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Liliam Lopez 12/31/2010m MJA^f,IBEACH 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 02-13-2009 Liliam Lopez 4200 Alton Rd Miami Beach, Florida 33140 ~JECT~~~: Miami Beach Sister Cities Program Congratulations! You have been appointed by Mayor Matti Herrera Bower 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, ~ ~ '~,~ S~ Robert Parcher City Clerk cc: Saul Frances, Parking Director Michael Aller 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 - (Parking Department Form) Booklet -Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employee We ore committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. ~. ~-. i r y~ y 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: (305j 673-741 1, Fax: (305) 673-7254 TO Lilliam Lopez RE: Miami Beach Sister Cities Program 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 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. '1 Lilliam e Sworn to and subscribed bef me thi~~~day of , 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 are committed to providing excellent public service and safety to a!1 who live, work and play in our vibrant, tropical, historic community. 12f 03f 20013 13:42 3055348355 SFLHCC PAr,E 02103 ~' ~l~l V ~~ ~~''~~,... C~-~~r t:tr- t~nlaMC ~~.~c:H ., i'D~RCb AND COi~il~il•f'3irB AF~P'f.,i4 Ti~.r@~t Pit=:P~1 0 z, • ~- 1 NAME: Last Na a First Name Middle I ' ' ~ DDRESS: ~~) / ~--=~~ a zip Code ~I/ HOME A _ No. Cp~ Street ~ ~ ~., .--, ~ y „~ > ~ ~ ~~~ . PHONE: ~~r~ i ~-•-D--~~~~' ~ Email dress Home Work ax C, (J~n ~~3~rnte.CG~~~ ~~fs~~~~/~ ~~ Business Name' ~~ Position; , Address: ~ Street Cily State Zip Code No. Expires; At2acir n cotay of ;f7e 1lctrn~e Professional LlCenso (describe} ~, Pursuant to Clty Code section 2-2;1(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the allowing ways: a) an individual shall have been a resident of the city for a minlmum of six months; orb) an individual shall derri~ ~nstrate ownershipInterest for a minlmum of six months in a business established In the city. • Resident of Miami Beach for a li ninlmum of six (6) months: Yes i 1 or No I::l • Demonstrate an ownership~nt~i •est in a business In ''amt Beach for a minimum of six (6) months: Yes ~. r No r:7 ~ r No r1 .Are you a registered voter in Miami Beach: Yes ._.l o _ .. .y • (Please circle one): I am now ~i resident of: North Beach South Beach Middle Beach • 1 am applying for an appolntm~l nt because I have spacial abilities, knowledge, experience. Please list below: Please list your preferences in order t; f ranking [1 ]first choice [2J second choice, and (3) third choice. Please note that only three (3} choices will be observed by thm Citf~ Clerk's Office. (Regular Boards of Clty) ; Affordable Housing Advisory Cora; nitteo i Cl Historic Preservation Boafd` _ 0 Art in Public PlacOS Committee ^ I-lousln Authorlt " ` f~ Beach Preservation Board D Loan Review Committee D Beautification Committee 0 Marine Authorft 0 Board of Ad~ustment" (~ Miami Beach Commission for Women 0 Bud et Advise Committee f~ Miami Beach Cultural Arts Council Ca ital Im rovements Oversi ht : iaml Beach Florida Sister CKles D Cammlttee on Homeless 0 Normandy Shores Local Gov't Neigh. Improvement D Committee far Qualit Education i - MB ^ Parks and Recreation Facilities Board D Communit Develo ment Advisor ~" 0 Personnel Board'" Relations Board _~~ Communlty D Plannln Board _ Convention Canter Advise Boali 1 D Police Citizens Relations Committee 0 Cultural Arts Nei hborhood Distrii t Overlay CANDO C1 Production Indust Council Debarment Cammlttee 0 Public Safet Advlso Committee r1 Desi n Review Board' D Safat Committee f_1 Oisab;ll Access Committo© ~ D Sin to Famil Residential Review Panel Fine Arts Board [] Sustainabilit Committee " " 0 Ga Business Development Ad NI )c TRAC D Transparenc Reliabilit & Accountabillt Committee D Golf Advise Cammlttee 0 Trans ortatlon and Parkin Committee ` ^ Health Advise Committe® D Visitor and Convention Authorft C7 Health Facilities Authority Board , Youth Center Advise Board ,_~•,,_. - ,.. ~- . . 0 His anic Affairs Committee -- ~ -- - -1~~-~_ <. • - ~ ~•-•-• --~• _ Board Ro utred to FIIe 3tEtte drsclosure form ' ' F ~r;,l.[=~.F2\NA1.lU`lorrrc.l K (;ommiltea2s~E}(~(a ~r.~plicr:~7linn\L?tt~(: ~f~plit'~llr)n Ilcvhl3[l '111:31)Fi.duU 12/03/2BB8 13:42 d Note: If applying for Youth Advisory B~ ard, please indicate your affiliation with the Scott Rakow Youth Center: 3855348365 PAGE B3/F~3 1. Past servl ~(~^ at on In tYouth tCerii grI ad vBlesrby your chifdrE 2. Present p p ~. ages, and which pro rams. List befovli Child's name: ~ I ~~ ~111"~rd Child's name: SFLHCC of rvlce: ra. If yes, please list the names of your children, their Age: ~ Program: 1 1__~~ - Age; Program: .Have you ever been convicted of ii i felony: Yes I:1 or No t~lf yes, please explain in detail: ave a violatiorli s) of City of Miami Beach codes: Yes I i or No~'If yes, please explain in detail: . Do you currently h ~ ~ • Do you currently owe the City ofb Jllami Beach any money: Yes r_i or No~ yes, explain in detail -.--- es; which board? . Are you currently serving on an Ciry Boards or Committees: Y s GI or No ' y - ~ ~ I ~~.~~:, CEO cm . What organizations in the City dl Miami Beach do you currently hold membership in? Title: Namo Tltls: Name: • Llst all properties owned or havii an intorest in, which are located within the Ci J iami Beach: D ~. ~ , ~ -- ,. • 1 am now employed by the Cityi .>f Miami Beach: Yes i~ or N hich department? s Pursuant to City Code S®ction ~~ 25 (b): po you have a parent r~, spouse ~), child ri, brother Ci, or sister r_1 who Is employed by the City of Miami Beach? Check all that 1~ pply, Identify the department(s): Gender: Male ^ Femal This section is "not required" buti~ lesired: Age: years old Ethnic Origin (Check one) White ^ African-AmericanBlack~l ispanic: ^ Asian or Pacific Islander ^ American Indian or Alaskan Native [I "I hereby attest to tlto accurac~i and truthfulness of the application and hav® received, read and will abide by Chapter 2, Artlclo VII - of the City Code "Sil lndard91of Conduct for City Officers, Employees and AgOncy Mombers." i ~ Name of Appli t ( AS PP ca lg atur ate RI T) /,' ~Y~"tci'tlti+~`~~'~tibel4lt~d iti~tllie tt"~t'~',~1~~Ni~Ytlrti~~if9~f~.~+'t~~~`~~t~N~'~'~,j~~ar Employment Status: Employed C i Retired Ll Home-maker ^ Other ^ , Rec6l~od In Clty Clerk's OfFlce by _„ Nama of Doputy Clerk ~~~~~~jj Document Control Number (Asslgno(I by the Clty Clerk's Offlce-~~~-~- Entered By oato L O G I' 1(;l~f=~i~1~~,At,1~\~loard & C:+.nrvriilltaMSll3t~~ :.~1>plic~a(innlilP„C ~ppllr,~lion I'~tvi~2td 11 iJf?U.dc+C