Filing Papers
TO:
MATERIAL FOR CANDIDATES
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DATE: ID -~/ -Or
YOU HAVE INDICATED YOUR DESIRE TO BECOME A CANDIDATE; THEREFORE, WE HAND YOU THE FOLLOWING:
1.
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2010 Qualifying Information & Municipal Election Schedule
Form DS-DE 9 Appointment of Campaign Treasurer and Designation of Campaign Depository for
Candidates (8/03) - TO BE SIGNED AND RETURNED TO CITY CLERK
Form DS-DE 84 Statement of Candidate (Must be filed within 10 days after filing Campaign Treasurer
Appointment) (8/03)
State of Florida Election Laws - Chapters 99, 105 & 106 (09/05)
Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
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Directions for Posting Temporary Political Sign
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City Commission District Map
Part I Charter, Article VII. Elections - City of Boynton Beach
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Part II Code of Ordinances - Chapter 2 Administration, Article III. Elections
Poll Watcher Form & FS 101.131 - "Watchers at Polls"
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13. ....-/ June 2008 Candidate Handbook for Candidates
Blank Campaign Report Summary Sheets, Contributions Sheets & Expenditures Sheets
Form 1 Statement of Financial Interests 2009 - TO BE FILLED OUT, SIGNED & RETURNED TO THE
CITY CLERK DURING QUALIFYING
~ L&A TESTING NOTICE (SIGN AND RETURN AT TIME OF QUALIFYING.)
Loyalty Oath - Oath of Candidate (DS-DE 24B)- TO BE RETURNED TO CITY CLERK DURING
QUALIFYING
14.
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Petition Form - Candidate for Commissioner - TO BE FILLED OUT, CERTIFIED BY SUPERVISOR OF
ELECTIONS AND RETURNED TO CITY CLERK DURING QUALIFYING
Statement of Residency Requirements & Article II of City Charter - TO BE SIGNED AND RETURNED
TO CITY CLERK
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16.
17.
18.
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Date Signed
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August 25, 2009
s:\CC\WP\ELECTION\year 2010\MATERIAL FOR CANDATE5.doc
RECEIVED BY:
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STATE OF FLORIDA OFFICE USE ONLY c:::> E:? ~
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APPOINTMENT OF CAMPAIGN TREASURER ("") -< ~
AND DESIGNATION OF CAMPAIGN -I ..:..,
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DEPOSITORY FOR CANDIDATES - ,
(Section 106.021(1), F.S.) ~:jl;~,
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(PLEASE TYPE) :'~:::,
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CHECK APPROPRIATE BOX: N /Tl.
M Original Appointment 0 Deputy Treasurer 0 Reappointment of Treasurer
Name of Candidate 1. Address (include post office box or street. city, state, Zip code)
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Telephone (optional) 2. Party (Partisan candidates only) 3. Office (add district, circuit, group number)
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I have appointed the following person to act as my [J Campaign Treasurer o Deputy Treasurer
4. Name of Treasurer or Deputy Treasurer
tNF"c I1Wylfi'05![
5. Mailing Address (If post office box or drawer add street address) 6. Telephone
)09 S,/A) 187#' .5lJ?~T
7. CitYB01NliN lJDJel/ 8. County 9. State 1%/?IP,,9 10. Zip Code
119m 73c/lW 33'1~"
I have designated the following named bank as my o Primary Depository o Secondary Depository
11 Name of Bank 13)'}IIK f1/M/Yti 12. Street Address
13 City l3oYJiJi'/Y EElJeI/ 14. County ?/))/? B,M!.# 15. StateatflP" 16. Zip Code
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17 }(nature of Candidate (1/) JJ /J4f Date ..
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Campaign Treasurer's Acceptance of Appointment
I, C/"IFF MPNJ/?~.sS , do hereby accept the appointment as
(Please Print or Type)
IRI Campaign Treasurer o Deputy Treasurer for the campaign of CA; F r MbNJirtJ55
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who is seeking nomination or election as a )j,pN' ?/i{(TJ 5J1N candidate to the office of
(Party)
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UNDER PENAL TIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE,
be.r: ~)J R,blJ9 X (lp;.n;;. . ..........-::. J
Date Signature of aln paign T7easurer or Deputy Treasurer
DS-DE 9 (Rev. 01/08)
OFFICE USE ONLY
STATEMENT OF
CANDIDATE
(Section 106.023, F.S.)
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candidate for the office of
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have received, read and understand the requirements of Chapter 106,
Florida Statutes.
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Si ature M Candidate
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Date
Each candidate must file a statement with the qualifying officer within 10 days after the
Appointment of Campaign Treasurer and Designation of Campaign Depository is filed. Willful
failure to fiie this form is a first degree misdemeanor and a civil violation of the Campaign
Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1 )(c), 106.265(1), Florida
Statutes).
OS-DE 84 (Rev. 03/08)
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RESIDENCY REQUIREMENTS
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CJ.. J FF f'/c;v 7/?O.s 5
(Print Name)
11vJ/~ Y PI2
(Mayor/Commissioner - District #)
. candidate for
of the City
Beach, have received, read and understand the
residency requirements of Article II of the Charter of
the City of Boynton Beach.
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(Sign re of c,indidate)
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(Date)
8/18/2009 5:43 PM
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Miscellaneous Cash Receipt
CITY OF BOYNTON BEACH
No.
56784
Account No. 001-0000-36Q-l0-00
CODE W4
$ 275.82
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Received of CLIFF MOlITROSS
Address 109 sw 18th St, Boynton Beach. FL 33426
For
1% State Assessment Fee for Filing for M~~or in th8
Oper: JACKS .~z
General Election on March 9 , 2010. D~te: 2/08/10 01
Dept. City Clerk' 5 Office By
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No.
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Account No. 001-0000-~6Q-l 0-00
CODE W4
$ 25. QO
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Received of
CLIFF MONTROSS
Address
109 SW 18th St., Boynton Beach, FL 33426
For
Filing Fee to the City of Bovnton Beach fox Mayor in thp
uper: .1(.jCK~'.i(4Z
General Election on March Date: iYtlB/10 ill
Dept. City Clerk's Office By
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FORM 1
STATEMENT OF
FINANCIAL INTERESTS I
2009
Please print or type'your name, mailing I
address, agency name, and position below:
LAST ;';~~~;S;AME --;;'~F~~P : rr.
MAILING ADDRESS:
I t>9 So W. /' 'ill s;:
"BOYN";" 8e1eJ, FIll. · 31'12~ .. fAl.HBuc#
CITY: ZIP: COUNTY:
FOR OFFICE
USE ONLY:
ID No.
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NAME OF AGENCY:
Conf. Code
NAME OF OFFICE OR POSITION HELD OR SOUGHT: .
MHJl6~ 6" 8011'1-';" ~QtJ//, flIP.
P. Req. Code
You are not limited to the space on the lines on this form. Attach additional sheets, if necessary.
CHECK ONLY IF ~ CANDIDATE OR 0 NEW EMPLOYEE OR APPOINTEE
"BOTH PARTS OF THIS SECTION MUST BE COMPLETED'"
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON
A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (check one):
X DECEMBER 31, 2009 OR 0 SPECIFY TAX YEAR IF OTHER THl\~ .THE CALENDAR YEAR:
MANNER OF CALCULATING REPORTABLE INTERESTS:
THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH
REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see
instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (check one):
o COMPARATIVE (PERCENTAGE) THRESHOLDS OR 0 DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
NAME OF SOURCE SOURCE'S
OF INCOME ADDRESS
.$li4i~' S4e~/n 1I1w8,i; U.s:tAlIM.ltf/if_r
N.V: ReliA~~ N,T'_~ Aw.o.
VE./lIZ''; P"'S,iiN S-,sTo1 ~ /I.~B~I rt:l94-I&4...
DESCRIPTION OF THE SOURCE'S
PRINCIPAL BUSINESS ACTIVITY
Mwe-
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H~~
PART B -. SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person]
(If you have nothing to report. you must write "none" or "n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
/I'NE"
PART C .- REAL PROPERTY [Land, buildings owned by the reporting person]
(If you have nothing to report, you must write "none" or "n/a")
FILING INSTRUCTIONS for
when and where to file this form
are located at the bottom of page 2.
",/fAre}l ,""--- -/1' S~ IIIi sr ~." ~..I'.'
IN/) ,(eSl~UU' - hl/~'JjJ'A~~ blJJl.("f~/";'" 3#JI"I
INSTRUCTIONS on who must
file this form and how to fill it out
begin on page 3.
OTHER FORMS you may need
to file are described on page 6.
CE FORM 1 - Eft. 1/2010
(Continued on reverse side)
PAGE 1
.-."
PART D - INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit. etc.]
(If you have nothing to report, you must write "none" or "n/a")
TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
NINE' 1I~lIr
PART E - LIABILITIES [Major debts]
(If you have nothing to report, you must write "none" or "n/a")
NAME OF CREDITOR .. ADDRESS OF CREDITOR
U,(,t IIf~iAI- [l.JNet/- - $.. ~"91tU1 ,fhr. ~,JE/fJIM .1'7".
PART F - INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses]
(If you have nothing to report, you must write "none" or "n/a")
BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 BUSINESS ENTITY # 3
NAME OF BUSINESS ENTITY !I~/lE
ADDRESS OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5%
INTEREST IN THE BUSINESS
NATURE OF MY
OWNERSHIP INTEREST
IF ANY OF PARTS). THROUGH F ARE CONTINUED ON A SEPARAl:E.SHEET"PLEASE CHECK HERE 0
SIGNATURE (required): '(JWI1r~-- DATE SIGNED (required):
- II .
. FILING INSTRUCTIONS:
WHAT TO FILE: WHERE TO FILE: WHEN TO FILE:
After completing all parts of this form, including If you were mailed the form by the Commission Initially, each local officer/employee, state
signing and dating it, send back only the first on Ethics or a County Supervisor of Elections for officer, and specified state employee must
sheet (pages 1 and 2) for filing, your annual disclosure filing, return the form to file within 30 days of the date of his or her
that location, appointment or of the beginning of employ-
If you have nothing to report in a particular Local officers/employees file with the Supervisor ment. Appointees who must be confirmed by
section, you must write "none" or "n/a" in that of Elections of the county in which they perma- the Senate must file prior to confirmation, even
section(s), nently reside, (If you do not permanently reside if that is less than 30 days from the date of their
in Florida, file with the Supervisor of the county appointment.
Facsimiles will not be accepted. where your agency has its headquarters,! Candidates for publicly-elected local office
NOTE: State officers or specified state employees must file at the same time they file their
MULTIPLE FILING UNNECESSARY: file with the Commission on Ethics, P,O, Drawer qualifying papers,
Generally, a person who has filed Form 1 for a 15709, Tallahassee, FL 32317-5709; physical Thereafter, local officers/employees, state
calendar or fiscal year is not required to file a address: 3600 Maclay Boulevard, South, Suite officers, and specified state employees are
second Form 1 for the same year. However, a 201, 1allahas'see, Fit. 32312, required to file by July 1 st following each
candidate who previously filed Form 1 because CandidateS file this form together with their calendar year in which they hold their posi-
of another public position must at least file a copy qualifying papers,' tipns,
of his or her original Form 1 when qualifying, To determine what category your position Finally, at the end of office or employment,
falls under, see the "Who Must File" Instructions each local officer/employee, state officer, and
on page 3, specified state employee is required to file a
final disclosure form (Form 1 F) within 60 days
of leaving office or employment
CE FORM 1 - Eff, 1/2010
PAGE 2
II ,I
LOYALTY OATH
OFFICE USE ONLY
(Sections 876.05-876.10. Florida Statutes)
NON-PARTISAN OFFICE
STATE OF FLORIDA
COUNTY OF P81..M BFA~II
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ell rFbRD
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M4K1lfIJSS'
First Name
Middle Name/Initial
Last Name
a citizen of the State of Florida and of the United States of America, and being [a candidate for public office] do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida.
Important: If elected, a candidate must retake the loyalty oath as specified in s. 876.05, Florida Statutes, and that oath shall be
filed with the records of the governing official or employing governmental agency prior to the approval of payment of salary,
expenses, or other compensation.
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
I,
CI..,Pr N"wTlt"ss
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT - NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am a candidate for the non-partisan office of MHY~R" 8o~ 1JE~,/,1f;,.
(office) (district)
; I am a qualified elector of I'III.H 8EltJI County, Florida;
(circuit) (group)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; by executing this form, I have taken the oath required by S5. 876.05-876.10, Florida Statutes; 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.
x
Telephone Number
Email Address
ZIP Code
Sworn to (or affirmed) and subscribed before me this ~ day of _rf' b.
120~.
Personally Known:
or
State of Florida
issioned Name of Notary Public
Produced Identification: \/
F LDL
:............jAMrE.jO.NES........~. .
: ",'''''''''tq.. Comm# 000763088
: !.~ 11.,\ ?
: i. . ~ Expkes 21271201.
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: -::"l/l()J."..,,*,~ Florida NotafY As$,
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Type of Identification Produced:
OS-DE 25 (Rev. 11/09)
II "
The City of Boynton Beach
,,','.., .'~~'.(r~,,:"
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City Clerk's Office
100 E BOYNTON BEACH BLVD
BOYNTON BEACH FL 33435
(561) 742-6060
FAX: (561) 742-6090
www. boynton- beach. org
PUBLIC NOTICE
TO:
CANDIDATES, POLITICAL PARTIES Arfl> OTHERS
/~
/
NOTICE IS HEREBY GIVEN that the Logic & Accuracy (LM) testing of the
voting equipment to be used in the March 9, 2010 General Election will be
held:
Friday, February 19, 2010 at 3:00 p.m.
Supervisor of Elections Office
240 South Military Trail
West Palm Beach, FL 33415
RECEIPT of this notice is hereby documented:
~~
/2"1 ~.//)
, Date Received
-----------------------------------------------------
-----------------------------------------------------
(Detach)
IF YOU AND/OR YOUR REPRESENTATIVE(S) plan(s) to attend the logic & Accuracy
elM) testing on Friday, February 19, 2010, please detach and return the lower portion
of this notice to the City Clerk.
Signature
Number Attending
9/9/20099:06 AM
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Palm Beach County
240 SOUTH MILITARY TRAIL
WEST PALM BEACH. FL 3341 5
POST OFFICE BOX 22308
WEST PALM BEACH, FL 33418
SUSAN BUCHER
Supervisor of Elections
TELEPHONE: (581) 858-8200
FAX NUMBER: (581) 858-8287
WEBSITE: www.pbcelections.org
CERTIFICATION
I, SUSAN BUCHER, SUPERVISOR OF ELECTIONS, for Palm Beach County, Florida, do
hereby certify that the 26 signatures on the Nominating Petition for MA VOR of CLIFF
MONTROSS are registered electors within the municipal limits of the City of Boynton
Beach, according to the registration records on file in this office.
This is to further certify that CLIFF MONTROSS is a registered voter in Precinct 3148, in
the City of Boynton Beach, Florida.
Signed, this the 3rd day of February, 2010.
.~~
SUSAN BUCHER
SUPERVISOR OF ELECTIONS
PALM BEACH COUNTY
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NOMINATING PETITION
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WI' "u undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do
henny nominate:
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to t!;f; ~!I candidate for:. MAYOR, City of Boynton Beach, Palm Beach Cou'1\Y,
Flor cia" for the term: . _ ("')::{
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SIGNATURE ..ADDRESS:t:
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MARCH 2010
to
MARCH 2013
purSllall'llt to the Charter and Ordinances of said City.
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NOMINATING PETITION
ill mrlf'fsigned, duly quaHfled voters of the CITY OF BOYNTON BEACH, do
in wrnmate.
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r ,~ndidate for MAYOR, City of Boynton Beach, Palm Beach Coun.tY,
;j'i, fijl the term: c;g-:
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MARCH 2.010
to
MARCH 2013
the Charter and Ordinances of said City.
SIGNI,\ lURE ADDRESS
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NOMINATING PETITION
We the undersigned, duly qualified voters of the CITY OF BOYNTON BEACH, do
hereby nominate:
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_....._.._..il1.S~JIL...sz_ 1J6f11H'" ~~ ,~ 3' "*t..
to be a candidate fo(, MAYOR, City of Boynton Beach, Palm Beach County,
Florida, for the term: ~
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MARCH 2010 to MARCH 2013 r"'\ ("')-Tl
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pursuant to the Charter and Ordinances of said City. '::-;z::
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I, the undersigned,
, do solemnly swear
(or affirm) that I am duly qualified to hold office under the Charter and Ordinances of the
City of Boynton Beach, Florida, and I do hereby accept the foregoing nomination as a
MPtVoR
candidate for the office of Gity CommiSiioJ:liJr for the City of Boynton Beach, Florida.
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Received at the City Hall in Boynton Beach this L day of JI~Ul-1
2010 at R~00 A.M. (
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Sworn to and subscribed before me at Boynton Beach, Florida, this ?!
day of ~b.--w 1L(j AD. 20 I D
m. P~ou~~t)
Janet M. Prainito, CMC
City Clerk