Barbara Montero 12/31/2010m M,IAMBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl4aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305i 673-7254
01 /14/2009
Barbara Montero
1900 Sunset Harbour Drive #2208
Miami Beach, Florida 33139
Community Relations Board
Congratulations! You have been reappointed by Commissioner Saul Gross
to the above referenced agency, board or committee for a term ending: 1213112010.
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
Barbara Hawayek
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 Barbara Montero
RE: Community Relations 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 ~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 ear on which I have served.
t'`'" ~..
Barbara Mont o
Sworn to and subscribed before me this ~ day of 200
c~ ~
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.
a1
m MIAMIBEACH
BOARDS AND COMMITTEE APPLICATION FORM
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.
n Resident of Miami Beach for a minimum of six (6) months: Yes [ Vr or No [ ]
~`' Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes [ f,~or No [
Q
I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes [~
My , , ~ , special _ ~ abilities, ._ knowledge, or experience
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Are you a
NAME:
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voter in Miami Beach: Yes ®'or No ^
~~
~~~~
Last Name ~ ~ First Name ~ Mi dle Initial
Home oo Jh.se (~-~. J'~ 1r. Z?A$ (iC~l~N~a ~ 1?~
Address: No. Street Cit State Zi Code
1~~g~~y(i y p
Phone: ~~7 ~~IZ ~ z..Z( d/ff~GS~s°-V"~"txi~1.~!ov~
Home Work Fax Email address
(Please check one): 1 am now a resident of: North Beach ^ South Beach ^ Middle Beach
Business Name: ~~~ -T- Y ~ ~ Applicant's Position: ~+ „~ ~~v~j ~+ ~ lam- ~ I Io.^S
Address: ~ t dIN~M ~R ~~'` V `- ~~ f 3
No. Street City State Zip Code
Owner ^ Stockholder/Shareholder ^ Corporate Officer ^ Other Explain:
Professional License (describe):
Expires:
Attach a copy of the license listed above.
1. Have you ever been convicted of a felony: Yes ^ or
No If yes, please explain in detail:
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No lss. 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
C:\DOCUMEMS AND SETTINGS\COMPGARJ\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLK87\BC APPLICATION NOV 2005.DOC
I am now employed by the City of Miami Beach: Yes ^ or No ~d: If yes, 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): ~/e
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.
Re ular Boards of Ci
^ Arf in Public Places Committee ^Housin Authori
^ Barrier Free Environment Committee ^Loan Review Committee*
^ Beach Preservation Board ^Marine Authori *
^ Beautification Committee ^Miami Beach Cultural Arts Cou i
^ Board of Ad'ustment Flood Mana ement * iami Beach Commission Women
^ Bud et Adviso Committee ^Miami Beach Florida Sister Cities
^ Committee on the Homeless ^Normand Shores Local Gov. Nei hborhood Im ovement
ommittee for Quali of Education in Miami Beach ^Norfh Beach Youth Center Oversi ht Committee
^ Communi Develo ment Adviso Committee* ^Oversight Committee for General Obligation Bond
^ Communi Relations Board ^Parks & Recreational Facilities Board
^ Convention Center Advisory Board ^ Personnel Board *
^ Debarment Committee ^ Plannin Board *
^ Desi n Review Board * ^ Police Citizens Relations Committee
^ Fine Arts Board Production Indust Council
^ Golf Adviso Committee ^ Public Safe Adviso Committee
^ Health Advis Committee ^ Safe Committee
^ Health Facilities Authori ^ Trans ortation & Parkin Committee
^Hispanic Affairs Committee ^ Visitor & Convention Authori
OHistoric Preservation Board * ^ Youth Center Advisory Board
*Board Required to File State Disclosure form ~csA~
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:
Child's name:
Age: Program:
Age: Program:
This section is "not required" but desired: Age: O
Ethnic Origin (Check one)
Whffe D African-American/Black ^ Hispanic: O
Asian or Pacific Islander ^ American Indian or Alaskan Native D
Employment Status: Employed ^ Retired ^ Home-maker ^ Other ^
Gender: Male or 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 embers."
LZ ~ 8 ~os~ G~ ~ ~1 ° ^ ~~
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.
~~
C:\DOCUMENTS AND SETTINGS\COMPGARJ\LOCAL SETifNGS\TEMPORARY INTERNET FILES\OLK87\BC APPLICATION NOV 2005.DOC
What organizations i in~the City ofMilami Beach do you currently hold membership ink
Name~'~~i~l~o~ ~ ~ Vd~~ ~~O ~JC Title: ~ ~LSZ-0.~~ ~~~ ~''~
Name: p~-~~c.~ ~~-tf~-,~-c~' ~Cl~ cc~'~~ Title: ~~r- ~F-So n - ~,naQ ~.g~~
List all properties owned or have an interest in, which are located withinrrthe City of Miami Beach:
C'n ~ ~ V -^ \ "~'Z 0.'E' SU v~ S-2"t t"~ cry b0 ~ ~ 1~ f ~ ~ n ~ ~ _
C:\DOCUMEMS AND SETTINGS\COMPGARJ\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLK87\BC APPLICATION NOV 2005.DOC