Vilma Yolanda Jimenez 12/31/2010I ---~ i
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: (3051 673-7254
02-18-2009
Vilma Yolanda Jimenez
675 84th St. Apt #2
Miami, Florida 33141
SU~[EC=~ ~;• Youth Center Advisory Board
Congratulations! You have been appointed by Commissioner Victor M. Diaz, Jr.
to the agency, board or committee named above for a term ending: 12/31/2010.
Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after
January 1st, 2007, the term of board members who are directly appointed by a member of
the City Commission shall automatically expire on December 31 of the year the appointing
elected official leaves office.
If you are unable to accept this appointment or have any questions, please call the City
Clerk's Office at 305-673-7411. Please read the enclosed materials carefully.
Congratulations again and good luck.
Sincerely,
7
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Ellen Vargas
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, 2-458 and 2-459
Ordinance No. 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 - (Paring Department Form)
Booklet -Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employee
We are committed to providing excellent public service and safely to all who live, work and play in our vibrant, tropical, historic community.
~,
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~ b73-741 1, Fax: 1305) 673-7254
TO Vilma Yolanda Jimenez
RE: Youth Center Advisory 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/o~ida Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Pub/ic ~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.
~~ rn r1-- '~ o~ ~v~c~c~- ~ i r/'e YVZ
Vilma~~pYolanda Jimenez c~
Sworn to and subscribed before me thi~ T`~day of ~ , 200 !.
~ ,
Silvia Priet
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.
M I AM ! B EAC N CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
_ .E ~ 1 o w
NAME:
Name
Middle Initial
HOME ADDRESS: >~ ~ ~ ~ ! S ~ ~ '/ 2' ' V ' ~~ ~"'~ 1 ~~ ~ ~ ,
No. Street City State Zip Code
~: ~_=. PHONE: ~ ~ ~ 3 ~ 'S ~ (l.
Home Work
Fax
Business Name: ~ ~~SC 14- ~ X3-2 ~ t C mA.i') osition:
Address: '~ ®~ _"~ ,S'fi' 1JJ111
No.~'7S~tr-ee~t± /~ ~j (~ City ~ StateQ 1 Zip Code
Professional License (describe) o~,~~~j? b~ 1~ 3 V 7 ~ _~ Expires: ~ ~Qti~ch a copy of 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; orb) an individual shall demonstrate ownership/interest for a mini m of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six 6 months: Yes ~ No ^
()
• Demonstrate an ownership/interest in a business in iami Beach for a minimum of six (ti) months: Yes or No ^
• Are you a registered voter in Miami Beach: Yes or No ^
• (Please circle one): I am now a resident of: orth Beach South Beach Middle Beach
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
Name
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 Citv Clerk's Office. (Regular Boards of City)
^ Affordable Housin Adviso Committee ^ Historic Preservation Board*
0 Art in Public Places Committee ^Housin Authorit *
^ Beach Preservation Board ^ Loan Review Committee*
^ Beautification Committee ^ Marine Authorit
^ Board of Ad'ustment* ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Ca ital Im rovements Pro~ects Oversi ht Committee ^ Miami Beach Sister Cities Pro ram
^ Committee on the Homeless ^ Normand Shores Local Gov't Nei h. Im rovement
^ Committee for Qualit Education in MB ^ Parks and Recreation Facilities Board
^ Communit Develo ment Adviso * ^ Personnel Board*
^ Communit Relations Board ^ Plannin Board
^ Convention Center Adviso 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* ^ Safet Committee
^ Disabilit Access Committee ^ Sin le Famil Residential Review Panel
^ Fine Arts Board ^ Sustainabilit Committee
^ Ga Business Develo m tl-I~c t ^ Trans arenc Reliabilit & Accountabilit Committee °TRAC"
^ Golf Adviso Committ ~' ~ ^ Trans ortation and Parkin Committee
^ Health Adviso Com e ^ Visitor and Convention Authorit *
^ Health Facilities Authorit Board ^ Youth Center Adviso Board
^ His anic Affairs Committ
--~ ~,~ ` r *Board Re wired to File State Disclosure form
Email address
lS~ ~ '~'n ~ , art n ~
- -.~;
F:\~"~ ~`'~~.~r`~LL`.L+r>;3~d ~ ~_:c,mmitt~.s1£:~! ;;pl>Iic;ai~or~ b,~C ,-.K~F!i c<a±~cn < ;visFd +, ~ ~ ~0^.<!oc
Note: If applying for Youth Advisory Board, please indicate your af~fliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: Yes ^ No~~ Years of ervice:
2. Present participation in Youth Center activities by your children Ye No ^. If yes, please list the names of your children, their
ages, and which ro rams. List elow:
Child's name: //~~ ~ ' Age: ~ Program: ~~'~-~ n V
Child's name: 1-t ~~ 't"C-.~n~-/'+ ~.+t- Age: ~ Program: ~.2~~ l~ ~ i
.Have you ever been convicted of a felony: Yes or No ^ If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes l~r No ^. If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ^ or No If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes ^ or No f yes; which board?
• What orga^ni~za ~ons in the City of Miami Beach do you currently hold membership in?
Name: d V Title:
Name: Title:
• List all propert' s owned or have an interest in, which are located within the City of Miami Beach:
• I am now employed by the City of Miami Beach: Yes ^ or N .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): ~/~1
. , ~-- . 1.
This section is "not required" but desired: Age: ~_ years Id Gentler: Male u remal
Race: White ^ African-American/Black ^ WhitelHispanic: Asian or Pacific Islander ^ ~ American Indian or
Alaskan Native ^ Haitian: ^ Origin Ethnic: Hispanic: Yes or No
"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 Offlcere, Employees and Agency Members."
Applicant's Signature ,Date Name of Applicant (PLEASE
PRINT)
Please attach a copy of your resume to this application
NOTE: Applications will remain on flk for a period of one (1) calendar year.
Employment Status: Employed ^ Retired ^ Home-maker ^ Other ^ » •' ~ _ ~ "` `" ~ °° °~
Received in City Clerk's Office by Date
Name of Deputy Clerk r' ~ / ~ ~ q
•l -s ~
Document Control Number (Assigned by the Clty Clerk's Office)°7 ~T Entered By •,~- Date
Revis 09/02/08 LH
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