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�LEAGUE <br />. 01 C:AIHUKNIA <br />CITIES <br />CITY: <br />2021 ANNUAL CONFERENCE <br />VOTING DELEGATE/ALTERNATE FORM <br />Please complete this form and return it to Cal Cities office by Wednesday, September 15, 2021. <br />Forms not sent by this deadline may be submitted to the Voting Delegate Desk located in the <br />Annual Conference Registration Area. Your city council may designate one voting delegate and up <br />to two alternates. <br />To vote at the Annual Business Meeting (General Assembly), voting delegates and alternates must be <br />designated by your city council. Please attach the council resolution as proof of designation. As an alternative, <br />the Mayor or City Clerk may sign this form, affirming that the designation reflects the action taken by the <br />council. <br />Please note: Voting delegates and alternates will be seated in a separate area at the Annual Business Meeting. <br />Admission to this designated area will be limited to individuals (voting delegates and alternates) who are <br />identified with a special sticker on their conference badge. This sticker can be obtained only at the Voting <br />Delegate Desk. <br />i �tl�l1l: [et U��xeln\ li <br />Name: <br />Title: <br />2. VOTING DELEGATE - ALTERNATE <br />Name: <br />3. VOTING DELEGATE - ALTERNATE <br />Name: <br />Title: Title: <br />04_1.90IF-A i[*70533*11CIOTAdio[dtloSili![dC 44;1CFAi4F9J1 *L•1Si�:[JF�i7Y�l:i <br />ATTEST: I affirm that the information provided reflects action by the city council to designate the <br />voting delegate and alternate(s). <br />Name: <br />Mayor or City Clerk <br />(rirrIH nnp) jciNnatnrNj <br />Email <br />Date <br />Please complete and return by Wednesday. September 15, 2021 to: <br />Darla Yacub, Assistant to the Administrative Services Director <br />E-mail: dyacub@cacities.org <br />Phone: (916) 658-8254 <br />Phone <br />Council 26 — 4 7/6/2021 <br />