Joseph Conway 12/31/2009~~~.
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Cihr of Miami Naeh, 1700 Convention Center Drive, Miami Beach, Fbrido 33139, www.miamibeachA.gov
OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk
TEL: 1305) 673-7411, FAX: (305) 673-7254
01 /26/2009
Joseph Conway
140 Jefferson Ave
Miami Beach, Florida 33139
SUBT;~~ Public Safety Advisory Committee
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
to the above referenced agency, board or committee for a term ending: 12/3112009.
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,
~~~
Robert Parcher r
City Clerk
cc: Saul Frances, Parking Director
Chief 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 commilfed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic communiy
'~
Cih- ei Miorni Such, 1700 Convention Center Drive, Miami Beach, Fbrido 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
TEL: (305) 673.7411, FAX: (305) 673-7254
TO Joseph Conway
RE: Public Safety 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: 12/31/2009.
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 Pub/ic 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.
seph Conway
Sworn to and subscribed before me this 3~ day of ~NV4~ , 200
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 ore communed to providing excellent public service and sofey to all who live, work, and play in our vibrant, tropical, historic communiy
~2~'12/'2~~8 15:29 9~5-531~F~9 Pa~~E X1/02
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CITY OF MIAMI BEACH BOARDS AND COMMITTEE
APPLICATION FORM
PursuanC to Ciry 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 shat) have been a resident of the dty for a minimum of six months; orb)
an individual shall demonstrate ownership/Interest for a minimum of six months in a business established in the clry.
Resident of Miami Beach for a minimum of six (6} months: Yes j~ or No [ ]
Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (~} months: Yes (~ or No [ ]
I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes Q(J
My special abilities, knowledge, or experience is:
Are you a regis/t~ered voter in Miami Beach: Yes JXJ or No [ ]
NAME: _ L O~~'`!''Q y - ' F~Na e~ Midd a Initial
Last Name
Home Ci State Zip Code
Address: No. Street tY
~- ~'-sue ,y~C~.v~//ry®
305 - ~ 3 ~ - 7900 3m s - S3i i.t z~ ,3~5'~~c.~3
Phone: Work Fax r:mailaddress ^'~'s'"l~~~CO'`~
Home
I am now a resident of: North Beach [ ~ South Beach ~ Middle Beach [ ]
Business Name: .~'Q~-LST~4 i -F 'd~/S y~/~'t~~~%Applicant's Position: ~r''`~~~'~
Address:
No. Street Clty State Zip Code
[~] Owner [ ]Stockholder/Shareholder [ ]Corporate Officer [ ]Other 6cplain:
Professional License (describe): ~ -
Attach a copy ofthe //tense listed above.
1. Have you ever been convicted of a felony: Yes [
Expires: •~ Ob y
or No (x] If yes, please explain in detail:
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes [ ] or No {~. If yes, please explain in detail:
\O~
3. Do you currently owe the City of Miami Beach any money: Yes [ ) or No ~] 4.~
If yes, explain in detail: t~
~~
4. Are you currently serving on any City Boards or Committees: Yes [ ] or No [~(]
If yes; which board?
What organizations in the Gty of Miami Beach do you currently hold membership in?
Name: G ,o M 6~" ~ ~6° A!-~~ ~ `~- Title: ~i~ ~. q !~
Name: ./'~ ~ ,s'~~/.~ / Title: ~~'`lN >~_
List all propertl caned or have an interest in, which are located within the City of Mfami~ch: ~~~:
I am now employed by the City of Miami Beach: Yes [ ) or No [jC]. If yes, which department.
Pursuant to City Code Section 2-25 (b}: Do you have a parent [ ], spouse [ J, child j ], brother [ ], or sister [ ]who
F \CLFR~~~I-UELI7.ABET~Bd:.CtBCAhPLICO~i.doc
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G~2i'12f26B8 15:29 3~5-`'~"•8G_1k3.3
is employed by the City of Mlaml Beach? Check all that apply. Identify the department(s)
PsaGE 02f 02
N ~
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that
only 3 choices will be observed by the City Clerk's Office.
(Regular Boards of Gty) ('Board Required to File State Disclosure form)
] Art in Public Places
] Audit Committee
] Barrier Free Environment Committee
] Beach Preservation Board
] Beautification Committee
] Board of Adjustment (Flood Mgmt.)*
] Budget Advisory Committee
] Committee an Homeless
] Committee for Quality Education in MB
] Community Development Advisory*
] Community Relations Board
] Convention Center Advisory Board
] Convention Center Capital Projects Oversight
] Debarment Committee
] Design Review Board`
] Fine Arts Board
] Golf advisory Committee
] Health Adv'~sory Committee
] Health Fadlities Authority
] Hispanic Affairs Committee
] Historic Preservation Board"
] Housing Authority:
] Loan Review Committee*
[ ]Marine Authority*
[ ]Miami Beach Cultural AttS Council
( ]Miami Beach Commission on Status of Women
[ ]Miami Beach Florida Sister Cities
[ ]Normandy Shores Local Gov't Neighborhood Improvement
[ ]North Beach Youth Center Oversight Committee
[ ]Nuisance Abatement Board*
[ ]Oversight Committee for General Obl-gation Bond
[ ]Parks and Recreation Facilities Board
[ ]Personnel Board*
[ ]Planning Board
( ]Police Citizens Relations Committee
( ]Production Industry Council
[ x] Public Safety Advisory Committee
[ ]safety Committee
[ ]South Point Advisory Boardi to Redevelopment Agency
[ ] ExleR-AuEf+eF+ty
[- J Transportation and Parking Board
[ ]Visitor and Convention Authority*
[ ]Youth Center Advisory Board
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth
Center: ___
i4
1. Past service on the Youth Center Advisory Board; Yes [ J No QC] (Years of Service [ ]
2. Present participation in Youth Center activities by your children Yes [1!] No [ ]. If yes, please list the names of your
children, their ages, and which programs. List below.
Child's name:
Child's name:
Age: Program:
Age; Program:
This section is "not required" but esined: Age: [~~] Gender: M [X] or F [ ]
Elthnlc Origin (Check one)
White [~ African-American/Black [ ] Hispanic: [ ]
Asian or Pacific Islander [ ~ American Indian or Alaskan Native [ ]
Employment Status: Employed [ ) Retired [ )Home-maker [ ]Other [
I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by
Chapter Z, Article VII - of the City Gode "Standards of Conduct for City Officers, Employees and Agency
Member /'
O ~~~ d2,1.I2~08 ~J~c'S~ja~ .~ ~,/bi,a
Applicant's Signatur Date Name of Applignt (PLEASE PRINT)
Attachment: Please attach a copy of your resume to your application.
NOTE: Applications will remain on file for a perlod,of one (1) calendar year.
Received in City Clerk's Office _ /_ /_ by T .~'/ Y I~° "~~- Clerk
Document Control Number (Assigned by the City Clerk's Office~'~(~ c~ Rev #7- 01/08/04
F:~RER'~sAJ.LaELIZAI3ET~A~-C! BCAPPCIC04.doc
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