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#0824-RE1005-AC
Supplemental Questionnaire

Last Name
First Name
1.

Do you possess a valid license as a Civil Engineer or Traffic Engineer as issued by the California Board for Professional Engineers, Land Surveyors and Geologists?

Yes No
1a.

If you answered "Yes" above, please provide your Professional Engineer license number and expiration date as issued by the California Board for Professional Engineers, Land Surveyors and Geologists.

2.

Do you possess a valid California driver's license?

Yes No
2a.

If you answered "Yes" above, please provide your California driver's license number and expiration date.

3.

Did you graduate with a Bachelor's Degree in Engineering or a closely related field from an ABET accredited college/university?   

Yes No
3a.

If you answered "Yes" above, please list the major and corresponding degree. List the college or university that issued the degree. 

4.

Please describe your professional experience in a supervisory, management and/or administrative capacity. Please include in your description the organization, its size and your role and responsibilities.

5.

Please describe your experience with local, state and federal agencies and their programs for water resources related programs/projects.

6.

Describe your experience working to build consensus and resolve conflicts on policies, projects/programs involving multiple stakeholders.