Gail Harris 12/31/2010m MI?,MfBEACH
City of Miami Beath, 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
03-05-2009
Gail Harris
5725 No. Bay Rd.
Miami Beach, Florida 33140
~SJ`~r Committee on the Homeless
Congratulations! You have been appointed by Commissioner Ed Tobin
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,
-d~~~L f Si
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Ingrid Usaga
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 are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
I
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
TO Gail Harris
RE: Committee on the Homeless
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: 12/31/2020.
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 Officers 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.
Gail Harris
Sworn to and subscribed before me this day of , 2
~7rul~ _ J
Silvia rieto
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 io all who live, work and play in our vibrant, tropical, historic community.
NAME:
MIAMIBE~,CH
CITY OF MIAMI BEACH
D AND COMMITTEE APPL,ICATiON FORM
,L/ r
Last~~~ ~~ / First Name `Gt~ ` `Middle Initial
HOME ADDRESS: ~
Apt No. House No. Street City State Zip Code
PHONE: ~ ~~~~
Ho a Work Fax // O- - Email address
Business Nam L Position:~G/G/2U f~,.E%% /,3~ `~~, ~~~fed
Address:
No. Street City State Zip Code
Professional License (describe) i p ~ ~ ~~~ ~ ~,~gaD Li/9~t)~xpires: .J/ Attach 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; 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 (Ei) months: Yell ^ Or No ^
• Are you a registered voter in Miami Beach: Yes lt7 or No ^
. (Please circle one): I am now a resident of: North Beach South Beach Middle Beach
• I am applying, for an appointment because I have special bilities, kno ledge, experience. Please list below:
• Are you presently a regisG~bbyist with the City of Miami Beach? Yes ^ or No
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
^ Art in Public Places Committee ^Housin Authori
^ Beach Preservation Board ^ Loan Review Committee
^ Beautification Committee ^ Marine Authori
^ 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 Quali Education in MB ^ Parks and Recreation Facilities Board
^ Communi Develo ment Adviso ^ Personnel Board
^ Communi Relations Board ^ Plannin Board"
^ Convention Center Adviso ~ Board ^ Police Citizens Relations Committee
^ Cultural Arts Nei hbofiood District Overla CANDO ^ Production Indust Council
^ Debarment Committee ^ Public Safe Adviso Committee
^ Desi n Review Board" ^ Safe Committee
^ Disabili Access Committee ^ Sin le Famil Residential Review Panel
^ Fine Arts Board ^ Sustainabili Committee
^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabili & Accountabili .Committee "TRAC"
^ Golf Adviso Committee ^ Trans ortation and Parkin Committee
^ Health Adviso Committee ^ Visitor and Convention Authori
^ Health Facilities Authori Board ^ Youth Center Adviso Board
^ His anic Affairs Committee
'' Board Required to File State Disclosure form
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application 21309.doc
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:
.Have you ever been convicted of a felony: Yes ^ or No
Age: Program:
yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes or 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 n any City Boards or Committegs: Yes ^ or No ^. If yes; which board?
• What organizations in the~C" i~ty~ of Mia/mi Beach do you currently hold membership in?
Name: ~,~' ~ !~~!-~~i ~~G~lom ~ Title:~~G~~1?;~~/
Name:
• List all properties owned or have an interest in, which
1'1/
Title:
located within the City of Miami Beach:
• I am now employed by the City of Miami Beach: Yes ^ or No hich 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): ~/~ ,
Gender: Male ^ Female lf~
Race: White ~ Black ^
Ethnic Origin:
Asian or Pacific Islander ^ African-American/Black ^ American Indian or Alaskan Native ^ Hispanic: ^ White -Not Hispani
Physically Challenged: Yes ^ or N
"I hereby att st to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII f the City Cod "Standards of Conduct for City Officers, Employees and Agency Members."
~ ~~~~ J~ f~~J,~
pllcant's Ignature Name of Applicant (PLEASE
PRINT)
Rlease:attach:azcopylof;yourxresu e~to~his:ap~ihcation
~IOtE~,~pplica><ionswillyremainto~n~iTe' r aapefiof~one;(a~)_calendar~:yea.
Employment Status: Employed retired ^ Home-maker ^ Other ^ /y'~ij~ - y~i~LQJ
Received in Gity Clerk's Office by Date
Name of Deputy Clerk
Document Control Number (Assigned by the City Clerk's Office) ~~ Entered By l Date ~ 5 O
Re 'sed 09/02106 LH
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application 21309.doc