21/12/2009 14:00 © ae60000000 DEPT FINANCIAL SVCS PAGE e2/e2 6°" BOARD OF COUNTY COMMISSIONERS f 3) FLAGLER COUNTY, FLORIDA “ec? . AGENDA REQUEST FORM Board Policy: Any person, group or organization wishing to personally address the Flagler County Board of County Commissioners in session shall fl out a written request form and file with the Gounty Administrator's office 20 days in advance of the scheduled meeting. PLEASE PRINT Agphioand’s Nerwec¥4 eandel Brown ¢etGe (pene dee ceeyaceEeueaaey Phone: 386-322-0914 E mail: RANDELL.BROWN@MYFLORIDACFO.COM Address: 135 Executive Circle, Suite 103, Daytona Beach, FL 32114 Group or Organization Name: State of Florida - Department of Financial Services ‘Subject matter to be discussed: "Safeguarcing Our Seniors’ the new program initiated by the Chief Financial Officer for the State of Florida, Alex Sink Has the subject been discussed and/or reviewed by County Departments or Officials? [Z1wo []ves: Names of County Departments or Officials: Specific questions end/or action desired from the Board of County Commissioners: VELLA “Tobe scheduled for the sent commission meeting dated ‘The person(s), group or organization making the request to be on the agenda will be contacted by tha County Administrator Office, informing him her of the scheduled meeting date and time. edule the request at the earliest possible meeting date. January 12, 2009 Date ignature of Applicant Presentations limited to 15 minutes per adopted Commis: n Meeting Procedures All copies submitted become public record and must remain on file with the County Clerk. For more information contact County Administration at (386) 313-4001 For Office Use Only ‘Canty Rairinitzator Dae Agenda Date: