Zeiven Beitchman 12/31/2010
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wrww miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
02/13/2009
Zeiven Beitchman
3328 Garden Ave
Miami Beach, Florida 33140
'Miami Beach Sister Cities Program
Congratulations! You have been reappointed by Mayor Matti Herrera Bower
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,
~~~ f ~~~~~5~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Michael Alter
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.
~ ~' t
+' ~ ( ~
r'td> v 1t .~~
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciry Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
TO Zeiven Beitchman
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 Public ~cers and Emp/ogees, 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.
~' I
Zeiven Beitchman
Sworn to and subscribed before me this ~~ay of ~~~~, 200_.
-~ ,~
~`lt'~ 4'~7 , ~ ---
Silvia Prie o
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 M ~ ~~ ~ g EAC ~ CITY OF MIAMI BEACH
_ BOARD AND COMMITTEE APPLICAT~ICa,N FORM
/ ~ / r
NAME: C ` '~`~ 1~ M~ ~C./ ~~. ~ ~/ -e .~
Last Name First Name ^~ Middle Initial
HOME ADDRESS: ~~~~ ~,~4-r'~~.~r /-~-u~ `v ~~ ~ ~ ~ (~ ~
No. Street City State Zip Code
PHONE: ~ ~ S~ ~ ~ ~{ O `~ ~- `( ~ 'C'~ G ?j o ~ ~{ c-( .~ -~- -
Home Work Fax Email address
~~V ~ ~ Position: V' S
Business Name:
~~
O
Address. -
No. Streeet City State Zip Code
Professional License (describe) '~'`~ ~--V`-~ v ~ t s~ Expires:_~0~~ 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 ownershiplnterest for a minimum of s' onths in a business established in the city.
f r a minimum of six 6 months: Yes r No ^
• Resident of Mlaml Beach o ( )
r hi /interest in a business in Mia ach for a minimum of six (6) months: Yes or No ^
• Demonstrate an owne s p
• Are you a registered voter in Miami Beach: Yes 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 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 only three l31
choices will be observed by the Citv Clerk's Office. (Regular Boards of City)
D Affordable Housin Adviso Committee ^ Historic Preservation Board
D Art in Public Places Committee ^Housin Authorit
^ Beach Preservation Board ^ Loan Review Committee
D Beautification Committee ^ Marine Authori
^ Board of Ad~ustment' ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami "Cultural Arts Council
D Ca ital Im rovements Pro'ects Oversi ht Committee i Beach Sister Cities Pro ram
0 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 hborhood District Overla CANDO ^ Production Indust Council
^ Debarment Committee ^ Public Safe Adviso Committee
D Desi n Review Board" ^ Safet Committee
^ Disabiti Access Committee D Sin le Famil Residential Review Panel
^ Fine Arts Board ^ Sustainabilit Committee
D Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabili & Accountabifit Committee "TRAC"
^ Golf Adviso Committee ^ Trans ortation and Parkin Committee
^ Health Adviso Committee ^ Visitor and Convention Authorit
^ Health Facilities Authori Board D Youth Center Adviso Board
^ His anic Affairs Committee
" Board Required to File State Disclosure form
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application 21 109.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: Agg~' Program:
.Have you ever been convicted of a felony: Yes ^ or No ~f yes. please explain in detail
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No yes, please explain in detail:
. Do you currently owe the City of Miami Beach any money: Yes ^ or No Cl!(f yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes ^ or No ~f yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name:
Name:
Title:
Title:
• List all properties 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 NoClTNhich department?
• Pursuant to City Code Section 2-25 (bj: Do you have a parent ^, spouse ^, child ^, brother ~, or sister ^ who is employed by the
City of Miami Beach? Check ill that apply. Identify the department(s):
Gender: Male ~ Female ^
Ethnic Origin:
Asian or Pacific Islander ^ African-A an/Black ^ American Indian or Alaskan Native ^
Hispanic: ^ White -Not Hispanic
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article - of the City C de "Standards of Conduct for C~ty icers, Employees and Agency Members."
Appiti Signature Date Name of Applicant (PLEASE
P T)
Pleaseattacha.copy of;your~resume4toahis~applic>#Eion
NOTE:°Iq;plilications~wlll~remain~on fllesfor a.peiodaf•one (1;)calendaryear.
cmpioyment status: tmployea a I•cetlred dome-maker Other ^
Received in City Clerk's Office by Date
Name of Deputy Clerk ~/O~
Document Control Number (Assigned by the City Clerk's Office) Entered By ~~ ~ Date
Revised 09/02/08 LH
F:\CLER\$All\aFORMS\BOARD AND COMMITTEES\BC Application 21 109.doc