Julie Marcus 464 -5710)
o The Supervisor will provide mail /absentee ballot dropoff locations. For locations, dates
and times please refer to Exhibit A.
POLL WATCHERS (Scott Kirby 464 - 6641):
o Early Voting poll watcher designations must be submitted to the City by February 15, 2014
(PRIOR TO NOON at least 14 days before early voting begins [F.S. 101.131(2)]). The City
will fax or scan and email a list of names along with all poll watcher designation forms
prescribed by the Division of Elections to Scott Kirby at (727) 453 -3239 or
skirbyCcuvotepinellas.com by 5 p.m. February 17, 2014 and the Supervisor will verify
whether they are Pinellas County registered voters.
o The Supervisor will furnish a list of approved Early Voting poll watchers to the City by 5
p.m. February 22, 2014 (no later than 7 days before early voting begins [F.S. 101.131(2)]).
o The City shall provide to each designated Early Voting poll watcher, no later than seven
days before the election, a poll watcher identification badge that identifies the poll watcher
Page 6 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
by name. Each Early Voting poll watcher must wear his or her identification badge while in
the polling room [F.S. 101.131(5)]. The supervisor will provide the City with a name badge
template.
o Precinct poll watcher designations for Election Day must be submitted to the City by
February 25, 2014 (PRIOR TO NOON on the second Tuesday preceding Election Day [F.S.
101.131(2)]). The City will fax or scan and email a list of names along with all poll watcher
designation forms prescribed by the Division of Elections to Scott Kirby at (727) 453 -3239
or skirbv @votepinellas.com by 5 p.m. February 26, 2014 and the Supervisor will verify
whether they are Pinellas County registered voters.
o The Supervisor will furnish a list of approved Precinct poll watchers to the City by 5 p.m.
March 4, 2014 (on or before the Tuesday before Election Day [F.S. 101.131(2)]).
o The City shall provide to each designated Precinct poll watcher, no later than seven days
before the election, a poll watcher identification badge that identifies the poll watcher by
name. Each Precinct poll watcher must wear his or her identification badge while in the
polling room [F.S. 101.131(5)]. The supervisor will provide the City with a name badge
template.
OVER - THE - COUNTER BALLOT PICKUP (Martin Munro 464 -6788)
o In -office ballot pickup will be available in each of the Supervisor of Elections locations
during the following dates and times:
o January 27- February 28: Monday - Friday, 8 a.m. -5 p.m. (Closed holidays, weekends)
o March 1- 9: Monday - Friday, 8 a.m. -6 p.m.; Saturdays and Sundays, 9 a.m. -5 p.m.
o March 10: Monday, 8 a.m. - 5 p.m.
o March 11: Tuesday, 7 a.m. to 7p.m.
o The Supervisor will bill the City 40 cents per ballot card if the City's portion of the ballot
creates an additional ballot card.
o In -office ballot pickup on election day: The Supervisor may not issue a mail /absentee ballot
to a voter or a voter's immediate family member on the day of the election, unless there is
an emergency, to the extent the voter is unable to go to his /her polling place. [F.S. 101.62]
Page 7 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
VOTING EQUIPMENT AND SUPPLIES (Ken Lanphar 464 -6788)
o The Supervisor will contract with a moving company to transport the voting equipment and
supplies to and from polling locations.
o Supplies not transported by the moving company will be picked up by the precinct clerks
after Clerks' Class at the Election Service Center.
POLLING PLACES (Karen Key 464 -6110)
o The Supervisor will select, contract with and compensate polling places.
POLLING PLACE CHANGE NOTICES (Marc Gillette 464 -4958)
o The Supervisor will mail any necessary polling place change notices, one per
household, and publish the list in a newspaper of general circulation.
POLL WORKERS (Wendy Grimes 464 -6110)
o The Supervisor will recruit, assign, train, and compensate ALL poll workers. A Deputy
Sheriff will deputize the poll deputies.
o The Supervisor will bill the City for additional poll workers needed to support voters who
are also eligible to vote in City's election.
Rates for poll workers are:
Precinct Clerk
Machine Manager
Asst. Clerk
Ballot Distribution Manager
Inspector
Poll Deputy
$190 + $10 per class (3) = $220
$150 + $10 per class (1) = $160
$150 + $10 per class (2) _ $170
$135 + $10 per class (1) = $145
$115 + $10 per class (1) = $125
$115 + $10 per class (1) = $125
CANVASSING MAIL / ABSENTEE BALLOTS (Martin Munro 464 -6788)
o The Supervisor, in the presence of the County Canvassing Board will open and prepare
mail /absentee ballots for tabulation at the Election Service Center. Questionable ballots
will be presented to the County Canvassing Board for decision. Florida Statute 101.68(2)
allows for the canvassing of mail /absentee ballots to begin 15 days prior to the election.
The Canvassing Board /testing schedule reflects ALL possible meeting days.
Page 8 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
The Canvassing Board will modify the schedule as needed based on the number of
mail /absentee ballots received. Updates to the canvassing board schedule will be posted
to the Supervisor's Web site.
PROVISIONAL BALLOTS (Martin Munro 464 -6788)
o The Supervisor will research each provisional ballot to determine the voter's eligibility and
will present the provisional ballots to the County Canvassing Board for decision. Voters
casting a provisional ballot have two days after Election Day to provide written proof of
eligibility to the County Canvassing Board. The deadline for this election is March 13, 2014
at 5 p.m. [Florida Statute 101.048]. All provisional ballots will be canvassed at the Election
Service Center.
ELECTION NIGHT PROCEDURE (Julie Marcus 464 -5710)
o The Supervisor will have unofficial election results modemed from the polling places to the
Election Service Center.
o The Supervisor will have the Precinct Scanner Memory Sticks, voted precinct and
provisional ballots, and Election Supplies transported to the Election Service Center.
o Results will be released throughout the night and posted to the Supervisor's Web site
(www.votepinellas.com). The Supervisor will provide unofficial results on election night.
These results do not include provisional and 10 -day overseas mail /absentee.
o Campaign signs — if candidates wish to reuse their campaign signs left at the polls on
Election Day, the signs must be collected by campaign staff prior to poll workers removing
and disposing of them after the polls close.
AFTER ELECTION DAY (Nancy Whitlock 464 -7493)
o Provisional ballots will be canvassed. All ballots accepted by the County Canvassing Board
will be processed and added to the election night results to produce Official Election
Results. Provisional ballots cannot be rejected until after the deadline for provisional
voters to provide written proof of eligibility [F.S. 101.048].
o 10 -day overseas ballots will be canvassed 10 days after the election. ALL races /questions
included on the special general election ballot must be counted. These votes will be
included in the official election results. [F.S 101.65]
Page 9 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
o The County Canvassing Board will certify the election results and will provide a certificate
of election and a conduct of election report to the City (ONE certificate of election and
conduct of election report will include all elections held on the same day). These
documents will be provided to the City via email after the County Canvassing Board
certifies the official election results. [F.S. 102.141]
o The County Canvassing Board will conduct a post - election audit in accordance with F.S.
101.591 and Division of Elections administrative rule 15- 5.026. The Supervisor will post the
required post - election audit notices to the Supervisor's Web site and at each elections
office. The Supervisor will provide a copy of the notices via email to the City to post at City
Hall (and Web site, if applicable). The Supervisor will post the final post - election audit
report to the Supervisor's Web site and will provide to the City a copy of the report, via
email, to post to City Web site, if applicable, after the County Canvassing Board completes
the audit.
o Election materials will remain sealed at the Election Service Center for the duration of the
public records retention period.
o The Supervisor of Elections in accordance with Florida Statute 98.0981(2) will report
precinct -level results to the Department of State within 30 days following the election.
DATA PROCESSING ORDERS (Nicole Foglio 464 -4958)
o City to place orders directly with the Data Center staff. Data processing information
can be found on the Supervisor's Web site under the "statistics" tab.
o City has requested and will be billed for the voter list on a CD within 10 days following the
Voter Registration Deadline.
VOTER HISTORY:
o When voter history is completed, the City will be provided with the names of those who
voted. Information to be provided on a CD.
ELECTION COSTS (Lori Sullivan 464 -6108)
o There will be a 10 -cent election administration fee per registered voter; the minimum
charge is $400.00.
Page 10 SK 11/08/13
AGREEMENT FOR CONDUCTING
IN CONJUNCTION SPECIAL GENERAL ELECTION /MUNICIPAL ELECTIONS
MARCH 11, 2014
By affixing their signatures hereto, the parties acknowledge each to the other that they have full
authority to enter into this Contract.
APPROVED:
DEBORAH C
Supervisor of Elections
Pinellas County, Florida
DATED:
APPROVED AS TO FORM:
JEW HITS I Print name
Sr. ssi nt County Attorney ISSE City Attorney
APPROVED:
Print name
City Manager
DATED: ' 230 \ (D' 3
APPROVED AS TO FORM:
DATED: ` ID
DATED: A
eS
OUR k2 31 X13
ATTEST TO:
kia
cC ��
Print name .aso,Y-0--riv--
Municipal Clerk
DATED: de je,/ (1.0
Page 11 SK 11/08/13
BALLOT LANGUAGE & ELECTED OFFICE INFORMATION FORM
MUNICIPALITY: (TOWN OR CITY) CLEARWATER
SUBMITTED BY: ROSEMARIE CALL, CITY CLERK
DATE OF ELECTION: MARCH 11, 2014
OFFICE
♦ Office Title:
(Circle One): (Mayor, ouncilmember Council Member, Council, Commissioner,
City Commission, Commission; IVlayor- Commissioner, City Commissioner)
(Circle One only if you want "Seat, District, or Ward and #" to appear on the ballot
er the office title):
istrict , Ward - If a Seat, District or Ward please indicate it 4 or
AA t arge (circle only if you want "At Large" to appear on the ballot under the office title)
♦ (Circle One): Vote for On
♦ Elected By (Circle One):
♦ Votes Needed to Win (Circle One):
• Candidate Order (Circle One):
• Number of Candidates for this Office: 3
Vote for no more than (Two Three Four)
Single- Member District
At Large
Majority
Draw Lots
• 1ST CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
DAVID ALLBRITTON
• 2ND CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
BILL JONSON
• 3RD CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
KONRAD McCREE, JR
• 4TH CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
• 5TH CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
(If additional candidates for this Office, please continue by completing an additional form)
♦ Term of Office: 3/2014 - 3/2018
♦ Date of Swearing -In (Effective Date of Term): 3/25/2014
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
2 7013
C77CtM.-KELOi4Y:'S
.LECISLIZIVE iSIZVCS DEFT
OFFICE USE ONLY
OATH OF CANDIDATE
(section 99.021, Honda Statutes)
itt) ) A LL0,,eci-J
(PLEASE PRINT NAMP AS YOU WISH IT TO APPEAR ON THE BALLOT* — NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am a candidate for the nonpartisan office of Cleat-Water COUnCilmember , N/A
(office) (district a)
NIA Seat # ; I am a qualified elector of Pinellas County, Florida;
teIrce It #) (group or seat #)
1 am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs
concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to
Section 99.012, Honda Statutes; and I will support the Constitution of the United States and the Constitution of the
State of Florida. I have continuously resided in the City of Clearwater for at least one year prior 10 submitting a petitio
for election(Sec. 2.02, Charter).
X :2;41M
Signature of Candidate
(-12;T)
Telephone Number
461141
Email Address
4 tk.,ko ,
(1_4
Address City State hP Code
Candidate's F lorida Voter Registration Number (located on your voter information card):
cr.C1 37
Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
' h disabilities (see instructions on page 2 of this form).
STATE OF FLORIDA
COUNTY OF-R;r---e-,Qj --
Sworn to (or affirmed) and subscribed before me this
day of -1>---C-,--‘-"L)---e-f
,zo5.
Personally Kn . Of
Signature of Notary Public
Produced 14entificatton: Print, Type, or Stamp Commissioned Name of Notary Public
Type of Identification Produced: 4h
: )(ARENS. VAUGHAN
''' ,.•:'`fe;.()E1/41SISe;c1)1"11D29011820113
nois',tro4flotarr PeNic Underwriters
Rule 1S-2.0001, F.A.C.
DS-DE 25 (Rev. 5111)
czm
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
oe'0,:47)
LECISLATArE
OFFICE USE ONLY
OATH OF CANDIDATE
Section 99_021, Florida Statutes)
4,
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT.- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am candidate for the nonpartisan office of Clearwater Councilmernber
.N/A ,
(once) (district #)
NIA , Seat # ,4-7 ; I am a qualified elector of Pinellas County, Florida:
,
(circuit #) (group or seat #)
i am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs
concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to
Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the
State of Florida. I have continuously resided in the City of Clearwater for at least one year prior to submitting a petitio
for election(Sc. 2.02, Charter).
t;SA-
',e9-fr't,-- 727 ) '‘'
X i i
/
Signatur(of Candidate
Email Address
,Q6
Address City
Telephone Number
state ZIP Code
Candidate's Florida Voter Registration Number 10Cateci on your voter information carril (e)(-)?
Please print name phonetically on the line below as you wish it to be pronounced
with disabilities (see instructions on page 2 of this form):
STATE OF FLORIDA
COUNTY OF—R
Sworn to (or affirmed) and subscribed before me this
on the audio ballot for persons
Per °natty Known: or
Produced Identification:
Type of Identification Produced
DS-DE 25 (Rey. 5111)
day of
, 2
Signature of Notary Pub -c
Print, Type, or Stamp Commissioned Name of Notary Public
KAREN B. VAUGHAN
MY COMMI5StON # D0918710
EXPIRES: December 20,2013
ThrJ Notary Public Underwriters
Rule 1,S-2.0001, F.A,C.
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
KiONIZ.IND tt\ 'Le
(PLEASE PRINT NAME AS OU WISH IT TO APPEAR ON THE BALLOT -- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am a candidate for the nonpartisan office of Clearwater Councilmember , N/A
(office) (district #)
County, Florida;
N/A , Seat # ; 1 am a qualified elector of Pinellas
(circuit #) (group or seat $r)
am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs
concurrent with the office I seek; and I have resigned from any office from which 1 am required to resign pursuant to
Section 99,012, Florida Statutes; and I will support the Constitution the United States and the Constitution of the
State of Florida. I ave continuously sided in the City of Clearwater for at least one year prior to submitting a petition
for election -c. .02, 'honer).
X
I/1
Signature of Candidate
c'fle•o tiA
Telephone Number Email Address
e It- i(D it gcoity CI
Address
State
ZIP Code
Candidate's Florida Voter Registration Number (located on your voter nformation card).
Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form):
STATE OF FLORIA
kika-,7>
COUNTY OF
worn to (or affirmed) and subscribed before me this 1 day of
—Tr
Personally Known: or
Produced Idenblicalion:
Type of Identification Produced
1
,
20 )
Signature of N Public
Print. Type, or
DS-DE 25 (Rev. 5111)
Commission ft DO 993889
Expires July 10. 21314
Rule 1S-2. 01, E.A.C.
BALLOT LANGUAGE & ELECTED OFFICE INFORMATION FORM
MUNICIPALITY: (TOWN OR CITY) CLEARWATER
SUBMITTED BY: ROSEMARIE CALL, CITY CLERK
DATE OF ELECTION: MARCH 11, 2014
OFFICE
♦ Office Title:
(Circle One): (Mayor,
City Commission, Commission,
Council Member, Council, Commissioner,
ayor- Commissioner, City Commissioner)
(Circle One only if you want "Seat, District, or Ward and #" to appear on the ballot
er the office title):
'strict , Ward - If a Seat, District or Ward please indicate # 5 or
arge (circle only if you want "At Large" to appear on the ballot under the office title)
♦ (Circle One): /.ote for One
♦ Elected By (Circle One):
♦ Votes Needed to Win (Circle One):
♦ Candidate Order (Circle One):
♦ Number of Candidates for this Office: 2
Vote for no more than (Two Three Four)
Single- Member District
Highest Number
Alpha Order
Majority
Draw Lots
• 1ST CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
HOYT HAMILTON
• 2ND CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
JON -PAUL ROSA
• 3RD CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
• 4TH CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
• 5TH CANDIDATE NAME - Attach Copy of Candidate Oath with this Form
(If additional candidates for this Office, please continue by completing an additional form)
♦ Term of Office: 3/2014 - 3/2018
♦ Date of Swearing -In (Effective Date of Term): 3/25/2014
CANDIDATE OATH -
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99021, Florida Statutes)
Y in I Lir) Aki
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT - NAME MAY NOT BF CHANGFD AFTER THE ENO OF ouAtwviNG)
m a candidate for the nonpartisan office of Clearwater Councilmember N/A
(office) (district #)
N/A . Seat # ; I am a qualified elector of Pinellas County, Florida;
(circuit #) (group or seat #)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated ar
elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs
concurrent with the office I seek; and 1 have resigned from any office from which I am required to resign pursuant to
Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the
State of Florida I have continuously resided in the City of Clearwater for at least one year prior to submitting a petitio
for election(Secf 2.02, Chart r)
x
Li; S-'6i jIht,
Address City
(12 5O2
Telephone Number Email Address
ZIP Cede
andidate's Florida Voter Registration Number Oocated on your voter information card): /0;:i7 7i/ 5'9
* Please print name phonetically on the line below as you wish t to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form).
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me this
Personally Known: or
Produced Identification.
Type of Identification Produced:
DS-DE 25 (Rev. 5/11
day of
20
Signature of Notary Pub
Print, Type, or Stamp Commissioned Name of Notary Public
N 8. VA
MY COMMISSION # OD 918710
EXPIRES: December 20,201
.A.C.
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99,021, Ronda Statutes)
1 f‹.0 5 0-
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT* — NAME MAY MOT BE CHANGED AFTER THE END OF QUALIFYING)
ern a candidate for the nonpartisan office of Clearwater C01111CiiMeMber N/A
(office) (district tt)
N/A Seat # (
; 1 am a qualified elector of Pinellas County, FlOrida,
(circuit R) (group or seat #)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; I have qualified for no other public office in the state, the terns of which office or any part thereof runs
concurrent with the office I seek and I have resigned from any office from which I am required to resign pursuant to
Section 99,012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the
State of Florida. I have continuously resided in the City of Clearwater for at least one year prior to submitting a petitio
for election(Sec. 2.02, Charter).
X
Sighature of Candidate
ji
,
Address
City
(7;: r 6-) 7 r C
Telephone Number
f H1 e- 0:j
mail Address
State
/
ZIP Code
ndidate's Florida Voter Registration Number (located on your voter info r atiOn car
6.;
-
Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form):
f.
fi
STATE OF FLORIDA
COUNTY OF
kirtr\
Sworn to (or affirmed) and subscribed before me this IA_ day
Personally Known: or
Produced Identification:
Type of Identification Produced.
201 .
Signature of Notary Public
Print, Type, or Stamp Commissioned Name of Notary Public
KAREN B. VAUGHAN
At COMMON 000918710
•• : 4 4
1;f 11;7 . • ..,,r1
,
DS-DE 25 (Rey.