Philip Levine 12/31/2009,.
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
01-21-2009
Philip Levine
SUBJECT: Budget Advisory Committee
Congratulations! You have been appointed by Commissioner Victor M. Diaz, Jr.
to the agency, board or committee named above for a term ending: 12/31/2009.
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,
,/~ . ~,
6~~ ~
~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Jose Cruz
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 vibran-, tropical, historic community.
m
Cih- of JNiotni moth, 1700 Convention Center Drive, Miami Beach, Fbrida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
TEI: (305) 673-7411, FAX: (305) 673-7254
TO Philip Levine
RE: Budget 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: 12/31/2009.
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 must comply with the financial disclosequit
ments of Miami-Dade County or the State of Florida (depending on the board on which
I serve) on July 1st, following the closing of the calendar year on which I veers
//° ilip Levine ~.p~
Sworn to and subscribed before me th' day of , 200_w
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 ro providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
m MIAMIBEACH
~;ITY OF MIAMI SEACN
GUARD AND COMMBIi"i'E=s~. APPLICATit3N FGRM
NAME: ~V\Nt;~ Qk'1~ \.1 P ~V \S
Last Name First Name Middle Initial
HOME ADDRESS: 1 y 25 1V 0 KS El V ~ >arJ IjR\V E M l F'~M\ f ~ R C ~t . F~,. 3314'0
Apt No. House No./Street City State Zip Code
PHONE: C3~ 531 t1 130b) b~3-Qs~y ~305~6'13-~1~1~} ~ g ~~~ a~ baroc~-~oCP•~M
Home Wo Fax Email ad ress
Ph `1i P C ~`r0~ -(ACP• ~ ~"-
Business Name: Q7A SON CO ~Po ~+R ~ 1~ N Position: (~ W tJE4.
Address: SAF'\V t?tS PrQyO~f Fi
No. Street City State Zip Code
Professional License (describe)
Expires: Attach a copy of tht license
Pursuant to City Code section 2-22(4) a and b: Members of agenaes, 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 mi`ni'mum of six months in a business established in the aty.
• Resident of Miami Beach for a minimum of six (6) months: Yes [for No ^
• Demonstrate an ownership/interest in a business in Miami Beach `for a minimum of six (6) months: Yes or No ^
• Are you a registered voter in Miami Beach: Yes r No ^ - - - "-
• (Please circle one): I am now a resident of: North Beach South Bea Middle Beach
• I am applying for an appointment because !have special abilities, knowledge, experience. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach? Yea ^ or N%~
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 City Clerk's Offtce. (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
ud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Ca ital Im rovements Pro'ects Oversi ht Committee ^ Miami Beach Sister Cities Pr 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
^ Commun' Develo ment Adviso ^ Personnel Board
^ Communi Relations Board ^ Plannin Board'
^ Convention Center Adviso Board ^ Police Citizens Relations Committee
^ Cultural Arts Nei hborhood District Overl CANDO ^ Production Indust Council
^ Debarment Committee ^ Public Safe Adviso Committee
^ Desi n Review Board• ^ Safe Committee
^ Disabil' Access Committee ^ Sin le Famil Residential Review Panel
^ Fine Arts Board ^ Sustainabil' Committee
^ Ga Business Develo ment Ad Hoc ^ Trans aren Reliabili 8 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 Re ulred to Flle State Dlaclosure form
F:\CLER\SAII\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 partiapation 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: Age: Program:
.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 ^ 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 on any City Boards or Committees: Yes ^ or No If yes; which board?
.What organizations in the City of Miami Beach do you currently hold membership in?
Name: Title:
Name: Title:
• Li properties owned or have an interest in, which are located within the City of Miami Beach:
/~~rliM
. I am now employed by the City of Miami Beach: Yes ^ or No Which department?
• Pursuant to Clty Code Section 2-25 (b): Do you have a paren ^, spouse ^, child ^, brother ^, or sister ^ who is employed by the
City of Miami BeachT Check all that apply. Identify the department(s):
Gender: Male Female ^ Race: White Black ^
Ethnic Orfgin:
Asian or Paafic Islander ^ African-AmericaNBladc ^ American Indian or Alaskan Native ^ Hispanic: ^ UVhite -Not Hispanic
Physically Challenged: Yea O or
"1 hereby attest to the acc thfulness of the applkation and have received, read and will abide by Chapter 2,
Article VII - of the C rds of Conduct for by O ers, Employees a Agency Membe ."
Applicant's i ~ - ; Date Name of Applicant (PLEASE
PRINK ~
Ple of your r+stume to thfg ap~StiG~tlon
NO ri~Il:terrraltr' on tite'far el Ae~'gd of.one (1yGa1(inda~yir.
Employm t Status: Employe Retired ^ Home-maker ^ Other ^
Received fn Clty Clerk's Office by Date
Name of Deputy Clerk ~ ~~ ,
Document Control Number (Assigned by the Clty Clerk's Offica)1~..11L- Fstered By to ~ L/
F:\CLER\SAI.I\aFORMS\BOARD AND COMMITTEES\BC Application 21309.doc