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2020 ROV Polling Place - March 3 Consolidated Primary ElectionREBECCA SPENCER Registrar of Voters REGISTRAR OF VOTERS COUNTY OF RIVERSIDE ART TINOCO Assistant Registrar of Voters La Quinta City Hall Monika Radeva August 28, 2019 78495 Calle Tampico La Quinta, CA 92253 PCT# 0046012 The County of Riverside Registrar of Voters thanks you for the use of your facility as a Polling Place in past elections. To prepare for the upcoming March 3, 2020 Consolidated Primary Election, we are again inquiring about the availability of your facility. Please confirm that your facility is available by completing, signing, and dating the attached "Polling Place Availability Request Agreement" form. You may return the completed agreement by mail in the enclosed postage paid envelope, by fax to (951) 486-7320, or by email to RoviDolls(@rivco.org. When completing the form please indicate the specific room space that will be available for Election Day. It is very important that our office provides the correct location to our voters. Please note that pursuant to elections code, private and gated facilities must allow nonresident voters access to the facility on Election Day to cast their ballot. We carefully review all facilities to determine which will be used as Polling Places. When a facility is SELECTED, a confirmation letter will be mailed 29 days before the scheduled election. When a facility is NOT SELECTED, a letter will be sent 1`5 days before the scheduled election providing the reason the facility was not selected. Please call us at (951) 486-7341 or (877) 663=9906 (toll free) if you have not received a letter 15 days prior to the election. Note: If your facility is SELECTED to serve as a Polling Place, the Inspector (Lead Election Officer) for your site will contact you to make arrangements to access the facility the day before the election for setup (about '/z hour) and to guarantee access to the facility from 6:00 a.m. to 9:30 p.m. on Election Day. Voting equipment will be delivered approximately 7 .days• prior to the election to the SELECTED Polling Places. Tables and chairs can be delivered upon request. The Office of the Registrar of Voters or our contracted carrier will .call to schedule a time and date for delivery of equipment. Please identify a secure area for voting equipment storage. Our office, or that of our carrier, will call to schedule pick up of the equipment within one week after the election. Should you at any time have questions or concerns regarding the use of your site as a Polling Place, please contact our office at (951) 486-7341 or (877) 663-9906 (toll free). Sincerely, Election Officers and Polls Division County of Riverside Registrar of Voters Please complete, sign and return the agreement on the next page by fax, email or mail POLLING PLACE AVAILABILITY REQUEST AGREEMENT RETAIN FOR YOUR RECORDS If you do not receive a call from the Inspector 3-4 days prior to Election Day, have questions or concerns, call our office at (951) 486-7341 or (877) 663-9906 (toll free). Please forward a copy of this contract to the contact person responsible for coordinating Elec io Eve and/or Election Day facility use. Provide the contact person's phone number (V) Polling Place location for the: March 3, 2020 Consolidated Primary Election 0 1 give my permission for the use of: La Quinta City Hall Study Session Room 78495 Calle Tampico La Quinta, CA 92253 ❑ Facility use not authorized for this Election Initial Here; Please provide the name of the room or rooms you are authorizing use of: Please check (X) the appropriate boxes that apply: JS Check here if you can provide two 6'- 8' tables and 6 chairs ❑ Check here if you require for the Registrar to deliver tables and chairs to your facility ID# 1675 ;3 Facility use "Free" PCT# 0046012 ❑ Request $25.00 Compensation (Must provide W-9 enclosed) ❑ Can accommodate up to. Precincts (Between 1-10) Contact Name (print):.�W&-(X QW6L Title: C( A Phone #: N J Alternate Contact Name (print): Q1AO�L CCVV)Q-6-C_ Phone #: � 92- *Emergency contact: U v 7»C04701 Phone #: L ��� � - 76? Z— *This is the person and phone num er the Registrar of Voters will use in an emergency (Election Day access, etc.) Mailing Address: 75� I��T�.n►n� G�,u:�,- . GAS s 3 After Business Hours Phone: C��o g35"' 776o Fax #: E-mail Address: c(X_tac�Ia I06,CA. 0-,1 For future requests how would. you prefer to be contacted? Fax ❑ E-Mail Regular Mail *I HAVE READ AND UNDERSTAND ALL THE TERMS OF THIS AGREEMENT, AND BY SIGNING THIS AGREEMENT VOLUNTARILY I AM AGREEING TO ABIDE BY THESE TERMS. Signature: Date: Please contact us at (951) 486-7341 within 15 days prior to the election if you have not received a letter informing you of a decision for your facility to serve as a polling place. REBECCA SPENCER Registrar of Voters REGISTRAR OF VOTERS COUNTY OF RIVERSIDE La Quinta Museum ART TINOCO Assistant Registrar of Voters Christina Calderon August 28, 2019 77885 Avenida Montezuma LA Quinta, CA 92247 PCT# 0046018 The County of Riverside Registrar of Voters thanks you for the use of your facility as a Polling Place in past elections. To prepare for the upcoming March 3, 2020 Consolidated Primary Election, we are again inquiring about the availability of your facility. Please confirm that your facility is available by completing, signing, and dating the attached "Polling Place Availability Request. Agreement" form. You may return the completed agreement by mail in the enclosed postage paid envelope, by fax to (951) 486-7320, or by email to Rov olls rivco.or . When completing the form please indicate the specific room space that will be available for Election Day. It is very important that our office provides the correct location to our voters. Please note that pursuant to elections code, private and gated facilities must allow nonresident voters access to the facility on Election Day to cast their ballot. We carefully review all facilities to determine which will be used as Polling Places. When a facility is SELECTED, a confirmation letter will be mailed 29 days before the scheduled election. When a facility is NOT SELECTED, a letter will be sent 15 days before the scheduled election providing the reason the facility was not selected. Please call us at (951) 486-7341 or (8T7) 663-9906 (toll free) if you have not received a letter 15 days prior to the election. Note: If your facility is SELECTED to serve as a Polling Place, the Inspector (Lead Election Officer) for your site will contact you to make arrangements to access the facility the day before the election for setup (about '/z hour) and to guarantee access to the facility from 6:00 a.m. to 9:30 p.m. on Election Day. Voting equipment will be delivered approximately 7. days prior to the election to the SELECTED Polling Places. Tables and chairs can be delivered upon request. The Office of the Registrar of Voters or our contracted carrier will call to schedule a time and date for delivery of equipment. Please identify a secure area for voting equipment storage. Our office, or that of our carrier, will call to schedule pick up of the equipment within one week after the election. Should you at any time have questions or concerns regarding the use of your site as a Polling Place, please contact our office at (951) 486-7341 or (877) 663-9906 (toll free). Sincerely, Election Officers and Polls Division County of Riverside Registrar of Voters Please complete, sign and return the agreement on the next page by fax, email or mail POLLING PLACE AVAILABILITY REQUEST AGREEMENT RETAIN FOR YOUR RECORDS If you do not receive a call from the Inspector 3-4 days prior to Election Day, have questions or concerns, call our office at (951) 486-7341 or (877) 663-9906 (toll free). Please forward a copy of this contract to the contact person responsible for coordinating Election Eve and/or Election Day facility use. Provide the contact person's phone number (V) yjoz- - - Polling Place location for the: March 3, 2020 Consolidated Primary Election Q I give my permission for the use of: — La Quinta Museum ❑ Facility use not authorized for this Election Meeting Room 77885 Avenida Montezuma Initial Here: La Quinta, CA 92253 Please provide the name of the room or rooms you are authorizing use of: I�L•[�'Gl r� I Please check (X) the appropriate boxes that apply: 8J Check here if you can provide two 6'- 8' tables and 6 chairs ID# 5233 ❑ Check here if you require for the Registrar to deliver tables and chairs to your facility 0 Facility use "Free" PCT# 0046018 0 Request $25.00 Compensation (Must provide W-9 enclosed) ❑ Can accommodate up to -Precincts (Between 1-10) Ce'a'w►y ` rPhone #: L Hai p� Contact Name (print): � v%,,L Title: C. / Alternate Contact Name (print) �ICtSG► 0-LC��Phone #: � 6D) 77 7Z_ � 3 *Emergency contact: 11" Phone #: *This is the person and phone number the egistrar of Voters will use in an emergency (Election Day access, etc.) Mailing Address: After Business Hours Phone: E-mail Address: t� C.0.- R a'� For future requests how would you prefer to be contacted? Fax ❑ E-Mail Regular Mail *I HAVE READ AND UNDERSTAND ALL THE TERMS OF THIS AGREEMENT, AND BY SIGNING THIS AGREEMENT VOLUNTARILY I AM AGREEING TO ABIDE BY THESE TERMS. Signature: Date: Please contact us at (951) 486-7341 within 15 days prior to the election if you have not received a letter informing you of a decision for your facility to serve as a polling place. POLLING PLACE AVAILABILITY REQUEST AGREEMENT COMPLETE, SIGN, AND RETURN THIS FORM VIA FAX, EMAIL, OR REGULAR MAIL TO THE REGISTRAR OF VOTERS OFFICE Fax # (951) 486-7320 E-Mail: Ro_ypolls(@rivco.orgMail: Use the self-addressed stamped envelope provided. Please forward a copy of this contract to the contact person responsible for coordinating Electio ,Eve and/or Election Day facility use. Provide the contact person's phone number (7,60) jO Z _ - l Polling Place location for the: March 3, 2020 Consolidated Primary Election, C 9 I give my permission for the use of: La Quinta Museum Meeting Room 77885 Avenida Montezuma La Quinta, CA 92253 ❑ Facility use not authorized for this Election Initial Here: Please provide the name of the room or rooms you are authorizing use of: Please check (X) the appropriate boxes that apply: Check here if you can provide two 6'- 8' tables and 6 chairs ❑ Check here if you require for the Registrar to deliver tables and chairs to your facility ID# 5233 ,W Facility use "Free" PCT# 0046026 ❑ Request $25.00 Compensation (Must provide W-9 enclosed) ❑ Can accommodate up to Precincts (Between 1-10) aa�� R,c��� cis Contact Name (print):�rulS lYl. , L��QAL7 Title '�� 6 -� Phone #: 0 Alternate Contact Name (print):Ckj ►S-6m 16\ Phone #: L�LQ 71 K3 *Emergency contact: t—U�--, Mq�qA�--z�_ Phone #:, � ( � J 77137 *This is the person and phone number the Registrar of Voters will use in an emergency (Election Day access, etc.) Mailing Address: After Business Flours Phone: 902. - vy5 Erb E-mail Address: v For future requests how would you prefer to be contacted? Fax ❑ E-Mail,d Regular Mai 92253 *I HAVE READ AND UNDERSTAND ALL THE TERMS OF THIS AGREEMENT, AND BY SIGNING THIS AGREEMENT VOLUNTARILY I AM AGREEING TO ABIDE BY THESE TERMS. Signature: Date:lD 17 Please contact us at (951) 486-7341 within 15 days prior to the election if you have not received a letter informing you of a decision for your facility to serve as a polling place. _ Request for Taxpayer Give Form to the Form (Rev. October2018) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ► Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your Income tax retum). Name Is required on this line; do not leave this line blank- 2 Business name/disregarded entity name, if different from above cQ mP 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the Y 4 Exemptions codes apply only to P� ( PP Y Y tM m following seven boxes. certain entities, not individuals; see a instructions on page 3): o ❑ C Cor oration ❑ Individual/sole proprietor or p S Corporation ❑Partnership ❑ Trust/estate Iv single -member LLC Exempt payee code (if any) no ,>+'� ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► o « Note: Check the appropriate box in thedine above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting w LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is code (if any) a another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that w is disregarded from the owner should check the appropriate box for the tax classification of its owner. d ❑ Other(see instructions) ► (Applies to accounts maintained outside the US.) to 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) tU Iv U) 6 City, state, and ZIP code 7 List account number(s) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid social security number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other — U]. — entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. or Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. I i I J T—T—❑ [ice Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later. Sign Signature of Here U.S. person ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov1FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file, an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. - Form 1099-INT (interest earned or paid) Date ► - Form 1099-DIV (dividends, including those from stocks or mutual funds) - Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) - Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) - Form 1099-S (proceeds from real estate transactions) - Form 1099-K (merchant card and third party network transactions) - Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) - Form 1099-C (canceled debt) - Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form V11-13 (Rev. 10-2018) REBECCA SPENCER Registrar of Voters REGISTRAR OF VOTERS COUNTY OF RIVERSIDE ART TINOCO Assistant Registrar of Voters SELECTED TG SERVE AS A POLLING PLACE La Quinta City Hall January 11, 2020 Study Session Room VOTER INFORMATION 78495 Celle Tampico GUIDE DESCRIPTION Voting Precinct: 0046012 La Quinta, CA 92253 PPID#: 1675 Dear Monika Radeva, This is to confirm that your facility, identified above, has been selected as a Polling Place for the Consolidated Presidential Primary Election, to be conducted on March 3, 2020. By agreeing to let us use your facility as a Polling Place you ascribe to the Oath of Allegiance on the back of this form. Please take a_ moment to confirm that we have the correct address for this facility. The address as it appears above will be published in the Riverside County Voter Information Guide mailed to all Polling Place voters and made available to voters over the phone and on our website. Please advise us immediately of any inaccuracies. Attached you will find a copy of the "Hold Harmless Agreement", please complete and return a copy signed by an authorized agent via fax (951) 486-7320, regular mail, or scanned copy attached in an e-mail to RovpollsCcDrivco.org. If you requested a "Certificate of Insurance" the County's Risk Management department will forward a copy to you prior to Election Day for your records. Within approximately 7 days prior to Election Day, voting equipment will be delivered to your location (upon request, a table and chairs can be delivered). For security purposes, the Accessible Voting Unit should be stored in a secure area out of plain view prior to and after Election Day and not accessible to the public. The Inspector (lead Pollworker) assigned to your facility will be contacting you to coordinate Election Eve (March 2, 2020) set up. Please arrange for the facility to be open on Election Day from 6:15 a.m. until completion of Election Board duties at approximately 10:00 p.m. If the Inspector does not contact you, or if you have any questions, please call the Election Officers and Polls Division of the Registrar of Voters at (951) 486-7341 or (877) 663-9906 (toll free). In the meantime, thank you for providing a Polling Place for your friends and community. Your assistance ensures the citizens in your area the opportunity to exercise their fundamental right to vote. Election Officers and Polls Division County of Riverside Registrar of Voters PS — Please forward a copy of this to the contact person responsible for coordinating Election Eve and/or Election Day facility use. NOTE: If anyone requests access to the voting equipment prior to Election Eve or after Election Day, ask for their credentials and contact the Registrar of Voters office at (877) 663-9906 (toll free) to get approval prior to permitting access to the equipment. Monika Radeva La Quinta City Hall 78495 Calle Tampico La Quinta, CA 92253 REBECCA SPENCER Registrar of Voters ART TINOCO Assistant Registrar of Voters REGISTRAR OF VOTERS COUNTY OF RIVERSIDE REGISTRAR OF VOTERS ID# 1675 HOLD HARMLESS AGREEMENT Sponsoring Agent CountV of Riverside La Quinta City Hall Registrar of Voters 78495 Calle Tampico 2724 Gateway Dr La Quinta, CA 92253 Riverside, CA 92507 This agreement applies to the Riverside County Registrar of Voters and the La Quinta City Hall for the use of all designated facilities for the March 3, 2020 Consolidated Presidential Primary Election. The County of Riverside shall indemnify and hold harmless from any liability whatsoever, based or asserted, upon any act or omission of the County, its officers, agents and employees, for damage of any kind or nature, relating to or in any way connected with or arising from its use of the premises, and the County shall defend, at its expense, including attorneys' fees, its officers, agents and employees in any legal action based upon such alleged acts or omissions. The Authority for the Registrar of Voters to execute this use permit is contained iiq Resolu ion No. 86-183 heretofore approoved bqy the County's Board of Supervisors on May 6,, 1986. Dated. I ow By: �UA tA Dated: January 11, 2020 Title: �;\%� %� *Ag ncy Representative COUNTY OF RIVERSIDE M Larry D. Smith Elections Coordinator *Please complete and return a copy signed by an authorized agent via fax (951) 486-7320, regular mail, or scanned copy attached to an e-mail to Rovpolls(&rivco.org prior to Election Day. REBECCA SPENCER Registrar of Voters REGISTRAR OF VOTERS COUNTY OF RIVERSIDE ART TINOCO Assistant Registrar of Voters SELECTED TO SERVE AS A Pt LING PLACE La Quinta Museum January 11, 2020 Meeting Room � VOTER INFORMATION 77885 Avenida Montezuma �_ GUIDE DESCRIPTION Voting Precinct: 0046013 La Quinta, CA 92253 ` PPID#: 5233 Dear Luis Magallanez, This is to confirm that your facility, identified above, has been selected as a Polling Place for the Consolidated Presidential Primary Election, to be conducted on March 3, 2020. By agreeing to let us use your facility as a Polling Place you ascribe to the Oath of Allegiance on the back of this form. Please take a moment to confirm that we have the correct address for this facilitv. The address as it appears above will be published in the Riverside County Voter Information Guide mailed to all Polling Place voters and made available to voters over the phone and on our website. Please advise us immediately of any inaccuracies. Attached you will find a copy of the "Hold Harmless Agreement", please complete and return a copy signed by an authorized agent via fax (951) 486-7320, regular mail, or scanned copy attached in an e-mail to Rovpolls(a).rivco.org. If you requested a "Certificate of Insurance" the County's Risk Management department will forward a copy to you prior to Election Day for your records. Within approximately 7 days prior to Election Day, voting equipment will be delivered to your location (upon request, a table and chairs can be delivered). For security purposes, the Accessible Voting Unit should be stored in a secure area out of plain view prior to and after Election Day and not accessible to the public. The Inspector (lead Pollworker) assigned to your facility will be contacting you to coordinate Election Eve (March 2, 2020) set up. Please arrange for the facility to be open on Election Day from 6:15 a.m. until completion of Election Board duties at approximately 10:00 p.m. If the Inspector does not contact you, or if you have any questions, please call the Election Officers and Polls Division of the Registrar of Voters at (951) 486-7341 or (877) 663-9906 (toll free). In the meantime, thank you for providing a Polling Place for your friends and community. Your assistance ensures the citizens in your area the opportunity to exercise their fundamental right to vote. Election Officers and Polls Division County of Riverside Registrar of Voters PS — Please forward a copy of this to the contact person responsible for coordinating Election Eve and/or Election Day facility use. NOTE: If anyone requests access to the voting equipment prior to Election Eve or after Election Day, ask for their credentials and contact the Registrar of Voters office at (877) 663-9906 (toll free) to get approval prior to permitting access to the equipment. Luis Magallanez 78495 Calle Tampico La Quinta, CA 92253 REBECCA SPENCER Registrar of Voters REGISTRAR OF VOTERS COUNTY OF RIVERSIDE ART TWOCO Assistant Registrar of Voters REGISTRAR OF VOTERS ID# 5233 HOLD HARMLESS AGREEMENT Sponsoring Agent County of Riverside La Quinta Museum Registrar of Voters 77885 Avenida Montezuma 2724 Gateway Dr La Quinta, CA 92253 Riverside, CA 92507 This agreement applies to the Riverside County Registrar of Voters and the for the use of all designated facilities for the March 3, 2020 Consolidated Presidential Primary Election. The County of Riverside shall indemnify and hold harmless from any liability whatsoever, based or asserted, upon any act or omission of the County, its officers, agents and employees, for damage of any kind or nature, relating to or in any way connected with or arising from its use of the premises, and the County shall defend, at its expense, including attorneys' fees, its officers, agents and employees in any legal action based upon such alleged acts or omissions. The Authority for the Registrar of Voters to execute this use permit is contained in esolutio No. 86-183 heretofore approved by the County's Board of Supervisors on May,6�, .11986. Dated: , o�L o o`LO By: I Dated: January 11, 2020 Title: U%F)u *A61ency Representative COUNTY OF RIVERSIDE 0 Larry D. Smith Elections Coordinator *Please complete and return a copy signed by an authorized agent via fax (951) 486-7320, regular mail, or scanned copy attached to an e-mail to Rovpolls@rivco.org prior to Election Day.