James "Jeff" Donnelly 12/31/2010m MIAPJ~iBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachll.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
01 /16/2009
James (Jeff) Donnelly
915 Jefferson Ave #3C
Miami Beach, Florida 33139
S JBJEG;T -;~~ Historic Preservation Board
Congratulations! You have been reappointed by the City Commission 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.
Sincerely,
~~~~v
obert Parcher
City Clerk
cc: Saul Frances, Parking Director
Thomas Mooney
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.
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
TO James (Jeff) Donnelly
RE: Historic Preservation Board
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 which I have served.
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-tip ~ ~~~~ 1
`~-% James (Jeft~ Donnelly
Sworn to and subscribed before me this :~? day of - ~ - 200
r Hernandez
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 commiried 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 sty; this
requirement shall tie fulfilled in the following ways: a} an individual shall have been a resident of the sty for a minimum of six months; or
b} an individual shag demonstrate ownership(nterest for a minimum of six months in a business established in the sty.
ReStc}ent ~ Mf,~mi Basch for a rnii#~XttNt# ~ s+x ,{5} months: Y~or ~A u
Demonstrate an ownershiptrnterest in a business in Miami E3each for a ~ninirnu~ of six (t?} rnorl+hs: Y,es u or M~
I am applying for a Board appointment because I have special a, fides kqo, e : Xe3,~4
My special abilities, knowledge, or experience is:.~•} 1 s~~~ ~ ~~~.~ y~~-1 ! Q /U
Ate yca4 .a registered voter in Miami ~Beaci~ Yes J .or No J
NAME: ~OIJI~ /}i1. "''4F ~' S ~V ~'i~l~~
Last Name First Name Middle Initial
F#ome:
adaress• gl~ ~ ~ ~F~~.S VIP ~,?~ iA~91 1~tAc14~ ~L . ~.~ ~
No. Street a ~ City State Zip Code
Phone: _.,,~~J~ 5~3,2'~'r~f l ~ ~' ~~" (~7.7- I.~.~ ~fF~DIJ~ /~ ~ •C~
Home Work Fax EmaU address
_; _J U U
Business Name: Applicant's Position:
Address:
No. Street City State Zip Code
U Owner U StockhoidarlSilat>~o#d~ ~ ~ ~~ U Otttiet' Bxpian:
Pn>fesswnatlirepse(des~a) ~0'rL5/!' /~U~ C4~t'D 'F Bxpiresc ~ d6 7
t , kiarvs you ever psar~ corrvictsri of a f,elarry: Yes U ,or ly~f yes, please ex~ain iri detagl:
2. Do you currently have a violation(s) of City of ~ttarrp 8eacti codas: Yes U or yes, phase exptaip ~ .detail:
3. Do you curnently owe the City of A~tami 8eac{t akRY money: Xes U or• fJq~if yes, exp~aip in .detain
4. Are you currently serving on any City i3oatds or Contn-itte~: Yss u or i~lf yes; which board?
What organizations in the City of Miapmi Bich do you currently hold membershi'p'' in?
Name: I ) ~~ ! ~~~ 1~! Otll~ I~~ itle: / l/ ~U /.D
Name•
List all properties awned ~ have an interest in, which aro located wfthi the City of Miami Beach:
9'/ ~es~ ~3 e.- t~srt/ ~~ F2 3/ 3
Qa~ ~ ~~.~ ~z Gta~ ~~ ~~~ ~ 3 3~ 39_-_
i arrl pow employed by the Cjty of Miairrfii 8eac11: Yes U At t~{o~ ~~ yes, which department?
1
':`~C ~ ~F2 ;a<~~. L.~?~ ::, ~;t ~~xC r'1;~~>>~ s:ion :=?ei...~:, C)+~ '?~.cla~:;
Pursuant ino City Code Sectlon 2 25 (b): Do you have a p~,rQr-t Jrl, spouses u, chjlc~ u: bmth~ LI. ;oF sjsUer L.1 who is empbyed by the City of Miami
Beach? Check all that appty. kierrttry the department(s): ~J ~J'
Please list your preferences in order of ranking j1] first choice [2] second choice, and [3] third choice. Please note that only three {3)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
u ~ ii? I''a~lc P~ GW~+i~
u Banter Fri M`nv-~n Co~ipae
u Beams ~+r~eryation Hoard
u @,eauip~icadora Gonl~itte!e
u Board of Ad1'ustn~t'
u Budget Ad~~Y ~1tea
u GoitZrnttse .on borneiess
u Co~rlrnittee for i;2uality Education In
u Got•rlrnunlty peyetoprnent AdvisoN"'
u Gor-~tunity Rela~& Board
u Convenpon G.entar Advisory Board
u Gonyention Center Gapit~ i?~rojaots C?versight
u Pabar~er~t G.an~;ttee
u pesi9n Review Board`
u i=ce Arts Board
u Golf Advsory Co-nprtttse
u Health Advisory Committee
u H~eaith F,ac+Npes Authority Board
Historic Preservapon Board"
J Housing Authority"
J Loan Review Cornrrijt~ae`
J n~}anns Authar'+fy'
J ~+N.a~ Beach Cultural Arts Coura,Gii
J Npaprti Beach G.onamission on Stat,4-s .of W.orr~
J A~.arXti Beach I`br+cla Sister Gres
J Norrna-IdY Sha'~ Local Gov't tyeigh. tlnprove~r~erit
J Oversight co-rirr~tt+ae ~ dal t~bli9at~on Bond
J Parks ,and R,ecreapon ~Fa;cilipes Boats
J PersolH'ei Board'
J P131rvkn9 Board`
J Pdicas ,Citizens Relat+~s ComrnitteB
J I?roducpon Industry Gouru~
J Public ~t~Y Advisoiy cw~i~
J ~tety ~e
J Transpor«ation and Pa~l?9 G.olritMtfse
J visitor ,and Convention A4lhority
J Routh Getter AdvlsolY Board
"Board Required to File State Disclosure form
Note: ff applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth
Center.. _ _ ._~
1. Past service on the Youth G,enter Advisory Board: yes u No u
2. Present partiapation in youth Center adivipes by your ,chitdr
and which programs. List below:
Child's name:
years ci# Setvicec
en yesu No u. tf yes, please list >~ i'1a~ of yoar +~ldrell, it~- ages,
Age: Program:
Child's name: Age: Program:
u•
Vic, ' .~~,~~, ~2. ~
This section is "not required" tort desired: Age ~ye old ~}, Asir: t~)<s~ r=~ u
EthMc Origin {Check one)
MlrRiiti~ i~#-A~#~t@~I~Ik a ~e~Ppc: U
l~3liitl of P~ii~lF tglallf~e/ ~ A~Iirt!'?fll~iili' ~ Ar' A~aalcar~ dye ~
Erripioyfrtent Status: Brngoyed U Rapped )alaFris-i~.ak~er u U
"I hereby attest to dte accuracy and truthfulness of the application and have received, read and will abide by Chapter Z,
Article Vii - of the City Code "Standards of Conduct for City Officers, Employees and Agency Membe-s."l
/I ~/~i ias'IC ~}~f s ~' ~l~EFF'1 ~~~ 1~ >~ `~
licant's Signature Date Name of Applicant (PLFJ~ 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 ~S Deputy Clerk Data
Document Control Number (Assigned by the City Clerk's Offroe Entered By Date ~
9/11/06 Ih
:1~'~E~ Sr,~,_~isa,'~~ tint r~'i~r r 5,~, r,l;p r~ ~,~;, u~ rti3~ {)~~~p g ~t~~.~~~c