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Wendy Kallergis 11/30/17j-i � i. )a :� � _ '� � W � � � a <� P'� � jl� J� � �„-'��. � �� � � �:�z �I � f a . � i � � � s' i' � 3 �'i �� Y ��.1 a� �. �a ����D ��� �O��1Ti�E +G�iE��(LlS� DATE OF APPOINTMENT: "//�v/�� Appointed by: /ti�V"� -[� /�'��OU� APPOINT�E: "" ��l/"�'J /4�%I��j , �,�s �� ,�� BOARD/COMMIiTEE:�n/i✓l����'�� �-y t�r'��t� � FOR SCANNER FOR CLERK STAFF Scan c o Letter o� �;ppointment Scan o o Letier of Reappointment o Copy of Letter oi Appoinim2nt/Reappointment e-m�iled to Commii�ee Liaison ��an o o Board and Cammiitee Appiica�ion (Completed on Scan o o Resum�/Curriculum Vitee o Diversiy S�atistics RepoRing (Comple.ed on S�an o o O��h I�r1PORTANT [�iFORMATION FOR BOARD AND COMMITTEE MEPABERS BOOK ✓ Ci'ty Code Ordinance Section flDPIfCBble to tn� agency, board or committee �,,� �;_ ✓ Ciy Code Seciions 2-21, 2-22, 2-23; 2-24, 2-25, 2-20, 2-458 �nd 2—^.59 r� a:u-� ✓ County Code Seccion 2-11.1 - Conr"Iict of fnte.res� �nd Cod� of E:hics Ordin2nc2 �:.:. `�+�.� amended tnrough Qecember 201 Q) ''''` ✓ Am�; �dmenis to the Cod:, of Elhics Ordir��nc� (Sep��mb:.r 20Q9 'through Ju!y 2G12) � �� -4 ��� ✓ Highligh'ts o� the Pni�mi-02de County E�hics Code ��?�'-'' ✓ Sunshine La�v and Pubiic Records - Freaue,n�ly As�ed Ques�ions �tw;��. -- �`_,,__ ✓ P�i�morandum - Solicita�ion by Ciy Board and Comm�`se Members � �;:� .� C_% j.. t.a.+ �+_; `w o Ci��;II�C P�; rn;t Applica�ion (Parkinc Denarm�nt Form) �•�.., �L.-" B�� ' .— � .., ^ l �..,,, � i-.. �"i��CS �� ' c. `J 'U���E rU'^= i0 .C_,LfCI�(11f;: n,"'''? ;^�^,^i8�1� £ 1�0�9 Qi Eii; i0' �'iJi;,i�., V�i ci, FtilDcOj�=., Scan o o Seurce o� fncom� S�a�emen: s�ai� U C �C�rCf10',t,'�c��i7lcRi Oi riClci iCfcf Discfosure Rc�UI�cI7lcCli Rec�iv2d on ProcessGd or Sc�nned on � Dl�IERSI � Y S't AT(STICS r��r�Or2Tl�lG 'n'e�� COPY in fife and ORIGf�':AL �cr �nnuz( Repor. /} � " `f'� �,/j ` I� ���� ��; ��,� UC�rx�� � i1J ���% i i Sigr��d `oy f'i l��%L�w� ��-� tk'�r� ��e ,�;� rd�or Comc�ii'te2 �v1e; � �ber �o %7�/� DG�e ��/� � /� Daie By Fmpioye�: By Emeloyee: ni:ia!s nitials ��������� � ����������� �� � ���� Term Expired Le �er � D��:, Proces�e� Ini'tia!s Scan o - -- -- _ ..-- - � � � ---- -- - - - Resignation Leti�r DGte ^rrocess�d ��- Sccn o I Iniiia�� � Removal Lei�er d�.�2 io ab�e,nces ! Date, proc�ssed � Iniiials Scan o i=:!.CL�RIEOARi� A.ND CQMi^:?IT(�� DA 1 P.��S�iCH-:,KLIST'vi:';J I�R\ScC C�icChll9� 2n � 5 ih.docx ''.�:'tr �.c , ^,Tm�t-_.. ,. �...-..... __ _ - .. e��1i�;��'�� �EACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 331 39 www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov October 13, 2017 Ms. Wendy Kallergis 1531 Miller Road Coral Gables, Florida 33146 SUBJECT: Mavor's Blue Ribbon Panel on Memorial Dav Weekend Dear Ms. Wendy Kallergis Congratulations! You have been reappointed by Mayor Philip Levineto the above referenced, board or committee named above, for a term ending: 11/30/2017. Pursuant to City of Miami Beach Code Section 2-22 (5) a, "Notwithstanding any other provision of the City Code or of any resolution, commencing with terms beginning on or after January 1, 2007, the term of every board member who is directly appointed by a member of the City Commission shall automatically expire upon the latter of: December 31 of the year the appointing City Commissioner leaves office or upon the appointmenbelection of the successor City Commission member." If you are unable to accept this appointment, or have any questions, please call the Office of the City Clerk at 305.673.7411. Please read the enclosed materials carefully. Congratulations and good luck. Regards, Rafa I Granado ity Clerk � cc: Saul Frances, Parking Director Amy Mehu, City Liaison ATTACHMENTS: Letter of Appointment Oath City Code/Ordinance section applicable to agency, board or committee City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 Ordinance No. 2006-3543 - Amendment to City Code Section 2-22 Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance City Wide Permit Application -(Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. i�ll���t� �EA�H City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 l, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Wendy Kallergis RE: Mayor's Blue Ribbon Panel on Memorial Day Weekend I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United States, the State of Florida, and the City of Miami Beach, and to perForm all the duties of a member of the above-mentioned board or committee of the City of Miami Beach to which I have been appointed for a term ending: 11/30/2017. To my colleagues and to all of those I represent and serve, I pledge fairness, integrity and civility, in all actions taken and all communications made by me as a public servant. I have been issued a copy of section 2-11.1 of the Miami-Dade County Code (Conflict of Interest and Code of Ethics Ordinance), as well as Florida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public Officers and understand that as a member of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure* requirements of Miami-Dade County or the State of Florida (depending on the board or committee on which I serve) on July 1st, following the closing of the calendar year on which I have served. c���, ��f����.� Ms. Wer{dy Kallergis Swom to and subscribed before me this � u� day of �c��;�`2017 '',i�i,� , `� Deputy Clerk �Ci.�'�L� 1/<(9 ���^-' *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. '�� �f ! � ,��1 �l �4 ��: ��� D1'V'�RSITY STAT15T1C5 REPORTING Narne: ��� ;(�/� � � ��-- 1011" � U� Baard / Cornmitiee: �° \ � S I�I 11"� ���f� I ���%���-/ ��� � ���e,�-d Appointmenf Date. ��' i� ;� �✓ ��� f�vl� Pursuant to City of Miami 3each Ordinance 2009-3632, the Ciiy is rea,uired to annualiy prepare and present a repor't to the City Commission ideniiiying the City's diversity statistics. This form allows �oard and committee �pplicants and members to voluntarily self-identify their race, ethnicity, disabled status and gender. Please check the appropriate box for each c�tegary: Gender: Male � Female �:�Y RGczlEthn;c C�.:egaries L'Vhat is ycur race? r— ��,� ricGn-Amer�caniBf�c��: � Caucus�an,"��vhite � As;�-� or Pacific isiar���r � �ailV2-F;Ei�@it�aii��R1c"IC�.�I .�.Gia�? � �ttl?i' — F"I(�f ��Ca: Do yau consicpr yours�lf to be Spanish, Hispaniv or Latin�la? I�i�rk tt�e "No" box i; not Spanish, H1s;�?nic, LGtrncta. � ,�/`! i `� 1YV � Yes ��� Do you consider yourseli Physically Disab(ed? � � Yes r�. � a-r ^�= �,�' n .'1<: I i �- � �„� . . ,. ,�....��� � _, t t.� �.. ' i, .. d. ' i�� >�iWG(i�uflC �U�400�<���r��=,.�� ;l'�;�'�_i� fi"�li��`�f�t!i .'�s.,;�i�...P•l�i"i�rc. �S Utal.c., ,1.c . in`ormatian forrn �5-20-f3 r�N,^-,L.dt�c U�� �_:e,�: r,icn;��.y, Junu� y 25. �0 �'; MIAMI•DADE SOURCE OF INCOME STATEMENT ��� Section 2-11.1(i) of the County Ethics Code requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July 1st of every year. Disclosure for Tax Year Ending Las N e 2016 �� L 1�..� f�i e� Mailing Address- Street Number, Street Name, or P.O�..B'ox City, State, Zip First Name Middle Nam�/Jnitial 111.� C/'"? C° `� - �J �-- ` If your home address is your mailing address, and your home address is exempt from public records pursuant to Fla. Stat. §119.07, read instructions on the following page and check here. ❑ Fili�g as an Err�playee �cnecx oa�e� � County �] Puhiic Health Trust � Municipal: Department Position or Title Work address (Municipality) � 1 Employee ID Number 1 I Work telephone Employment hegan on/ended on 1 I , Filing as a Board Member (check one) - - - - � County [�'Municipal: � �� y 7ti1 �� �— _ (Municipality) Board where serving ;-� �� ) I�"�i.a l.` C' ��`j �j � U`� J L l�- ��'�-!�'-� (� ��i1M0 r'lQ,( �'vl '^` Q��� Alternate a�d'dress (if home address is exempt) Work tefephone Term began on/ended on l , lt����� l I List below every source of income you received, along with the address and the principal activity of each source. Include your public salary. Piace the sources of income in descending order, with the largest source first. Examples of sources of income include: compensation for services, income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. Also, include any source of income received by another person for your benerit. However, the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here.❑ Name of Source of Income Address Description of the Principal Business Activity � — - -- — -- _ ��� � � l t�� `-1 �-�i v���-►�►� l��., -}-��1 � �r�� ��� �-�'l �j ��{� � 1-� i`E 1 ��.,.� �.k. `�1. 3�135 ����t�c,l �'1�tP.� I� �� , - , I hereby swear (or affirm) that the information above is a true and correct statement. 1,�•�'I��l�/�'�� �e �����'� �-��,- �-- Signature of Person Disclosing '' ���� I� /I � Dai� signed � RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy !�F¢IrF I ICF OiJl V/{mart?d: Y% N Deficiznr_.y: Processed Date/Initials ____. _ Scanned Date/Initials: 138 SP-54 COE 2016 ; � y� { ` �y ; � f�y f � ,1'� � �� s � � , -� �J� i j! e, i i; i i 8. ��' ��,� � � City of Miami Beach 1700 Convention Center Drive, Miami Beach, F(orida 33139, wv,n,v. m iam i beachfl.aov CITY CLERK'S OFFICE Telephone:305.b73.7411 Fax:305.673.7254 CityClerk@miamioeachfl.gov Acknowledgement of fines/suspension fior BoardlCommittee Members for failure to comply with Miami- Dade County Financiai Disclosure Code Provision Code Section 2-�1.1(i) (2) Board Member's Narne: " " �����`�% ����� / � �� � � - I understand that no later than July 1, of each vear all members of Boards and Committees oT the City o� Miami Beach, including those of a pure(y advisory nature, are required to comply with Miami-Dade County Financial Disclosure Requirements. This means thai the members of City Advisory Boards, whose sole or primary responsibility is to recommend legislation or give advice to the City Commission, must file, even though they may have been recentiy appointed. One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida, no later than 12:Q0 noon of Jufy 1, ofi each year. 1. A��S�urce OT II1C0^'?� StaT�m�n�" 2. A"Statement of Financial fnteresis (Form 1)" 3. A Copy of your latest Federal Income Tax Return Failure to fi(e one of these forms, pursuant to the Miami-Dade Couniy Code, may subject ihe person to a fine of no more 'tnan S50Q, 60 days in jaii or botn. l /V � Signature � Updated: Monday, Aprif 20, 2015 Page 4 of � F:\CLcR1SALU2FURNl5\60ARD ANU COiNi111Ti CCS'�SC APPLICA � 10�1 REVIscU 06�22014.cocx /a//��/�7 Date °O Note: If app{ying for the Youth Cen#er positlons of the Parks and Recreations Facili#ies Board, please indicate your affiliation with the Scott Rakow Youfh Center andlor the North Shore Parks Youth Center: • Please describe your past service with the City's Youth Centers (include dates o# service): • Present paRicipafion in Youth Center activities by your chi[dren: Yes � No � If yes, please list below the names of your children, their ages and the programs in which they participate: Chilci's name: Child's name� Age: Program: Age: Program: • Fiave you ever been convicted of a felony? Yes � or No �If yes, please expiain in detaii: • Do you currently have a violaiion(s} of City of Miami Beach Code? Yes �-9 or No�l If yes, please explain in detail: • Do you currentiy owe the City of Nliami Beach any money7 Yes � or No 4L� lf yes, explain in detail: • Are you currently serving on any City Baard or Cammittee? Yes �u or No �U ]f yes, which boardlcommittee? • In what organization(s} in the City of Miami Beach do you currently hold membership? �1 I`�l�a( ���L� �.G�.,�, i��o�_ i°01-wt�.2.s,r.o �-��wt �P�✓ Name Position Name Position • List all properties owned or in which you have �n int� st w[thin the City of Miami Beach: �/ • Are you now employed by the City of Miami Beach? Yes �l or No � Which department and title? • Pursuant to City Code Section 2-25 (b �: -D-�,o� you have a parent �i, spouse 1 IF, child �J brother' " or sister 4�u who is employed by the City of Miami Beach? Yes 4�ar o�c' �, J If "Yes," identify person(s) and department(s): ��_ Jc�}�i� I V t � � � �L�i �(J , �� 5� �St . ��� �'G1/N�- ��. �'� ��- 7�T I iLv A � � The following information is voluntary and is neither part of your application nor has any bearing on your conslderatlon for appointment. It is being asked to comply with City diversity reporting requirements. Gender: Ma1e � Female � RacelEthnic Categories What is your race? ��d! can-AmericanlBlack 4,� CaucasiaNUUhite � Asian or Pacific Islander �1 Native-AmericanlAmerican Indian Page 2 of 4 C:1UsersICLERQueR\DssktoplBC APPLICATION.docx �1 Other— Print Race: Do you co�sider yourself to be Spanish, Hispanic or Lafinola? Mark the "No" box if not Spanish, Nispanic, Lafino/a. �No � Yes Do you consider yourself Physicafly Disabled? 0 Yes NOTE: IF APPOINTED, YOU WlLL BE FtEQUIRED TO FOLLOW CERTAIN LAWS THAT APRLY TO CITY BOARDlCOMMITTEE MEMBERS. THESE LAWS INCLUDE, BUT ARE NOT LfMITED TO: o Prohibition from directly or indirectly lobbying City personnef (Miami Beach City Code section 2-459). o Prohibition from contracting with the City (Miami-Dade County Code sectian 2-91.1 j. o Prohibition from lobbying before the board/committee you have served on for period of one year after leaving office (Miami Beach City Code section 2-26). o Requirement ta disclase Certain financiaf interests and gifts (Miami-Dade County Code section 2-11.1). o CIV16 Community Development Advisory Comrnittee: prohibitian, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties {CFR 570.691). o Sunshine Law - Florida's Government-in-the-5unshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in Chaoter 286 of the Florida Statutes. These statutes establish a basic right of access to most meetings of boards, commissions and other governing bodies of state and focal governmental agencies or authorities. o Voting conflict — Form 8B is for use by any person serving at the county, city or other local level of government on an appointed or elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Upon request, copies of these laws may be obtained from the Cify Clerk. I HEREBY ATTEST TO THE ACGURACY AND TRUTHFULNESS OF TWE APPLICATION; AND I HAVE RECElVED, READ AND WILL ABIDE BY CHAP7ER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBEI2S AND ALL OTHER APPLICABLE COUNTY AND(OR STATE LAWS AND S7A7U7ES ACCORRINGLY." .Q�.U1 ��%-�1�- _ �� �. �� ��i`5 Ap Eicant's SignatuFe Date /} e A licant {PLEASE PRf NT) ( / `� Received in the Office of the City Clerk hy: /�� /` -� �r / N�'e of ep ty r '� Control o. �` `/�ate , c �� � V / � `%.�-� ��.� I f� �� l� ,. ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLfCABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, 1F NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3 of 4 C:4UserslClERQueR\DeskioplBC APPLICATION.docx MIAMIBEACH City of Miami Beach 170p Convention Center Drive, Miami Beach, Fiorida 33139, www. miamibeachfl.qov OFFICE OF THE C1TY CLERK CityClerk@m iam i beachfl.gov Telephone:305.673.7411 Fax:305.b73.7254 Acknowiedgement of fineslsuspension for Board/Commi�tee Members for failure to comply with Miami- Dade County Financial Disclosure Code Provision Code Sectlon 2»19.1(i) (2) Board Member's Name: �� �� � ` ��'t-� � � � I understand that no later than Julv 1, of each vear all members of Boards and Committees ofi the City o# Miami Beach, inc(uding those of a purely advisory nature, are requ9red to comply with Miami-Dade County Financial Disclosure Requirements. This means that the members of City Advisory Boards, whose sole or primary responsibility is to recommend legislation or give advice to the City Commission, mus# file, even though they may have been recently appainted. One of the following farms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Seach, Fforida, no later than 12:00 noon of July 1, of each year. 1. A"Source of Income Statement" 2. A"Statement of Financial Interests (Form 1)" 3. A Copy of your latest Federal Income Tax Return Failure to file one of these forms, pursuant to the Miami-Dade County Code, rnay subject the persan to a fine of no more than $500, 60 days in jai! or both. , � � ��: �� Si n ture��/�� g a Updated: Thursday, December 22, 2096 Page 4 of 4 C:1Users1CLERQueRlDesktaplBC APPLICATION.docx � �D�-�- l �'�� r � Date 1 Wendy E. Kallergis 1531 Miller Road Coral Gables, Florida 33146 305.282.2812 wkallergis@aol.com Education Modern Gourmet Cooking School Diplome Professional Chef Annecy, France Diplome Professional Teacher Madeleine Kamman January 1981 - June 1981 Cordon Bleu L'Ecole de Cuisine Paris, France University of Paris, La Sorbonne Paris, France George Washington University Washington, D.C. Experience January 2010 — Present September 2005 — November 2009 May 2002 — August 2005 April 1999 — May 2002 February 1997 - April 1999 May 1996 - February 1997 May 1993 - May 1996 July 1992 - May 1993 September 1991 - June 1992 November 1987 - August 1991 Diplome French Cuisine Winter 1979 French History, Language and Art, 1979 B. A. French Language and Literature, 1979 President & CEO Greater Miami & The Beaches Hotel Association President & CEO Miami Beach Chamber of Commerce General Manager The Miami City Club, Miami, Florida Director of Membership The Miami City Club, Miami, Florida Director of Catering and Conference Services The Grand Bay Hotel, Coconut Grove, Florida Food and Beverage Director The Blue Door, Delano, an Ian Shrager Hotel South Beach, Florida Director of Catering and Convention Services The Biltmore Hotel, Coral Gables, Florida Director of Catering Mayfair House, The Coastal Hotel Group Coconut Grove, Florida Catering Manager, Off Premises Catering Gene's Catering, Inc, included Super Bowl XXV, Corporate Events and Lipton Championships Tennis Tournaments Assistant Directar of Catering The Biltmore Hotel, Coral Gables, Florida February 1986 - October 1987 February 1984 - February 1986 December 1979 - December 1980 May 1979 - October 1979 Catering and Convention Services Manager Hotel Inter-Continental Miami, Florida Sous Chef Apprentice to Guy Gateau Pavillon Grill, Pavillon Hotel, Miami, Florida Executive Chef Finesse Fine Foods, Washington, D.C. Off Premise Catering and Prepared Foods Boutique Chef Garde Manger Restaurant Nora, Washington, D.C. Conversational ability in French and Spanish Community Activities White House Champion of Change for promoting citizenship in the workplace — October 2014 Board Member — Greater Miami Convention & Visitors Bureau Board Member - MDCPS Academy of Hospitality & Tourism, Present Board Member — Greater Miami Chamber of Commerce Board Member — Miami Dade College Culinary Institute Business Advisory Council Board Member — FIU Chaplin School of Hospitality Management Industry Advisory Board Member — Black Hospitality Initiative of Greater Miami Committee Member — City of Miami Beach Sister Cities Committee Member Member — Les Dames d' Escoffier Member — International Women's Forum, Miami Chapter Vice Chair — The Coalition of Miami-Dade Chambers of Commerce 2008 - 2009 Member — Miami Beach Mayor's Blue Ribbon Task Force, 2008 —2009 Member — Project NewBorn, 1990 — Present, Recipient of Corporate Award Board Member — Board of Directors Big Brothers Big Sisters of Greater Miami, 2001 - 2006 Board Member — Board of Directors The Foundation For Villa Vizcaya, 1997 - 2001 President - The Mercy Hospital Foundation Angels of Mercy, 1999 - 2001 References furnished upon request � !�'�'�' � . DRIVER LIGENSE CLASS E �'f s��62-885-57-750-0 , � � WENDY ELLEN ECONOMY � ; KALLERGIS 1531 MILLER RO � CORAL GABLES, FL 33146-0000 Doe 07-10•1967 SEx F i55UED 06•1Z-2012 HG�:6� ExPIRE.s 07-10-��0 . � � REsr A � ,R , 4/, ,. ,t Y'`�� ENOORSE� ' W A SAFEDRIVER . � �,�M,.���y„M��,��„adGrw�. . . . .. . , �.�,�.,� . .. . .., � -- -- --'----'� ' RESTPICTIONS: A-•Cartec�ive Lanses �, HNDORSEMENTS: CLASS: E• P�y �on•commercial vehicle with a OVWR leas the� Z8,007 Ibs. or any RV REPIACEMENT LICENSE REQUIRED WITFBN 10 DAYS OF ADORES9 OR NAME GHANGE. � The State of Florida ratains all propeAy rights hereln. (�.,,�,,� yiI�(�I /`�{I`t(1,�(, eRecuuveov.ua.��g+� 'T IIIII�1�Iv���Q1�����'�vy���y�,�����llll p,r�ctoLolLlAelan'3�ervIClt I, Qll f1�1 P1i. Tp41Z06t700N 4 �y� ��� �jf� RrvD�te0i-01-11 � ,., ���� �� w �� I � � www.flhsmv.gav I _ _ _ �