Precincts 1505 1510 and 1511 Imagine Chancellor SchoolThe City of
ton Beach
PRECINCT NUMBER(S): 1505 1510. and 1511
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: IMAGINE SCHOOLS CHANCELLOR CAMPUS FROM: CITY OF BOYNTON BEACH
3333 HIGH RIDGE ROAD CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33426 100 E. OCEAN AVENUE
BOYNTON BEACH, FL 33435
This agreement, dated this/l day of�QlXkar 2023, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
Imagine Schools Chancellor Campus
NAME OF POLLING LOCATION (Include name and/or room number)
3333 High Ridge Road, Boynton Beach, FL 33426
(POLLING LOCATION STREET ADDRESS, CITY AND ZIP CODE)
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION------------------------------------------------------ TUESDAY, MARCH 14, 2023
RUN-OFF ELECTION (if necessary) ------------------------------------TUESDAY, MARCH 28,2023
To provide the following items from 5:30 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes
No
CHAIRS FOR ELECTION WORKERS Ll,-'
❑
TABLES FOR ELECTION WORKERS
❑
RESTROOM FACILITIES AVAILABLE ®�
❑
• To provide access to the Polling Place on election day by one of the following means:
19'� Owner will open Polling Place NO LATER THAN 5:30 a.m. on Election Day
❑ Owner will provide the Precinct Clerk with a key to the premises prior to Election Day.
THE CITY OF BOYNTON BEACH, THROUGH THE CITY CLERK, AGREES:
• To pay the owner $ 500. 00 for the use of the above described location for each Election, if
it is used.
I AGREE TO THE ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
BEA(fkON THE'DATES INDICATED ABOVE.
A611le" 26adtifind G-41
IG2-5!�I--
E PRI NAME TITL TELEPHONE NO.
H,Y oL�cti LMAILING ADDRESS CLUDE CITY . ATE AND ZIP CODE DATE SIGNED
ADDITIONAL INFORMATION
• To provide access to the premises for delivery and pickup of voting equipment before and after each
Election, please provide the days/hours facility is open for equipmenT_delivery/pickup:
A 1,,_„ — f;r, X11 st---m — ,�9'OV-1
• Name of contact person and telephone number at Polling Place:
V
• Name of contact person and telephneer befor and after regular
emergency. �J/ & 1 ' 5 77 — "
Make checks payable to:
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hours, in case of