Change of Director : Joint Powers Insurance Authority

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Change of Director

Change of Director fields marked with * are required fields. As an alternative, you may also download this form, type in the information into the form fields, save the file as an adobe document formatted file, and either fax it to (916)774-7040 or email it to Bobbette.

JPIA Board of Directors - Member/Alternate
An excerpt from the JPIA Agreement: "Article 7 - Board of Directors"
(a) The Authority shall be governed by the Board of Directors which is hereby established and which shall be composed of one representative from each Member, who shall be a Member director selected by the governing board of that Member. Each Member, in addition to appointing its member of the Board, shall appoint at least one alternate who shall be an officer, member of the governing board, or employee of that Member. The alternate appointed by a Member shall have the authority to attend and participate in any meeting of the Board when the regular member for whom he or she is an alternate is absent from said meeting.
(b) Each Director or alternate of the Board shall serve until a successor is appointed. Each Director or alternate shall serve at the pleasure of the Member by which he or she has been appointed.
(c) Each Director representing a Member, or his or her alternate, shall have one vote.
* District
JPIA Director Representative
* Representative Name:
Must be a member of the agency’s board of directors.
* Mailing Address:
* City:		* State:	* Zip Code:
* Phone Number:
* EMail Address:
* Assuming Office Date:	(assuming the position of JPIA Director)
JPIA Alternate Representative
Representative Name:
Mailing Address:
City:		State:	Zip Code:
Phone Number:
EMail Address: