1997-34
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MEMORANDUM OF AGREEMENT FOR POYllfG PLACES
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PR'ËCINCT 15
The Owner (Occupant) agrees to provide a polling place for the following Elections to be held
on
Sept. 1. 1998 ,Oct. 1. 1998
,Novo 3. 1998
at the following location:
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~ 1/ W/{) Vl-f rO5e .s+r r¿>ef
C !eV'1/t} OVJ+ FL. 3'11 JI
To the extent sovereign immunity has been waived,
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"hold harmless the owner for any claims for bodilý
POLLING PLACE
'TELEPHONE NUMBER
~9C¡- ~/t¡1
!Èe County of La-ke-'ag,L~gs, -t,Q indemnify and
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injury or property damage occuring on the
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occupied premis~s' arising from-'neg-iigeri't. acts \øf,--the ~oun.ty -or 'tanT o,f.~-it'S, agents ,<or-.emp'ioyees.
Lake County agrees to pay the amount of $
for each election held at the above location,
CHECK SHOULD BE MADE PAYABLE TO:
MAILING ADDRESS:
DO YOU HAVE TABLES AND CHAIRS AVAILABLE FOR THE ELECTION BOARD MEMBERS TO USE ON ELECTION DAY?
YES vi NO
YOUR SPECIAL INSTRUCTIONS re use of building, delivery of equipment, election day, pickup of
equipment and any other instructions you may have.
-0
Person(s) to contact for access tg building preceding election for delivery of voting equipment,
, ...~;~OO -A-.M. .. eleèti~n day for pollw05keÚ; and after the ele¿Ùòn' for pièkùp ot'-voting -equipment.
.. .' IF POSSIBLE
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NAME /1 () cu a ;.J 5focj(,.f-o 41 f
ADDRESS .. P>~ D ~:8 ox I ;to..41 Z
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PROVIDE TWO CONTACT PEOPLE
NAME (J)ð 1ne. ::5a. Utile/e.;",:;;.
c./PI/'Vlllnu-fADDRESS p.O, Bê)){ f20.:?/9 C(erW1CM+
PHONE NUMBER
PHONE NUMBER
.~9L/- ;to~ I
***** OR *****
A key can be obtained from
NAME
ADDRESS
PHONE NUMBER
PLEASE FILL IN ALL
INFORMATION NEEDED
1.
Return white copy in
enclosed self-addressed
envelope
Keep yellow 'copy
Wa ne Sla!unders
Signature of ow~t~~~~~~elt)
- P.O. Box '120219. ClermÖnt. FL- 34712-0219
2.
ELECTION OFFICE TELEPHONE NUMBER
Address
(352) 394-4081
TAVARES
343-9734
Phone Number
THANK YOU FOR YOUR COOPERATION
Emogene W. Stegall
Supervisor of Elections
Lake County Florida
P.O. Drawer 457
Tavares, FL 32778
PRECINCT
15
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