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Seth Frohlich 12/31/2009m 4 ^4 A~ I .~`~ ~ v~ 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 04-08-2009 Seth Frohlich 3126 Pinetree Dr Miami Beach, Florida 33140 =i ~ ~~ t :ti~ee on the Homeless Congratulations! You have been appointed by Commissioner Deede Weithorn 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, ~' ~ S , 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. City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov OFFICE OF THE CITY CtERK, Robert Parcher, City Clerk Tel: (305) 673-741 1, Fax: (305) 673-7254 TO Seth Fronhlich 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: 12/31/2009. 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 disclosure require- ments of Miami-Dade Count or the State of Florida (dependin n the b rd or committee on which I serve) on July 1st, following the closing of the calendar year or~which ave ed - -- ~J Seth Fronhlich Sworn to and subscribed before me thi day of ~~ ~ ~.. , 20 ,~ ~, n t' Silvia Prieto Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Baard 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. NAME ."J~'P,P,~ I BtA.CH ~`!T?' OF M1AM1 BEA:H B~~,~D ,~iND COr,>~n~cTTEE ~.PPi_IC TiON FCJR(Vi ~~~ Last Name ~ I 1 F" st Name /~ Midldle Initial HOME ADDRESS: ~ ~~~ ~ r /~ 1~(~E-~ ~ ( ~(..,~,. ~~:c c~ Ir~ ~ ~~ ~~ Apt No. House No./Street `~ City State Zip Code ~-~ s .~~z ~~31~ ~c 1 ~,5-_~ ~~-~G '~3.;~C ~{ a ~ G~~ -% s~=~-i-, ~=mot, I,'~.'~,~,- ~~t.,Mc PHONE: ~,Y some Work Fax Email address Business Name: Address: t ' ~-'~1 l ~` ^~' ~ °j~~ ~er~~ Position: ~_.3'~ ~3 ~L -~ ~ i ~~i No. Professional License (describe) State Zip Expires: 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 [~ir No ^ • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes~ar No ^ • Are you a registered voter in Miami Beach: Yes.~O-er 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: • Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or Nor- , 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 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 0 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 ommittee 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 ^ Communit Relations Board ^ Plannin Board* ^ Convention Center Adviso Board ^ Police Citizens Relations Committee ^ Production Indust Council ^ Debarment Committee ^ Public Safe Adviso Committee ^ Desi n Review Board* ^ Safet Committee ^ Disabilit Access Committee ^ Sin le Famil Residential Review Panel ^ Fine Arts Board ^ Sustainabili Committee ^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC" ^ Golf Adviso Committee ^ Trans ortation and Parkin Committee ^ Health Adviso Committee ^ Visitor and Convention Authorit ^ Health Facilities Authorit Board ^ Youth Center Adviso Board ^ Hispanic Affairs Committee '` Board Required to File State Disclosure form Street /~. 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 Ci Years of Service: 2. Present participation in Youth Center activities by your children Yeses 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 Ncd~T~ if yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes D or No ~If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes ^ or Nq'~ 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: • List all properties owned or have an interest in, which are located within the City o Mjami 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 u, child G, brother C, or sister ~ who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): Gender: Mals`.~ Female ^ Race: White ¢f- Black ^ Ethnic Origin: Asian or Pacific Islander ^ African-American/Black ^ American Indian or Alaskan Native ~ Hispanic: ^ White -Not Hispanic ^ Physically Challenged: Yes :-, or No _:. "I hereby att t to the accuracy an truthfulness of the application and have received, read and will abide by Chapter 2, Article II - f the Co "tan rds of Conduct for City Officers, Employees and Agenc Memb s " . ~~ Appl ant's Signature Dat Name of Applicant (PLEASE PRINT) Please-attach a copy ofyour resume to this applicatioh NOTE:-Applications will>remaire;on file`for:a;period of,one.(1,)..calendar°year. Employment Status: Employed~4,Retired ^ Home-maker ^ Other ^ Received in City Clerk's Office by ate Name of Deputy Clerk 2 Document Control Number (Assigned by the City Clerk's Office) y-y 3~ Entered By Date Revised 09/02/08 LH F:\CLER\~ALL\aFORMS\BOARD AND COMMITTEES\BC Application 21309.doc