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* 1. Date

Date

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* 2. Nominee Name

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* 3. Nominee Job Title

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* 4. Division

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* 5. Nominator Name & Contact Info

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* 6. Accomplishment / Reason for Nomination
  • What specifically did this employee do?
  • Where did this occur?
  • When did this occur?
  • Why is the action/service outside of and/or in addition to the normal requirements and expectations of regular duties?
  • The tangible or intangible benefit the City obtains from the service, including but not limited to cost savings, favorable public relations, safety improvements, environmental improvements, or morale boosting.
  • Please also check the recommended category of award identified below is it applies

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* 7. Recommended Category (check all that apply)

T