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09-006 Municipal Naming Renaming and Sponsorship PolicyPage 1 of 23 RECREATION, CULTURE AND PARKS Policy 9-006: Municipal Naming/Renaming and Sponsorship Policy Approval Date: January 27, 2025 Approval Authority: Council, By-Law 2025-010 Effective Date: January 27, 2025 Next Scheduled Review Year: 2030 Department: Recreation, Culture and Parks Last reviewed: January, 2025 Revision Date/s: April 25, 2016 (By-Law 4012, repealed) Schedules: Schedules A, B and C POLICY STATEMENT The Town of Tillsonburg is committed to providing a fair, consistent and efficient process with respect to the naming of municipal assets, after a person, persons or family name, organization or service club. The application of this policy includes four main types of naming situations: • the opening of a new municipal facility, park, property or feature. • the re-opening of a municipal facility, park, property or feature following renovation or refurbishment. • the renaming of an existing facility, park, property or feature to recognize significant contributions that organizations or individuals have made to the public and well-being of the Town of Tillsonburg. • providing recognition of gifts generously given or donated to the Town of Tillsonburg 9-006 Page 2 of 23 PURPOSE The purpose of this policy is to provide clear guidelines, a consistent evaluation framework and approval process in regards to the Naming, Renaming or sponsoring of Town assets and to allow for comprehensive and open public consultation in accordance with the Town’s Public Engagement Policy. This process will ensure the application of key criteria in order to determine the appropriateness of a name and shall recognize the important role played by the legislative bodies involved (i.e. Committees and Council). SCOPE This Policy applies to the Naming, Renaming or sponsoring of parkland, open spaces, trails, structures and public spaces after a particular individual(s),family name, business or organization. The Municipal Naming, Renaming or Sponsorship Policy is intended to recognize the geographical, natural, cultural, historic features and/or civic significance of properties owned by the Town, as well as to honour the outstanding achievements, distinctive services, or significant community contributions made by an individual or group. Any member of the public or Town Council may submit a nomination application for the Municipal Naming, Renaming or Sponsorship of parkland, open space, trail, structure or public building/room. This Policy is not intended to address: Individual naming dedications such as for park benches or tree program memorials; Naming of Town-owned facilities leased to commercial tenants; Naming of Town Buildings that provide core services (i.e. Town Hall, Fire Services, Police Services, EMS). This restriction does not apply to the courtyards, squares, gardens, lawns, etc. or indoor components of these buildings (wings, halls, auditoriums, galleries, lounges, lobbies, boardrooms, etc.). GENERAL This Policy shall be administered by the Director of Recreation, Culture and Parks; This Policy shall be referred to as the “Municipal Naming Policy”; This Policy shall come into force and effect on the date adopted. 9-006 Page 3 of 23 AUTHORITY The authority for the Municipal Naming Policy shall be by the approval of the Council of the Town of Tillsonburg. DEFINITIONS Commemorative Names Reserve List: Names submitted that qualify, but may not be chosen by the Committee for a particular asset, will be added to a list and may be considered for future assets (Names will be kept on the Commemorative Names Reserve List for 5 years). Commemorative Naming Committee (CNC): Shall be comprised of one member of the Museum, Culture, Heritage and Special Awards Committee, Parks Beautification and Cemeteries Committee as well as the Sport and Recreation Committee, one member of Council, Town Clerk, Development Commissioner and the Director of Recreation, Culture & Parks (or Designate). Meetings will be held in- camera, in accordance with Section 239 (2)(b) of the Municipal Act, “personal matters about an identifiable individual, including municipal or local board employees”. Corporate Naming Rights: means a mutually beneficial business arrangement wherein an organization provides goods, services or financial support to the Town in return for access to the commercial and/or marketing potential associated with the public display of the organization’s name on a Town property for a finite period. Individual Naming Rights: means the naming of Town property in return for a financial or in-kind contribution from an individual or their estate. Typically, such support is given to enhance the community and to help sustain the property in question for a negotiated period of time. Matrix Rating System: Shall be comprised of weighted questions to assist Committee Members in the analyzation and determination of qualified/appropriate names for Town assets (attached as Appendix 'A' of this Policy). 9-006 Page 4 of 23 Other Open Spaces: Valleys, forests/woodlots, watercourses (lakes, rivers), utility features such as storm- water management areas, downtown squares, and plazas. Parkland: Refers to land dedicated by the Town for use as a public park or for recreational purposes. All parkland designations are defined within the Town of Tillsonburg’s Parks, Recreation, and Cultural Strategic Master Plan and Zoning Bylaw. For commemoration purposes, the term municipal park shall include other components, such as sporting fields contained within a larger park. Public Buildings: Town owned public buildings and their outdoor service areas (pools, arenas, parking garages, recreation centre, facility yards, plazas, courtyards, squares, gardens, lawns, etc.), as well as their indoor components (wings, halls, auditoriums, galleries, lounges, lobbies, boardrooms, etc.). Public Consultation Process: The two-way exchange of information between The Town and the public before decisions are made. It is an open and accountable process allowing individuals and groups to participate in the decision-making process of naming Town owned assets. Statistical information on comments received under consultation will be provided to individuals other than staff, upon request. However, specifics and written comments received will be available only to the Committee and Town Council. Trails: An off-road Recreational path system or Pedestrian walkway which may be made of Limestone, Asphalt, packed earth, woodchips, granular surface or other material, for use by walkers, cyclists, snowshoers, cross-country skiers, etc. Significant Financial Gifts: A minimum monetary donation of real or capital cost or appraised value, whichever is greater, of the amenity being considered for naming/renaming. 9-006 Page 5 of 23 Financial Gift levels: Gold – 100 % of capital costs Silver – 50% of capital costs Bronze – 25% of capital costs IMPLEMENTATION PROCEDURE A. Process for Commemorative Naming/Renaming Submitting an Application Applicants are required to submit a completed Commemorative Naming Application Form (attached as Appendix 'B' of this Policy), the sworn Affidavit Forms (attached as Appendix 'C' of this Policy) along with the required supporting documentation when requesting the Commemorative Naming, Renaming or Sponsoring of a municipal property. Background information and/or biographical information (if named after an organization or an individual) shall demonstrate the significance of the proposed name to the community. It is recommended that the applicant include letters of support for the request, including documentation by the individual being honoured or their legal representative. A petition may also be included in the event that a request is being made for the renaming of a municipal property. The commemorative naming process for parkland, open spaces, trails, structures and public buildings, may differ from application to application depending on the circumstances surrounding the request/requirement for naming. Application Criteria When an Application Form is submitted, at least one of the following criteria shall apply: • The nominated individual has demonstrated excellence, courage or exceptional service to the citizens of the Town of Tillsonburg, the Province of Ontario and/or Canada; • The nominated individual has provided extensive community service and has an extraordinary community service record; • The nominated individual has worked to foster equality and reduce discrimination; • The nominated individual is a current Town of Tillsonburg employee, and has made 9-006 Page 6 of 23 an outstanding contribution to the Town of Tillsonburg unrelated to and outside of his/her job responsibilities, capacity and duties as a Town employee; • The nominated individual is a former employee of the Town of Tillsonburg and is to be recognized for his/her exceptional service unrelated to and outside of his/her job responsibilities, capacity and duties as a former Town employee; • The nominated individual has made a significant financial contribution to parkland, an open space, trail, structure or public building, and the contribution significantly benefits the community that the municipal property serves (i.e. the project may not have been otherwise possible without the financial assistance); • The nominated name has a geographical, natural, cultural, historical or civic significance to the community, Town of Tillsonburg, Province of Ontario or Canada. *Out of respect to the deceased, no proposal for the Naming or Renaming of municipal property shall be considered by the Naming Committee within ninety (90) days of the death of the person for whom the naming request is being made. Renaming The Commemorative Naming Committee will consider renaming an existing Municipal Asset after receiving a submission from a private individual or organization, or direction from Council to undertake the Commemorative Naming process as outlined herein. Recognizing that established names contribute significantly to community identity and pride, proposals to rename existing municipal property, must be predicated by exceptional circumstances. Existing names will not be changed without consideration of: The historical significance of the existing name; The impact on the individual or organization associated with the existing name; The cost and impact of changing existing signage, rebuilding community recognition and updating records (data bases, letterhead, promotional materials, etc.). Processing of Application The following section sets out the procedures for the selection and approval of a Commemorative name. Applications received requesting the Commemorative Naming of municipal assets, shall be forwarded to the Commemorative Naming Committee for consideration. The Naming 9-006 Page 7 of 23 Committee will utilize an established Matrix Rating System (refer to Appendix ‘A’ of this Policy) when evaluating applications. As part of the approval process, a preliminary investigation of the commemorative name will be conducted to ensure that the name has not been used in the past and that the nomination is meritorious in nature. Processing the application involves confirmation of criteria, reference checks (if applicable), discussion with the applicant and the applicable Town departments, initial meeting of the Commemorative Naming Committee (CNC), public consultation, compiling consultation results and a reconvening meeting of the CNC for final decision. Public notice in regards to the application(s) received, shall be provided in accordance with the Town of Tillsonburg’s Notice Policy. Notice shall be made in the local newspaper and on the Town of Tillsonburg website as part of the Public Consultation Process for a (30)thirty-day period. A copy of the notice shall also be provided to applicable Town departments. The notice shall include: An invitation for public comments in regards to the proposed name(s) of the Town asset(s), as provided for by the Commemorative Naming Committee; Directions on how comments can be submitted to the Town for consideration; Directions on where further information can be found regarding the Commemorative Naming Program (i.e. Commemorative Naming Policy and accompanying forms, etc.); The date on which a report will be scheduled for consideration by Town Council. Public Consultation Public consultation is required as the issue of commemorative naming of municipal property directly affects citizens and provides identity to the communities in which they live. Through public consultation at the community and Town-wide level, residents will be able to ensure they maintain a strong connection to their communities and will be able to gain a better understanding of the individual(s)/family/organization who has been nominated for commemoration. Public consultation shall be undertaken in accordance with the size and scope of the specific municipal property being named. Consultation may consist of formal written notification of the proposed name to affected community associations, applicable interest 9-006 Page 8 of 23 groups and Town of Tillsonburg Advisory Committees (where appropriate). Advertisements may be placed in the local newspapers, where appropriate, and on the Town’s website. Statistical information on comments received under consultation will be provided to individuals other than the Commemorative Naming Committee, upon request. However, specifics and written comments received will only be available to the Committee and Town Council. Town staff will provide the final decision on a proposal to individuals who submit a comment under the public consultation component, and provide a copy of the Commemorative Naming policy and information sheet, when necessary. Evaluation Process The CNC shall reconvene to review the public consultation results and departmental comments. When a name is recommended for approval, an In-camera report to the appropriate Standing Committee and Council will be prepared containing the CNC’s recommendation. First consideration by the Naming Committee will be given to those Names that are representative of the geographical, natural, cultural, or historical features and/or the civic significance of the municipal property to which the name will be applied. Second consideration by the Naming Committee will be given to those Names that fall under at least one of the following criteria: The nominated individual has demonstrated excellence, courage or exceptional service to the citizens of the Town of Tillsonburg, the Province of Ontario and/or Canada; The nominated individual has provided extensive community service and has an extraordinary community service record; The nominated individual has worked to foster equality and reduce discrimination; The nominated individual is a current Town of Tillsonburg employee, and has made an outstanding contribution to the Town of Tillsonburg unrelated to and outside of his/her job responsibilities, capacity and duties as a Town employee; The nominated individual is a former employee of the Town of Tillsonburg and is to be 9-006 Page 9 of 23 recognized for his/her exceptional service unrelated to and outside of his/her job responsibilities, capacity and duties as a former Town employee; The nominated individual has made a significant financial contribution to parkland, an open space, trail, structure or public building, and the contribution significantly benefits the community that the municipal property serves (i.e. the project may not have been otherwise possible without the financial assistance); The nominated name has a geographical, natural, cultural, historical or civic significance to the community, Town of Tillsonburg, Province of Ontario or Canada. Council Approval The Commemorative Naming Committee will prepare and send a report to Council outlining the proposed name for each Town asset and the reasons why the name was chosen (i.e. analysis against the criteria). Upon Committee and Council approval, implementation of the approved commemorative name will be undertaken. This involves final notification to the nominee, preparation of an official letter signed by the Mayor, and an official unveiling ceremony for the nominee and family with the presentation of a plaque to be erected at the site, indicating the name as well as its significance for commemoration. New Development of Municipal Property Building and Planning Services, will notify the Town Clerk when the new development of municipal parkland, an open space, trail, structure or public building occurs and provide information regarding the specific project and the applicable time frame for construction, Town ownership, and, if applicable, information with respect to proposed names for the development. The Town Clerk or designate may convene a meeting of the Commemorative Naming Committee as required to discuss and name all new municipal properties which have been identified as requiring a name, or to discuss a recommended commemorative name. The Committee shall review the approved list of names eligible for consideration to determine if there is an appropriate name for the identified project or undertake necessary steps to solicit proposed names. If a commemorative name is selected for the project from the Commemorative Names Reserve List, or a name is recommended through another means, the public consultation process will commence for (30) thirty days. 9-006 Page 10 of 23 The Commemorative Naming Committee will request comment from the Museum, Heritage, Culture and Special Awards Advisory Committee, Parks, Beautification and Cemeteries Advisory Committee, Sports and Recreation Advisory Committee and the Economic Development Advisory Committee regarding the proposed name. The Commemorative Naming Committee will reconvene to review public comment and develop a final recommendation. Council Approval The Commemorative Naming Committee will prepare and send a report to Council outlining the proposed name for each Town asset and the reasons why the name was chosen (i.e. analysis against the criteria). After Council approval, staff will initiate the implementation of the approved Names on official documents, construction and permanent signage and plan/implement the appropriate protocols (e.g. dedication ceremony). Commemorative Names Reserve List Maintenance and Use A name may be submitted that is not site or venue specific. In this regard, the application will undergo the same process with respect to the criteria evaluation and investigation process included within this policy. Staff will discuss possible options with the nominator and the suitability. If a site or/and geographic location is not determined through these discussions, the name is placed on the Commemorative Names Reserve List (for municipal properties) maintained by the Town Clerk, and the Street Names Reserve List maintained by Building Services. The Commemorative Naming Committee will meet to review the Name Reserve List, new submissions and complete the Matrix Rating for each completed submission. The committee will also appoint a member to verify the accuracy of the proposed names for each asset, using reference documents including atlases, other official municipal/civic publications and local historians/contacts. In accordance with Council direction, historical names will be given precedence. Otherwise, there shall be no prioritization system of commemorative names on the list. Nominators are free to designate the name for use in a parkland, open space, trail, structure or public building, at the time of nomination if they chose. The List shall be made available on request to any interested party, although the results of 9-006 Page 11 of 23 the investigations of the naming requests shall remain confidential. A commemorative name may be used for parkland, open space, trail, structure or public building only once. If the nominator wishes that a nominated commemorative name be associated with a particular municipal property, it shall be noted on the Commemorative Names Reserve List. B. Donor Recognition Naming Rights: The Town of Tillsonburg will consider naming a public amenity as a means of providing recognition for significant financial gifts, in accordance with this and other applicable town policies. The names of living individuals may be used in recognition of significant financial gifts. The Town of Tillsonburg reserves the right to immediately withdraw a name from an amenity should that name come into disrepute in the Town or in the general community. Individual Naming Rights All individual naming rights shall be for a fixed term that does not exceed the useful life of the asset. Every such agreement shall specify the duration of the naming opportunity. Individual naming rights may be subject to renewal on mutual agreement. Corporate Naming Rights Naming rights shall be held for a fixed term that shall not exceed the useful life of the property. Such agreements shall not be renewed without Municipal Council approval. Corporate naming rights agreements are subject to the following conditions: i. Parties that are disqualified from doing business with the Municipality are not eligible for naming right opportunities. ii. The benefits to the naming rights holder are limited to those expressly stated in the naming rights agreement. iii. No form of indemnification will be provided to any naming rights holder. iv. Naming rights may only be transferred or assigned by a naming rights holder with the consent of the Municipality. Where a naming rights holder changes its name, the naming rights may, with the consent of the Municipality and at the expense of the naming rights holder, be modified to reflect the new name for the remainder of the Term. v. Naming rights holders are prohibited from implying that their products, services or ideas are sanctioned by the Municipality nor will the Municipality 9-006 Page 12 of 23 be under any obligation to purchase the product or services of the naming rights holder. vi. The naming right must not result in, or be perceived to result in, any competitive advantage, benefit or preferential treatment for the naming rights holder, outside of the agreement. Length of Naming Rights: 1. If the parkland, open space, trail, structure or public building is named after a person(s) the name will remain for the lifespan of the facility. 2. If the parkland, open space, trail, structure or public building is named after a company or organization due to significant contribution to the community, the name will remain for the lifespan of the facility or until the company or organization is no longer in operation. 3. If the parkland, open space, trail, structure or public building is named after a company or organization, due to a financial contribution to the project, the naming rights will remain for a period of 20 years or until the company or organization is no longer in operation. After the 20-year period the company or organization may make a financial contribution to extend the naming rights. At this point if the company or organization no longer wishes to continue, the naming rights will be opened to other companies or organizations. Naming Rights Agreements: 1. All naming rights agreements shall be confirmed by written contract containing terms and conditions satisfactory to the Municipality. 2. All agreements are subject to Council approval. 3. Every naming right agreement shall conform to all applicable federal and provincial statutes, and to all Municipal bylaws, policies, contracts, and practices. 4. The naming right shall not unduly detract from the character, integrity, aesthetic quality or safety of the property or unreasonably interfere with its enjoyment or use. Agreements must include: 5. The term of the agreement and renewal options, if permitted, must be included 6. The payment schedule 7. Release, indemnification and early termination clauses as appropriate 9-006 Page 13 of 23 8. Insurance clauses 9. Confidentiality terms if applicable 10. 10% annual reinvestment for the lifespan of the asset in order to maintain the asset 9-006 Page 14 of 23 SCHEDULE A THE CORPORATION OF THE TOWN OF TILLSONBURG MUNICIPAL PROPERTY AND BUILDING COMMEMORATIVE NAMING SCHEDULE A: Matrix Rating System - For Use By The Commemorative Naming Committee ASSET: PROPOSED NAME: Check one (1) box for each criteria met. When complete, add and total at the bottom (5= excellent, 1 = poor). NO. Criteria RATE 5 4 3 2 1 1 Civic engagement 2 Cultural or Historic significance: Arts, Culture, heritage and natural significance 3 Demonstrated excellence, courage or exceptional service to Tillsonburg, the Province or Canada 4 Has worked to foster equality and reduce discrimination (READI – Racism, Equity, Adversity, Diversity and Inclusion) 5 Volunteer in community organizations 6 Has made a positive impact to the Town 7 Contributing towards environmental preservation, conservation or enhancement of the Town. TOTAL: 9-006 Page 15 of 23 SCHEDULE B COMMEMORATIVE NAMING APPLICATION FORM (TO BE REVISED BASED ON UPDATED POLICY) COMMEMORATIVE NAMING OF A MUNICIPAL PARKLAND, OPEN SPACE, TRAIL, STRUCTURE & PUBLIC BUILDING A. NOMINATOR’SINFORMATION *A COMMEMORATIVE NAME MAY BE USED ONLY ONCE IN THE TOWN OF TILLSONBURG SUBSEQUENT REQUESTS WILL BE DENIED Name (Individual or Organization): Mailing Address: Telephone: Home Work E-mail: Affiliation to Nominee: B. NOMINEE’S INFORMATION (NAME TO BE COMMEMORATED) Name: Mailing Address: Date of Birth: Telephone: Home Work E-mail: 9-006 Page 16 of 23 E. APPLICABLE CRITERIA (SELECT ONE)  The nominated individual has demonstrated a strong history of civic engagement  The nominated individual has demonstrated excellence, courage or exceptional service to the citizens of the Town of Tillsonburg, the Province of Ontario and/or Canada.  The nominated individual has worked to foster equality and reduce discrimination.  The nominated individual is a current Town of Tillsonburg employee, and has made an outstanding contribution to the Town of Tillsonburg unrelated to and outside of his/her job responsibilities, capacity and duties as a Town employee.  The nominated individual is a former employee of the Town of Tillsonburg and is to be recognized for his/her exceptional service unrelated to and outside of his/her job responsibilities, capacity and duties as a former Town employee.  The nominated individual has made a significant l contribution towards environmental preservation, conservation or enhancement of the Town.  The nominated individual has extensive volunteer experience in community organizations that have had a positive impact on the Town C. NOMINATOR’SINFORMATION *A COMMEMORATIVE NAME MAY BE USED ONLY ONCE IN THE TOWN OF TILLSONBURG SUBSEQUENT REQUESTS WILL BE DENIED Name (Individual or Organization): D. NOMINEE’S INFORMATION (NAME TO BE COMMEMORATED) Name: 9-006 Page 17 of 23  The nominated name has Cultural or Historic significance including Arts, Culture, Heritage and Natural significance to the community, Town of Tillsonburg, Province of Ontario or Canada. 9-006 Page 18 of 23 F. RATIONALE FOR NOMINATION AND ATTACHED BACKGROUND INFORMATION RELATED TO THE CRITERION CHOSEN, WHICH SUBSTANTIATES ALL CLAIMS MADE: INCLUDE COPIES OF NEWSPAPER ARTICLES, CERTIFICATES, AWARDS, LETTERS OF SUPPORT OR COMMENDATION, SERVICE RECORDS, PICTURES, ETC. Please note all information provided below and/or attached to this Application Form will form part of the Commemorative Naming Application Form and will therefore be released to the public in any public notices/advertisements produced, public Agenda and Minutes, Committee discussions/meetings and Reports which may go forward to Council. 9-006 Page 19 of 23 G. PLEASE INDICATE WHAT YOU WOULD LIKE THE NAME USED FOR (PLEASE CHECK ONE):  Street  Parkland  Open Space  Trail  Structure  Public Building H. IS THERE APARTICULAR STREET/PARKLAND/OPEN SPACE/TRAIL/STRUCTURE/OR PUBLIC BUILDING WHICH YOU WOULD LIKE THE NAME USED FOR?: 1st choice 2nd choice Property’s Current Identification, Address or Location Information: I. RENAMING: (Please note that before a Renaming Application is accepted, the nominator must have written permission from the family or next of kin―if this application results in a request to displace an existing commemorative name [person, persons, or family]): Does the property currently have a name? If so, provide current name, details and rationale for the proposed renaming of this property. J. ADDITIONAL INFORMATION: (ADD INFORMATION AS NEEDED) 1 The nominee or a representative on their behalf (next of kin, solicitor, notary public, etc.) must provide consent to this nomination. 9-006 K. INVESTIGATION AND REFERENCE CHECKS REQUIRED A Criminal Reference Check* (CRC) for the nominee is required as part of this process. It is necessary for the nominee to obtain the CRC. The nominee must provide the Clerk’s Office with a copy of the processed CRC provided by Police Services together with the completed Application Form. To obtain a CRC, contact the Ontario Provincial Police Service at 519-688-6540. (Note: If the nominee is deceased, it is not possible to obtain a CRC, but the next of kin must complete the section below and submit an Affidavit of the next of kin). In addition to the above, a sworn affidavit* (issued separately) must be provided to the Town Clerk’s Office. The affidavit provides information with respect to Outstanding Offence Convictions or infractions under a Federal or Provincial statute. Please note that an outstanding conviction or infraction under any of the above may result in the disqualification of an application. Confirmation that the information has been collected through the above investigations will be presented at the public Commemorative Nominating Committee meeting at the time of its consideration of the application – but any details of the results of the clearance checks will only be discussed with Committee Members In-Camera. CONSENT1 Does the nominee consent to a CRC and providing the information to the Town? Yes No Does the nominee or nominator consent to a Provincial Offences Act Check? Yes No Does the nominee or nominator consent to providing the sworn affidavit to the Town? Yes No Does the nominee or nominator consent to the release of the status of the clearance checks? Yes No * Any fees associated with the Criminal Reference Check and/or the sworn affidavit are the responsibility of the applicant. Nominator’s Signature Date Nominee’s Signature Date Town to pay for CRC if there is a cost. Only the names chosen by the committee will be required to get a CRC 2 The nominee or a representative on their behalf (next of kin, solicitor, notary public, etc.) must provide consent to this nomination. 9-006 L. CONSENT TO THE RELEASE OF INFORMATION PROVIDED IN SECTIONS C- J IN WHOLE OR IN PART The information collected on this form will be used as part of the Commemorative Naming Process. Personal information on the form, attached to the form or subsequently submitted to be included or attached to the Application Form, and all subsequent information collected as a result of the research and the staff investigation of the person’s information, and subsequently found on websites, in local archived materials, in newspapers articles, as a result of a public consultation process, etc., will be used by Town staff and will be made available to the members of the Commemorative Naming Committee, the public, the Mayor’s Office and Elected Officials―except the contact information collected in Sections A and B . Nominator’s Signature Date Nominee’s Signature2 Date SCHEDULE C MUNICIPAL COMMEMORATIVE NAM ING PROGRAM TO BE COMPLETED BY THE NOMINEE AFFIDAVIT OF ___________________________ (Nominee) I,_________________________, of the Town of Tillsonburg, in the Province of Ontario, MAKE OATH AND SAY: 1. I have never been convicted of an offence as set out in a Federal Statute. 2. I do not have any outstanding convictions or infractions as set out in the Provincial Offences Act and/or any Town of Tillsonburg Municipal By-laws. 3. I make this Affidavit in support of the Application Form for the Commemorative Naming Policy, Town of Tillsonburg, and for no improper purpose. __________________________ (Nominee) SWORN BEFORE ME at the Town of Tillsonburg, in the Province of Ontario, this day of , 20 __________________________ A Commissioner, etc. MUNICIPAL COMMEMORATIVE NAMING PROGRAM TO BE COMPLETED BY THE NOMINATOR OR NEXT OF KIN TO THE NOMINEE (APPLICABLE IF THE NOMINEE IS DECEASED) AFFIDAVIT OF ___________________________ (Nominator Or Next of Kin) I, __________________________, of the Town of Tillsonburg, in the Province of Ontario, MAKE OATH AND SAY THAT TO THE BEST OF MY KNOW LEDGE, 1. Was never convicted of an offence as set out in a Federal Statute. 2. Does not have any outstanding convictions or infractions as set out in the Provincial Offences Act and/or any Town of Tillsonburg Municipal By-laws. 3. I make this Affidavit in support of the Application Form for the Commemorative Naming Policy, Town of Tillsonburg, and for no improper purpose. __________________________ (Nominator or Next Of Kin) SWORN BEFORE ME at the Town of Tillsonburg, in the Province of Ontario, this day of , 20 __________________________ A Commissioner, etc. Renaming will honour old name (ie: honour the history of it)