CITY OF COTATI
APPLICATION FOR COUNCILS POINTMENT TO ADVISORY BODY
ahis may be made avalade d any meter of the pult upon request. Appoint e on at tomation a de pulsed in the City of Cotati public informational roster.
ppointees to certain advisory bodies will be required to complete a Statement of Economic Interest as required by Californi overnment Code §87200 et seq. and the City of Cotati Conflict of Interest Cod Choose one; please complete a separate application for each advisory body for which you would like to be considered.
Advisory body to which appointment is sought:
Measure G Oversight Committee
Planning Commission
Marin/Sonoma Mosquito & Vector Control District Other
CONTACT INFORMATION
Last Name: BERMAN
First Name: MICHELLE
I COTATI, CA 94931
Mailing
Address:
E-mail:
Phone:
Alt phone:
EDUCATION
• High School Graduate; or Location: SKYLINE HIGH, OAKLAND, CA • GED
Major Degree/Date
College/University
AA/ 1982
COLLEGE OF ALAMEDA BUSINESS ADMINISTRATION
Other formal education:
FIRE SPRINKLER • INSTALLATION
Application for appointment to advisory body
EMPLOYMENT HISTORY
List all employment during the last five years. If retired, list last employer.
Period Employer (include location) Position/Title
1995- PRESENT STATE OF CALIFORNIA IN HOME SUPPORTIVE
SERVICES CAREGIVER
PERSONAL INFORMATION
Year you became a Cotati resident: 2000
Are you a City of Cotati registered voter? EYes •No
Are you related to any member of the City Council, any City advisory body •Yes Member or City Employee? If yes, please list name and relationship:
Are you currently a vendor or contractor with the City of Cotati •Yes ENo Are you currently employed by the City of Cotati? •Yes ANo Have you ever been convicted of a felony? If yes, please explain: •Yes ENO List civic activities, clubs, associations, etc.:
Pushing Limits, Disability Themed Radio Program on KPFA, 94.1fm: Volunteer producer, editor AnD host. Caregina for how-income folks living with a disatility and living independently. I watts 2 hours per day in cotati (over) Briefly state your reasons for interest in the appointment sought:
"Business As Usual" is no Longer. With the Climate Crisis and scarcity being the norm, I feel drawn to Planning for a More resilient throuch innovative thinking and appropriate choices to benefit catati residant.
Please initial the following 2 paragraphs:
I understand that this application is considered a public record pursuant to The California Public Records Act (Government Code 6520 et seg.) and may be made available to any member of the public upon request. Appointee's MSB contact information may be published in the City of Cotati public informational roster.
I understand that appointees to certain advisory bodies will be required to complete a Statement of Economic Interest as required by California Government Code §87200 et seg. and the City of Cotati Conflict of Interest Code.
I certify that the foregoing is true and correct to the best of my knowledge:
Unbell s. 1/91/23
Signature Date
Emergency contact information (confidential; for emergency use only):
Name Relationship Phone number
Thank you for your interest. Please return completed form to the Deputy City Clerk via email at [email protected] or deliever to City of Cotati, Attn.: Deputy City Clerk, 201 West Sierra Avenue, Cotati, CA 94931-4217
civic Activities, continued:
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to the •city.