Stephanie Berman 12/31/2010
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, v~rww.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (3051 673-7254
01 /16/2009
Stephanie Berman
2850 Sheridan Ave.
Miami Beach, Florida 33140
SIJ,BJECT:, Affordable Housing Advisory Committee
Congratulations! You have been reappointed by the City Commission to the above
referenced agency, board or committee for a term ending: 12/31/2010.
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,
s,~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Anna Parekh
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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Cil~- of Miami Math, 1700 Convention Center Drive, Miami Beach, Fbrida 33139, www.miamibeachA.gov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
TEL: (305) 673-7411, FAX: (305) 673-7254
TO Stephanie Berman
RE: Affordable Housing Advisory 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 ~cers 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.
Stephanie Berman
Sworn to and subscribed be re me this 31S day of -~~~~~ , 2008
Fde-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 communiy.
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PHONE: ~ '1 `~ ~11~ SS _1 ~ -l S~~ ~~V J~~~`' U JOU Q`~ 1 . \"1~` , State Zip Code
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Home ~\ C, f Wr`ork ~ ~.Q Fax r
Business Name: \ v~~ Jy V~~ ~ ` ~~~`n~osition: 1 Email address
Address: ~~ ~ ~y ~ ~N• ~ S 1~l Q ~ ~ J ~'
No. Street Ciry State Zip Code
Professional License (describe) Expires:
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 lizB city.
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• Resident of Miami Beach for a minimum of six (6) months: Yes~(or No "< ~ ZT
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• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes or~
.Are you a registered voter in Miami Beach: Yes ~or No ~ ..a `"`
~ ~ ~
• (Please circle one): I am now a resident of: North Beach South Beach Middle Belch ~ O
_` ~
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list:~elov~r;.i
~ n f1 r~ L~n r I,. ~ ,~ r 0 l.i i ,,,~ n D \
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice.
choices will be observed by the Citv Clerk's Office. (Regular Boards of City)
Affordable Housin Advisor Committee ^ Health Facilities Authorit Board
iil Art in Public Places Committee ^ His anic Affairs Committee
^ Beach Preservation Board ^ Historic Preservation Board'
^ Beautification Committee ^ Housing Authority"
C] Board of Ad~ustment* Loan Review Committee"
^ Bud et Advisor Committee ^ Marine Authorit '`
^ Capital Im rovements Oversi ht ^ Miami Beach Commission for Women
Committee on Homeless ^ Miami Beach Cultural Arts Council
^ Committee for Qualit Education in MB ^ Miami Beach Florida Sister Cities
^ Communit Develo ment Adviso ^ Normand Shores Local Gov't Nei h. Im rovement
^ Communit Relations Board ^ Parks and Recreation Facilities Board
C Convention Center Advisor Board ^ Personnel Board'
^ Cultural Arts Nei hborhood District Overla CANDO ^ Plannin Board
^ Debarment Committee ^ Police Citizens Relations Committee
^ Desi n Review Board"` ^ Production Industr Council
^ Disabilit Access Committee ^ Public Safet Advisor Committee
^ Fine Arts Board ^ Safet Committee
^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee °TRAC
^ Golf Adviso Committee ^ Transportation and Parkin Committee
^ Green Ad Hoc Committee ^ Visitor and Convention Authorit '
[] Health Advisory Committee ^ 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:
.Have you ever been convicted of a felony: Yes or No7( If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes or No~(. If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes or No7(. If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes ' or No'~( If yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name:
Name:
Title:
Title:
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
a~~~ Shw~d~an ~v~,~Ue. ~.iQ~ bead,, ~ 33r~~
• I am now employed by the City of Miami Beach: Yes or No~ Which department?
• 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 department(s):
This section is "not required" but desired: Age: ~~ years old Gender: Male ^ Female
Ethnic Origin (Check one)
White ^Rfrican-American/Black ^ Hispanic: ^ Asian or Pacific Islander ^ American Indian or Alaskan Native ^
"1 hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
~a ~ ~
A plic is Signature ate Na a of Applicant (PLEASE PRINT)
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
Employment Status: Employed ^ Retired ^ H me-maker ^ Other ^
..
Received in City Clerk's Office by Date
Name of Deputy Clerk ~ ~ ~ ~ ~~
Document Control Number (Assigned by the City Clerk's Office) Entered By Date
R vised 04/18/08 LH
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