NON
RECEIVED
MAY 2 2 2025
0[lY LL,: , ' '] iilluL
CITY OF VERNON
COMMISSION AND COMMITTEE APPLICATION
a
ALIFORNIA
Cdnmission/Committee (select all of interesl) read back of form for qualificalions and meeling inlormation siness and lndustry Cdnmission as
usiness Representative OheatEstateProfessional Q-aoorRepresentatlve UNITY Fund Grant Committee as
Qausiness Representative ernon Area Representative
sing Commission as
Eusiness Representa(ive Oemdoyee ot vernon Business O nesioent usiness Representative Environmental Representative OLabor Representative Na.e JACQUIE CABRERA
Residence Address
OIRECTOR OF HUMAN RESOURCES Employer: ROSE & SHORE, INC.
EmployerAddress Sl5l ALCOA AVE, VERNON' CA' 90058
Emait: [email protected] phone:
By signing below, I atfirm that I meet the requirements ol the appointing categov I nav-1i191c9te9.. I affirm that t ri1tt ite jstaternent of Economic lntere$s Form 700 and complete the required 2-ht AB1234 Ethics Training within 30 da iving notice of appointmenl to a Commission Sign
DS ?? 70
Email to [email protected] or tllall 1o Clty Clerk Oeparlmcnt, 4305 Sant. Fe Avenue' Fot Ollica Use only
Ou alificalions confi rogd bY 5'27-zF
{r'flk EReal Es El|.abor E Envrronmental E Vernon Area E Emdoyee EResidenl Vernon, CA 9005E.
[feen vernon commission as:
t a
Occupation:
Oualifications and Reasons for lnteresl in Serving on a Commission / Committee (attach additional sheet if necessary):
Date.
REGEIVED
MAY 2 I 2025
NOr.l ALIFORNIA
CIiY CLERK'S OFFICE
CITY OF VERNON
COMMISSION AND COMMITTEE APPLICATION
Commission/Committee (select all of interest) read back of form for qualifications and meeting information usiness and lndustry Commission as:
Sr"in"r" Represenlative GealEstateProfessional QlaborRepresentative mUNITY Fund Grant Committee as
usiness Representalive emon Area Representative
ployee of Vernon Business Cn""iuent
en Vemon Commission as
usiness Representative vironmental Representative or Representative *"r". Frank Gavina
Residence Address:
Occupation: Executive Employer . Gavina Coffee Company
2700 Fruitland Ave. Vernon CA 90058 Employer Address:
Email: frank. [email protected] Phone:
Qualifications and Reasons for lnterest in Serving on a Commission / Committee (attach additional sheet if necessary):
I have chaired both the Vernon Housing Commission and the Community Fund Grant Committee c I
By signing below, I afiirm that I meet the requirements of the appointing category I have indicated. I afiirm that I will file a Statement of Economic lnterests Form 700 and complete the required 2-ht A81234 Ethics Training within 30 days of receiving notice of appointment to a Commission.
SiEnature:
eb5Losc{b76<!@-e2c8. ffi Date 5t28t25
Emall to [email protected] or Mall to Clty Clerk Departmont, 4305 Santa Fe Avenue, Vernon, CA 90058.
EResldent
Eqrr,nn commission as:
L)Business Representative
For Olllce Use only
ouatiflcerons confirmro o, Yonnie Parker ",
512912025
vr, F- .v ,1L- Ett ,rEausl#is /flR€al Estal€ E Labor ! Envlronmental E Vemon ArBa E EmPloyee