Precinct 1525 Intreacoastal Park ClubhouseThe City of Boynton Beach
PRECINCT NUMBER(S): 1525
POLLING LOCATION AGREEMENT FORM
CITY OF BOYNTON BEACH CITY CLERK'S OFFICE
TO: INTRACOASTAL PARK CLUBHOUSE FROM: CITY OF BOYNTON BEACH
2240 N. FEDERAL HWY CITY CLERK'S OFFICE
BOYNTON BEACH, FL 33435 100 E. OCEAN AVENUE
BOYNTON BEACH, FL 33435
This agreement, dated this _ day of 2023, by and between the City of Boynton
Beach, FL, and the owner of the Polling Place located at:
Intracoastal Park Clubhouse
NAME OF POLLING LOCATION (Include name and/or room number)
2240 N. Federal Highway, Boynton Beach 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 14, 2023
RUN-OFF ELECTION (if necessary) -------------------------------------TUESDAY, MARCH 28, 2023
• 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 ❑
❑
• To provide access to the Polling Place on election day by one of the following means:
k 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 $ 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.
Recreation and Parks, Director 561-742-6236
StGNATU`E G PRINT NAME TITLE TELEPHONE NO.
n2
100 E Ocean Avenue, Boynton Beach FL 33435 I 1 v 7
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:
Monday -Friday 9am -5 pni
• Name of contact person and telephone number at Polling Place: Mary Declraffenreidt 561-742-6642
• Name of contact person and telephone number before and after regular business hours, in case of
emergency. Mary Degraffenreidt 561-742-6642: Mike Pinkney 561-836-0831: Franky Lazo 561-564-6821:
Kacv Young 561-702-8014 _
• Make checks payable to:
S:\CC\WP\ELECTION\Year 2023\Polling Location Agreements\District II\Precinct 1525 Intracoastal Park Clubhouse.doc