Erika Brigham 12/31/201002/03/2009
Erika Brigham
735 2nd Street
Miam Beach, FI 33139
SUBJECT:: ;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,
Robert 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
s ~ .., ..,R '~ax+'
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciry Clerk
Tel: (305 673-741 1, Fax: (305) 673-7254
TO Erika Brigham
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 Pub/ic ~cers and Emp/ogees, 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.
_ ~~ ~ ~~-
Erika Brigham
Sworn to and subscribed before me this ~ day of G8 , , 200 `~
i ~ _
Kerry 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 committed to providing excellent public service and safety to oll who live, work and play in our vibrant, tropical, historic community.
~..
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 have special abilities, knowledge, experience: Yes tyC
My special abilities, knowledge, or experience is: 'Q~2.f~, =. ~~ (.~Qc u ,-~e°t-u+'tE
Are you a registered voter in Miami Beach: Yes for No ^
NAME: ~~ ~ C~'tuA~~'1 ~ Rl k~
,~~a~Na2N~ S'~ ~ ~ First Name Middle Initial
Home:
Address: MIAMI g ~,~.~ f ~-- 33 t 3 Y
No. Street City State Zip Code
Phone: 3"~ ~v ~ G'3 ~`3 3 aS q 6 2 $ 6 d ~ ~ ~~~73 y2S~{ ~2t vcr~a ~ 7~~-B~e ~,
Home •aAlefJt nn o~ ~ t;E Fax Email address N ~ t
(Pisses ci~eck one): 1 errs now a resident of: North Beach ^ South Desch f~Middie Beach ^
Business Name:
Address:
Applicant's Position:
No. Street City State Zip Code ~
^ Owner ^ Stockholder/Shareholder ^ Corporate Officer ^ Other Explain:
P$ryyo~sfessional License (describe) Expires:
tt Ad&~YC~D Y~ i" Y•~ ~ ~~ P
1. Have you ever been convicted of a felony: Yes ^ or No [~1f yes, please explain in detail:
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or D+Q ^. If yes, please explain in detail:
3. Do you currently owe the City of Miami Beach any money: Yes ^ or No ~ If yes, explain in detail
4. Are you currently serving on any City Boards or Committees: Yes~,or No ^. If yes; which board? T2A NS~fZT !~ .'1 ofu .S~
-~-~ P 8 P A2 ~ N ~;
What organizations in the City of Miami Beach do you currently hold membership in?
Name: (V1fJaM~ D~2'31~N P2GS~vA'i'roN
r'1~ 1~P~-- lr C~ 6 V~ Title: t'~A2~
B m>;~,3~
Name: Y1'1~` /fit-l.ll~NG~ Fp2 (ZEL~A~~E W-ti~r-BE~
TRA t~S Fe/t T Title:
List all p+r~operties owned or have an interest in, which are located within the City of Miami Beach:
/ ~ ~ ~.IV O S~r'2~~.-
I am now employed by the City of Miami Beach: Yes ^ or Nom If yes, which department?
~''~y' l ~ ~'D 'Z ® 1
F.tGL.F~=RtwALl_1E3$(:; RpplicationtB&C Applicaticrs Revised OJ11C1Ei.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 department(s):
Please list your preferences in order of ranking [1 ]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)
^ Art in Public Places Committee
^ Barrier Free Environment Committee
^ Beach Preservation Board
^ Beautification Committee
^ Board of Adjustment*
^ Budget Advisory Committee
^ Committee on 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 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
^ Personnel Board*
^ Planning Board*
^ Police Citizens Relations Committee
^ Production Industry Council
^ Public Safety Advisory Committee
^ Safety Committee
^ 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
Ethnic Origin (Check one)
White ^Afncan-American/Black ^ Hispanic: ^
Asian or Pacific Islander ^ American Indian or Alaskan Native ^
Employment Status: Employed ^ Retired ^ Home-maker ^ Other 0
Gender: Male ^ Female ^
"I 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."
~~t.~/l 1/12)1 a~ ~t~~uc~ $~1~N~-,r--~
Applicant's Signature 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 De Jerk ate
Document Control Number (Assigned by t e City Clerk ffice) Entered Date Z- ~'
evi ed 9/11/06 Ih
F.tCLERt~ALLii3&C Applicationll3&C Applicatio€~ Reuised t1~11{7fi.doc