Polling Location AgreementsI\
' Y .. The City of Boynton Beach
03 .S :
k`of - PRECINCT NUMBER 7178
'L TON e
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: SHEILA SERAS FROM: CITY OF BOYNTON BEACH
TEMPLE BETH KODESH CITY CLERK'S OFFICE
501 NE 26TH AVENUE 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33444 BOYNTON BEACH FL 33426
1
This agreement, dated this I`I day of 1 EC.6-742.6k , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
MPLE 057,-I Ko-bos4.
NAME OF POLLING LOCATION (Include na-B4O ,411-0,4
e and/or room number)
Em IV. L 01.9-4's F--T V B o 4 n1 Tt,4 Mack 3 3 -(3:S—
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
CM
Yes No 0.) .,
rii 1T
CHAIRS FOR ELECTION WORKERS CJ1 0 izzi
-ricn
TABLES FOR ELECTION WORKERS i 0 `' . _)
2_
RESTROOM FACILITIES AVAILABLE 27 0 O
Na
•• -rn
c)r
• To provide access to the Polling Place on election day by one of the following means: 31 �'_
l Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day
0 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 $ 1 3 0, 06 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
BEACH ON THE
/PATES INDICATED ABOVE.
jatA-- u., SIfEi<_4 S4"g4S c9,=r=1c6 H, Ae'Eic 1/4,5-a- y Va2-
SIGNATURE PRINT NAME TITLE TELEPHONE NO.
Ol Wil: -2(o F- rvc. 1=SoYnlronl RGAc.t+ Fi._ .33 `/3S 13/lt/lr
MAILING ADDRESS (INCLUDE CITY, STATE 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:
f 1ON — —T+uv S - q.-a F",2( - cl.- It2J
• Name of contact person and telephone number at Polling Place: S H EVL.4 seta- 94,2
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. F(1IT7_ PE21GLES 74-4-- < 911- 9n19
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-7178.doc
`' The City of Boynton Beach
„xi PRECINCT NUMBER 3200&3202
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: SUSAN GEERY FROM: CITY OF BOYNTON BEACH
�0C • GOLVIEW HARBOUR CLUBHOUSE CITY CLERICS OFFICE
?NS lCa Ahos-027755W 14TH STREET 3301 QUANTUM BLVD. #101
Inq;tb OK BOYNTON BEACH,FL 33426 BOYNTON BEACH FL 33426
M 1 This agreement, dated this 7 day of Sh d)LLa1 20111, by and between the City of Boynton
t"i0. i i`� ` 1111 5 Beach,FL,and the owner of the Polling Place located at:
C1/4 Shic,h N G fcy, vi" (yo l ch, 4) 1--1 o-Ar 6atr Ol J io&Lse_
ZSS(° SOI I-4}e h NAME OF POLLING LOCATION(Include name and/or room number)
,44-aa 13E46 FG33gzc
yhch®�ellsr�uM1•ri�t .a'77S SO / 4 ' sr 60�Jfn4y1 gi.gL,"IL• 339z 4
tip %4b 'I/7/0X (POLLING LOCATION STREET ADDRESS,CITY AND ZIP CODE)
at-Ste - 130 "al THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION-- -- TUESDAY, MARCH 12,2019
RUN-OFF ELECTION(if necessary) TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 a.m. until all dosing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No
CHAIRS FOR ELECTION WORKERS 1i3' 0
TABLES FOR ELECTION WORKERS 13' 0
RESTROOM FACILITIES AVAILABLE Er' ❑
• To provide access to the Polling Place on election day by one of the following means:
0 Owner will open.Polling Place NO LATER THAN 6 a.m.on Election Day
E - 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:
2d, oo ,rrg/u tec bol prternefs 2200 c 3Zo2 - pe.t 2016 twmme.+-
• To pay the owner$ 3 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)ILAVAILABLE TO THE CITY OF BOYNTON
BINTHE DATES NDICATED E.
41 Sa_vz GEfle l Y P Set sic/-516 EPHONE -136 /
SIGN
2554 SLC) /r-C. o /)N/T/SC'4C, ' 331 Z6 J/7/t I q
• MAILING ADDRESS(INCWDE CITY,STATE A ZIP CODE) D 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:
• Name of contact person and telephone number at Polling Piace:SNSaavz ore teu S 4'(-s% '/36 /
or dark 'Hoe (he inrtel, .x(0136,y
• Name of contact person and telephone number before and after regular business hours, in case ofSy%O
emergency.
• Make dhedcs payable to: & r',1
CE -HA l c •
SACLAWPa2cfl AVea20I9WPOLIING LncanQ$\powj,g Location Agreement-3200&3202.da
R
`'�Y c), 'I've City of Boynton Beach
ri- rte
, ,I- - PRECINCT NUMBER 4066, 4068,4070, &7190
4'roN e
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: RANDY PATTERSON FROM: CITY OF BOYNTON BEACH
SEACREST PRESBYTERIAN CHURCH CITY CLERK'S OFFICE
2703 N. SEACREST BLVD. 3301 QUANTUM BLVD. # 101
DELRAY BEACH, FL 33444 BOYNTON BEACH FL 33426
9 ll- y -bec
This agreement, dated this Ik da of L./ , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
Seat' S-1' P'tSylei,.avv diu1c 1.
NAME OF POLLING LOCATION (Include name and/or room number)
f® 3 A. cectotst Aida , btiic,y 3 4eL, Ft, yLii-i
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No
cu
CHAIRS FOR ELECTION WORKERS ❑ <c
TABLES FOR ELECTION WORKERS fK ❑ — ij.°J,
o .- ? , ___ -
RESTROOM FACILITIES AVAILABLE 0 -s,a-
o,r_
N T'm
• To provide access to the Polling Place on election day by one of the following means: v �'-"
r rn
z
Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day
0 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 $ ?GD. W for the use of the above described location for each Election, if
it is used. — 9�2 r- ./e ,:)G a 3
I AGREE TO THE ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
AC 0 T ATES NDICATED ABOVE.
,c.puQ -- Li�
a0)pI . � 6-1--{uo„ S,. AL/.3-4/ C-Col -246)—S5 33
SI NATU PRINT NAME TITLE TELEPHONE NO.
2703 AL Ste/Ned 14 , �CIray 3,eah . FL 33v1114 IZile9 )14
MAILING ADDRESS (INCLUDE CITY, STATE 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 equipmentidelivery/pickup:
Mond4y — Fi,Jgy g: IC- 3'.00
• Name of contact person and telephone number at Polling Place: ok L-1'e I Pa-r}'e'sen c(0 I- Y<1 - Z}9y
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. -371 Fo,4s-1-c,, scot- 3o9-ZG23
• Make checks payable to: SeaCdts-i- P/fsb\I lei;a,,, CLu,ck
S:\CC\WP\ELEC ION\Year 2019\POLLING LOCATIONS\Pohang Location Agreement-4066,4068,4070,&7190.doc
Y °F The City of Boynton Beach
i
` mwer_ h ,
°I- �, PRECINCT NUMBER 7186
ti TON ex/'
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: BOYNTON BEACH SENIOR CENTER FROM: CITY OF BOYNTON BEACH
1021 S. FEDERAL HIGHWAY CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33435 3301 QUANTUM BLVD. # 101
BOYNTON BEACH FL 33426
This agreement, dated this `.day of U% 1_0 1:-.)L 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
NAME OF POLLING LOCATION (Include name and/or room number)
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 ID/t El//
TABLES FOR ELECTION WORKERS C3 • ❑
RESTROOM FACILITIES AVAILABLE Ind ❑
• To provide access to the Polling Place on election day by one of the following means:
q/ Owner will open Polling Place NO LATER THAN 6 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 $ 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
BEACH ON THE DATES INDICATED ABOVE.
SIGIQATURE PRINT NAME TITLE TELEPHONE NO.
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: grelw — e-DCT_ F ( 17
• Name of contact person ancl telephone number before and after regular business hours, in case of
emergency. (, i$4/
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-7186.doc
co Y
°A- The City of Boynton, Beach
( 03
°� a�P PRECINCT NUMBER 7182
TON 6
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: CAROLYN SIMS CENTER FROM: CITY OF BOYNTON BEACH
225 NW 12TH AVENUE CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33435 3301 QUANTUM BLVD. # 101
BOYNTON BEACH FL 33426
This agreement, dated this 9"day of'/r e) (?> >r 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
NAME OF POLLING LOCATION (Include name and/or room number)
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 GY ❑
TABLES FOR ELECTION WORKERS [ ❑
RESTROOM FACILITIES AVAILABLE ❑
• Toprovideaccess to the Polling Place on election day by one of the following means:
Vt4 Owner will open Polling Place NO LATER THAN 6 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 $ 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
BEACH ON THE DATES INDICATED ABOVE.
CA,44/91c/Dec I eF07 a� Q67C
SIGNATURE PRINT NAME / TITLE TELEPHONE NO.
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: Prievin/K Y-Cc eAttia C-cr X Li(
• Name of contact person and telephope number before and after regular business hours, in case of
emergency. i, tc.y
• Make checks payable to:
5:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Poilling Location Agreement-7182.doc
�;-,Y 0„
The City of Boynton Beach
) cr i
r , '
oj- d,- PCI PRECINCT NUMBER 4054
�r0N 6
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: AMANDA DEVLIN FROM: CITY OF BOYNTON BEACH
LAKEVIEW BAPTIST CHURCH CITY CLERK'S OFFICE
2599 N. SWINTON AVENUE 3301 QUANTUM BLVD. # 101
DELRAY BEACH, FL 33444 BOYNTON BEACH FL 33426
This agreement, dated this 1 rday of Thb&P/IYI /ir , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
NAME OF POLLING LOCATION (Include name and/or room number)
02_69g Ni si \-on A-v-e.. 1 `L el r l,, PL
(POLLING LOCATION STREET ADDRESS, CITY AN IP CODE)
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION TUESDAY, MARCH 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florigfa
Statutes to be performed by the Election Board are completed: n
O.
Yes No n• c
CHAIRS FOR ELECTION WORKERS E r
TABLES FOR ELECTION WORKERS 9 ❑ x' N
RESTROOM FACILITIES AVAILABLE C ❑ c-E,
e0.
s r^
:-J m>
x
• To provide access to the Polling Place on election day by one of the following means:
0 Owner will open Polling Place NO LATER THAN 6 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 $ 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
BEACH ON THE DATES INDICATED ABOVE.
eliin , AM A-N404 1 V LI A l A-1m;n ksf. ,5 1-,27(0- 55 93 7
SIG ATURE PRINT NAME TITLE TELEPHONE NO.
c25-99 N (Ja-, n A-tte 1 \r(WI 6eoLeJA 17 331
' 0 —//—/eSi
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: M10100 tVU A/ neI-51-t -2'? ')
CCG II
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. - ctmtie OS Rlfo\/e
• Make checks payable to:
S:\CC\WP\ELEC ION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-4054.doc
-- S Y
°F
-- The City of Boynton Beach
ref -
''3 --47-c , PRECINCT NUMBER 4050
ti T OiN e
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: CREON SMITH FROM: CITY OF BOYNTON BEACH
HUNTER'S RUN COURTSIDE CAFE CITY CLERK'S OFFICE
3500 CLUBHOUSE LANE 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33436 BOYNTON BEACH FL 33426
This agreement, dated this /4 day of Tje 6V`T3Z). , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
li- -c tv2 a PeA 3S0o Cc - s& Lwwn'. jb•, s 3€w-u, CL334-36
NAME OF POLLING LOCATION (Include name and/or room number)
Csq-beSlbt; Cif-i[ , .3 Coo Gc-ugaa-e- 4T L-e 137yatz.n.J -)+t41 F=c 3343e0
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No cu
m
Wil.
CHAIRS FOR ELECTION WORKERS ❑r ❑ n
TABLES FOR ELECTION WORKERS Er 0 r0
RESTROOM FACILITIES AVAILABLE [ 0
IV a`
4 co
• To provide access to the Polling Place on election day by one of the following means: T m�
Q' Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day
0 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 $ for the use of the above described location for each Election, if
it is used.
I AGR TO E ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
41,
EAC/ 07 ' 'E DATES INDICATED ABOVE.
C P (�4i ) 73S- 4oiS"
iG1 • ��{'C- 02rY Pecs 1
SIGNATURE I PRINT NAME TITLE TELEPHONE NO.
3Soo CL ae4o1.4SC- LA.Hzc frfI"Q`'J-3elare._N FIT_oI2rbA 33430
MAILING ADDRESS (INCLUDE CITY, STATE 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 equipmentidelivery/pickup: \1
• Name of contact person and telephone number at Polling Place: cRockthWt t Cat-Nix-1 (al) 733--14°1+7-\
• Name of contact person and telephone number before and after regular business hours, in case o, f
emergency.
• Make checks payable to:
S:\CC\WP\ELEC ION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-4050.doc
r
'�Y °F The City of Boynton Beach
•°� _v- PRECINCT NUMBER 4036&4062
'i'r°N 6
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: COLONIAL CLUBHOUSE I FROM: CITY OF BOYNTON BEACH
26 COLONIAL CLUB DRIVE CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33435 3301 QUANTUM BLVD. # 101
BOYNTON BEACH FL 33426
This agreement, dated this day of , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
NAME OF POLLING LOCATION (Include name and/or room number)
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 0
TABLES FOR ELECTION WORKERS lit 0
--PEP".
u1 roc
RESTROOM FACILITIES AVAILABLE 0 °-.
x
3
c
• To provide access to the Polling Place on election day by one of the following means: W --''.,m
m>
*YE,` Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day =
0 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 $ for the use of the above described location for each Election, if
it is used.
I AGREE TO THE ABOVE COND ON� MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
BEACH ON THE DATES INDICAT VE:" 1 QM .jfi4J10 Patc-"SIOv✓f
$ /61I' &c•(-cAti VA-n+y 1bSt 1 Prt a 0 kNr I $ v 731- 3151
SIGNATUR f PRINTNAME //�� TITLE r TELEPHONE NO.
`t- coLcNI4L. -LL4G O - e('1VNTcho 61'/ 1-1-) FLUa21OA- ,..3(5)`-i1/435-
MAILING
*-HMAILING ADDRESS (INCLUDE CITY, STATE 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: B q,,,(
N Lin 2'-1 1-lou 2 /leo-r I° A,uO Dk'�.,✓ r t),.-v 0oc.J tET.Lu ei"/1) 3 PA'1
• Name of contact person and telephone number at Polling Place: F—:11:-&-t.
O s.c t Lt rrrl 52 1 - 7 3.--1-2-0677
• ' Name of contact person and telephone number before and after regular business hours, in case of
emergency. 1=0
5c4L7a rri 9. I.•t 3 y-2-0 6,-7
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-4036&4062.doc
co-Y°� The City of Boynton; Beach
iw �
°� _�P PRECINCT NUMBER 4024
ry r0N
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: HARVEY E. OYER JR. PARK FROM: CITY OF BOYNTON BEACH
2010 N. FEDERAL HIGHWAY CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33426 3301 QUANTUM BLVD. # 101
`�/ BOYNTON BEACH FL 33426
This agreement, dated this Q(5lAday of SDC-Cfr-f L7 bt_2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
NAME OF POLLING LOCATION (Include name and/or room number)
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 Ig/ ❑
TABLES FOR ELECTION WORKERS Q ❑
RESTROOM FACILITIES AVAILABLE I ❑
• To provide access to the Polling Place on election day by one of the following means:
❑ Owner will open Polling Place NO LATER THAN 6 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 $ _ 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
BEACH ON THE DATES INDICATED =e . .
(. 9
SIGNATURE PRINT NAME TITLE TELEPHONE NO.
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: G�/-p ---, X Co r�SCD
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. 6a241--
•
,241-• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-4024.doc
c.\-TY °F The City of Boynton Beach
m \ r .
o- v PRECINCT NUMBER 3194
To N e ` (FIRE STATION # 2)
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: CHIEF GLENN JOSEPH FROM: CITY OF BOYNTON BEACH
BOYNTON BEACH FIRE STATION #5 CITY CLERK'S OFFICE
2080 HIGH RIDGE ROAD 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33426 BOYNTON BEACH FL 33426
This agreement, dated this 171-hday of nerembar , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
Boynton Beach-Fire Rescue; Station /#2
NAME OF POLLING LOCATION (Include name and/or room number)
2615 W. Woolbright Road, Boynton Beach, FL :33436
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 RI ❑
TABLES FOR ELECTION WORKERS Ll ❑ cc,
='
cry
RESTROOM FACILITIES AVAILABLE ® ❑ n
(-) o
c;
rV _.
• To provide access to the Polling Place on election day by one of the following means: r- :
A
a
7C e_
l Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day c- _Tc?
..1 t7l
❑ Owner will provide the Precinct Clerk with a key to the premises prior to Election Day. t'E2
THE CITY OF BOYNTON BEACH, THROUGH THE CITY CLERK, AGREES:
• To pay the owner $ 0 for the use of the above described location for each Election, if
it is used.
I AGREE TO THE ABOVE Ce •••ITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
BEACH ON THE DATES IED ABOVE. `�
'-- ei&tlim c�CC,1Jti (Cite C4hel 5141 ca- 6 369
SIGNATURE PRINT NAME TITLE TELEPHONE NO.
2080 High Ridge Road, Boynton Beach, FL 33426 ( 2-/ (2/�f
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: Captain •or Lio urnn•,ot nn chit),
561-742-6626/ .561-742-6634/ 561-742-6633
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. 561-742-6634
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\PoIlling Location Agreement-3194.doc
°' v °F The City of Boynton Beach
r( _ 2
°ti -�7- PRECINCT NUMBER 3198
tiroNI e cm
POLLING LOCATION AGREEMENT FORM CO =�-`
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE o
---) n
TO: BOYNTON BEACH LEISUREVILLE CLUBHOUSE FROM: CITY OF BOYNTON BEACH — rnC.
1807 SW 18TH AVENUE CITY CLERK'S OFFICE
x2-
BOYNTON BEACH, FL 33426 3301 QUANTUM BLVD. # 101 x'= qi
vi—
BOYNTON BEACH FL 33426
-n
This agreement, dated this i.,2#' day of bt V- 2018, by and between the City ofooynOn
Beach, FL, and the owner of the Polling Place located at:
//�� x
eOYi'i i-el-itis -eV /lam eonnokh , }Ly i.SSOC /c/i2
NAME OF POLLING LOCATION (Include name and/or room number)
I 07 Su.) / �-± ? Sertoi075 &71) M. 6&ct_ok PL- 33 v aCa
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 $ ❑ ..
TABLES FOR ELECTION WORKERS ❑
RESTROOM FACILITIES AVAILABLE w.- ❑
• To provide access to the Polling Place on election day by one of the following means:
gr Owner will open Polling Place NO LATER THAN 6 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 $ for the use of the above described location for each Election, if
it is used.
AGREE TO THE ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
etA
•, • : • • S INDICATED ABOVE.
7
G'; _ ,CCA aesa r- al-7 .)- 2307
SI NATURE PRINT NAME TITLE TELEPHONE NO.
18v7 so 1 &S $L 8oyrr 4\ &-ea.a4 FL 33 5 c2A3k.o/s/
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: Cindy 6ri i;x 524-'739-m07
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. 'T,ec! S/-e-en ori 9 59— a&3-))5 3
• Make checks payable to: GOY✓--011 ice isctvice.it) (It arvi vluav, )9, Asor%1c/1-,` l
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\PotIIing Location Agreement-3198.doc
CA
___..
C,�T}Y._oF The City of Boynton !Beach
1! - I
oti �,e- PRECINCT NUMBER 3182&3190
Ifv
tON 9
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: SUSAN ONORI FROM: CITY OF BOYNTON BEACH
IMAGINE-CHANCELLOR SCHOOL CITY CLERK'S OFFICE
3333 HIGH RIDGE ROAD 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33426II BOYNTON BEACH FL 33426
This agreement, dated this I
-44,-
y of DecrnkcK2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
z Q ,ncsck06k- keroo \lo- G6wus jg . 1aL
NAME 00 POLLING LOCATION (Include name and/or room number) 7
3 3 ON \ , RA- • AND � , FL
' q 6
PO N STREETFCD
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION TUESDAY, MARCH 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 -...a cia C.,=4
TABLES FOR ELECTION WORKERS ❑ o -<c
RESTROOM FACILITIES AVAILABLE ❑ a- 7
ss.
7_8:
• To provide access to the Polling Place on election day by one of the following means: o CD Y
1 G:
- r Ca--`
® Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day rn
` x
❑ 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 $ 0 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
:44H ON THE DATES INDICATED ABOVE.
SU IrTh o(.\ Pr\Y`ct • ti C61-S-Eis=11 � l
SIGNATURE PRINT NAME TITLE TELEPHONE NO.
< 3?) \ \-\ V J?-C 1 Q 2.I . �h,4 r ISck Ft. 33'126 102-10 -IJ
MAILING ADDRESS (INC-LUDE CITY, SATE 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 equipmentmdelivery/pickup:
I-
• Name of contact person and telephone number at Polling Place: 1 OLi'M Sa\a S 1 541—.SSCs 1 I kl
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. S l U S n fl O no r i 9 ci-i - SO I —4 Q f=s—
• Make checks payable to: /U I IA-
5:\CC\WP\ELECTION Wear 2019\POLLING LOCATIONS\Pealing Location Agreement-3172&3176.doc
'1 Y O� The City of Boynton Beach
, / lit: -.
0i �P PRECINCTNUMBER 3168 & 3174
4/TON 0 (FIRE STATION # 3)
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH.CITY CLERK'S OFFICE
TO: CHIEF GLENN JOSEPH FROM: CITY OF BOYNTON BEACH
BOYNTON BEACH FIRE STATION #5 CITY CLERK'S OFFICE
2080 HIGH RIDGE ROAD 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33426 BOYNTON BEACH FL 33426
This agreement, dated this 12th day of December , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
Boynton Beach Fire Rescue Station #3
11110 NAME OF POLLING LOCATION (Include name and/or room number)
, --3-01t2N: -Congrea-s'Avenue, 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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
C>
Yes No Er T-'
1
CHAIRS FOR ELECTION WORKERS C ❑ rn �--
C w
TABLES FOR ELECTION WORKERS ® ❑ r' T=<
RESTROOM FACILITIES AVAILABLE ® ❑ s u'ci
Tit-
i�
• To provide access to the Polling Place on election day by one of the following means: o mw -,
® Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day
O 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 $ a for the use of the above described location for each Election, if
it is used.
I AGREE T• THE ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
CCDATES INDICA D ABOV
cAir
SIGNATU'E PRINT NAME TITLE TELEPHONE NO.
2080 High Ridge Road, Boynton Beach, FL 33426 1 -a/(210
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: Captain/ Lieutenant on ^,h i ft
561-742-6606/ 561-742-6634
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. '561-742-6634
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCA7lONS\Pollling Location Agreement-3168&3174Aoc
°p. The City of Boynton Beach
t
o� P PRECINCT NUMBER 3146
evtON 9
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: CHRISTOPHER DORNEY . FROM: CITY OF BOYNTON BEACH
DISCOVERY VILLAGE AT BOYNTON BEACH CITY CLERK'S OFFICE
4735 NW 7TH CT 3301 QUANTUM BLVD. # 101
BOYNTON BEACH FL 33426 BOYNTON BEACH FL 33426
This agreement, dated this day of I a , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
DitCo\tect. UiMet° 14- Qodn on 6eeacv,
NAME'OF POLLING LOCATION-(Include name and/or room number)1-tingI�I , C- , 604*n Reach FL 33`QG
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No cc) --
o <c
CHAIRS FOR ELECTION WORKERS [( ❑ h -�m
—cc
—
TABLES FOR ELECTION WORKERS d 0 r �-
RESTROOM FACILITIES AVAILABLE 12/ ❑ ' o
c9
TjG
• To provide access to the Polling Place on election day by one of the following means: rnc-)
Crf Owner will open Polling Place NO LATER THAN 6 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 $ 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
BEACH ON THE DATES INDICATED ABOVE.
Ch ►•_. Ree c iron 4J cuenk bictior RAI- 7-.3745
IGN URE PRINT NAM TITLE TELEPHONE NO.
'11,3E NUJ `1�4, C jn Rcx .. FL, 33tiaa nlial isc
MAILING ADDRESS (INCLUDE CITY, STATE 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:
• Name of contact person and telephone number at Polling Place: Ckn'sT oc'e.3i .5G1-as-)-3745
(757-xia-c1gel)Celt
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. -WOO ParK-ill 5-61-9591-3745
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-3140&3142.doc
rr.,
01
Y°F The City of Boynton Beach
° 1i y U PRECINCT NUMBER 3140 &3142
ti T.°N 6
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: JONATHAN SOTO FROM: CITY OF BOYNTON BEACH
BOYNTON LAKES NORTH HOA CITY CLERK'S OFFICE
100 REDFORD DRIVE 3301 QUANTUM BLVD. # 101
BOYNTON BEACH FL 33436 BOYNTON BEACH FL 33426
This agreement, dated this it day of Dece 1..4-er- 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
- - -(i -r,f-4;)-r. - l-.aIce r Nor h .. . tib-l..O\rte
NAME OF POLLING LOCATION (Include name and/or room number)
) vo "Le A4-oen Or;u1 (3O 10,, 4e ...ri„ Izt J1nig,
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed: c.--)
r,
Yes No
r° t
CHAIRS FOR ELECTION WORKERS 0 n a;
/ N nr
TABLES FOR ELECTION WORKERS �I ❑
x
CA---:-.
RESTROOM FACILITIES AVAILABLE1 0 CD Z.
-"m
rnrn
C>
—
• To provide access to the Polling Place on election day by one of the following means: P1?
g
JOwner will open Polling Place NO LATER THAN 6 a.m. on Election Day
7YJ 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 $ IQ(ID: C'O 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
BEACH
C/a. THE DATES/ INDICATED ABOVE.
r�/!1 dIf 4.11-777+ ,. /✓ to /e s 1-t[1 i --4tPs,
SIGNATURE PRINT NAME TITLE TELEPHONE NO.
1 QO rata--d 'a O`'✓QI au „dor, 4 tc—t,L1 N- ? S `! 4 I-0 th>-
MAILING ADDRESS (INCLUDE CITY, STATE 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:
S(a1
• Name of contact person and telephone number at Polling Place: 7 ..rnir. 't€ .I Le rA 4 3q-9A'S-'
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. r 6 Fr,rn- - F .1- 0 5 r S b I — 3 8b- 5-1-m--
• Make checks payable to: a 0 tr-4Dn L,Jc-Q1 Ku r'a'h
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-3140&3142.doc
r
•Y OF The City of Boynton, Beach
""� ,I l I ur tic l Il I ui, t t.ACII
r CITY CLERK'S OFFICE
°cI ro N_e 18
DEC 13 PHI PRECINCT NUMBER 7180 & 7184
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: THELMA LYONS FROM: CITY OF BOYNTON BEACH
ST. JOHN MISSIONARY BAPTIST CHURCH CITY CLERK'S OFFICE
900 N. SEACREST BLVD. 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33435 T BOYNTON BEACH FL 33426
This agreement, dated this WA day of f et em h et 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
<S4-. l'nkm Miss ;na/n2y AMg sJ Ci�.teh j 701/owship .l1a //
NAME OF POLLING LOCATION (Inclu name and/or room nu err)
900970 Al. S cAe 2 LJ cc E R lyd. 60tptiloA/ PA[!l� 1::i. 3 3 zi3`;
(POLLING LOCATION STREET ADDRESS, CITE AND Z1P CODE)
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION TUESDAY, MARCH 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 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 5( ❑
TABLES FOR ELECTION WORKERS EV/ ❑
RESTROOM FACILITIES AVAILABLE l ❑
• To—prprovide access to the Polling Place on election day by one of the following means:
LSA Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day
0 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 $ a 5b bD for the use of the above described location for each Election, if
it is used. L— 9x..,9,-+oa=
I AGREE TO THE ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
BEACH ON THE DATES INDICATED ABOVE.
6U/
0CHy l ,i n�t4 lh&Ij A I p/0 b /Lc ,SreQeiai '732-4377
;NF) TURE / PRINT NAME TITLE /TELEPHONE NO.
qDO Al. .S e i ite51 AIvc%, Anillks &Ae/I1 FL , 33g3 s ia/:, i8
MAILING ADDRESS (INCLUDE CITY, STATE ND ZIP CODE) DAT 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:
l
• Name of contact person and telephone number at Polling Place: A liked ki.5ow Sal- 708-)718
• Name of contact rson and telephone number before nd a er regular business hours, in case of
emergency. dJ OchuieIs 5&/ -4301 _SbSS ))
• Make checks payable to: Si. A,t/Al,-`in 0 Ab/ 60451- (Avid)
S:\CC�WP\ELECTION\Year 2019\POLLING LOCATIONS\PoIlling Location Agreement-7180& 184.doc
�I °� The City of Boynton .Beach
S
oc ,„..,,,?-0
P PRECINCT NUMBER 4026
^'rove
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: RACHAEL RAPPAPORT FROM: CITY OF BOYNTON BEACH
STERLING VILLAGE CITY CLERK'S OFFICE
500 SOUTH FEDERAL HIGHWAY 3301 QUANTUM BLVD. # 101
BOYNTON BEACH, FL 33435 BOYNTON BEACH FL 33426
This agreement, dated this \ day of 1NLIA14) / , 2018, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
'tg2U vt U Meri5e. Condorniiii kv\ WA-LL.
NAME OF POLLING LOCATION (Include name and/or room number)
0 S -° I tfwy ` y -n t3ecc �n , -6.%i 3313c
(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 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No '=r'
cp
CHAIRS FOR ELECTION WORKERS1 ❑ , Jc
TABLES FOR ELECTION WORKERS 0 --,K
RESTROOM FACILITIES AVAILABLE \0- ❑ — o
O IFI:,.,
• To provide access to the Polling Place on election day by one of the following means: ' rnn
l Owner will open Polling Place NO LATER THAN 6 a.m. on Election Day
0 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 $ 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
BEAC ON THE DATES INDICATED ABOVE.
eobpPapt± PM Spk i . `4,1c\--
SIGNATURE
,1csSIGNATURE PRINT NAME TITLE TELEPHONE NO.
SUD s - CCIOVA;I Ii�-cr� fry. -PI 5-3-13c 1zrli iijE3
MAILING ADDRESS (INCLUDE CITY, ATE AND ZIP CODE DATE SIG E
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:
• Name of contact person and telephone number at Polling Place: ' .AC*th ., Q-preetrisl000x
• Name of contact perso and telephone number before and after regular business hours, in case of
emergency. �A-CF - Pi,1)r',.1. i
g0 i 3t 33l0 soar
• Make checks payable to: Steel.\!J&- V Ilifter
S:\CC\WP\ELECTION\Year 2019\POLLING LOCATIONS\Pollling Location Agreement-4026.doc
0
1
The City of Boynton Beach
,! r _;T,
� .
PRECINCT NUMBER 3186,3187,3258,&4020
:iin,nl.7.'
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: LIZA POPOUR FROM: CITY OF BOYNTON BEACH
CHRIST FELLOWSHIP CHURCH CITY CLERK'S OFFICE
801 CONGRESS AVE#401 3301 QUANTUM BLVD.#101
BOYNTON BEACH,FL 33426 n� BOYNTON BEACH FL 33426
i
This agreement,dated this 1�day of ak-VAW t'_'\ 2018, by and between the City of Boynton
Beach,FL,and the of PollingPlaceat:
NAME OF POLLING LOCATION(Include and/or r number)
3
POLLING LOCATION SthET ADDRESS,CITY AND ZIP CODE)
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION----------------------------TUESDAY,MARCH 12,2019
RUN-OFF ELECTION(if necessary)-----------------TUESDAY,MARCH 26,2019
• To provide the following Items from 6:00 a.m. until all dosing piutedures required by the Florida r�
Statutes to be performed by the Election Board are completed: r;-
c
Yes/' No L c,
CHAIRS FOR ELECTION WORKERS IBV ❑ 3 n-r,
C.3
TABLES FOR ELECTION WORKERS LN"— ❑ — - —1 x <
J.- -
RESTROOM FACILITIES AVAILABLE 4d'❑ -n N-
3; CD It
C:
• To provide arrncs to the Polling Place on election day by one of the following means: IV G,'
r ,
n
iiii- Owner will open Polling Place NO LATER 11-IAN 6 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$ —EC___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
qEAc5H ON i DATES INDI : • ROVE.
C - -
SIGN PRINT NAME ,TITLE. __ , _ TELEPHONE �:
N...LA. < : 1 ,. . t• .I
MAILING ADDRESS(INCLUDE CITY,STATE AND ZIP ODE) ._ 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:
• Name of contact person and telephone number at Polling Place: i� , f '1 l -7.1\at-n Lam_01) q 1 S _11q2 (5
i
• Name of contact, ard tele phone number before and r gufar b I ess hQyry, iacaSe of %al i �c
emergency. . 1 ,rYl Y11:) -"r7 / lC1
• Make checks payable to:
5:\Q\MWP\EIECfON\Year 20 MAXIM IOcATIONSPdlling Lg4tbn Agna,ent-3186,3187,3188&402O.dnc
I
.r
•
Ellis, Shayla
From: Liza Popour <LizaP@cftoday.org>
Sent: Thursday, January 17, 2019 12:43 PM
To: Ellis, Shayla
Subject: Re: Christ Fellowship
Hi Shayla,
My apologies, no we do not charge a fee to the city.
Thank you,
•1 Ir•sl '
e;ZS
Liza Popour
i�ow Administrative Assistant
Fellowship 561.799.7603 x3876
/012i8. 04. goChristFellowship.com
From: "Ellis, Shayla" <EllisS@bbfl.us>
Date: Thursday, January 17, 2019 at 12:05 PM
To: Liza Popour<LizaP@cftoday.org>
Subject: RE: Christ Fellowship
Good Afternoon Liza,
I did receive the attached Agreement. There was a section on if there would be a fee charged for use of the facility that
was not completed. I just need to know if therr will be a charge to use the facility.
Thanks,
Shayla Ellis
Records Coordinator
C. , x" City Clerk's Office
/�tx �. - .. Mailing Address: P.O. Box 310 I Boynton Beach, Florida 33425
I . t Physical Address: 3301 Quantum Blvd., Suite 101 I Boynton Beach, Florida 33426
>t
r.
1, " ai t„ 561-742-6063
*, 4,'"cs .567,--4,..•/ EllisS@bbfl.us boynton-beach.org/
\TO Ntr
" r nax e,.
-. `riiiidirogi0r1, lel
Please he advised that Florida has a broad public records law and all correspondence to me via email may he subject to
disclosure.Under Florida records law, email addresses are public records. Therefore, your e-mail communication and
your e-mail address may be subject to public disclosure.
J.
From: Liza Popour<LizaP@cftoday.org>
Sent:Wednesday,January 16, 2019 5:00 PM
To: Ellis, Shayla <EllisS@bbfl.us>
Cc: Kristen Hicks <Kristen.Hicks@cftoday.org>
Subject: Christ Fellowship
Hi Shayla,
Here is the signed document from Christ Fellowship. Please let me know if you need anything else.
I noticed that some things where left unanswered. Please see below...
• We will open no later than 6am on the day of polling.
• Name of contact:
1) Kristen Hicks—561-799-7600 x 3912
2) Phil (561) 685-3677
3) Liza Popour 561-568-4189
Please let me know if you need anything else.
Thank you,
r re' Liza Popour
Christ Administrative Assistant
Fellowship 561.799.7603 x3876
goChristFellowship.com
The material contained in this email may be confidential, and may also be the subject of copyright and/or
privileged information. If you are not the intended recipient, any use, disclosure or copying of this document is
prohibited. If you have received this document in error, please advise the sender and delete the document.
The material contained in this email may be confidential, and may also be the subject of copyright and/or
privileged infonnation. If you are not the intended recipient, any use, disclosure or copying of this document is
prohibited. If you have received this document in error, please advise the sender and delete the document.
2
.ii` The City of Boynton Beach
�
s PRECINCT NUMBER 3192
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: LEISUREVILLE CLUBHOUSE # 1 FROM: CITY OF BOYNTON BEACH
1007 OCEAN DRIVE CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33426 3301 QUANTUM BLVD, # 101
p r BOYNTON BEACH FL 33426
This agreement, dated this d day of ` l VutiQ,✓? , 201 , by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at..)
Pa tar; l Pr tevfl� e // 6I !Aiwa 4 i (r2-1.
NAME OF POLLING LOCATION (Include name and/or room number)
/ 0OOCe / uAs ✓& mi a�co(POL N STREET DDRESS, QI AND IP c) ,
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION TUESDAY, MARCH 12, 2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m. until all dosing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No
CHAIRS FOR ELECTION WORKERS Q ❑
TABLES FOR ELECTION WORKERS Lia / 0
RESTROOM FACILITIES AVAILABLE Cs7� 0
• To provri access to the Polling Place on election day by one of the following means:
V _;OwnerEwill openiPolling Place`N:O LATER:THAN 6,a in. on{Election;Day
'JD — 0 Ownerwill provide°tfie PrecinctClerk with a key to'the preinises prior to Election Day.
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK, AGREES:
• To pay the owner $ 0' U 0 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
BEACH ON THE DATES IrICATED ABOV .
Oyes( h" i ' )-Si ,A/044 5f. "in - '13a-7`wy
SIGNATURE I ' 'PRINTNAME TITLE TELEPHONE.NO.
ILI/0O7 jradn Drive, SrS r P1 33Yea f 19
MAILING ADDRESS (INCLUDE CITY, STATE AND ZIP CODE) DATE'SIGNED
Y °.. The City of Boynton Beach
t ti `Y v PRECINCT NUMBER 3196
• r.p{n et t
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: LEISUREVILLE CLUBHOUSE # 3 FROM: CITY OF BOYNTON BEACH
2001 SW 13TH AVENUE CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33426 3301 QUANTUM BLVD. # 101
BOYNTON BEACH FL 33426
6
This agreement, dated this 6 day of L i t(M..46 vf, 2011, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
Palm WSLek we.chi(e Clu,lolew 4 let-3 )
NAME OF POLLING LOCATION (IInclude nal e and/or room number) y/
90°1 SLAJ TIONSIKEETADDRESSICIII',�ID CODE) .3 ��10
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION . TUESDAY, MARCH 12,2019
RUN-OFF ELECTION (if necessary) TUESDAY, MARCH 26, 2019
• To provide the following items from 6:00 a.m, until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes o
CHAIRS FOR ELECTION WORKERS / 0
TABLES FOR ELECTION WORKERS 0
RESTROOM FACILITIES AVAILABLE ❑
• To provide access to the Polling Place on election day by one of the following means:
,-Owner will+opeaolhng Place NO IATER THAN 6 a m on:Election Day
MO — Cr, , ',Owner will;provide tiieRPreanct Clerk with a key to tlie'premises'`prwr to Election Day.
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK, AGREES:
• To pay the owner$ 0 'O 0 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
BEACH ON THE DATES INDICATED ABOVE.
SIGNATU E_. ..
R "' rp PRINTNAME:"" TITLE i ' TELEPHONE'N0.
t �iD�
MAILING ADDRESS (INCLUDE LnY 'STATE+AND ZIIS;CODE .' 4 ;DATESIGNED
cc, �j-.eThe City of Boynton Beach
Y. 1)•::,.::'to
q}
PRECINCT NUMBER 3136
ro N:0 .
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERICS OFFICE
TO: FREEDOM SHORES ELEMENTARY SCHOOL FROM: CITY OF BOYNTON BEACH
3400 HYPOLUXO ROAD CITY CLERK'S OFFICE
BOYNTON BEACH FL 33436 3301 QUANTUM BLVD. # 101
e•-•( BOYNTON BEACH FL 33426
IVI
This agreement, dated this D day of I 7 l�N 1U , DIV by and between the City of Boynton
Beach,FL,and the owner of the Polling Place ocated at: r
4:110
NAME OF POLLING LOCATION(Include name and/or room number)
(POLLING LOCATION STREET ADDRESS,CITY AND IIP CODE)
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION — -TUESDAY,MARCH 12,2019
RUN-OFF ELECTION(if necessary) ----------- TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 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 K ❑
TABLES FOR ELECTION WORKERS V ❑
RESTROOM FACILITIES AVAILABLE CO' a
• Toprovide access to the Polling Place on election day by one of the following means: .
'Ili Owner will open Polling Place NOIATER THAN 6 a m.on Election Day
p Owner will provide the Precinct Clerk with a key to the premises pdor to Election Day.
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK,AGREES:
• To pay the owner§ 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
BEACH ON THE DA$'a ITED ABOVE.
SIGNATURE__.__•.- . PRINT NAME -- 1111E ' — 'TELEPHONE TELEPHONE NO:
Wanda Paul,Chief Operating Officer f/� '20(9
Phone:561-357-7573 DATE SIGNED
3300 Forest Hill Blvd.,WPB,Fl.33406 . E) -. _
ADDITIONAL INFORMATION
• In provide access Gitlin premisesfoi delivery andipickup pf voting equlpnSent tSefa're and after each
Election,please provide the days/hours focality s open for equipment delhrery/pickup:
• Name of contact person and telephone number at Polling Place: iI ivnlY+iH. fR"u4P(2S.?-<UI.^$0IJ-3100
I
• Name of contact person and telephone number before and after regular business hours, In case of
emergency. i: . : .-t1c
.act et -'`.�Abertcno"-.-)6+I;KUM 3I DD - • - .
• Make checks payable to:
s:1CC\WP1t1ECTION1Year 20191POW NG LOCATIONS-Waling Location Agreement-1116 ticc
The City of Boynton Beach
M1f . —
6
•fr" PRECINCT NUMBER 3138&3164
�Jo Nie.
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
Cove-
TO: CITRUS GROVE ELEMENTARY SCHOOL FROM: CITY OF BOYNTON BEACH
8900 LAWRENCE ROAD CITY CLERK'S OFFICE
BOYNTON BEACH FL 33436 3301 QUANTUM BLVD. N 101
BOYNTON BEACH FL 33926
- -2o let
This agreement, dated this L) day oK -to
20167by and between the City of Boynton
Beach,FL,and the owner of the Polling Place located at:
A hoe
NAME OF POLLING LOCATION(Include name and/or room number)
(POLLING LOCATION STREET ADDRESS,CITY AND ZIP CODE)
THE OWNER AGREES TO
• Provide the Polling Place for holding the following elections:
GENERAL ELECTION — ------TUESDAY,MARCH 12,2019
RUN-OFF ELECTION(if necessary) ------ ----TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes
No
CHAIRS FOR ELECTION WORKERS (0 ❑
TABLES FOR ELECTION WORKERS m' ❑
RESTROOM FACILITIES AVAILABLE l ❑
• To provide access to the Polling Place on election day by one of the following means:
Owner will open Polling Place NO LATER THAN 6 a.m.on Election Day
❑ Owner will provide the Precinet perk with a keyto tlie,premises prior to.Election Day,
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK,AGREES:
• To pay the owner$ 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
SON,E ATES I TolDiZOVE,
SIGRATURE _.:PRINT_NAh1E ' TITLE -.` TELEPHONE NO.
Wanda Paul,Chief Operating Officer /yw •920/9
Phone:561-357-7573 :ODE). , _ DRTE �J
3300 Forest Hill Blvd.,WPB,FL 33406 ' -
ADDTTIONAC INFORMATIQI4
• To provide access mthe premises for-delWery and-pidup.of voting equlpmen4 before`and after each
Election,please provide the days/hours facility Is open.for equipment delivery/pii7ckup:
• Name of contact person and telephone number at Polling Place: t PRN1C t2 -hi� �)-`-Slot- 7C04
(,t}(0, Megrei-th I- sirs-24u-700I
• Name of contact person and telephone number before and after regular business hours, n case of
emergency. l- (-t'•�i�0.' vtF-e t:( � —5b1-i:1.2-.77140:1 r.
• Make checks payable to:
SicCtwP\RaTON\Year 2019WOW NG LCUnONS\PMI6ny location Ayieement•31311 h 31 W.doc
c ttv.'o,-
Ire _. The City of Boynton Beach
m` _ o 1
o}a -*,sf? PRECINCT NUMBER 7288
%Powe .
POLLING LOCATION AGREEMENT FORM ,
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE •
TO: FOREST PARK ELEMENTARY FROM: CITY OF BOYNTON BEACH
1201 SW 30 STREET CITY CLERK'S OFFICE .
BOYNTON BEACH,FL 33435 3301 QUANTUM BLVD.if 101
BOYNTON BEACH FL 33426
This agreement, dated this t7 of LUN.. .20t8,by and between the City of Boynton
Beach,FL,and the owner of the Polling Place located at:
ah-,ue,
NAME OF POLLING LOCATION(Include name and/or room number)
(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 12,2019
RUN-OFF ELECTION(if necessary) -----------TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
I �
Yes No
CHAIRS FOR ELECTION WORKERS 1ff ❑
TABLES FOR ELECTION WORKERS e ❑
RESTROOM FACILITIES AVAILABLE Er 0 .
.
• To provide access to the Polling Place on election day by one of the following means:
Owner will open Polling Place NO LATER THAN 6 a.m.onElecbon•Day
E _Owner wiltprovide the Precinct deck with key-to the prunlscs prior to Election Day.
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK,AGREES:
• To pay the owner$ for the use of the above described location for each Election,If
it is used.
I AGREE TO THE ABOVECONDITIONSAND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
. BEACH THE-DA'7 DILATED ABOVE.
SIGNATURE' • __. 'PRENTNAM&' TITLE 'L3T1FPHONEND:
Wanda Paul.Chief Operating Officer /• ib ,eZeie
M Phone:561-357-7573 E)- • ----_:,_• L- - -'-:- - -'DAITT,SLGNED
3300 Forest Hill Blvd.,WPB,Fl.33406 -
ADD37IONALINFORMATtON
• To provide a¢e9s to thelpremises•for delhrery and pickup of voting equipment before and.after eadi
Eder-tion,please providethe days/hoursfacllityasopenfor,equipment delhiery/pkkup:
• Name of contact person and telephone number at Polling Place: I ','a RIC.-"W-P-- SGL-.- i-=LG r('-(
• Name of contact person and telephone number before and after regular business.hours, In case of
emergency. r 'nnn(y Qob,ne'rirt - 5(,P-Zcl2:p; 11 - - ..
• Make checks payable to:
91CC\WP'EEECnON1Yea,2019WLUNG LOCATIONS Painng IgWNn Agreement•7188.oa
i.
.c.0::: or
The City of Boynton Beach
. , :
�I'ro Nf e"P PRECINCT NUMBER 7179
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: DOMIENICK MAZZELLA FROM: CITY OF BOYNTON BEACH
VILLAGE ROYAL ON THE GREEN CITY CLERK'S OFFICE
2505 NE 2ND COURT 3301 QUANTUM BLVD. # 101
BOYNTON BEACH,FL 33435 BOYNTON BEACH FL 33426
This agreement, dated this ',n day of \1c Ccc OC r 2018, by and between the City of Boynton
Beach,FL,and the owner of the Polling Place located at:
V\\a,,gc ci-�ya\r ov\ 4,4 G-«A - (../0<-1A- CU)fl0t3C
NA OF POLLING LOCATION(Include name and/or room number)
31501 NE 1St Court, ISc w}cn Rcacl,. FL. 33435
(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 12,2019
RUN-OFF ELECTION(if necessary) TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
No
Q/
CHAIRS FOR ELECTION WORKERS N]// 0 --,F.
TABLES FOR ELECTION WORKERS 0
3: `n
r--u2.
-- - - _ -r
6a/ .J
RESTROOM FACILITIES AVAILABLE 0 Cn -::�__,-
-.-x-j:
• To provide access to the Polling Place on election day by one of the following means: — Lr
oTd--
—
'TICE
rid Owner will open Polling Place NO LATER THAN 6 a.m.on Election Day _,i m.^.-
. .. with a y t premises prior Y _ay c-D
❑ Owner will provide the Precinct Clerk a key[o the remises to Election Da ' z
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK,AGREES:
• To pay the owner$ ISO, 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
ABEA ON THE DATES INDICATED ABOVE.
'C'423i(A(',�.� 09M G'witoh ,L642_,,,,L ��m. C61-4-501--14 4' q
GNATURE . - 1 U PRINT NAME TITLE. , . __ TELEPHONE NO.
3So5 NE .rJ (ourt, Goyv \o , But,L. FL 33939 ID, pcy Ig
MAILING ADDRESS,(INCLUDE CITY,STATE AND ZIP CODE) DATE SIGNED
ADDITIONAL INFORMATION
• To provide access to the _remises for deliveryand pickup of votin
P P P equipment before and after,each
Election, please provide the days/hours facility is open for equipmentAdelivery/pickup:
• Name of contact person and telephone number at Polling Place: AI;A Rncc ,,,a-n tc I lin 9173
• Name of contact.person and telephone number before and after regular business hours, in case of
emergency. . a'co;11c /Saaztell&- r'1,01-'a,$1= Sa31
• Make checks payable to: -rm. Lcagvt. 03- U'R 6 , .enc.
S:\CC\W ViEECTION\Year 2019\POLLING LOCATIONS\Polliing Location Agreement-7179.doc
The City of Boynton Beach
oy 4) ,6P PRECINCT NUMBER 4034,4052,&4053
h TOMO
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: CROSSPOINTE ELEMENTARY SCHOOL FROM: CITY OF BOYNTON BEACH
3015 S.CONGRESS AVENUE CITY CLERK'S OFFICE
BOYNTON BEACH,FL 33426 3301 QUANTUM BLVD.# 101
BOYNTON BEACH FL 33426
btG
This agreement,dated this l tday of 6H z
, 20IR, by and between the City of Boynton
Beach,FL,and the owner of the Polling Place cated at:
Abo Ire-
NAME OF POLLING LOCATION(Include name and/or room number)
(POLLING LOCATION STREET ADDRESS,CITY AND ZIP CODE)
THE OWNER AGREES TO
• Provide the Poling Place for holding the following elections:
GENERAL ELECTION---------- ------TUESDAY,MARCH 12,2019
RUN-OFF ELECTION(if necessary)---- -------TUESDAY,MARCH 26,2019
• To provide the following Items from 6:00 a.m. until all closing procedures required by the Florida
Statutes to be performed by the Election Board are completed:
Yes No
CHAIRS FOR ELECTION WORKERS g ❑
TABLES FOR ELECTION WORKERS
L( ❑
RESTROOM FACILITIES AVAILABLE Di/ o
• To provide access to the Polling Place on election day by one of the following means:
Owner will open Polling Place NO LATER THAN 6 a m•.on.Election Day
0. . Owner will'proNdethe Precinct Gerk with a key to the,premises prior to Election Day,
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK,AGREES:
• To pay the owner$ for the use of the above described location for each Election,if
Itis used.
I AGREE TO THE ABOVE CONDITIONS AND WILL MAKE MY FACILITY AVAILABLE TO THE CITY OF BOYNTON
BEACH ON THE DATES 2D ABOVE.
SIGNATURE!:'.__ — • PRIM NAME' T-. '1 T RE r' -.TELEPHONE NO.
Wanda Paul,Chief Operating Officer /, ib'201q
Phone:561-357-7573
M 3300 Forest Hit Blvd.,WPB,Fl.33406 E) _ - -, _ _' -DATE SIGNED
ADDITTONAi..... ftrIte
• To:provide aecess,[o[tie premises for delBeery and5iickup of voting equipment Before and`aftereach
Election,_please piovkethe days/hours,fadtltyJs open,forequipment delivery/pickup:
• Name of contact person and telephone number at Polling Place: 4FiK ei)t-1(;e511 j,f,I'Lrw-'-3 .09
)
• Name of contact person and tele_phone number before and after regular business hours, In case_of
emergency. :. 1S'rruG7 Yro-64/6711 --'c�l- Suq-4t/&Z ;'
• Make checks payable to:
s:\CC\W PIELECnONIYear 2019\POLLt4G LOCATIONS\Pu':enu Locaalm Agreement-9034,4052,a 4053.tloc
(r-�t The City of Boynton Beach
�r�,
®E, f.,
PRECINCT NUMBER 4072
i'oNYB-
PO W NG LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: CONGRESS MIDDLE SCHOOL FROM: CITY OF BOYNTON BEACH
101 S.CONGRESS AVENUE CITY CLERK'S OFFICE
BOYNTON BEACH,FL 33426 3301 QUANTUM BLVD. 101
1, BOYNTON BEACH FL 33426
WI,,"GV uYIU -o Ir'l
This agreement, dated this I`=day of 2&F8;by and between the City of Boynton
Beach,FL,and the owner of the Polling Place-ocated at:
NAME OF POLLING LOCATION(include name and/or room number)
(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 12,2019
RUN-OFF ELECTION(if necessary)— TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 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 GYe ❑
TABLES FOR ELECTION WORKERS C3 ❑
RESTROOM FACILITIES AVAILABLE LJ ❑
• To provide access to the Polling Place on election day by one of the following means:
0 Ownecwili open Polling Place NO LATER THAN 6 an.-on Election Day
❑ - Owner will provMe the Precinct 0erk wy to the prem'ries..pdor to Election Day:
THE CITY OF BOYNTON BEACH,THROUGH THE CITY CLERK,AGREES:
• To pay the owner$ 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 THE OA D ABOVE.
A
SIGNATURE ; _._PRINrNAQ1E ._.- _ T -It-- -- • _,; _TELEPHONEN0.
Wanda Paul,Chief Operating Officer /// -201'6
Phone 561-357-7573 / (� /
3300 Forest Hill Blvd.,WPB,Fl.33406 ODE)_ ,__ � , __DATE SIGNED
/tDDTiiGNAI INFORMATION
_. -_ __ -_4__ .. __ _ __._ -- _ -_
• To.pmvide acoessdo the premises Por delNeryand pkkup ofvoting;equlpmenrbelore and ager each
Elation,please provide the dais/hours,facllity Is open for equipment delivery/pickup:
•
II
• Name of contact person and telephone number at Polling Place: @L?frY\tt ,• lLob TT�t
• Name of contact person and telephone number before and after regular business hours, In case of
emergency. + '-fiA Fainii
• Make checks payable to:
S:\CCW/P\fLECnON\tear 20 i9\POLLING LOCATIONSIPoIIIInq Lacallm Agreement-4022.doc
S
The City of Boynton Beach
PRECINCT NUMBER 3172&3176
'to N'se
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: BOYNTON BEACH HIGH SCHOOL FROM: CITY OF BOYNTON BEACH
4975 PARK RIDGE ROAD CITY CLERK'S OFFICE
BOYNTON BEACH,FL 33426 3301 QUANTUM BLVD.# 101
n BOYNTON BEACH FL 33426
016.1
This agreement, dated this fI4day of hI�!0 ,]6n , by and between the City of Boynton
a
Beach,FL,and the owner of the Polling Pla located at:
Ile/0 lie.-
NAME OF POLLING LOCATION(Include name and/or room number)
(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 12,2019
RUN-OFF ELECTION(If necessary)-------------------------TUESDAY,MARCH 26,2019
• To provide the following items from 6:00 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 di D
TABLES FOR ELECTION WORKERS th ❑
RESTROOM FACILITIES AVAILABLE 0 0
• To provide access to the Polling Place on election day by one of the following means:
O Owner will open PollingPlace NO LATER THAN 6 a m.on Election Day
❑. _ Owner will proNdethe Precind 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$ — 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
BEACH ONTHE DA DICATED ABOVE.
Wanda Paul,Chief Operating Officer ('(41` :._.. .0 "
�
Phone'.661-357-7573
XiDE)L_ + Jr__- ",DATE SIGNED
3300 Forest Hill Blvd.,WPB,Fl.33406 ...
AOITTlfOf1AL IIVFORMAI?ON '
•
To provide actess.titfie premises for'dclivcryantl pldcup ofwUng.equipment before and after each
Election,please provide the days/hours.fadlity,is openfor equipment delivery/pickup:
• Name of contact person and telephone number at Polling Place: Kq K'QDSQ.�- Oztfeh{""-* 752-/211
J
• Name of contact pperson and telephone q4u�mtxr befo_re__and after regyular business hours, In cose of
emergency. IiMF.Ani-iv\NCI IOrrivm:P-• - S( I57.S-2, .12'007. --_.
• Make checks payable to: '
SACC\lWP\ntc11ON1Yem 9019\POWNC LOCATONS\Pdging Location Agreement-3172 A 3176.doc
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