Precincts 1509 1514 Christ FellowshipThe City of Boynton Beach
S:\CC\WP\ELECTION\Year 2023\Polling Location Agreements\District IV\Precinct 1509 and 1514 Christ Fellowship Church BB.doc
PRECINCT NUMBER(S): 1509
and 1514
POLLING LOCATION AGREEMENT FORMCITY OF BOYNTON BEACH CITY CLERK’S OFFICE
TO:CHRIST FELLOWSHIP CHURCH BOYNTON BEACH FROM:CITY OF BOYNTON BEACH
801 N. CONGRESS AVENUE, # 401 CITY CLERK’S OFFICE
BOYNTON BEACH, FL 33426 100 E. OCEAN AVENUEBOYNTON 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:
Christ Fellowship Church Boynton Beach
NAME OF POLLING LOCATION (Include name and/or room number)
801 N. Congress Avenue, # 401, 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, 2023RUN-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:
□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.
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: __________________________________
Name of contact person and telephone number before and after regular business hours, in case of
emergency. ___________________________________________________________________________
Make checks payable to:___________________________________________________________________
0
Jessee Houchins Campus Coordinator 561-329-7063
801 N Congress ave, suite 401, Boynton Beach Fl 33426 1/12/23
Jessee Houchins561-329-7063
Jim Bradie 561-398-7272
n/a
12th January