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Rachel Umlas City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.oov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-741 1, Fax: (305J 673-7254 01 /14/2009 Rachel Umlas 1424 S. Biscayne Point Rd Miami Beach, Florida 33139 Community Development Advisory Commit Congratulations! You have been reappointed by Commissioner Saul Gross to the above referenced agency, board or committee for a term ending: 12/3112010. 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, ,~ n ~~~ ~~~~~ Robert Parcher City Clerk cc: Saul Frances, Parking Director Mercedes Rovirosa 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. m IAM,IBEAC 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 Rachel Umlas RE: Community Development 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 Officers and Employees, and understand that as a member of a City of Miami Beach Board and/or Committee, I r~st 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 calendaryear on yvhich 4 have erved. ,. I .f ~ Rachel Umlas Sworn to and subscribed before me this ~ / day of !"L~'~~ , , 200 . - ~, ..~. v. _ . ~. - . ~~.. = Z ---- 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. BOkRC ~,NQ COMtJI[T T EE IaPPLIC~, T IOh' FOP.Ii(I NAME: `~ Last Name ~F[rst Name ~ Middle Initial J HOME ADDRESS: ~ [",l ~ ~ ~; ~ f~l1S l ~.~, ~~i'rk' ~ I ~ C ~/~ l ~ ~~~ -~ ?t ~/ No. '~, Street City State Zip Code ~ ~. PHONE: `~ ~,' _ ~lY ~ ~~~'~ ~U~ _ ~ `1 ~~ ,'1 U .- `~~-~~ I~ClC`7 , Cry Home Work Fax Emai address QC~~(~~i'I'l Business Name: ~ ~ ~~ C ~ (.~ ~~ ~~~ !°P ~osition: ~~a (~ ~,4~ ~,~'~ __ ~~ Address: ~ ~~.-~ ~ ~7~ ~C~ ~ .~~~1 ~ ~ E ~~ ~ 5l ~-t No. Street City State Zip Code Professional License (describe) nr Expires: Attach a copt~ or the license 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 ownershiplinterest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months: Yesor No ^ • Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes ^ or No • Are you a registered voter in Miami Beach: Ye~(9 or No,.-I~~--~, • (Please circle one): I am now a resident of: North Beach , South Beach Middle Beach _r' • I am applying for an appointment because I have special abilities, knowledge, experience. Please list below: Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that oniy three (3) choices will be observed by the Citv Glerk's Office. (Regular Boards of City) D Affordable Housin Adviso Committee ^ Historic Preservation Board"` D Art in Public Places Committee D Housin Authorit " D Beach Preservation Board ^ Loan Review Committee"' D Beautification Committee ^ Marine Authorit ^ Board of Ad'ustment' ^ Miami Beach Commission for Women ^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council ^ Capital Im rovements Oversi ht ^ Miami Beach Florida Sister Cities D Committee on Homeless ^ Normand Shores Local Gov't Nei h. Im rovement ^ Co mittee for Qualit Education in MB ^ Parks and Recreation Facilities Board ommunit Develo ment Adviso ^ Personnel Board" ^ ommunit Relations Board ^ Plannin Board ^ Convention Center Advisor Board ^ Police Citizens Relations Committee ^ Cultural Arts Nei hborhood District Overla (CANDO ^ Production Indust Council ^ Debarment Committee ^ Public Safet Adviso Committee ^ Desi n Review Board" D Safet Committee O Disabilit Access Committee ^ Sin le Famil Residential Review Panel D Fine Arts Board D Sustainabilit Committee ^ Ga Business Develo ment Ad Hoc ^ Trans arenc Refiabiiit & Accountabilit Committee "TRAC" ^ Golf Adviso Committee ^ Trans ortation and Parkin Committee D Health Adviso Committee ^ Visitor and Convention Authorit " ^ Health Facilities Authorit Board ^ Youth Center Adviso Board ^ His anic Affairs Committee Board Required to File State Disclosure form ,~~Ri~;P,'_~1Escarc ~ ~amrnitt°Fs\6&C tin;_dn,auoniS~C P,unii::auo~ FFVist=r <3p..ou: rTl Note: If applying for Youth Advisory Board, please indicate your affiliation with the a ow Youth Center: 1. Past service on the Youth Center Advisory Board: Ye ~ C Years of Service: 2. Present participation in Youth Center activiti y your children Yesr No ^. tf yes, please list the names of your children, their ages, and which programs. List b_,e,,l9sw-~''"~~ Child's name: / _ Age: Program: Child's na _ .I-lava vni i avar haan rnnvirted of a fel~nv Yes ~ or No age: Prog dam: ves. Dlease explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or Noo~lf yes, please explain in detail: • Do you currently owe the City of Miami Beach any money:°Yes ^ or No~lf yes, explain in detail . Are you currently serving on any pity Boards or Committees: Yes~r No ^. If yes; which board? • What organizations in the ity of Miami Beach do you currently hold membership in? ~J ~ J p ~~ _ ,~-~r~1 Name: ^~~ ~'i~`2 ~ Ci ~~ ~- I~ ~2 Title: ~~./v ~? 1 ~~ c ? ' l!~'i L + t Name: ~~~~~-~ ~'~.Q ~ ~ ~~ I ~IL~'~u-+`~'. ~ ti~Z/` • List all properties Qyvned or have an interest in, which ark ioc~ted within the City of Miami Beach: • I am now employed by the City of Miami Beach: Yes ^ or Ncvvhich department? • Pursuant to City Code Section 2-25 (b): Do you have a parent ^, spouse ^, cl~ii~ ,`brother ^, or sister 0 who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): ~ V l.~` Gender: Male ^ Female Ethnic Origin: Asian or Pacific !slander ^ Africac~- erican/Black ^ American Indian or Alaskan Native ^ Hispanic: ^ White -Not Hispani "I er by attest to the accu acy and truthfulness of the application and have received, read and will abide by Chapter 2, A rcl VII -oft a City Cod "Standa s of Conduct f r City Officers, Employee nd Agency Members." / A li an ' nat re Date Name of Applicant (PLEASE P INT) Please;attach:a.copy-of,your=resume~ao his=application X NOTE: Applications willremain:on'flle'for a period:of=one (1);calendar year. Employment Status: Employed~Retired ^ Home-maker ^ Other ^ Received in City Clerk's Office by of Deputy Document Control Number (Assigned by the City Clerk's Office) Entered By Date cam" (~ F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Aopiication 21 109.doc