Regina Suarez 12/31/2010m P,4LAlV,IBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, vvww.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
01 /14/2009
Regina Suarez
4410 Alton RD.
Miami Beach, Florida 33140
~~
~~ Police Citizens Relations Committee
Congratulations! You have been reappointed by Commissioner Saul Gross
to the above referenced agency, board or committee for a term ending: 12131/2010.
If you are unable to accept this appointment, please notify the City Clerk's Office at
(305) 673-7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Si~nc'erely, ,~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Chief Carlos Noriega
ATTACHMENTS:
Letter of Appointment
Oath
City Code Ordinance section, applicable to agency, board or committee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-2458, 2-459
Ordinance 2006-3543 -Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet -Guide to the Sunshine Amendment and Code of Ethics for Public Officers and
Employees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305j 673-741 1, Fax: (305j 673-7254
TO Regina Suarez
RE: Police Citizens Relations Committee
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the
United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of
a member of the above-mentioned board or committee of the City of Miami Beach to which I have
been appointed for a term ending: 12/31/2010.
I have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Interest
and Code of Ethics Ordinance), as well as theF/orida Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Public Officers and Employees, and understand that as a member
of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure* require-
ments of Miami-Dade County or the State of Florida (depending on the board or committee on which
I serve) on July 1st, following the closing of the calendar year on wh~ichC~-I~I~-v-$.s~ed..
Regina Suarez
Sworn to and subscribed before me this ~ day of / `~ , 200
7 ~ ~ ~~z:E%L~.~
r -
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachFl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
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Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this
requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; or
b) an individual shall-demonstrate ownership/interest for a minimum of six months in a business established in the city.
Resident of Miami Beach for a minimum of six (6) months: Yes or No ! '
Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes ~ or No
I am applying for a Board appointment because I
My special abilities, knowledge, or experience is:
Are you a registel:ed voter in Miami Beach: Yes
NAME: ~~~-k.~ ~-~~ ~ Z.
Home:
Address:
special. abilities,
No i7
I ~ ~ ~ti--
Yes
Middle Initial
N\o. ` Street
Phone: ~~~ )/„ ~ <~' ~ ~'~ ~_ ~ G'~ ~~~~" ~'OGl
City State Zip Code
Hoare Work Fax ail address
(I"`!G~?~a:'3 c`:17 a Y .. ' .;rd ,.... ~_ _ C'. ~C ._ .. rl .~~ .. + :'# .'~..E4ui ^
,.
Business Name: Applicant's Position:
Address:
No. Street City State Zip Code
~ Owner 0 Stockholder/Shareholder ^ Corporate Officer ^ Other Explain:
Professional License (describe)
f=xpires:
1. Have you ever been convicted of a felony: Yes C or No yes, please explain in detail:
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes C or No ~y/ff yes, please explain in detail:
3. Do you currenty owe the City of Miami Beach any money: Yes ^ or No ~ If yes, explain in detail
4. Are ~ cuurrently serving on ny ity~Boards Committees: Yes~(or No ~. If yes; which board?
~l t l ~ Lam.- ~ ~~ ~ ~~~
What organizations in the City of Miami Beach do you currently hold membership in?
Name:
Name: Title:
List all properties owned or have an interest in, which are located within the City of Miami Beach: '
I am now employed by the City of Miami Beach: Yes (] or No~f yes, which department?
1
1=.1CLERISALL4f~&C; ~pplicai:o3~`:El4,C% G.r;olicatior~ i~eviseci tl?~ 7G6.cloc
Pursuant to City Code Section 2-25 (b): Do you have a parent ,spouse ' ,child ,brother , or sister who is employed by the City of Miami
Beach? Check all that apply. Identify the tlepartment(s):
Please list your preferences in order of ranking [1] first choice (2] second choice, and [3j third choice. Please note that only three (3)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
Art in Public Places Committee
C: Barrier Free Environment Committee
C~ Beach Preservation Board
~:~ Beautification Committee
i i Board of Adjustment`
i, Budget Advisory Committee
^ Committee on Homeless
^ Committee for Quality Education in MB
^ Community Development Advisory*
G Community Relations Board
^ Convention Center Advisory Board
^ Convention Center Capital Projects Oversight
^ Debarment Committee
^ Design Review Board`
^ Fine Arts Board
^ Golf Advisory Committee
^ Health Advisory Committee
^ Health Facilities Authority Board
^ Historic Preservation Board'
Housing Authority'
Loan Review Committee*
Marine Authority'
Miami Beach Cultural Arts Council
Miami Beach Commission on Status of Women
Miami Beach Florida Sister Cities
~ Normandy Shores Local Gov't Neigh. Improvement
Oversight Committee for General Obligation Bond
. Parks and Recreation Facilities Board
i:7 Personnel Board*
i :~ Planning Board*
~olice Citizens Relations Committee
'~ Production Industry Council
[;Public Safety Advisory Committee
i~ Safety Committee
L:; Transportation and Parking Committee
Visitor and Convention Authority*
^ Youth Center Advisory Board
"Board Required to File State Disclosure form
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth
Center:
1. Past service on the Youth Center Advisory Board: Yes No ~:~; Years of Service:
2. Present participation in Youth Center activities by your children Yes^ No ~. If yes, please list the names of your children, their ages,
and which programs. List below:
Child's name: Age: Program:
Child's name:
Age: Program:
This section is "not required" but desired: Age: years old Gender: Male ^ Female
Ethnic Origin (Check one)
White ^ African-American/Black L~ Hispanic: _
Asian or Pacific Islander L American Indian or Alaskan Native ^
Employment Status: Employed C Retired ^ Home-maker ^ Other ^
"I hereby attest to the accuracy-and-truthfulness of the application and have received, read and will abide by Chapter 2,
4Mticle VII = of`t(fte City Code "Standards of Conduct for City Officers4 Employees and Agenc~.Members."
•,
...
i
._.. _
Applicant's Slgnatur ~-- -~' Date Name of Applicant (PLEASE PRINT)
Attachment: Please attach a copy of your resume to your application.
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in City Clerk's Office by Deputy Clerk Date
Document Control Number (Assign d by the City Clerk's Office) '~ Entered By Date
evised 9/11/t~ Ili
F:ICI_ER\~At_I_1t3&C; Apralat~atic ~ ~>" i.. ~y;,; i ~t~; e-=,c1 J ~' ~ ~C• sec