CITY OF HARTFORD

HARTFORD POLICE DEPARTMENT

50 Jennings Road
Hartford, Connecticut 06120
Telephone: (860) 757-4000
EDDIE A. PEREZ Fax: (860)722-8270 DARYLK. ROBERTS
Mayor www.hartford.gov Chief of Police

QUESTIONS REGARDING CONVICTIONS

(Question must be completed)

Please note the following definitions that relate to your response to this question.

"Conviction", for the purpose of this application, means a final judgment or verdict of guilty, a
plea of guilty, or a plea of nolo contendefe, in any state or federal court, regardless of whether an
appeal is pending or could be taken.

"Conviction", for the purpose of this application, does not include a final judgment or verdict
that has been expunged by pardon, reversed, set aside or otherwise rendered invalid. Further,
you are not required to disclose any arrestfs), criminal chargcs(s) or convictionfs) the
recordis) of which have been erased under law. Such records can include records of a finding
of delinquency or that a child was a member of a family with service needs, adjudication of
youthful offender status, criminal charges dismissed or nolled, or charges for which a person is
found not guilty or a conviction later resulting in an absolute pardon.

Further, any person whose criminal records have been erased is deemed under law never to have
been arrested with respect to such erased proceedings and may so swear under oath.

A history of criminal conviction(s) will not necessarily bar consideration of employment-

Factors such as the time, seriousness and nature of the offense, rehabilitation, as well as the
nature of the position for which you are applying, will be taken into account.

Should you have any questions about answering questions on this application, or your rights
concerning erased records, please contact the Personnel Department.

Have you ever been convicted of a crime? D No Yes

If yes, please explain.
f Dec, 12 ^ KLqp> Conuid-M
Of

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Date

Date

Position for which you are Applying

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Exam#

Background Investigation Unit

 I HARTFORD POLICE DEPARTMENT
Background Investigation Unit

DETECTIVE BUREAU
Det. Frances DuBose Watson

Candidate: Biffle, Henry

The following information reported to the Fire Department on or about

4/07/08:

• Candidate has Charges of Assault Third and Threatening- 2nd during 1996

Sentenced to probation 1 year suspended, 1-3- years probation

> Candidate has a charge of Violation of Protective Order during 1997

Sentenced to Probation 1 year suspended, 1-3 year's probation.

• He had no MA/ Violations as of 4/07/08

 CITY OF HARTFORD
HARTFORD POLICE DEPARTMENT
50 Jennings Road
Hartford, Connecticut 06120
Telephone: (860) 757-4000
EDDIE A. PEREZ Fax: (860)722-8270 DARYL K. ROBERTS
Mayor www.hartford.gov Chief of Police

Background Investigation Unit

CIVILIAN APPLICANT AFFIDAVIT

Mnuncc [Applicant's Name Printed]

, certify

that the personal history form (Background Investigation Questionnaire) contains no

MISREPRESENTATIONS, FALSIFICATIONS, OMISSIONS, or CONCEALMENTS
material fact and that the information given by me is completed to the best of my
knowledge and belief. I am aware that all statements made by me on the personal history
form are subject to later investigation.

I am further aware that should any investigation disclose ANY misrepresentations,

falsifications, omissions, or concealment of any material fact, either on the personal history
form or during any other stage of the background investigation, my application may be
rejected and my name may be removed from eligibility. I will also be disqualified from
applying in the future for any position in the service of the City of Hartford.

Applicant's Signature

tf
Subscribed and sworn before me, this ¥ day
My
of February 28, 20! 0

Notary's Signature:
*~^C^
Official Raised Stamp

Background Investigation Unit

 ORIGINAL (White) - Personnel
DUPLICATE (Blue) - Department
TRIPLICATE (Yellow) - Employer

CITY OF HARTFORD
PROBATIONARY EMPLOYEE PERFORMANCE EVALUATION
I. NAME 2. EMPLOYEE NO. 3. DEPARTMENT
Henry Biffle 942167 Fire

4. CLASS CODE AND TITLE 5. DATE OF APPOINTMENT TO CLASS

5101-Firefighter 5/5/08
6. EVALUATION DUE DATE 7. TYPE OF EVALUATION INITIAL INTERIM FINAL Must Complete
CHECK ONE (X)
11/5/08 X

Under requirements set by the City Charter, every person certified and appointed to a regular position must satisfactorily complete a
working test period during a probationary period. The procedures to be followed are set forth in the Personnel Rules and Regulations
and/or the collective bargaining agreements. Departments are responsible for the timely submission of all initial, interim and final
evaluation forms. Extensions of probationary periods for Local 1716 employees are to be done in accordance with that collective
bargaining agreement. Once completed and signed by the immediate supervisor, the form should be forwarded to any intermediate
supervisors, if any for their review and sign-off. Then, the form should be forwarded to the department head. Once signed by the
department head, the employee shall be asked to sign the form signifying that he or she has received a copy and the white copy sent to the
Personnel Department.

EVALUATION BY IMMEDIATE SUPERVISOR:

Based on daily contact and close observation I have considered carefully and without bias the following factors of the employee'
work performance.
DEPENDABILITY:
Attendance record, punctuality and work habits.

JOB KNOWLEDGE AND SKILLS:

Possession of knowledge's, skills and abilities required for satisfactory performance on the job and demonstration of
progress in learning work procedures sufficient to indicate successful completion of the working rest.

HULMAN RELATIONS:
Ability to work in harmony with co-workers at all levels. Courtesy and patience required of City Employees in dealing
with the public.

CHECK ONE, BASED ON THE ABOVE:

During the Period covered by this evaluation, the employee's performance has been CD
CO
satisfactory in all of the above factors. ^Q
JO"
rn
m TJ ,•*-?
C/i
During the period covered by this evaluation, the employee's performance indicates' r\> O
z
a need for improvement in the factors described below (If an extension of the fT| °° "X.
probationary period is recommended for Local 1716 members. Please so indicate^ m
(Use separate sheet, if required.) ^

Thpnrinre Rnrnwski F-H

IMMEDIATE SUPERVISOR'S NAME TITLE """SIGNATURE

REVIEW OF EVALUATION:
I HAVE REVIEWED AND AGREE WITH THE IMMEDIATE SUPERVISOR'S EVALUATION

Michael A. Parker Sr. Assistant Fire Chief

NAME
Anthony R. Milner

EMPLOYEES'S SIGNATURE SIGNIFYING RECEIPT OF COPY SIGNATURE OF DEPARTMENT HEAD DATE

Charles A. Teale Sr., Fire Chief
 ORIGINAL (White) - Personnel
DUPLICATE (Blue) - Department
TRIPLICATE (Yellow) - Employee

i CITY OF HARTFORD
PROBATIONARY EMPLOYEE PERFORMANCE EVALUATION
1. NAME ,: 2. EMPLOYEE NO. 3. DEPARTMENT ;
Henry Biffle f 942167 Fire

4. CLASS CODE AND TITLE 5. DATE OF APPOINTMENT TO CLASS

5101-Firefiphter 5/5/08 .
6. EVALUATION DUE DATE 7. TYPE OF EVALUATION INITIAL INTERIM FINAL Must Complete
CHECK ONE (X) * RevtrseSide *
05/05/09 X

Under requirements set by the City Charter, every person certified and appointed to a regular position must satisfactorily complete a
working test period during a probationary period. The procedures to be followed are set forth in the Personnel Rules and Regulations
and/or the collective bargaining agreements. Departments are responsible for the timely submission of all initial, interim and final
evaluation forms. Extensions of probationary periods for Local 1716 employees are to be done in accordance with that collective
bargaining agreement. Once completed and signed by the immediate supervisor, the form should be forwarded to any intermediate
supervisors, if any for their review and sign-off. Then, the form should be forwarded to the department head. Once signed by the
department head, the employee shall be asked to sign the form signifying that he or she has received a copy and the white copy sent to the
Personnel Department.

EVALUATION BY IMMEDIATE SUPERVISOR:

Based on daily contact and close observation I have considered carefully and without bias the following factors, of the,employee'
work performance.
DEPENDABILITY:
Attendance record, punctuality and work habits.

JOB KNOWLEDGE AND SKILLS:

Possession of knowledge's, skills and abilities required for satisfactory performance on the job and demonstration of
progress in learning work procedures sufficient to indicate successful completion of the working rest.

HUMAN RELATIONS:
Ability to work in harmony with co-workers at all levels. Courtesy and patience required of City Employees in dealing
with the public.
>
CHECK ONE, BASED ON THE ABOVE:
During the Period covered by this evaluation, the employee's performance has been
satisfactory in all of the above factors.

During the Period covered by this evaluation, the employee's performance indicates
a need for improvement in the factors described below (If an extension of the
probationary period is recommended for Local 1716 members. Please so indicate.)
(Use separate sheet, if required.)

endnre F.-15
IMMEDIATE SUPERVISOR'S NAME TITLE DATE

REVIEW OF EVALUATION:
I HAVE REVIEWED AND AGREE WITH THE IMMEDIATE SUPERVISOR'S EVALUATION

Michael A. Parker Sr. Assistant Fire Chief

NAME TITLE
Anthony R. Milner Assistant Fire Chief
NAME TITLE DATE

EMPLOYEES S SIGNATURBSIGN 'OF COPY DATE

Charles A, Teale Sr., Fire Chief
 irta i miu i IUNS: / o 0« completed with me Final Performance Evaluation.

From: Charles A, Lre Chief

NAME AND TITLE OF DEPARTMENT HEAD

To: DIRECTOR OF PERSONNEL

Subject: Final Performance Evaluation of Maggy BiMle

EMPLOYEE'S NAME AND CLASS TITLE

CHECK ONE: jt
nnXmis EMPLOYEE HAS SATISFACTORILY COMPLETED THE PROBATIONARY PERIOD AND is CONTINUED AS A PER-
LJa MANENT EMPLOYEE IN MY DEPARTMENT. v
I RECOMMEND THE DISMISSAL OF THIS EMPLOYEE FOR UNSATISFACTORY PERFORMANCE DURING THE PROBA-
D TIONARY PERIOD FOR THE REASONS DESCRIBED IN DETAIL BELOW. (USE SEPARATE SHEET, IF REQUIRED.)

SIGNATURE OF DEPARTMENT HEAD

From: DIRECTOR OF PERSONNEL

To:
NAME AND TITLE OF DEPARTMENT HEAD

YOUR RECOMMENDATION FOR DISMISSAL HAS BEEN REVIEWED AND IS APPROVED. PLEASE INSURE THAT THE EM-
PLOYEE IS GIVEN TWO WEEKS' NOTICE WHICH MAY, IF NECESSARY. CONTINUE BEYOND THE END OF THE PROBA-
TIONARY PERIOD

DATE DIRECTOR OF PERSONNEL