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97-27i z 3 4 5 6 � s 9 io ii iz 13 14 is 16 16 Presented By Referred To RESOLUTION �INT PAUL, MINNESOTA RESOLVED, that the Saint Paul City Councii consents to and approves of the appoiniments and reappointments, made by the Mayor, of the following individuals to serve on the ADVISORY COMD�TTEE ON AGING. • . "� h Yul ► Katherine Barron Sister Frances Mary Benz Mark Flahavan Dennis Gerhardstein Harold Hebl Kenneth Lawrence Dean Lemke Nicole Otto Steven Sarrazin Richard Taylor Jamie Warndahl APPOINT'MENTS Jacqueline Heintz Micheile Johnson Greta Brockhausen Michaels 7ane Royse B� � a` c-� �,,,�I� ...� �..: � l Approved by Mayor: Date d By: _ 1 " C/ ��fi�""'r'� Requested by Department of: By: Form Approved by City Attorney By: ��u.✓� � -'/�/— Approved by Mayor for Submission to Council i �� `-' By: � � , f ..,� � g �� r F ,� Council File #� { 9� ts t i' c..,.` � i�. . ,..e Green Sheet # CJ2�� Adopted by Council: Date�� Adoption Certified by Council Secretary 266-8531 1-13-47 GREEN SHEET lNIMIlOATE— O DE7qRTMENT O7RECTOR 4SSIGN �CITYATTORNEY JtlNBER iOR ?OUTING O ��ET DIR£CTOR )RD� � MqYOR (OR ASSISTAN'f) TOTAL # OF SIGNATURE PAGE5 1 (CLIP ALL LOCATIONS FOR SIGNATURE) �� -� 4020� �Nmamn� CRY CAUNCI� CIIYGLERK FIN. 8 MiGL CaERV(CES fl4R. Approval of the appointment of 4 members and the reappointment of 11 members to the Advisory Committee on Aging. (Itesolution lists the individu ls) o� _ CIB CAMMITTEE _ _ _ S7AFF _ ' _DISTRICTCAURT _' SUPPORTS WHICH EQUNCIL OBJEGT�VE7 PERSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING OUESiIONS: 1. Has this parsoNRrm ever worked under a conhact for Mis departmen[? YES NO 2. Has Mis permnRrm ever been a c�ty employee? YES NO 3. Ooas this personlfirm possess a skill rwt normally pos5essed by any current city employee? YES NO Explain eIi yes answers on separata aheet and anaeh to green sheet '�� f� n6� t"D.3s�Ae.^P y, 'i ' ^ r., z x.aS�Lw .....a..�iS :.9E€..:� .i�li� 1 U � t��7 � � . _ _ ._�_�..,,-� lO7AL AMOUNT OF TRANSACiION S CO57/REVENUE BUDGEiED (CIRCLE ONE) YES NO 'UNDIfiG SOURCE ACTIYITY NUMBER IP7ANCIAL INFORFiAT10N: (EXPlA1N) / l J V � Interdepartmental Memorandum CITY OF SAINT PAUL TO: Saint Paul City Councilmembers Counci� President Dave Thune Councilmember 7erry Blakey Councilmember Daniel Bostrom Councilmember Mike Harris Councilmember Mazk Mauer Counciimember Roberta Megazd Councilmember Janice Rethnan E��]�A DATE: fi� Roger C. Curtis R•� � Assistant to the Mayor Januazy 14, 1997 ADVISORY COMMITTEE ON AGING Mayor Coleman has recommended that the following individuals be appointed and reappointed to the Advisory Committee on Aging. Reappointments Katherine Barron Sister Frances Mary Benz Mark Flahauan Dennis Gerhazdstein Hazold Hebl Kenneth Lawrence A.p�ointments Jacqueline Heintz Greta Brockhausen Michaels Michelle Johnson Jane Royse Dean Lemke Nicole Otto Steven Sarrazin Richazd Taylor Jaznie Wamdahl Each member will serve x two-year term that wi31 expire on November 30, 1998. A copy of the resolurion recommending these members is attached and copies of the new members' applications. Also attached is an applicant report listing atl applicants on file since January 1, 1994. ff you have any quesrions or concems, feel free to contact me at 266-8531. Attachments cc: Nancy Anderson Alberto Quintela Mimi Weinber$er Council File # � Green Sheet # �� Presented By Reterred To Committee: Date i RESOLVED, that the Saint Paul City Council consents to and approves of the z appointments and reappointments, made by the Mayor, of the following individuals to a serve on the ADVISORY COINMIT"I'EE ON AGING. � 5 6 � a 9 io ii iz 13 14 15 16 16 REAPPOINTMENTS Katherine Barron Sister Frances Mary Benz Mark Flahavan Dennis Gerhardstein Harold Hebl Kenneth Lawrence Dean Lemke Nicole Otto Steven Sarra�in Richard Taylor Jamie Warndahl APPOINTMENTS Jacqueline Heinxz Micheile Johnson Greta Brockhausen Michaels Jane Royse Requested by Department ot: By: Adopted by Council: Date Adoption Gertified by Council secretary By: Approved by Mayor: By: RESOLUTION CITY OF SAINT PAUL, MINNESOTA Date Form Approved by City Attorney ay: �lJ�� -` _�y_ - Approved by Mayor for Submission to Council .�� ""' '� tG ' By: 9� �-� ffice s 266-8531 qTE INITIATE� � � � �J � 1-13-97 GREEN SHEET INITIAVDATE INITIALIDASE ��EPARTMENT6IRECTOR QCIT'ICOUh'CIL ISSIGR �pNATiORNEY �qNCLEPK iUNBEfl FOP iOUTINC � BUDGET DIRECTOR Q FIN. & MGT. SERVICES D1F. �A�� MAVOF4 (OR ASSiSTAN� � TOTAL # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE) AC�ION REOUESTEO: Approval of the appointment of 4 members and the reappointment of 11 members to the Advisory Committee on Aging. (Resolution lists the indi _ PLANNING COMMISSION _ qVIISEFViCECOMMISSI�N _ CIB COMMtTTEE _ _ StAPF _ _ DISTRICTCOURT __ SUPPOR7S WHICH COUNCR O&IEGTIVE? INITIATING IFAPPROVED: PERSONAL SERVICE CONTRACTS MUSTANSWER THE FOLLOWING QUE$TIONS: 7. Has t�is persoNfirm ever worked untler a crontract for this tlepartment? YES NO 2. Has ihis person/iirm ever been a ciry employee? YES NO 3. Qoes this personlfirm possess a skdl aot normally possessed by any currenS ciry employee? YES NO Expiain ell yes answers on aeperate sheet and attaeh to green sheet OTAI AMOUNT OFTRANSAC710N $ COST/REVENUE BUDGETED (CIRCLE ONEJ YES NO � JNDIqG SOURCE ACTIVITY NUMBER JANCIAL INFORMATION' (EXPL4IN) . �� . 390 CITY HA'E,L I�� rtc�csr�,.. SAT2� P21IIL, MINNESOTA 55102 -� � ' 266-8525 FAX: 2b6-8513 N4V � 3 1996 Name: ' �1 iG� �t f GL � N 1... ' 1 r � f'u� ��G (�� f vTT_ F.aBYQ�� (1FF1 .F Home Addzess ; () ` I J u�� f ry�'Q �] T �Q LJ{. � � 1 i 1 V � f 0 a. Stzeet Czty Zyp Telephone 2:umber: tHome) � Id� � 1 b - S �io�`� ��ork� �a - �s39 _ .«�,3�a - � �� Planning Distzict Co�ci1: ! City Council Aard: �. P=eferred Hailing Address_ ��-Q CLS ��-Q ��e� Ahat is poux occupation? Place�o£ Eaployment: Co�ittee(s) Applied For: ns. T S. C _�1��,� . • Ahat skills/trai.ning or eaperience do pou possess £oz the committee(s) appointment? � � � � t_- �'_I .� / • .L ! � _ 11� S The infor�ation included in this application is considered priva�e data according to the Hznnesota Goverment Data Practices Act. As a xesult, thi.s information is no:, released to the general public. (OVE.R)' � Itev. 2; ZS/96 PERS�NAI. REFESLENCES Name: V ��T p�C Address: Phone: lHomel !�1 � � � �' � �� Name: ��NI �«.��. �� Address: � t-i� !� � �V � �, � lCj (�Q'1��" �} �' S t-I o 1 I Phone: Name Address aas -3 ,g� !✓ � � 30 � ., - Fhone: [Home) fWork) q"_t�- � q�`�n R��^ Por your interest in -, _ _ _ .�1�� .��Q. _ �1`11�0��12C� 1,�� /,y '. S. `fJ2.a14.U2 `..� ��a p.e �va 5 [,Q d- � (�VD V W C .,.t.. ,.x � � v � .t ..�.Q � - �l - l m'��'� C:u�rnx�ritsStov� -tb rn�.ke Sur�. St Peul is a t�a�utcscrimatary Have you had previous contact vith the co�nittee for which you are making applicati,on. I£ so, when, and circumstances? 5�,� �tto,c�n.ed SheeF �� 'l0 -Frn` �lq � r.g Go rn rn;fitee . In an attempt to ensure that committee repzesentation reflects the makeup of our community, please check the line applicab2e to pou. This in£ormation is strictly voluntary. •� White (Caucasian) Hispanic Black (African American) Asian or Paci£ic Islander American Indian or Alaskan Eski.mo Male �_ Female Date of Birth: ( � " 30 " `,Q � Disabled: Yes Z7o � If special accommodations are needed, glease apeci£y. ! W��—� 13- Hov did you hear about this opening? , PERSONAI, REFEREflCES xame: �I p� Address• vs.,,,.e. �v,.__, ...'� `l � — ��i - 27 —/)2� 1 .�, Name: �SDN1 �«�� Address= � IID�C ��Z ��j �7 � �, 5� i i Phone Name Address aas-3qg� I✓ � Ji2 30► � -- Phone: CHome) lAork) �'�1�� ( �� kzec.�3v�, ,nVOlve� w�� Reasons fOr yOi1L interest lI1 i�11S DHLt1ClllaY.r.nmmittna• i�i. �nn�. �F'1� �. _il n .. .+''`n.�r6 • S 1C34�1f.1A.4 r-� t .+.�.. , � � v � .c - � --i— ts�'��.f s C.�vn.rri� s s tav� - �z> Make Sur-e S�- Pau! i s a r��ndc scr, maf Bave pou had previous contact vith the committee for vhich pou are making application. If so, �rhen, and circumstances7 Se�, atto�c,�a Shee� �'�10 far �Ag � rg Co rn rn�ttee .� In an attempt to ensure that committee representation re£lects the makeup of our community, please check the line apglicable to you. This information is stricLly voluntary. '` Ahite (Caucasian) Hispanic Black (African American) Asian or Pacific Islandez American Indian or Alaskan Eskimo Ma1e �( _ Female Disabled: Yes No � Date of Birth: 1 l' 30 ^' �Q � I£ special accommodations are needed, please specify. r v�y ��c. Hov did you hear about this opening? ��.�� n( Y __� � l,l lJ/ 97-�� c�m a Is� %n sf�d u� `� Co m m{ttee o n t`� g, r� .�-rzx�t� ca�'� o�' rny �el�x I y {'af h�,r -F �'/a t� �5 - �beca,us.e h�. suf-E'e�ed �! S�ht'o kes •,� �now �e S•l-ru�c� �e s aur �. Id�er� � Ga m rn u n�t c� -Fo�ce 5� i kQ. -�r� � r� - �v �',ric� assis��r�ce w� hor�..e CmrQ �.spe�,iat1�{ '�F' t�'r2 �� t 1 bu+ u.�ct.r� �- -fa ( �v2 a.� hcsrnrn.e ,�i �t� � r� `` � �ax�. " i F I t�.x�.�'e cQ -Eo c�o a u�� G. whi 1�., �rnaki i� s u �� E,ine't� 1'� i t l s O,t�e - Ftz.ke vl ca+r � o� — h�21 � s i�o� 't'he,v� -� i c� u r e o u f c�ha� F YY�ed i ca,�e w� 1 l rn� U� i I l n ot (�c►a,i °�s w� I l ct s w1�� `-f'(n�e Su�p4e rn.e.r�+ Y� (.�c�u,� . Oc�+r �ei�i� �i dese;rv-e -h� bR. �-i�re�ed �`a�rl`'I � w i� In �`�e s e.ck . Th� 1�A��2 Y, �j l�t� s j us� 1 i ke. U5 -� +t si�a Ul d n� 1� ttx.k.Q� c�dvQ,vt+a�e oF a� d�sc�r�v,�� a+ed o,t�a��nSk k 1 ecct,usQ o� � i' h2ir �Ti�e� �n+1-�-ri tou+e a tbf -t oUr �i t� -`�'YZYO�t� v��ur� wo�k, pc�� fir�.� wt�k, as w-��1 G.s `�Nnro u.�h �'h2� r I� � S�-�rrt� o� � u�r u t� —�'1^se,� ��e t��es�.� s�-o�rtes — �Y�e,� a,r�. - fi�xr�f �c ht S��r�ans ( 6� �� o;,� po � nfed `�ta th t'S C�,m��te�e, i� wou.ld a11ow rne - b h�e.1P p�o�eck fh2�� r►ght -� prnr�,o�e f t,t s2�'ul �n2 s� � Ga,��-y; bu�hon s �e G��Ec� • r ��'11c- �� . r � G � � � .r' r � JACQUELL�IE �1. HELti s�i .�-�o �ti� ST. PAL=L, �� »102 612-298-892-� OBJECTIVE: "Po pursue a career as a Claun Rej.iewer. EDUCATION: Hill-'�furray I-Iigh SchooI, tiiapies�ood �LV" 1977-1981 Graduaced l�iay 31, 1981 Universiry of Viinnesota, \Qinneapolis, ,LIN 1982-1986 1�Sajor: Intemational Relations with emphasis in Diplomacy, Bargainuig 3c Ne�otiation �Ietro State liniversity, St. Paul, i�IN -Enrolling in Winter 1996 to fuiish Degree t�iORK EYPERIFNCE: Reliastar Insurance (formerly Nti4"�,Z) 3146-present Employed as a Senior LTD Benefit Spccialist. Duties inciude analyang ASO, ]PG and Insured clairns bv Plan lan�uage, medical documentation; processing nen; ciaims, mail on Clauntech, reviewing ciaims by benefit amount for approval, review claims for Change in Definition and'or �fedicat�JOC Rehab, investi2ate Pre-E;�sting Conditions, heaw phone contact iiith empioyers, claimants, physici:u�s. Additional duties as listed under Northwestem Na[ional Life. Sed�wick James 7%95- 3r96 EmpIoy as a Benefit Coordinator for Lon� Te7m Disabiliry. Duries inciude analyzing claims for eli�bility, detemuning and documentin� on�oin� total disaUi3ity through information obtained from uLCC's, physicians; detennining henefit amoants when coordinated u itk Social Security Disabiliry Pension, Workers' Compensation; assisting with Social Security applications; interacrion �vith SSDI andJOr Vacational Rehabilitation Representative, Cwtomer Ser4ice Client Seriices and LT'B nurses; investigate Pre-Esisting conditions, heaw phone contact, processing mail, obtains documentation for claim, manual calcutations of overgayments, e�pe�ience �vith Words for uiindows. Word Perfect. �' �-�� ISIInsurance 2'9�- 7/9� Employed as �Iedical Clauns Representative in I�TO-FauIt claim depariment. Duties include anal}-ang \TO-Fault & MedPay claims for l4iidwest reo�'on utciuding California deterniinin� percentage of benefit gayable for medical, wa�eloss, replacement services, etc., detemuning liability, subroga�on, investi?atin� prior injuries, scheduling IME°s, negoriating settlements, arbitrations, heacy phone cantact with insureds, claimants, attomeys and medical professionals, processin,a� mail, obtaining documentation fding, extensive work w7th 10 key and Claim svstem. Northwestem National Life Iasurance 7 991-1995 Held position in Employee �3enefit� Di�ision as Senior I?isability Benefits Specialist. Duries inchide determining insured's eli�biIity, work with ASOIIPGi INSLJRED �oups, investigating pre-e�sting conditions flocumenting ongoing total disability, tim�Yy deternunation and payments of LTD clauns. Calculation of federal & state ta�es, assisting with Social Security Disabitity applications, interaction �vith physicians, lawyers; processing maii, heavy phone & customer contact handlin� appeals of denied claims, experience with Words for Windows, Word PerFect, ICD-9 & CPT coding, Caseload- 500+ nationR-ide. ERISCO!CLALMTECH experience. �iutual Benefit Life (Fortis) 1990-1991 Worked as Disability Anal,yst in LTD claizns. Duties inciuded analyzing, processing �Z paymznt of LTD clauns in �iidwest region. Processittg mail, calculatut� overpayments, assisting with Social Securiry apglicafions, anditit�, interaction with physicians, lawyers, rehabiliTatian consultants, hea�y phones and customer contact, PC experience, ICD-9 & CPT coding. St. Paui Comparnes, Inc. 1°87-1990 �Vorked as Customer Service Representatioe for rlssi�ed Risk ALto. 33uties included issusnce of all new business applicatians, renewals, endonements, reinstatements, & cancellaTions for Persc�nal & Commercial tluto in 34 states. Interacrion wizh agents, insureds, State Insurance Plans, Service Centers in re�ard to rating, coding, underwiiting rules & billin�. 97 �� Vork with CrDS system, heavy phone work, mail. State Fann Insurance Companies, Inc. 1983-1986 �Vorked as a Secretary far 2-a�ent office. Duties included typutg, filing, heavy phones, custotner cantact, processin� necv policies, clsims, endorsements, accident reports, rating, codin� ECHrJ Computer System. State Farrn Insurance Companies, Inc. 1980-1982 Duties included X-Datina £or praspective clients. RELATED EXPERIENCE: -Phone Tone Seminar- dealin� rvith an irrate customer -Self tiiana�eci Teas� Steering Committze Niember-N�V��I, -Record'mg Secretary-Self ivfana;ed Team-NtiVNI, -Health Fraud Seminar offered by Twin Cities F3ealth Claim Associarion -Meclical Aspects of Disabi]iry Seminar-Abbott Northwestem Hospital's Sister Kenny Institute 1994 1942 1992 1992 1943 -Numeraus In-House Seminars affered by Reliastar (?�T�t+i�,Z) Benefits U- empioyee continuing eciucatian pro�am 1991-present -PC traiiung for NtiV�+'L affered by the Science �Iuseum of 1�Sinnesata -Excel for Windo4vs �.0 Computer class -E 12ai1 Training Seminar through Raliastar SPECIAL ACTIVI�'IES/TNTERESTS: -Participant in Ramsey County Sheriffs Civilian Academy -Participant in St. Paul Pofice Department Civilian Police :�cademy -Volunteer Panei Member, St. Paul Police Oral Inter�ieFV Raview Board & Youth Gang 7'ask I'orce Coznmittee -St. Paul Winter Carnival Volunteer -St. Patrick's Day Button Cosnmittee vlember -Vtember of Tw�i�� Cities T3eatth Claim Association -Vluscular Dystrophy :�ssociation Volunteer -United 4Vay Volunteer -tilember of iVlaple�voad Figure Skaiing CluU -Volunteer for St. Paul Police Bepariment-different duties i993 1994 1996 199& 199� 1994-present 1986-present 1986-1992 1992-present 198d-przsent 1987-1992 1977-1981 1994-present REFERE� 10E5: Avvlabie upon request. �� TTase: t t l, l G[ wl,'{ aome aaaress: b? � Street Telephone Number: lHoae Planning District Co�cil: Prefexred 2iailing Address: Rhat is your occupation? � Place�of Employsant: � Coffiittee(s) Applied For: OFFZCE OF THE 24AYOR 390 CITY HALL SAINT PAIII,� MINSIESOTA 55102 266-8525_� FAX: 266-8513 City �7-�7 R'c�F �'�� ocr z s i9ss Zip �u � � City Council Gard: �r�lJ�i�lr C �� Ahat srillsJtzai.ning or esperience do you possess foz the co�ittee(s) Por vhicn you seek appointment? r.Q ��r�n c� �,nR,Ps PG�rP.r� �znc� �- �lmrn�ll-�fl �� rv �,� c �ip �, � a.� � -e-/I�L� t CJL ' G� �' �Tlf � P �( C3�-�Yi ��t..� � f�t�.l-Lv�( � . -^�, ��. ti-� (' c�c�r�� , n .�� ,u.�, QF t��s.�� c� -� `=�---�' l,c�L�:�� . The in£ormation included in this application is considered private dzta according to the Hinnesota Governent Data Practices Act. As a result, this information is not released to the general public. (OP�R.) Rev. 2/28/96 PERS021AT. REFERENCES Rame Addri Phoni Name: aaa=ess Phone Name: Addre �C� �a n � � � �/L/' � 3! 4� R 7-� 7 �; Phone: (Aome) `��CC,i� �.v>X.P CWork) r� �� / R ^ easans foz your interest in paxticular committee L'1 i\ In n n. /� n,� ,.. _ I L. . i7 nn A l�_ n.� �._ Have you had previous contact vith the co�ittee £oz vhich you are making application. If so, whea, and circumstances? N� ' In an attempt to ensure that coffiittee representation reflects the makeup o£ our commvnity, please check the line app2icab2e to yoci. This information i.s strictly volvntary_ t� phite (Caucasian) Hispanic Black (African Americaa) Asian or Pacific Is2ander American Indian or Alaskan Eskimo Hale � _]� Female Date of Bizth: I I'�I ��' r LP Disabled: Yes No � f� Tf special accommodations are needed, p2ease specify. �� Hov did you hear about this opening? PERSONAL Name;� Address: Phone• Name: Address• Address: Phone: C� / R � eason ( s £or youz interest ia particular committee: C 1 r� !n n .: n � 1..._ _ I1. . a hn n ... 1�,. n i �., tor y�-331 0 9�-a�_ c� $ave you had previous contact vith the committee for vhich you are making application. I£ so, when, aad circumstancesT Na � In an attempt to ensure that committee representation reflects the makeup af our coarmimitp, please check the li.ne apglicable to you. This in£ormation is strictly voluntary. I� Ahite (Caucasian) $ispanic Black (African American) Asian or Yaci.fic Islander 9merican Indian or Alaskan Eskimo 2�fale �1 Female Date of Birth: ,�� I �`�1' 1�� t.F' Disabled: Yes No � I£ special accommodations are needed, please speciEy. _)V �� Hov did you hear about this opening? �- TLY"' �� V'� Name : .>-` �{ �T/-7 390 CITY HAI,L SAINT PAIIL, MINNESOTA 55102 26b-8525 FAX: 266-8513 �� -7 �£�� P10V � 3 1996 Pv�YQ+R`� �FICE Home Address: °�� &° G�� s: NayT G�-vc.r' ST. l�Fl-✓t SS"7aF1 Street City 2ip Telephone T�uaber: (Home) �o�S�--ss �� (Aork) -��) Planning District Co�ci2: i� Citp Council Aard: � Yreferred Hailing Add=ess: a/S� cvssi �yo �r ,r�-,�� Sr �fr�L (•..� z yL> � Cs v.....-.�-c�� G� 7GJ wr..r�.� a.<J 1-�9-�-`" ./L/J_ �J/�-.ci/.v.c� «:� 5 Ahat is yovr occupation? 1� = n i� m s n -�- �� Place �of F�plopment: $i�. P/1-�� O.�.Pc_; � sc�-i ,�, �S Conmittee(s) Applied Eor: /-��r1f �0 2� G.�s ,-y�r i� � ca,c� �� r �Ihat skillsJtraining or eaperience do you possess £or the committee(s) £or whicn you seek appointment? C ��rL/�-c'��Y Go Gi�,fa-i�Z c7f � i �.<-� ��arv !�✓�J2-�� LOGic N'vits' fL1J�..1c ✓ Mc�.�?c. /�/Ld6iC./� �}Z O� P�- �/�!Z O �/7 Ga�-i A f�� 3-.c->>7 v�7? ?Z--i�-r�r3x /� t'L-l�3Zo dJS C'O'Kf NI i� '� � ��`'+-'( 1'.�� t O�E-'�6�+[,J ^ ' z/'�-TIo•J /^a,/�- / �yU�/ G�9-�Y E3s iN Si . .AY� . The information included in this application is conside=ed private data accozding to the Hinnesota Gover,nent Data Practices Act. As a result, this in£or,�tion is not releaszd to the gene=al public. (OV�Tt) Rev. Zi 28J95 P�o�. ��N�ES � � a � xame: �+'�/� eon�z/.�->c9a Address: � 33 / ,� vi-o�-.� �,i�-ryz.�v,_�' S� f�6yv r,.,,,�/` s�s2 v`g' Phoae: tHome) � �� - r� C c, (Work) ""� Name: A.!/-}2.,�c�yLec° �'R-.�-i � �1s a.J , °! 0 4/� iS. �v s� 'j s G ��-n.� ��'y{.,v/J Address:_ •`� ,-✓ oi i c. .��-r�--.�aa � T-YYr' .� S'T. J�/3 v� �-t.t1 S S i�-`l Phone : (Home) (Ao=k) E Y' 9 - � -� � Name: ��- t zr��s c�"�-� 8r� ��-' Address: -3�' "3 f � C�o.�li+-c ,� �rn-� � L3„� ^i /�r�-./c .�1.J �2 � � Phone: (Home) G�+ Y�- 6�s � (Gork) Reasons for youz interest i.n this particular committee: Rj-iZfYL ��vr Yr�2s� i�v c�. Tir�' �Sc,Dc-.e ��.s� A�ic �.�tsr,�-�s�i .a,•-, �dr�'L co.�cc.-x-�vcr.� %7/�-; i�iz� ca��✓.�'.."']' 7> rvc2 /� � .�-i Y�-.2�s� ot' ,ssY�-�i.vc s= s.it. v�C. I.c�t✓C.�_"Y-ne..v Qa.aov </-a-Tt c� �T- ��"�-u^ °n 1- � ,Gc�yLr •.�s Have pou had previous contact vith the committee for vhich pou are making applicatibn. If so, when, and circumstances? Tn an attempt to ensure that co�ittee representation reflects the makeup of our communitp, please check the line applicable ta you. This information is strictly voluntarg. _� Ahite (Caucasian) B1ack (Atrican American) American Tndian or Alaskaa Eskimo Iiale _�__ Female Disahled: Yes No �_ Date of Birth: Hispanic Asian or Pacific Islander 3/ i. /2 If special acco�odations are needed, please speci£p_ � Hov did pou hear about this openi.ng? 77y.zd ,.�-i�.s.,,..rs io Svo-n sA:.,� i:.c.c� � f�l= �= � c 1 PERSONAL REFERE2ICES Hame: � �/V Co�c z/3-,c» 9� Address: _ a 33 / q �i o�-� iy,_i�lyvv..,� S?. /'6h.�� r,..J' s.r1 c� Phone: CHome) ��^ — �� c� n (Aork) J Name: d-!/3 �.r viz c.-' ✓lt-�-r � �-n a.J °% o U� i5 ..�r 'Y 7 s G � c.-r✓ Address • " ��3v � r.+� S. J�i� v ��..�� s S i a� Phone: (Home) (Qork) �Y9��'Z.� Name' `� r a✓�.s r57-r 3<s ��czl Addzess: �'3 t� CoM.,-r �� rn .�, � -r />.�..i< 2 i Phone: (Home) � Y�- bc,a ., tAork) Reasons £or your interest in this particular committee: Ri-T'2tYL � i �c- YcYa2s� �>v v >a ..i<-r--1 .-r✓ i c�i — 7a Tl-s-� !'� c,o c � .cJ�JSU <" �.2 aCitirr�-�s � .a.y EJtYL hvnr Ca.�c_�-n.ycv� %�f�-i i'7-� t��r'�ry�.ti " 7�-'t�c2 /� �P�� oa�ie ��-;z' f-i �-a.a>r o.- �.c- NC �' S/L �v2 l.c��r4. Q�s�v �!a-� e ...� oT- �ri ar�'r <-- 6c-rtr Nr � . Have you had previous contact vith the committee for which pou a=e maFcing agplication. I£ so, vhen, and circumstances? In an attempt to ensure that committee representation reflects the makeup o£ our coarmunity, please check the line applicable to you. This information is strictly voluntary. �c Ahite (Caucasian) Black �African American) American Zndisn or Alaskan Eskimo Ha1e �_ Female Disabled: Yes No �_ Hispanic Asian ar Pacific Islander Date o£ Birth: 3/i��LS I£ special acco�odations are needed, please specifq. �` Hov did you hear about this opening7 77�-rz✓ __f-r.�.s,,,,.�� S,�-✓ s�� j,;t ,� JTi� c 1 � � S 3 ��.� �� ^ _ � � � Name: Home Address: Street ' �. �. Citp Zip Telephone Number: CHome) /�� D,('{D (Aork) � f�s'�7�� Plaffiing District Council: City Crnmcil iTazd: Pre£erred 2failing Address: Ahat is yovr occupation7 Plac.. ef Q.,.^�lc�er.t: Co�ittee(s) Applied Ahat skills/training or eaperience do pou possess for the committae(s) for vhich you seek q/v-w�L 4� Sy�iiiZ� 1� 9�'�-� �� MAY 3 0 i991 �3AYOR'S OfFtCE �u� , C�- UD-C'E�r,C./_/.v �-�`�' d �-" � 1`(+� �j /L-�.-c.Q� �Y[ /��st�-L .L� . o ,. . �e � uz�� vz-Lfi ,�u e L� .��-� o -�-� �L��i C� � ,C� (�OO2[ — e �ir��} Iti'—TLIJ .lr2� �SZ,{�� bL. `C�L. � li�'�_ ./,. // � �Y� n rl e n , 1 . �. .,. . . _ _ C .v _.... ; C s a-E-�`-ti �2� UJ--a tic-2 G4� ��tt � �� L:� �� A:� � � l' d V �� x� �� A� �:�w(/� /� // / [. Wf a�� The information i.ncluded in this application is considered private data according to the 2iinnesota Goverment Data Practices Act. As a result, this information is not released to the general public. ORFICE OF THE MAYOR 347 CITY HALL SAIIiT PAIIL� MINNESOTA 55102 298-4736 .CG.9�ir�.fiU � L (04ER) Rev. 8-15-90 PERSONAL / REFEttgNCES q � _ � !/. . � �7� ,. . � _ _ � Add=ess: � � (�h// f� /� U Pfione: (Home) �S vS 'f' -" / /J (i7 � CGork) ��e'�-�� Name: Addre: Fhone Name: Address Phone (Qork) Reasons Eor your interest in this particular committee: 7u..�6��G(�-n-t�e-�X �- � :�'�e� .Urt C%`Yy%vy�-�ZL�✓�� . � ��. ,lLc i�e., f Have you had previous contact with the committee for vhich you are making application. If so, when, and circumstances? _ i!Y e/�7�Q�/ In an attempt to ensuxe that co�ittee representatian reflects the makeup of our co�mity, please check the line applicable to you, This information is strictly volutt�ry. � Ahite (Caucasian) Hispanic Black (African American) Asian or Paci£ic Islander American Zndian or Alaskan Eskimo � ?fale Female Disabled: Yes No Y Date of Birth: / ��/ If special accommodations are needed, please specify. Hov did you hear about Lhis opening? ��CUU=��-� /��,.0 PFSS� Rame Addr� • � • • i�1'G�L�/Z� ' . / � $ame: Addte Phoae Hame- Address Phone•---CHome) (Aork) Reasons for your interest in this partieular committee % Have you had previous contact with the committee for vhich you are making application. If so, vhen, and circumstances? /YIiiY�l.P� Ea an attempt to ensure that committee regresentation reflects the makeup of our community, please check the line applicable to you. This information is strictly vOlt]S!t3if. � Sfhite (Caucasian) Hispanic Black (African American) Asian or Pacific Islander Ame=ican Indian or Alaslun Eskimo � Ma1e Female Disabled: Yes Ho � Date of Birth: ��.% 1 Tf special accommodations are needed, please specify. Hov did you hear ahout this opening? . n _� , _� _ . /7 ^,, 9� �� 01-14-97 COMMITTEE APPLICANTS REPORT APPLZCANTS.RPT COMMITTEE : ACOA Advisory Committee on Aging FOR APPLICATIONS DATED AFTER O1JO1J94 APPLICANT / REFERENCE COMMENTS WARD PLANNING SENATE ET APP DATE G OQ3111 Bannigan, Brendan 2020 Portland Avenue St. Paul, MN 55104 Program Administrator 003188 Carlson, Erland E. 1923 Crown Point Drive Mendota Hghts., MN 551184206 Retired Lutheran Pastor 003181 Cook, Teresia (Teri) Senior Center Director 003243 Heinz, Jacqueline Marie 871 Juno Avenue St. Paul, MN 55102 Sr. Disability Benef. Spclst. DZSTRICT DZSTRICT (PRIAR) (OSHER COMMITTEE5 SERVING ON) ---- -------- -------- -- -------- - W 11J30J95 M 7 4 r^_. L•7 PAGE 1 W 06J11/96 M W 06f10/96 F W 11f13J96 F 003189 Heuer, Eunice Johnson 1158 Carlton Drive St. Paul, MN 55112 Registered NursejHealth Coord 002161 Hilton, Maureen 456 Summit Avenue St. Paul, MN 55102 2 16 Real Estate Broker 003232 Johnson, Michelle #3 1835 Portland Avenue St. Paul, MN 55104 Outreach Case Manager 4 13 W 06/11f96 F W 1Oj18j96 F W 1Of25J96 F 003121 Kuhlman, Barbara W O1J02/96 F 8560 Magnolia Trail, #332 Eden Prairie, MN 55344 9� �� O1-14-97 COMMITTEE APPLICANTS REPORT APPLICANTS.RPT COMMITTEE : ACOA Advisory Committee on Aging FOR APPLICATIONS DATED AFTER O1/O1f94 PAGE 2 APPLICANT / REFERENCE COMMENTS WARD PLANNING SENATE ET APP DATE G DISTRICT DISTRICT (PRIOR) (OTAER COMMITTEES SERVING ON) ----------------------------------- ---- -------- ------° -- -------- - 001641 Lapidos, Morris 1077 SibLey Hwy #406 Saint Paul, MN 55118 Retired 003242 Michaels, Greta Brockhausen 218� W. Hoyt Avenue St. Paul, MN 55108 Retired Teacher 003029 Nyhus, Art 824 Lake Street St. Paul, MN 55119 Retired 003018 Pappen£us, Mabe1 1128 Laurel Ave. St. Paul, MN 55104 Retired Teacher 003033 Pentecost, Carol 1D44 Orange Avenue E. St. Pau1, MN 55106 Self-EmployedJPUblisher 043229 Reed, Aelen Doris 1561 North Western St. Pavl, MN 55117 Public Aealth Nurse 4 12 6 5 � W 12JO�J95 M W 11f13f96 F W 08/02/95 M W 07/20/95 F W 08f09f95 F U 1�f31/96 F 003180 Royse, .7ane 2 17 W 06/1Oj96 �' 10301 Scarborough Road Bloominqton, MN 55437 Div_ Adm. Catholic Charities 97-�7 O1-14-97 APPLZCANTS.RPT COMMITTEE APPLICANTS REPORT COMMITTEE : ACOA Advisary Committee on Aging FOR APPLICATIONS DATED AFTER O1/O1/94 APPL2CANT j REFERENCE COMMENTS 003171 Wilcox, Rachel A. #1910 66 E. 9th Street St. Paul, MN 55101 vocational Counselor 003187 Winters-Bruce, Gertrude #1611 1181 Edgcumbe Road St. Paul, MN 55105 Retired TeacherjVOlunteer PAGE 3 WARD PLANNING SENATE ET APP DATE G DISTRICT DZSTRICT (PRIOR) (OTHER COMMITTEES SERVING ON) 2 17 W 06/03/96 F 3 14 W 06/11/96 F i z 3 4 5 6 � s 9 io ii iz 13 14 is 16 16 Presented By Referred To RESOLUTION �INT PAUL, MINNESOTA RESOLVED, that the Saint Paul City Councii consents to and approves of the appoiniments and reappointments, made by the Mayor, of the following individuals to serve on the ADVISORY COMD�TTEE ON AGING. • . "� h Yul ► Katherine Barron Sister Frances Mary Benz Mark Flahavan Dennis Gerhardstein Harold Hebl Kenneth Lawrence Dean Lemke Nicole Otto Steven Sarrazin Richard Taylor Jamie Warndahl APPOINT'MENTS Jacqueline Heintz Micheile Johnson Greta Brockhausen Michaels 7ane Royse By: � a_ _ _2. _ �lr-�^�.� 1 \ l Approved by Mayor: Date d By: _ 1 " C/ ��fi�""'r'� Requested by Department of: By: Form Approved by City Attorney By: ��u.✓� � -'/�/— Approved by Mayor for Submission to Council i �� `-' By: � � , f ..,� � g �� r F ,� Council File #� { 9� ts t i' c..,.` � i�. . ,..e Green Sheet # CJ2�� Adopted by Council: Date�� Adoption Certified by Council Secretary 266-8531 1-13-47 GREEN SHEET lNIMIlOATE— O DE7qRTMENT O7RECTOR 4SSIGN �CITYATTORNEY JtlNBER iOR ?OUTING O ��ET DIR£CTOR )RD� � MqYOR (OR ASSISTAN'f) TOTAL # OF SIGNATURE PAGE5 1 (CLIP ALL LOCATIONS FOR SIGNATURE) �� -� 4020� �Nmamn� CRY CAUNCI� CIIYGLERK FIN. 8 MiGL CaERV(CES fl4R. Approval of the appointment of 4 members and the reappointment of 11 members to the Advisory Committee on Aging. (Itesolution lists the individu ls) o� _ CIB CAMMITTEE _ _ _ S7AFF _ ' _DISTRICTCAURT _' SUPPORTS WHICH EQUNCIL OBJEGT�VE7 PERSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING OUESiIONS: 1. Has this parsoNRrm ever worked under a conhact for Mis departmen[? YES NO 2. Has Mis permnRrm ever been a c�ty employee? YES NO 3. Ooas this personlfirm possess a skill rwt normally pos5essed by any current city employee? YES NO Explain eIi yes answers on separata aheet and anaeh to green sheet '�� f� n6� t"D.3s�Ae.^P y, 'i ' ^ r., z x.aS�Lw .....a..�iS :.9E€..:� .i�li� 1 U � t��7 � � . _ _ ._�_�..,,-� lO7AL AMOUNT OF TRANSACiION S CO57/REVENUE BUDGEiED (CIRCLE ONE) YES NO 'UNDIfiG SOURCE ACTIYITY NUMBER IP7ANCIAL INFORFiAT10N: (EXPlA1N) / l J V � Interdepartmental Memorandum CITY OF SAINT PAUL TO: Saint Paul City Councilmembers Counci� President Dave Thune Councilmember 7erry Blakey Councilmember Daniel Bostrom Councilmember Mike Harris Councilmember Mazk Mauer Counciimember Roberta Megazd Councilmember Janice Rethnan E��]�A DATE: fi� Roger C. Curtis R•� � Assistant to the Mayor Januazy 14, 1997 ADVISORY COMMITTEE ON AGING Mayor Coleman has recommended that the following individuals be appointed and reappointed to the Advisory Committee on Aging. Reappointments Katherine Barron Sister Frances Mary Benz Mark Flahauan Dennis Gerhazdstein Hazold Hebl Kenneth Lawrence A.p�ointments Jacqueline Heintz Greta Brockhausen Michaels Michelle Johnson Jane Royse Dean Lemke Nicole Otto Steven Sarrazin Richazd Taylor Jaznie Wamdahl Each member will serve x two-year term that wi31 expire on November 30, 1998. A copy of the resolurion recommending these members is attached and copies of the new members' applications. Also attached is an applicant report listing atl applicants on file since January 1, 1994. ff you have any quesrions or concems, feel free to contact me at 266-8531. Attachments cc: Nancy Anderson Alberto Quintela Mimi Weinber$er Council File # � Green Sheet # �� Presented By Reterred To Committee: Date i RESOLVED, that the Saint Paul City Council consents to and approves of the z appointments and reappointments, made by the Mayor, of the following individuals to a serve on the ADVISORY COINMIT"I'EE ON AGING. � 5 6 � a 9 io ii iz 13 14 15 16 16 REAPPOINTMENTS Katherine Barron Sister Frances Mary Benz Mark Flahavan Dennis Gerhardstein Harold Hebl Kenneth Lawrence Dean Lemke Nicole Otto Steven Sarra�in Richard Taylor Jamie Warndahl APPOINTMENTS Jacqueline Heinxz Micheile Johnson Greta Brockhausen Michaels Jane Royse Requested by Department ot: By: Adopted by Council: Date Adoption Gertified by Council secretary By: Approved by Mayor: By: RESOLUTION CITY OF SAINT PAUL, MINNESOTA Date Form Approved by City Attorney ay: �lJ�� -` _�y_ - Approved by Mayor for Submission to Council .�� ""' '� tG ' By: 9� �-� ffice s 266-8531 qTE INITIATE� � � � �J � 1-13-97 GREEN SHEET INITIAVDATE INITIALIDASE ��EPARTMENT6IRECTOR QCIT'ICOUh'CIL ISSIGR �pNATiORNEY �qNCLEPK iUNBEfl FOP iOUTINC � BUDGET DIRECTOR Q FIN. & MGT. SERVICES D1F. �A�� MAVOF4 (OR ASSiSTAN� � TOTAL # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE) AC�ION REOUESTEO: Approval of the appointment of 4 members and the reappointment of 11 members to the Advisory Committee on Aging. (Resolution lists the indi _ PLANNING COMMISSION _ qVIISEFViCECOMMISSI�N _ CIB COMMtTTEE _ _ StAPF _ _ DISTRICTCOURT __ SUPPOR7S WHICH COUNCR O&IEGTIVE? INITIATING IFAPPROVED: PERSONAL SERVICE CONTRACTS MUSTANSWER THE FOLLOWING QUE$TIONS: 7. Has t�is persoNfirm ever worked untler a crontract for this tlepartment? YES NO 2. Has ihis person/iirm ever been a ciry employee? YES NO 3. Qoes this personlfirm possess a skdl aot normally possessed by any currenS ciry employee? YES NO Expiain ell yes answers on aeperate sheet and attaeh to green sheet OTAI AMOUNT OFTRANSAC710N $ COST/REVENUE BUDGETED (CIRCLE ONEJ YES NO � JNDIqG SOURCE ACTIVITY NUMBER JANCIAL INFORMATION' (EXPL4IN) . �� . 390 CITY HA'E,L I�� rtc�csr�,.. SAT2� P21IIL, MINNESOTA 55102 -� � ' 266-8525 FAX: 2b6-8513 N4V � 3 1996 Name: ' �1 iG� �t f GL � N 1... ' 1 r � f'u� ��G (�� f vTT_ F.aBYQ�� (1FF1 .F Home Addzess ; () ` I J u�� f ry�'Q �] T �Q LJ{. � � 1 i 1 V � f 0 a. Stzeet Czty Zyp Telephone 2:umber: tHome) � Id� � 1 b - S �io�`� ��ork� �a - �s39 _ .«�,3�a - � �� Planning Distzict Co�ci1: ! City Council Aard: �. P=eferred Hailing Address_ ��-Q CLS ��-Q ��e� Ahat is poux occupation? Place�o£ Eaployment: Co�ittee(s) Applied For: ns. T S. C _�1��,� . • Ahat skills/trai.ning or eaperience do pou possess £oz the committee(s) appointment? � � � � t_- �'_I .� / • .L ! � _ 11� S The infor�ation included in this application is considered priva�e data according to the Hznnesota Goverment Data Practices Act. As a xesult, thi.s information is no:, released to the general public. (OVE.R)' � Itev. 2; ZS/96 PERS�NAI. REFESLENCES Name: V ��T p�C Address: Phone: lHomel !�1 � � � �' � �� Name: ��NI �«.��. �� Address: � t-i� !� � �V � �, � lCj (�Q'1��" �} �' S t-I o 1 I Phone: Name Address aas -3 ,g� !✓ � � 30 � ., - Fhone: [Home) fWork) q"_t�- � q�`�n R��^ Por your interest in -, _ _ _ .�1�� .��Q. _ �1`11�0��12C� 1,�� /,y '. S. `fJ2.a14.U2 `..� ��a p.e �va 5 [,Q d- � (�VD V W C .,.t.. ,.x � � v � .t ..�.Q � - �l - l m'��'� C:u�rnx�ritsStov� -tb rn�.ke Sur�. St Peul is a t�a�utcscrimatary Have you had previous contact vith the co�nittee for which you are making applicati,on. I£ so, when, and circumstances? 5�,� �tto,c�n.ed SheeF �� 'l0 -Frn` �lq � r.g Go rn rn;fitee . In an attempt to ensure that committee repzesentation reflects the makeup of our community, please check the line applicab2e to pou. This in£ormation is strictly voluntary. •� White (Caucasian) Hispanic Black (African American) Asian or Paci£ic Islander American Indian or Alaskan Eski.mo Male �_ Female Date of Birth: ( � " 30 " `,Q � Disabled: Yes Z7o � If special accommodations are needed, glease apeci£y. ! W��—� 13- Hov did you hear about this opening? , PERSONAI, REFEREflCES xame: �I p� Address• vs.,,,.e. �v,.__, ...'� `l � — ��i - 27 —/)2� 1 .�, Name: �SDN1 �«�� Address= � IID�C ��Z ��j �7 � �, 5� i i Phone Name Address aas-3qg� I✓ � Ji2 30► � -- Phone: CHome) lAork) �'�1�� ( �� kzec.�3v�, ,nVOlve� w�� Reasons fOr yOi1L interest lI1 i�11S DHLt1ClllaY.r.nmmittna• i�i. �nn�. �F'1� �. _il n .. .+''`n.�r6 • S 1C34�1f.1A.4 r-� t .+.�.. , � � v � .c - � --i— ts�'��.f s C.�vn.rri� s s tav� - �z> Make Sur-e S�- Pau! i s a r��ndc scr, maf Bave pou had previous contact vith the committee for vhich pou are making application. If so, �rhen, and circumstances7 Se�, atto�c,�a Shee� �'�10 far �Ag � rg Co rn rn�ttee .� In an attempt to ensure that committee representation re£lects the makeup of our community, please check the line apglicable to you. This information is stricLly voluntary. '` Ahite (Caucasian) Hispanic Black (African American) Asian or Pacific Islandez American Indian or Alaskan Eskimo Ma1e �( _ Female Disabled: Yes No � Date of Birth: 1 l' 30 ^' �Q � I£ special accommodations are needed, please specify. r v�y ��c. Hov did you hear about this opening? ��.�� n( Y __� � l,l lJ/ 97-�� c�m a Is� %n sf�d u� `� Co m m{ttee o n t`� g, r� .�-rzx�t� ca�'� o�' rny �el�x I y {'af h�,r -F �'/a t� �5 - �beca,us.e h�. suf-E'e�ed �! S�ht'o kes •,� �now �e S•l-ru�c� �e s aur �. Id�er� � Ga m rn u n�t c� -Fo�ce 5� i kQ. -�r� � r� - �v �',ric� assis��r�ce w� hor�..e CmrQ �.spe�,iat1�{ '�F' t�'r2 �� t 1 bu+ u.�ct.r� �- -fa ( �v2 a.� hcsrnrn.e ,�i �t� � r� `` � �ax�. " i F I t�.x�.�'e cQ -Eo c�o a u�� G. whi 1�., �rnaki i� s u �� E,ine't� 1'� i t l s O,t�e - Ftz.ke vl ca+r � o� — h�21 � s i�o� 't'he,v� -� i c� u r e o u f c�ha� F YY�ed i ca,�e w� 1 l rn� U� i I l n ot (�c►a,i °�s w� I l ct s w1�� `-f'(n�e Su�p4e rn.e.r�+ Y� (.�c�u,� . Oc�+r �ei�i� �i dese;rv-e -h� bR. �-i�re�ed �`a�rl`'I � w i� In �`�e s e.ck . Th� 1�A��2 Y, �j l�t� s j us� 1 i ke. U5 -� +t si�a Ul d n� 1� ttx.k.Q� c�dvQ,vt+a�e oF a� d�sc�r�v,�� a+ed o,t�a��nSk k 1 ecct,usQ o� � i' h2ir �Ti�e� �n+1-�-ri tou+e a tbf -t oUr �i t� -`�'YZYO�t� v��ur� wo�k, pc�� fir�.� wt�k, as w-��1 G.s `�Nnro u.�h �'h2� r I� � S�-�rrt� o� � u�r u t� —�'1^se,� ��e t��es�.� s�-o�rtes — �Y�e,� a,r�. - fi�xr�f �c ht S��r�ans ( 6� �� o;,� po � nfed `�ta th t'S C�,m��te�e, i� wou.ld a11ow rne - b h�e.1P p�o�eck fh2�� r►ght -� prnr�,o�e f t,t s2�'ul �n2 s� � Ga,��-y; bu�hon s �e G��Ec� • r ��'11c- �� . r � G � � � .r' r � JACQUELL�IE �1. HELti s�i .�-�o �ti� ST. PAL=L, �� »102 612-298-892-� OBJECTIVE: "Po pursue a career as a Claun Rej.iewer. EDUCATION: Hill-'�furray I-Iigh SchooI, tiiapies�ood �LV" 1977-1981 Graduaced l�iay 31, 1981 Universiry of Viinnesota, \Qinneapolis, ,LIN 1982-1986 1�Sajor: Intemational Relations with emphasis in Diplomacy, Bargainuig 3c Ne�otiation �Ietro State liniversity, St. Paul, i�IN -Enrolling in Winter 1996 to fuiish Degree t�iORK EYPERIFNCE: Reliastar Insurance (formerly Nti4"�,Z) 3146-present Employed as a Senior LTD Benefit Spccialist. Duties inciude analyang ASO, ]PG and Insured clairns bv Plan lan�uage, medical documentation; processing nen; ciaims, mail on Clauntech, reviewing ciaims by benefit amount for approval, review claims for Change in Definition and'or �fedicat�JOC Rehab, investi2ate Pre-E;�sting Conditions, heaw phone contact iiith empioyers, claimants, physici:u�s. Additional duties as listed under Northwestem Na[ional Life. Sed�wick James 7%95- 3r96 EmpIoy as a Benefit Coordinator for Lon� Te7m Disabiliry. Duries inciude analyzing claims for eli�bility, detemuning and documentin� on�oin� total disaUi3ity through information obtained from uLCC's, physicians; detennining henefit amoants when coordinated u itk Social Security Disabiliry Pension, Workers' Compensation; assisting with Social Security applications; interacrion �vith SSDI andJOr Vacational Rehabilitation Representative, Cwtomer Ser4ice Client Seriices and LT'B nurses; investigate Pre-Esisting conditions, heaw phone contact, processing mail, obtains documentation for claim, manual calcutations of overgayments, e�pe�ience �vith Words for uiindows. Word Perfect. �' �-�� ISIInsurance 2'9�- 7/9� Employed as �Iedical Clauns Representative in I�TO-FauIt claim depariment. Duties include anal}-ang \TO-Fault & MedPay claims for l4iidwest reo�'on utciuding California deterniinin� percentage of benefit gayable for medical, wa�eloss, replacement services, etc., detemuning liability, subroga�on, investi?atin� prior injuries, scheduling IME°s, negoriating settlements, arbitrations, heacy phone cantact with insureds, claimants, attomeys and medical professionals, processin,a� mail, obtaining documentation fding, extensive work w7th 10 key and Claim svstem. Northwestem National Life Iasurance 7 991-1995 Held position in Employee �3enefit� Di�ision as Senior I?isability Benefits Specialist. Duries inchide determining insured's eli�biIity, work with ASOIIPGi INSLJRED �oups, investigating pre-e�sting conditions flocumenting ongoing total disability, tim�Yy deternunation and payments of LTD clauns. Calculation of federal & state ta�es, assisting with Social Security Disabitity applications, interaction �vith physicians, lawyers; processing maii, heavy phone & customer contact handlin� appeals of denied claims, experience with Words for Windows, Word PerFect, ICD-9 & CPT coding, Caseload- 500+ nationR-ide. ERISCO!CLALMTECH experience. �iutual Benefit Life (Fortis) 1990-1991 Worked as Disability Anal,yst in LTD claizns. Duties inciuded analyzing, processing �Z paymznt of LTD clauns in �iidwest region. Processittg mail, calculatut� overpayments, assisting with Social Securiry apglicafions, anditit�, interaction with physicians, lawyers, rehabiliTatian consultants, hea�y phones and customer contact, PC experience, ICD-9 & CPT coding. St. Paui Comparnes, Inc. 1°87-1990 �Vorked as Customer Service Representatioe for rlssi�ed Risk ALto. 33uties included issusnce of all new business applicatians, renewals, endonements, reinstatements, & cancellaTions for Persc�nal & Commercial tluto in 34 states. Interacrion wizh agents, insureds, State Insurance Plans, Service Centers in re�ard to rating, coding, underwiiting rules & billin�. 97 �� Vork with CrDS system, heavy phone work, mail. State Fann Insurance Companies, Inc. 1983-1986 �Vorked as a Secretary far 2-a�ent office. Duties included typutg, filing, heavy phones, custotner cantact, processin� necv policies, clsims, endorsements, accident reports, rating, codin� ECHrJ Computer System. State Farrn Insurance Companies, Inc. 1980-1982 Duties included X-Datina £or praspective clients. RELATED EXPERIENCE: -Phone Tone Seminar- dealin� rvith an irrate customer -Self tiiana�eci Teas� Steering Committze Niember-N�V��I, -Record'mg Secretary-Self ivfana;ed Team-NtiVNI, -Health Fraud Seminar offered by Twin Cities F3ealth Claim Associarion -Meclical Aspects of Disabi]iry Seminar-Abbott Northwestem Hospital's Sister Kenny Institute 1994 1942 1992 1992 1943 -Numeraus In-House Seminars affered by Reliastar (?�T�t+i�,Z) Benefits U- empioyee continuing eciucatian pro�am 1991-present -PC traiiung for NtiV�+'L affered by the Science �Iuseum of 1�Sinnesata -Excel for Windo4vs �.0 Computer class -E 12ai1 Training Seminar through Raliastar SPECIAL ACTIVI�'IES/TNTERESTS: -Participant in Ramsey County Sheriffs Civilian Academy -Participant in St. Paul Pofice Department Civilian Police :�cademy -Volunteer Panei Member, St. Paul Police Oral Inter�ieFV Raview Board & Youth Gang 7'ask I'orce Coznmittee -St. Paul Winter Carnival Volunteer -St. Patrick's Day Button Cosnmittee vlember -Vtember of Tw�i�� Cities T3eatth Claim Association -Vluscular Dystrophy :�ssociation Volunteer -United 4Vay Volunteer -tilember of iVlaple�voad Figure Skaiing CluU -Volunteer for St. Paul Police Bepariment-different duties i993 1994 1996 199& 199� 1994-present 1986-present 1986-1992 1992-present 198d-przsent 1987-1992 1977-1981 1994-present REFERE� 10E5: Avvlabie upon request. �� TTase: t t l, l G[ wl,'{ aome aaaress: b? � Street Telephone Number: lHoae Planning District Co�cil: Prefexred 2iailing Address: Rhat is your occupation? � Place�of Employsant: � Coffiittee(s) Applied For: OFFZCE OF THE 24AYOR 390 CITY HALL SAINT PAIII,� MINSIESOTA 55102 266-8525_� FAX: 266-8513 City �7-�7 R'c�F �'�� ocr z s i9ss Zip �u � � City Council Gard: �r�lJ�i�lr C �� Ahat srillsJtzai.ning or esperience do you possess foz the co�ittee(s) Por vhicn you seek appointment? r.Q ��r�n c� �,nR,Ps PG�rP.r� �znc� �- �lmrn�ll-�fl �� rv �,� c �ip �, � a.� � -e-/I�L� t CJL ' G� �' �Tlf � P �( C3�-�Yi ��t..� � f�t�.l-Lv�( � . -^�, ��. ti-� (' c�c�r�� , n .�� ,u.�, QF t��s.�� c� -� `=�---�' l,c�L�:�� . The in£ormation included in this application is considered private dzta according to the Hinnesota Governent Data Practices Act. As a result, this information is not released to the general public. (OP�R.) Rev. 2/28/96 PERS021AT. REFERENCES Rame Addri Phoni Name: aaa=ess Phone Name: Addre �C� �a n � � � �/L/' � 3! 4� R 7-� 7 �; Phone: (Aome) `��CC,i� �.v>X.P CWork) r� �� / R ^ easans foz your interest in paxticular committee L'1 i\ In n n. /� n,� ,.. _ I L. . i7 nn A l�_ n.� �._ Have you had previous contact vith the co�ittee £oz vhich you are making application. If so, whea, and circumstances? N� ' In an attempt to ensure that coffiittee representation reflects the makeup o£ our commvnity, please check the line app2icab2e to yoci. This information i.s strictly volvntary_ t� phite (Caucasian) Hispanic Black (African Americaa) Asian or Pacific Is2ander American Indian or Alaskan Eskimo Hale � _]� Female Date of Bizth: I I'�I ��' r LP Disabled: Yes No � f� Tf special accommodations are needed, p2ease specify. �� Hov did you hear about this opening? PERSONAL Name;� Address: Phone• Name: Address• Address: Phone: C� / R � eason ( s £or youz interest ia particular committee: C 1 r� !n n .: n � 1..._ _ I1. . a hn n ... 1�,. n i �., tor y�-331 0 9�-a�_ c� $ave you had previous contact vith the committee for vhich you are making application. I£ so, when, aad circumstancesT Na � In an attempt to ensure that committee representation reflects the makeup af our coarmimitp, please check the li.ne apglicable to you. This in£ormation is strictly voluntary. I� Ahite (Caucasian) $ispanic Black (African American) Asian or Yaci.fic Islander 9merican Indian or Alaskan Eskimo 2�fale �1 Female Date of Birth: ,�� I �`�1' 1�� t.F' Disabled: Yes No � I£ special accommodations are needed, please speciEy. _)V �� Hov did you hear about this opening? �- TLY"' �� V'� Name : .>-` �{ �T/-7 390 CITY HAI,L SAINT PAIIL, MINNESOTA 55102 26b-8525 FAX: 266-8513 �� -7 �£�� P10V � 3 1996 Pv�YQ+R`� �FICE Home Address: °�� &° G�� s: NayT G�-vc.r' ST. l�Fl-✓t SS"7aF1 Street City 2ip Telephone T�uaber: (Home) �o�S�--ss �� (Aork) -��) Planning District Co�ci2: i� Citp Council Aard: � Yreferred Hailing Add=ess: a/S� cvssi �yo �r ,r�-,�� Sr �fr�L (•..� z yL> � Cs v.....-.�-c�� G� 7GJ wr..r�.� a.<J 1-�9-�-`" ./L/J_ �J/�-.ci/.v.c� «:� 5 Ahat is yovr occupation? 1� = n i� m s n -�- �� Place �of F�plopment: $i�. P/1-�� O.�.Pc_; � sc�-i ,�, �S Conmittee(s) Applied Eor: /-��r1f �0 2� G.�s ,-y�r i� � ca,c� �� r �Ihat skillsJtraining or eaperience do you possess £or the committee(s) £or whicn you seek appointment? C ��rL/�-c'��Y Go Gi�,fa-i�Z c7f � i �.<-� ��arv !�✓�J2-�� LOGic N'vits' fL1J�..1c ✓ Mc�.�?c. /�/Ld6iC./� �}Z O� P�- �/�!Z O �/7 Ga�-i A f�� 3-.c->>7 v�7? ?Z--i�-r�r3x /� t'L-l�3Zo dJS C'O'Kf NI i� '� � ��`'+-'( 1'.�� t O�E-'�6�+[,J ^ ' z/'�-TIo•J /^a,/�- / �yU�/ G�9-�Y E3s iN Si . .AY� . The information included in this application is conside=ed private data accozding to the Hinnesota Gover,nent Data Practices Act. As a result, this in£or,�tion is not releaszd to the gene=al public. (OV�Tt) Rev. Zi 28J95 P�o�. ��N�ES � � a � xame: �+'�/� eon�z/.�->c9a Address: � 33 / ,� vi-o�-.� �,i�-ryz.�v,_�' S� f�6yv r,.,,,�/` s�s2 v`g' Phoae: tHome) � �� - r� C c, (Work) ""� Name: A.!/-}2.,�c�yLec° �'R-.�-i � �1s a.J , °! 0 4/� iS. �v s� 'j s G ��-n.� ��'y{.,v/J Address:_ •`� ,-✓ oi i c. .��-r�--.�aa � T-YYr' .� S'T. J�/3 v� �-t.t1 S S i�-`l Phone : (Home) (Ao=k) E Y' 9 - � -� � Name: ��- t zr��s c�"�-� 8r� ��-' Address: -3�' "3 f � C�o.�li+-c ,� �rn-� � L3„� ^i /�r�-./c .�1.J �2 � � Phone: (Home) G�+ Y�- 6�s � (Gork) Reasons for youz interest i.n this particular committee: Rj-iZfYL ��vr Yr�2s� i�v c�. Tir�' �Sc,Dc-.e ��.s� A�ic �.�tsr,�-�s�i .a,•-, �dr�'L co.�cc.-x-�vcr.� %7/�-; i�iz� ca��✓.�'.."']' 7> rvc2 /� � .�-i Y�-.2�s� ot' ,ssY�-�i.vc s= s.it. v�C. I.c�t✓C.�_"Y-ne..v Qa.aov </-a-Tt c� �T- ��"�-u^ °n 1- � ,Gc�yLr •.�s Have pou had previous contact vith the committee for vhich pou are making applicatibn. If so, when, and circumstances? Tn an attempt to ensure that co�ittee representation reflects the makeup of our communitp, please check the line applicable ta you. This information is strictly voluntarg. _� Ahite (Caucasian) B1ack (Atrican American) American Tndian or Alaskaa Eskimo Iiale _�__ Female Disahled: Yes No �_ Date of Birth: Hispanic Asian or Pacific Islander 3/ i. /2 If special acco�odations are needed, please speci£p_ � Hov did pou hear about this openi.ng? 77y.zd ,.�-i�.s.,,..rs io Svo-n sA:.,� i:.c.c� � f�l= �= � c 1 PERSONAL REFERE2ICES Hame: � �/V Co�c z/3-,c» 9� Address: _ a 33 / q �i o�-� iy,_i�lyvv..,� S?. /'6h.�� r,..J' s.r1 c� Phone: CHome) ��^ — �� c� n (Aork) J Name: d-!/3 �.r viz c.-' ✓lt-�-r � �-n a.J °% o U� i5 ..�r 'Y 7 s G � c.-r✓ Address • " ��3v � r.+� S. J�i� v ��..�� s S i a� Phone: (Home) (Qork) �Y9��'Z.� Name' `� r a✓�.s r57-r 3<s ��czl Addzess: �'3 t� CoM.,-r �� rn .�, � -r />.�..i< 2 i Phone: (Home) � Y�- bc,a ., tAork) Reasons £or your interest in this particular committee: Ri-T'2tYL � i �c- YcYa2s� �>v v >a ..i<-r--1 .-r✓ i c�i — 7a Tl-s-� !'� c,o c � .cJ�JSU <" �.2 aCitirr�-�s � .a.y EJtYL hvnr Ca.�c_�-n.ycv� %�f�-i i'7-� t��r'�ry�.ti " 7�-'t�c2 /� �P�� oa�ie ��-;z' f-i �-a.a>r o.- �.c- NC �' S/L �v2 l.c��r4. Q�s�v �!a-� e ...� oT- �ri ar�'r <-- 6c-rtr Nr � . Have you had previous contact vith the committee for which pou a=e maFcing agplication. I£ so, vhen, and circumstances? In an attempt to ensure that committee representation reflects the makeup o£ our coarmunity, please check the line applicable to you. This information is strictly voluntary. �c Ahite (Caucasian) Black �African American) American Zndisn or Alaskan Eskimo Ha1e �_ Female Disabled: Yes No �_ Hispanic Asian ar Pacific Islander Date o£ Birth: 3/i��LS I£ special acco�odations are needed, please specifq. �` Hov did you hear about this opening7 77�-rz✓ __f-r.�.s,,,,.�� S,�-✓ s�� j,;t ,� JTi� c 1 � � S 3 ��.� �� ^ _ � � � Name: Home Address: Street ' �. �. Citp Zip Telephone Number: CHome) /�� D,('{D (Aork) � f�s'�7�� Plaffiing District Council: City Crnmcil iTazd: Pre£erred 2failing Address: Ahat is yovr occupation7 Plac.. ef Q.,.^�lc�er.t: Co�ittee(s) Applied Ahat skills/training or eaperience do pou possess for the committae(s) for vhich you seek q/v-w�L 4� Sy�iiiZ� 1� 9�'�-� �� MAY 3 0 i991 �3AYOR'S OfFtCE �u� , C�- UD-C'E�r,C./_/.v �-�`�' d �-" � 1`(+� �j /L-�.-c.Q� �Y[ /��st�-L .L� . o ,. . �e � uz�� vz-Lfi ,�u e L� .��-� o -�-� �L��i C� � ,C� (�OO2[ — e �ir��} Iti'—TLIJ .lr2� �SZ,{�� bL. `C�L. � li�'�_ ./,. // � �Y� n rl e n , 1 . �. .,. . . _ _ C .v _.... ; C s a-E-�`-ti �2� UJ--a tic-2 G4� ��tt � �� L:� �� A:� � � l' d V �� x� �� A� �:�w(/� /� // / [. Wf a�� The information i.ncluded in this application is considered private data according to the 2iinnesota Goverment Data Practices Act. As a result, this information is not released to the general public. ORFICE OF THE MAYOR 347 CITY HALL SAIIiT PAIIL� MINNESOTA 55102 298-4736 .CG.9�ir�.fiU � L (04ER) Rev. 8-15-90 PERSONAL / REFEttgNCES q � _ � !/. . � �7� ,. . � _ _ � Add=ess: � � (�h// f� /� U Pfione: (Home) �S vS 'f' -" / /J (i7 � CGork) ��e'�-�� Name: Addre: Fhone Name: Address Phone (Qork) Reasons Eor your interest in this particular committee: 7u..�6��G(�-n-t�e-�X �- � :�'�e� .Urt C%`Yy%vy�-�ZL�✓�� . � ��. ,lLc i�e., f Have you had previous contact with the committee for vhich you are making application. If so, when, and circumstances? _ i!Y e/�7�Q�/ In an attempt to ensuxe that co�ittee representatian reflects the makeup of our co�mity, please check the line applicable to you, This information is strictly volutt�ry. � Ahite (Caucasian) Hispanic Black (African American) Asian or Paci£ic Islander American Zndian or Alaskan Eskimo � ?fale Female Disabled: Yes No Y Date of Birth: / ��/ If special accommodations are needed, please specify. Hov did you hear about Lhis opening? ��CUU=��-� /��,.0 PFSS� Rame Addr� • � • • i�1'G�L�/Z� ' . / � $ame: Addte Phoae Hame- Address Phone•---CHome) (Aork) Reasons for your interest in this partieular committee % Have you had previous contact with the committee for vhich you are making application. If so, vhen, and circumstances? /YIiiY�l.P� Ea an attempt to ensure that committee regresentation reflects the makeup of our community, please check the line applicable to you. This information is strictly vOlt]S!t3if. � Sfhite (Caucasian) Hispanic Black (African American) Asian or Pacific Islander Ame=ican Indian or Alaslun Eskimo � Ma1e Female Disabled: Yes Ho � Date of Birth: ��.% 1 Tf special accommodations are needed, please specify. Hov did you hear ahout this opening? . n _� , _� _ . /7 ^,, 9� �� 01-14-97 COMMITTEE APPLICANTS REPORT APPLZCANTS.RPT COMMITTEE : ACOA Advisory Committee on Aging FOR APPLICATIONS DATED AFTER O1JO1J94 APPLICANT / REFERENCE COMMENTS WARD PLANNING SENATE ET APP DATE G OQ3111 Bannigan, Brendan 2020 Portland Avenue St. Paul, MN 55104 Program Administrator 003188 Carlson, Erland E. 1923 Crown Point Drive Mendota Hghts., MN 551184206 Retired Lutheran Pastor 003181 Cook, Teresia (Teri) Senior Center Director 003243 Heinz, Jacqueline Marie 871 Juno Avenue St. Paul, MN 55102 Sr. Disability Benef. Spclst. DZSTRICT DZSTRICT (PRIAR) (OSHER COMMITTEE5 SERVING ON) ---- -------- -------- -- -------- - W 11J30J95 M 7 4 r^_. L•7 PAGE 1 W 06J11/96 M W 06f10/96 F W 11f13J96 F 003189 Heuer, Eunice Johnson 1158 Carlton Drive St. Paul, MN 55112 Registered NursejHealth Coord 002161 Hilton, Maureen 456 Summit Avenue St. Paul, MN 55102 2 16 Real Estate Broker 003232 Johnson, Michelle #3 1835 Portland Avenue St. Paul, MN 55104 Outreach Case Manager 4 13 W 06/11f96 F W 1Oj18j96 F W 1Of25J96 F 003121 Kuhlman, Barbara W O1J02/96 F 8560 Magnolia Trail, #332 Eden Prairie, MN 55344 9� �� O1-14-97 COMMITTEE APPLICANTS REPORT APPLICANTS.RPT COMMITTEE : ACOA Advisory Committee on Aging FOR APPLICATIONS DATED AFTER O1/O1f94 PAGE 2 APPLICANT / REFERENCE COMMENTS WARD PLANNING SENATE ET APP DATE G DISTRICT DISTRICT (PRIOR) (OTAER COMMITTEES SERVING ON) ----------------------------------- ---- -------- ------° -- -------- - 001641 Lapidos, Morris 1077 SibLey Hwy #406 Saint Paul, MN 55118 Retired 003242 Michaels, Greta Brockhausen 218� W. Hoyt Avenue St. Paul, MN 55108 Retired Teacher 003029 Nyhus, Art 824 Lake Street St. Paul, MN 55119 Retired 003018 Pappen£us, Mabe1 1128 Laurel Ave. St. Paul, MN 55104 Retired Teacher 003033 Pentecost, Carol 1D44 Orange Avenue E. St. Pau1, MN 55106 Self-EmployedJPUblisher 043229 Reed, Aelen Doris 1561 North Western St. Pavl, MN 55117 Public Aealth Nurse 4 12 6 5 � W 12JO�J95 M W 11f13f96 F W 08/02/95 M W 07/20/95 F W 08f09f95 F U 1�f31/96 F 003180 Royse, .7ane 2 17 W 06/1Oj96 �' 10301 Scarborough Road Bloominqton, MN 55437 Div_ Adm. Catholic Charities 97-�7 O1-14-97 APPLZCANTS.RPT COMMITTEE APPLICANTS REPORT COMMITTEE : ACOA Advisary Committee on Aging FOR APPLICATIONS DATED AFTER O1/O1/94 APPL2CANT j REFERENCE COMMENTS 003171 Wilcox, Rachel A. #1910 66 E. 9th Street St. Paul, MN 55101 vocational Counselor 003187 Winters-Bruce, Gertrude #1611 1181 Edgcumbe Road St. Paul, MN 55105 Retired TeacherjVOlunteer PAGE 3 WARD PLANNING SENATE ET APP DATE G DISTRICT DZSTRICT (PRIOR) (OTHER COMMITTEES SERVING ON) 2 17 W 06/03/96 F 3 14 W 06/11/96 F i z 3 4 5 6 � s 9 io ii iz 13 14 is 16 16 Presented By Referred To RESOLUTION �INT PAUL, MINNESOTA RESOLVED, that the Saint Paul City Councii consents to and approves of the appoiniments and reappointments, made by the Mayor, of the following individuals to serve on the ADVISORY COMD�TTEE ON AGING. • . "� h Yul ► Katherine Barron Sister Frances Mary Benz Mark Flahavan Dennis Gerhardstein Harold Hebl Kenneth Lawrence Dean Lemke Nicole Otto Steven Sarrazin Richard Taylor Jamie Warndahl APPOINT'MENTS Jacqueline Heintz Micheile Johnson Greta Brockhausen Michaels 7ane Royse By: � a_ _ _2. _ �lr-�^�.� 1 \ l Approved by Mayor: Date d By: _ 1 " C/ ��fi�""'r'� Requested by Department of: By: Form Approved by City Attorney By: ��u.✓� � -'/�/— Approved by Mayor for Submission to Council i �� `-' By: � � , f ..,� � g �� r F ,� Council File #� { 9� ts t i' c..,.` � i�. . ,..e Green Sheet # CJ2�� Adopted by Council: Date�� Adoption Certified by Council Secretary 266-8531 1-13-47 GREEN SHEET lNIMIlOATE— O DE7qRTMENT O7RECTOR 4SSIGN �CITYATTORNEY JtlNBER iOR ?OUTING O ��ET DIR£CTOR )RD� � MqYOR (OR ASSISTAN'f) TOTAL # OF SIGNATURE PAGE5 1 (CLIP ALL LOCATIONS FOR SIGNATURE) �� -� 4020� �Nmamn� CRY CAUNCI� CIIYGLERK FIN. 8 MiGL CaERV(CES fl4R. Approval of the appointment of 4 members and the reappointment of 11 members to the Advisory Committee on Aging. (Itesolution lists the individu ls) o� _ CIB CAMMITTEE _ _ _ S7AFF _ ' _DISTRICTCAURT _' SUPPORTS WHICH EQUNCIL OBJEGT�VE7 PERSONAL SEHVICE CONTRACTS MUST ANSWER THE FOLLOWING OUESiIONS: 1. Has this parsoNRrm ever worked under a conhact for Mis departmen[? YES NO 2. Has Mis permnRrm ever been a c�ty employee? YES NO 3. Ooas this personlfirm possess a skill rwt normally pos5essed by any current city employee? YES NO Explain eIi yes answers on separata aheet and anaeh to green sheet '�� f� n6� t"D.3s�Ae.^P y, 'i ' ^ r., z x.aS�Lw .....a..�iS :.9E€..:� .i�li� 1 U � t��7 � � . _ _ ._�_�..,,-� lO7AL AMOUNT OF TRANSACiION S CO57/REVENUE BUDGEiED (CIRCLE ONE) YES NO 'UNDIfiG SOURCE ACTIYITY NUMBER IP7ANCIAL INFORFiAT10N: (EXPlA1N) / l J V � Interdepartmental Memorandum CITY OF SAINT PAUL TO: Saint Paul City Councilmembers Counci� President Dave Thune Councilmember 7erry Blakey Councilmember Daniel Bostrom Councilmember Mike Harris Councilmember Mazk Mauer Counciimember Roberta Megazd Councilmember Janice Rethnan E��]�A DATE: fi� Roger C. Curtis R•� � Assistant to the Mayor Januazy 14, 1997 ADVISORY COMMITTEE ON AGING Mayor Coleman has recommended that the following individuals be appointed and reappointed to the Advisory Committee on Aging. Reappointments Katherine Barron Sister Frances Mary Benz Mark Flahauan Dennis Gerhazdstein Hazold Hebl Kenneth Lawrence A.p�ointments Jacqueline Heintz Greta Brockhausen Michaels Michelle Johnson Jane Royse Dean Lemke Nicole Otto Steven Sarrazin Richazd Taylor Jaznie Wamdahl Each member will serve x two-year term that wi31 expire on November 30, 1998. A copy of the resolurion recommending these members is attached and copies of the new members' applications. Also attached is an applicant report listing atl applicants on file since January 1, 1994. ff you have any quesrions or concems, feel free to contact me at 266-8531. Attachments cc: Nancy Anderson Alberto Quintela Mimi Weinber$er Council File # � Green Sheet # �� Presented By Reterred To Committee: Date i RESOLVED, that the Saint Paul City Council consents to and approves of the z appointments and reappointments, made by the Mayor, of the following individuals to a serve on the ADVISORY COINMIT"I'EE ON AGING. � 5 6 � a 9 io ii iz 13 14 15 16 16 REAPPOINTMENTS Katherine Barron Sister Frances Mary Benz Mark Flahavan Dennis Gerhardstein Harold Hebl Kenneth Lawrence Dean Lemke Nicole Otto Steven Sarra�in Richard Taylor Jamie Warndahl APPOINTMENTS Jacqueline Heinxz Micheile Johnson Greta Brockhausen Michaels Jane Royse Requested by Department ot: By: Adopted by Council: Date Adoption Gertified by Council secretary By: Approved by Mayor: By: RESOLUTION CITY OF SAINT PAUL, MINNESOTA Date Form Approved by City Attorney ay: �lJ�� -` _�y_ - Approved by Mayor for Submission to Council .�� ""' '� tG ' By: 9� �-� ffice s 266-8531 qTE INITIATE� � � � �J � 1-13-97 GREEN SHEET INITIAVDATE INITIALIDASE ��EPARTMENT6IRECTOR QCIT'ICOUh'CIL ISSIGR �pNATiORNEY �qNCLEPK iUNBEfl FOP iOUTINC � BUDGET DIRECTOR Q FIN. & MGT. SERVICES D1F. �A�� MAVOF4 (OR ASSiSTAN� � TOTAL # OF SIGNATURE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURE) AC�ION REOUESTEO: Approval of the appointment of 4 members and the reappointment of 11 members to the Advisory Committee on Aging. (Resolution lists the indi _ PLANNING COMMISSION _ qVIISEFViCECOMMISSI�N _ CIB COMMtTTEE _ _ StAPF _ _ DISTRICTCOURT __ SUPPOR7S WHICH COUNCR O&IEGTIVE? INITIATING IFAPPROVED: PERSONAL SERVICE CONTRACTS MUSTANSWER THE FOLLOWING QUE$TIONS: 7. Has t�is persoNfirm ever worked untler a crontract for this tlepartment? YES NO 2. Has ihis person/iirm ever been a ciry employee? YES NO 3. Qoes this personlfirm possess a skdl aot normally possessed by any currenS ciry employee? YES NO Expiain ell yes answers on aeperate sheet and attaeh to green sheet OTAI AMOUNT OFTRANSAC710N $ COST/REVENUE BUDGETED (CIRCLE ONEJ YES NO � JNDIqG SOURCE ACTIVITY NUMBER JANCIAL INFORMATION' (EXPL4IN) . �� . 390 CITY HA'E,L I�� rtc�csr�,.. SAT2� P21IIL, MINNESOTA 55102 -� � ' 266-8525 FAX: 2b6-8513 N4V � 3 1996 Name: ' �1 iG� �t f GL � N 1... ' 1 r � f'u� ��G (�� f vTT_ F.aBYQ�� (1FF1 .F Home Addzess ; () ` I J u�� f ry�'Q �] T �Q LJ{. � � 1 i 1 V � f 0 a. Stzeet Czty Zyp Telephone 2:umber: tHome) � Id� � 1 b - S �io�`� ��ork� �a - �s39 _ .«�,3�a - � �� Planning Distzict Co�ci1: ! City Council Aard: �. P=eferred Hailing Address_ ��-Q CLS ��-Q ��e� Ahat is poux occupation? Place�o£ Eaployment: Co�ittee(s) Applied For: ns. T S. C _�1��,� . • Ahat skills/trai.ning or eaperience do pou possess £oz the committee(s) appointment? � � � � t_- �'_I .� / • .L ! � _ 11� S The infor�ation included in this application is considered priva�e data according to the Hznnesota Goverment Data Practices Act. As a xesult, thi.s information is no:, released to the general public. (OVE.R)' � Itev. 2; ZS/96 PERS�NAI. REFESLENCES Name: V ��T p�C Address: Phone: lHomel !�1 � � � �' � �� Name: ��NI �«.��. �� Address: � t-i� !� � �V � �, � lCj (�Q'1��" �} �' S t-I o 1 I Phone: Name Address aas -3 ,g� !✓ � � 30 � ., - Fhone: [Home) fWork) q"_t�- � q�`�n R��^ Por your interest in -, _ _ _ .�1�� .��Q. _ �1`11�0��12C� 1,�� /,y '. S. `fJ2.a14.U2 `..� ��a p.e �va 5 [,Q d- � (�VD V W C .,.t.. ,.x � � v � .t ..�.Q � - �l - l m'��'� C:u�rnx�ritsStov� -tb rn�.ke Sur�. St Peul is a t�a�utcscrimatary Have you had previous contact vith the co�nittee for which you are making applicati,on. I£ so, when, and circumstances? 5�,� �tto,c�n.ed SheeF �� 'l0 -Frn` �lq � r.g Go rn rn;fitee . In an attempt to ensure that committee repzesentation reflects the makeup of our community, please check the line applicab2e to pou. This in£ormation is strictly voluntary. •� White (Caucasian) Hispanic Black (African American) Asian or Paci£ic Islander American Indian or Alaskan Eski.mo Male �_ Female Date of Birth: ( � " 30 " `,Q � Disabled: Yes Z7o � If special accommodations are needed, glease apeci£y. ! W��—� 13- Hov did you hear about this opening? , PERSONAI, REFEREflCES xame: �I p� Address• vs.,,,.e. �v,.__, ...'� `l � — ��i - 27 —/)2� 1 .�, Name: �SDN1 �«�� Address= � IID�C ��Z ��j �7 � �, 5� i i Phone Name Address aas-3qg� I✓ � Ji2 30► � -- Phone: CHome) lAork) �'�1�� ( �� kzec.�3v�, ,nVOlve� w�� Reasons fOr yOi1L interest lI1 i�11S DHLt1ClllaY.r.nmmittna• i�i. �nn�. �F'1� �. _il n .. .+''`n.�r6 • S 1C34�1f.1A.4 r-� t .+.�.. , � � v � .c - � --i— ts�'��.f s C.�vn.rri� s s tav� - �z> Make Sur-e S�- Pau! i s a r��ndc scr, maf Bave pou had previous contact vith the committee for vhich pou are making application. If so, �rhen, and circumstances7 Se�, atto�c,�a Shee� �'�10 far �Ag � rg Co rn rn�ttee .� In an attempt to ensure that committee representation re£lects the makeup of our community, please check the line apglicable to you. This information is stricLly voluntary. '` Ahite (Caucasian) Hispanic Black (African American) Asian or Pacific Islandez American Indian or Alaskan Eskimo Ma1e �( _ Female Disabled: Yes No � Date of Birth: 1 l' 30 ^' �Q � I£ special accommodations are needed, please specify. r v�y ��c. Hov did you hear about this opening? ��.�� n( Y __� � l,l lJ/ 97-�� c�m a Is� %n sf�d u� `� Co m m{ttee o n t`� g, r� .�-rzx�t� ca�'� o�' rny �el�x I y {'af h�,r -F �'/a t� �5 - �beca,us.e h�. suf-E'e�ed �! S�ht'o kes •,� �now �e S•l-ru�c� �e s aur �. Id�er� � Ga m rn u n�t c� -Fo�ce 5� i kQ. -�r� � r� - �v �',ric� assis��r�ce w� hor�..e CmrQ �.spe�,iat1�{ '�F' t�'r2 �� t 1 bu+ u.�ct.r� �- -fa ( �v2 a.� hcsrnrn.e ,�i �t� � r� `` � �ax�. " i F I t�.x�.�'e cQ -Eo c�o a u�� G. whi 1�., �rnaki i� s u �� E,ine't� 1'� i t l s O,t�e - Ftz.ke vl ca+r � o� — h�21 � s i�o� 't'he,v� -� i c� u r e o u f c�ha� F YY�ed i ca,�e w� 1 l rn� U� i I l n ot (�c►a,i °�s w� I l ct s w1�� `-f'(n�e Su�p4e rn.e.r�+ Y� (.�c�u,� . Oc�+r �ei�i� �i dese;rv-e -h� bR. �-i�re�ed �`a�rl`'I � w i� In �`�e s e.ck . Th� 1�A��2 Y, �j l�t� s j us� 1 i ke. U5 -� +t si�a Ul d n� 1� ttx.k.Q� c�dvQ,vt+a�e oF a� d�sc�r�v,�� a+ed o,t�a��nSk k 1 ecct,usQ o� � i' h2ir �Ti�e� �n+1-�-ri tou+e a tbf -t oUr �i t� -`�'YZYO�t� v��ur� wo�k, pc�� fir�.� wt�k, as w-��1 G.s `�Nnro u.�h �'h2� r I� � S�-�rrt� o� � u�r u t� —�'1^se,� ��e t��es�.� s�-o�rtes — �Y�e,� a,r�. - fi�xr�f �c ht S��r�ans ( 6� �� o;,� po � nfed `�ta th t'S C�,m��te�e, i� wou.ld a11ow rne - b h�e.1P p�o�eck fh2�� r►ght -� prnr�,o�e f t,t s2�'ul �n2 s� � Ga,��-y; bu�hon s �e G��Ec� • r ��'11c- �� . r � G � � � .r' r � JACQUELL�IE �1. HELti s�i .�-�o �ti� ST. PAL=L, �� »102 612-298-892-� OBJECTIVE: "Po pursue a career as a Claun Rej.iewer. EDUCATION: Hill-'�furray I-Iigh SchooI, tiiapies�ood �LV" 1977-1981 Graduaced l�iay 31, 1981 Universiry of Viinnesota, \Qinneapolis, ,LIN 1982-1986 1�Sajor: Intemational Relations with emphasis in Diplomacy, Bargainuig 3c Ne�otiation �Ietro State liniversity, St. Paul, i�IN -Enrolling in Winter 1996 to fuiish Degree t�iORK EYPERIFNCE: Reliastar Insurance (formerly Nti4"�,Z) 3146-present Employed as a Senior LTD Benefit Spccialist. Duties inciude analyang ASO, ]PG and Insured clairns bv Plan lan�uage, medical documentation; processing nen; ciaims, mail on Clauntech, reviewing ciaims by benefit amount for approval, review claims for Change in Definition and'or �fedicat�JOC Rehab, investi2ate Pre-E;�sting Conditions, heaw phone contact iiith empioyers, claimants, physici:u�s. Additional duties as listed under Northwestem Na[ional Life. Sed�wick James 7%95- 3r96 EmpIoy as a Benefit Coordinator for Lon� Te7m Disabiliry. Duries inciude analyzing claims for eli�bility, detemuning and documentin� on�oin� total disaUi3ity through information obtained from uLCC's, physicians; detennining henefit amoants when coordinated u itk Social Security Disabiliry Pension, Workers' Compensation; assisting with Social Security applications; interacrion �vith SSDI andJOr Vacational Rehabilitation Representative, Cwtomer Ser4ice Client Seriices and LT'B nurses; investigate Pre-Esisting conditions, heaw phone contact, processing mail, obtains documentation for claim, manual calcutations of overgayments, e�pe�ience �vith Words for uiindows. Word Perfect. �' �-�� ISIInsurance 2'9�- 7/9� Employed as �Iedical Clauns Representative in I�TO-FauIt claim depariment. Duties include anal}-ang \TO-Fault & MedPay claims for l4iidwest reo�'on utciuding California deterniinin� percentage of benefit gayable for medical, wa�eloss, replacement services, etc., detemuning liability, subroga�on, investi?atin� prior injuries, scheduling IME°s, negoriating settlements, arbitrations, heacy phone cantact with insureds, claimants, attomeys and medical professionals, processin,a� mail, obtaining documentation fding, extensive work w7th 10 key and Claim svstem. Northwestem National Life Iasurance 7 991-1995 Held position in Employee �3enefit� Di�ision as Senior I?isability Benefits Specialist. Duries inchide determining insured's eli�biIity, work with ASOIIPGi INSLJRED �oups, investigating pre-e�sting conditions flocumenting ongoing total disability, tim�Yy deternunation and payments of LTD clauns. Calculation of federal & state ta�es, assisting with Social Security Disabitity applications, interaction �vith physicians, lawyers; processing maii, heavy phone & customer contact handlin� appeals of denied claims, experience with Words for Windows, Word PerFect, ICD-9 & CPT coding, Caseload- 500+ nationR-ide. ERISCO!CLALMTECH experience. �iutual Benefit Life (Fortis) 1990-1991 Worked as Disability Anal,yst in LTD claizns. Duties inciuded analyzing, processing �Z paymznt of LTD clauns in �iidwest region. Processittg mail, calculatut� overpayments, assisting with Social Securiry apglicafions, anditit�, interaction with physicians, lawyers, rehabiliTatian consultants, hea�y phones and customer contact, PC experience, ICD-9 & CPT coding. St. Paui Comparnes, Inc. 1°87-1990 �Vorked as Customer Service Representatioe for rlssi�ed Risk ALto. 33uties included issusnce of all new business applicatians, renewals, endonements, reinstatements, & cancellaTions for Persc�nal & Commercial tluto in 34 states. Interacrion wizh agents, insureds, State Insurance Plans, Service Centers in re�ard to rating, coding, underwiiting rules & billin�. 97 �� Vork with CrDS system, heavy phone work, mail. State Fann Insurance Companies, Inc. 1983-1986 �Vorked as a Secretary far 2-a�ent office. Duties included typutg, filing, heavy phones, custotner cantact, processin� necv policies, clsims, endorsements, accident reports, rating, codin� ECHrJ Computer System. State Farrn Insurance Companies, Inc. 1980-1982 Duties included X-Datina £or praspective clients. RELATED EXPERIENCE: -Phone Tone Seminar- dealin� rvith an irrate customer -Self tiiana�eci Teas� Steering Committze Niember-N�V��I, -Record'mg Secretary-Self ivfana;ed Team-NtiVNI, -Health Fraud Seminar offered by Twin Cities F3ealth Claim Associarion -Meclical Aspects of Disabi]iry Seminar-Abbott Northwestem Hospital's Sister Kenny Institute 1994 1942 1992 1992 1943 -Numeraus In-House Seminars affered by Reliastar (?�T�t+i�,Z) Benefits U- empioyee continuing eciucatian pro�am 1991-present -PC traiiung for NtiV�+'L affered by the Science �Iuseum of 1�Sinnesata -Excel for Windo4vs �.0 Computer class -E 12ai1 Training Seminar through Raliastar SPECIAL ACTIVI�'IES/TNTERESTS: -Participant in Ramsey County Sheriffs Civilian Academy -Participant in St. Paul Pofice Department Civilian Police :�cademy -Volunteer Panei Member, St. Paul Police Oral Inter�ieFV Raview Board & Youth Gang 7'ask I'orce Coznmittee -St. Paul Winter Carnival Volunteer -St. Patrick's Day Button Cosnmittee vlember -Vtember of Tw�i�� Cities T3eatth Claim Association -Vluscular Dystrophy :�ssociation Volunteer -United 4Vay Volunteer -tilember of iVlaple�voad Figure Skaiing CluU -Volunteer for St. Paul Police Bepariment-different duties i993 1994 1996 199& 199� 1994-present 1986-present 1986-1992 1992-present 198d-przsent 1987-1992 1977-1981 1994-present REFERE� 10E5: Avvlabie upon request. �� TTase: t t l, l G[ wl,'{ aome aaaress: b? � Street Telephone Number: lHoae Planning District Co�cil: Prefexred 2iailing Address: Rhat is your occupation? � Place�of Employsant: � Coffiittee(s) Applied For: OFFZCE OF THE 24AYOR 390 CITY HALL SAINT PAIII,� MINSIESOTA 55102 266-8525_� FAX: 266-8513 City �7-�7 R'c�F �'�� ocr z s i9ss Zip �u � � City Council Gard: �r�lJ�i�lr C �� Ahat srillsJtzai.ning or esperience do you possess foz the co�ittee(s) Por vhicn you seek appointment? r.Q ��r�n c� �,nR,Ps PG�rP.r� �znc� �- �lmrn�ll-�fl �� rv �,� c �ip �, � a.� � -e-/I�L� t CJL ' G� �' �Tlf � P �( C3�-�Yi ��t..� � f�t�.l-Lv�( � . -^�, ��. ti-� (' c�c�r�� , n .�� ,u.�, QF t��s.�� c� -� `=�---�' l,c�L�:�� . The in£ormation included in this application is considered private dzta according to the Hinnesota Governent Data Practices Act. As a result, this information is not released to the general public. (OP�R.) Rev. 2/28/96 PERS021AT. REFERENCES Rame Addri Phoni Name: aaa=ess Phone Name: Addre �C� �a n � � � �/L/' � 3! 4� R 7-� 7 �; Phone: (Aome) `��CC,i� �.v>X.P CWork) r� �� / R ^ easans foz your interest in paxticular committee L'1 i\ In n n. /� n,� ,.. _ I L. . i7 nn A l�_ n.� �._ Have you had previous contact vith the co�ittee £oz vhich you are making application. If so, whea, and circumstances? N� ' In an attempt to ensure that coffiittee representation reflects the makeup o£ our commvnity, please check the line app2icab2e to yoci. This information i.s strictly volvntary_ t� phite (Caucasian) Hispanic Black (African Americaa) Asian or Pacific Is2ander American Indian or Alaskan Eskimo Hale � _]� Female Date of Bizth: I I'�I ��' r LP Disabled: Yes No � f� Tf special accommodations are needed, p2ease specify. �� Hov did you hear about this opening? PERSONAL Name;� Address: Phone• Name: Address• Address: Phone: C� / R � eason ( s £or youz interest ia particular committee: C 1 r� !n n .: n � 1..._ _ I1. . a hn n ... 1�,. n i �., tor y�-331 0 9�-a�_ c� $ave you had previous contact vith the committee for vhich you are making application. I£ so, when, aad circumstancesT Na � In an attempt to ensure that committee representation reflects the makeup af our coarmimitp, please check the li.ne apglicable to you. This in£ormation is strictly voluntary. I� Ahite (Caucasian) $ispanic Black (African American) Asian or Yaci.fic Islander 9merican Indian or Alaskan Eskimo 2�fale �1 Female Date of Birth: ,�� I �`�1' 1�� t.F' Disabled: Yes No � I£ special accommodations are needed, please speciEy. _)V �� Hov did you hear about this opening? �- TLY"' �� V'� Name : .>-` �{ �T/-7 390 CITY HAI,L SAINT PAIIL, MINNESOTA 55102 26b-8525 FAX: 266-8513 �� -7 �£�� P10V � 3 1996 Pv�YQ+R`� �FICE Home Address: °�� &° G�� s: NayT G�-vc.r' ST. l�Fl-✓t SS"7aF1 Street City 2ip Telephone T�uaber: (Home) �o�S�--ss �� (Aork) -��) Planning District Co�ci2: i� Citp Council Aard: � Yreferred Hailing Add=ess: a/S� cvssi �yo �r ,r�-,�� Sr �fr�L (•..� z yL> � Cs v.....-.�-c�� G� 7GJ wr..r�.� a.<J 1-�9-�-`" ./L/J_ �J/�-.ci/.v.c� «:� 5 Ahat is yovr occupation? 1� = n i� m s n -�- �� Place �of F�plopment: $i�. P/1-�� O.�.Pc_; � sc�-i ,�, �S Conmittee(s) Applied Eor: /-��r1f �0 2� G.�s ,-y�r i� � ca,c� �� r �Ihat skillsJtraining or eaperience do you possess £or the committee(s) £or whicn you seek appointment? C ��rL/�-c'��Y Go Gi�,fa-i�Z c7f � i �.<-� ��arv !�✓�J2-�� LOGic N'vits' fL1J�..1c ✓ Mc�.�?c. /�/Ld6iC./� �}Z O� P�- �/�!Z O �/7 Ga�-i A f�� 3-.c->>7 v�7? ?Z--i�-r�r3x /� t'L-l�3Zo dJS C'O'Kf NI i� '� � ��`'+-'( 1'.�� t O�E-'�6�+[,J ^ ' z/'�-TIo•J /^a,/�- / �yU�/ G�9-�Y E3s iN Si . .AY� . The information included in this application is conside=ed private data accozding to the Hinnesota Gover,nent Data Practices Act. As a result, this in£or,�tion is not releaszd to the gene=al public. (OV�Tt) Rev. Zi 28J95 P�o�. ��N�ES � � a � xame: �+'�/� eon�z/.�->c9a Address: � 33 / ,� vi-o�-.� �,i�-ryz.�v,_�' S� f�6yv r,.,,,�/` s�s2 v`g' Phoae: tHome) � �� - r� C c, (Work) ""� Name: A.!/-}2.,�c�yLec° �'R-.�-i � �1s a.J , °! 0 4/� iS. �v s� 'j s G ��-n.� ��'y{.,v/J Address:_ •`� ,-✓ oi i c. .��-r�--.�aa � T-YYr' .� S'T. J�/3 v� �-t.t1 S S i�-`l Phone : (Home) (Ao=k) E Y' 9 - � -� � Name: ��- t zr��s c�"�-� 8r� ��-' Address: -3�' "3 f � C�o.�li+-c ,� �rn-� � L3„� ^i /�r�-./c .�1.J �2 � � Phone: (Home) G�+ Y�- 6�s � (Gork) Reasons for youz interest i.n this particular committee: Rj-iZfYL ��vr Yr�2s� i�v c�. Tir�' �Sc,Dc-.e ��.s� A�ic �.�tsr,�-�s�i .a,•-, �dr�'L co.�cc.-x-�vcr.� %7/�-; i�iz� ca��✓.�'.."']' 7> rvc2 /� � .�-i Y�-.2�s� ot' ,ssY�-�i.vc s= s.it. v�C. I.c�t✓C.�_"Y-ne..v Qa.aov </-a-Tt c� �T- ��"�-u^ °n 1- � ,Gc�yLr •.�s Have pou had previous contact vith the committee for vhich pou are making applicatibn. If so, when, and circumstances? Tn an attempt to ensure that co�ittee representation reflects the makeup of our communitp, please check the line applicable ta you. This information is strictly voluntarg. _� Ahite (Caucasian) B1ack (Atrican American) American Tndian or Alaskaa Eskimo Iiale _�__ Female Disahled: Yes No �_ Date of Birth: Hispanic Asian or Pacific Islander 3/ i. /2 If special acco�odations are needed, please speci£p_ � Hov did pou hear about this openi.ng? 77y.zd ,.�-i�.s.,,..rs io Svo-n sA:.,� i:.c.c� � f�l= �= � c 1 PERSONAL REFERE2ICES Hame: � �/V Co�c z/3-,c» 9� Address: _ a 33 / q �i o�-� iy,_i�lyvv..,� S?. /'6h.�� r,..J' s.r1 c� Phone: CHome) ��^ — �� c� n (Aork) J Name: d-!/3 �.r viz c.-' ✓lt-�-r � �-n a.J °% o U� i5 ..�r 'Y 7 s G � c.-r✓ Address • " ��3v � r.+� S. J�i� v ��..�� s S i a� Phone: (Home) (Qork) �Y9��'Z.� Name' `� r a✓�.s r57-r 3<s ��czl Addzess: �'3 t� CoM.,-r �� rn .�, � -r />.�..i< 2 i Phone: (Home) � Y�- bc,a ., tAork) Reasons £or your interest in this particular committee: Ri-T'2tYL � i �c- YcYa2s� �>v v >a ..i<-r--1 .-r✓ i c�i — 7a Tl-s-� !'� c,o c � .cJ�JSU <" �.2 aCitirr�-�s � .a.y EJtYL hvnr Ca.�c_�-n.ycv� %�f�-i i'7-� t��r'�ry�.ti " 7�-'t�c2 /� �P�� oa�ie ��-;z' f-i �-a.a>r o.- �.c- NC �' S/L �v2 l.c��r4. Q�s�v �!a-� e ...� oT- �ri ar�'r <-- 6c-rtr Nr � . Have you had previous contact vith the committee for which pou a=e maFcing agplication. I£ so, vhen, and circumstances? In an attempt to ensure that committee representation reflects the makeup o£ our coarmunity, please check the line applicable to you. This information is strictly voluntary. �c Ahite (Caucasian) Black �African American) American Zndisn or Alaskan Eskimo Ha1e �_ Female Disabled: Yes No �_ Hispanic Asian ar Pacific Islander Date o£ Birth: 3/i��LS I£ special acco�odations are needed, please specifq. �` Hov did you hear about this opening7 77�-rz✓ __f-r.�.s,,,,.�� S,�-✓ s�� j,;t ,� JTi� c 1 � � S 3 ��.� �� ^ _ � � � Name: Home Address: Street ' �. �. Citp Zip Telephone Number: CHome) /�� D,('{D (Aork) � f�s'�7�� Plaffiing District Council: City Crnmcil iTazd: Pre£erred 2failing Address: Ahat is yovr occupation7 Plac.. ef Q.,.^�lc�er.t: Co�ittee(s) Applied Ahat skills/training or eaperience do pou possess for the committae(s) for vhich you seek q/v-w�L 4� Sy�iiiZ� 1� 9�'�-� �� MAY 3 0 i991 �3AYOR'S OfFtCE �u� , C�- UD-C'E�r,C./_/.v �-�`�' d �-" � 1`(+� �j /L-�.-c.Q� �Y[ /��st�-L .L� . o ,. . �e � uz�� vz-Lfi ,�u e L� .��-� o -�-� �L��i C� � ,C� (�OO2[ — e �ir��} Iti'—TLIJ .lr2� �SZ,{�� bL. `C�L. � li�'�_ ./,. // � �Y� n rl e n , 1 . �. .,. . . _ _ C .v _.... ; C s a-E-�`-ti �2� UJ--a tic-2 G4� ��tt � �� L:� �� A:� � � l' d V �� x� �� A� �:�w(/� /� // / [. Wf a�� The information i.ncluded in this application is considered private data according to the 2iinnesota Goverment Data Practices Act. As a result, this information is not released to the general public. ORFICE OF THE MAYOR 347 CITY HALL SAIIiT PAIIL� MINNESOTA 55102 298-4736 .CG.9�ir�.fiU � L (04ER) Rev. 8-15-90 PERSONAL / REFEttgNCES q � _ � !/. . � �7� ,. . � _ _ � Add=ess: � � (�h// f� /� U Pfione: (Home) �S vS 'f' -" / /J (i7 � CGork) ��e'�-�� Name: Addre: Fhone Name: Address Phone (Qork) Reasons Eor your interest in this particular committee: 7u..�6��G(�-n-t�e-�X �- � :�'�e� .Urt C%`Yy%vy�-�ZL�✓�� . � ��. ,lLc i�e., f Have you had previous contact with the committee for vhich you are making application. If so, when, and circumstances? _ i!Y e/�7�Q�/ In an attempt to ensuxe that co�ittee representatian reflects the makeup of our co�mity, please check the line applicable to you, This information is strictly volutt�ry. � Ahite (Caucasian) Hispanic Black (African American) Asian or Paci£ic Islander American Zndian or Alaskan Eskimo � ?fale Female Disabled: Yes No Y Date of Birth: / ��/ If special accommodations are needed, please specify. Hov did you hear about Lhis opening? ��CUU=��-� /��,.0 PFSS� Rame Addr� • � • • i�1'G�L�/Z� ' . / � $ame: Addte Phoae Hame- Address Phone•---CHome) (Aork) Reasons for your interest in this partieular committee % Have you had previous contact with the committee for vhich you are making application. If so, vhen, and circumstances? /YIiiY�l.P� Ea an attempt to ensure that committee regresentation reflects the makeup of our community, please check the line applicable to you. This information is strictly vOlt]S!t3if. � Sfhite (Caucasian) Hispanic Black (African American) Asian or Pacific Islander Ame=ican Indian or Alaslun Eskimo � Ma1e Female Disabled: Yes Ho � Date of Birth: ��.% 1 Tf special accommodations are needed, please specify. Hov did you hear ahout this opening? . n _� , _� _ . /7 ^,, 9� �� 01-14-97 COMMITTEE APPLICANTS REPORT APPLZCANTS.RPT COMMITTEE : ACOA Advisory Committee on Aging FOR APPLICATIONS DATED AFTER O1JO1J94 APPLICANT / REFERENCE COMMENTS WARD PLANNING SENATE ET APP DATE G OQ3111 Bannigan, Brendan 2020 Portland Avenue St. Paul, MN 55104 Program Administrator 003188 Carlson, Erland E. 1923 Crown Point Drive Mendota Hghts., MN 551184206 Retired Lutheran Pastor 003181 Cook, Teresia (Teri) Senior Center Director 003243 Heinz, Jacqueline Marie 871 Juno Avenue St. Paul, MN 55102 Sr. Disability Benef. Spclst. DZSTRICT DZSTRICT (PRIAR) (OSHER COMMITTEE5 SERVING ON) ---- -------- -------- -- -------- - W 11J30J95 M 7 4 r^_. L•7 PAGE 1 W 06J11/96 M W 06f10/96 F W 11f13J96 F 003189 Heuer, Eunice Johnson 1158 Carlton Drive St. Paul, MN 55112 Registered NursejHealth Coord 002161 Hilton, Maureen 456 Summit Avenue St. Paul, MN 55102 2 16 Real Estate Broker 003232 Johnson, Michelle #3 1835 Portland Avenue St. Paul, MN 55104 Outreach Case Manager 4 13 W 06/11f96 F W 1Oj18j96 F W 1Of25J96 F 003121 Kuhlman, Barbara W O1J02/96 F 8560 Magnolia Trail, #332 Eden Prairie, MN 55344 9� �� O1-14-97 COMMITTEE APPLICANTS REPORT APPLICANTS.RPT COMMITTEE : ACOA Advisory Committee on Aging FOR APPLICATIONS DATED AFTER O1/O1f94 PAGE 2 APPLICANT / REFERENCE COMMENTS WARD PLANNING SENATE ET APP DATE G DISTRICT DISTRICT (PRIOR) (OTAER COMMITTEES SERVING ON) ----------------------------------- ---- -------- ------° -- -------- - 001641 Lapidos, Morris 1077 SibLey Hwy #406 Saint Paul, MN 55118 Retired 003242 Michaels, Greta Brockhausen 218� W. Hoyt Avenue St. Paul, MN 55108 Retired Teacher 003029 Nyhus, Art 824 Lake Street St. Paul, MN 55119 Retired 003018 Pappen£us, Mabe1 1128 Laurel Ave. St. Paul, MN 55104 Retired Teacher 003033 Pentecost, Carol 1D44 Orange Avenue E. St. Pau1, MN 55106 Self-EmployedJPUblisher 043229 Reed, Aelen Doris 1561 North Western St. Pavl, MN 55117 Public Aealth Nurse 4 12 6 5 � W 12JO�J95 M W 11f13f96 F W 08/02/95 M W 07/20/95 F W 08f09f95 F U 1�f31/96 F 003180 Royse, .7ane 2 17 W 06/1Oj96 �' 10301 Scarborough Road Bloominqton, MN 55437 Div_ Adm. Catholic Charities 97-�7 O1-14-97 APPLZCANTS.RPT COMMITTEE APPLICANTS REPORT COMMITTEE : ACOA Advisary Committee on Aging FOR APPLICATIONS DATED AFTER O1/O1/94 APPL2CANT j REFERENCE COMMENTS 003171 Wilcox, Rachel A. #1910 66 E. 9th Street St. Paul, MN 55101 vocational Counselor 003187 Winters-Bruce, Gertrude #1611 1181 Edgcumbe Road St. Paul, MN 55105 Retired TeacherjVOlunteer PAGE 3 WARD PLANNING SENATE ET APP DATE G DISTRICT DZSTRICT (PRIOR) (OTHER COMMITTEES SERVING ON) 2 17 W 06/03/96 F 3 14 W 06/11/96 F