Michael Piazza 12/31/2009m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachN.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (3051 673-7254
08-27-2009
Michael Piazza
1401 West 27th Street
Miami Beach, Florida 33140
SUBJECT ~ Committee for Quality Education in MB
Congratulations! You have been appointed by Commissioner Jonah M. Wolfson
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,
o %2~t~?.l~cPiZ S~ .
~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Leslie Rosenfeld
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.
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive; Miami Beach; Florida'33-1:39, i~viw.miamibeachA.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk "
...
Tel: (305) 673-7411, Fax: (305 673-7254 " ~ '
TO Michael Piazza
RE: Committee for Quality Education in MB
I do solemnly swear or affirm to gear 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 Ethic for Pub/ic Officers and Emp/oyees, 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 1 have serve)
- Micha is a
Sworn to and subscribed before me is '~ 9 day of ~ OPT , 200_0
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 commiHed to providing excellent public service and safely to al! who live, work and play in our vibrant, lropicol, historic community.
a+ r,~IAMIBEACH
NAME:
CITY OF MIAM! BEACH
~~ COMMITTEE APPLIC~ION FORM
Last Name'/', /~ ~ 1 s me J~J ~~, ~ Midd~leylnitiala~
HOME ADDRESS: ~TtJ~ ~Y~.~/ ~ ~~/ • /'~~~~'/• 1"~zttl~ /'"~. ..7~..J~'j'tr5
Aft Noy, _ Hbdse No./Street City _ , State Z~ Code
PHONE: .fi -i
Hom ~•_Work
Business Name:
Position:
ax
Email address
Address:
No. Street City State Zip Code
Professional License (describe)
Expires: Attach a copy of the license
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shalt be affiliated with the city; this
requirement shall be fulfilles~ in the following ways:•:a) an individual shall have been'a`resident of the bity for a minimum of six
months; or li) 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 (6) months: Yes ^ or No ^
. 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 and experience. Please list below:
• Are you presently a registered lobbyist 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 ^Housin Authori .,~
^ Art in Public Places Committee ^ Loan Review Committee
^ Beautification Committee ^ Marine Autho '
^ Board of Ad'ustment* ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
0 Ca ital Im rovements Pro'ects Oversi ht Committee ^ Miami Beach Sister Cities Pro ram
^ Committee on the Homeless ^ Normand Shores Local Government 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
^ Debarment Committee ^ Production Indust Council
0 Desi n Review Board* ^ Public Safe Adviso Committee
^ Disabil' Access Committee ^ Safe Committee
^ Fine Arts Board ^ Sin le Famil Residential Review Panel
^ Ga ,Lesbian, Bisexual and Trans ender GLBT ^ Sustainabili Committee
^ Golf Adviso Committee ^ Trans arenc Reliabili & Accountabil' Committee °TRAC°
^ Health Adviso Committee ^ Trans ortation and Parkin Committee
^ Health Facilities Autho ' Board ^ Visitor and Convention Authori
0 His anic Affairs Committee ^ Watertront Protection Committee
^ Historic Preservation Board ^ Youth Center Adviso Board
*Board Required to Flle State Disclosure Form
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~participatiori'~in Youth Center activities liy your children Yes^ No'G'. 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:
!q*
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application062609 NEW.doc
!~//~~
.Have you ever been convicted of a felony: Yes C~ or No ^,l If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes a or No . If yes,' please `explain in detail:
t.t ,`
. • Do you currently~owe the City\of Miami Beach any money: Yes ~~ or Not . 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:
• List all
owned or
in, which, are
Title:
at~{i~thi ~~e City ~jT~lliami Beach:
- r - -- -
• I am now employed by the City of Miami Beach: Yes ^ or NoC lllhich 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):
The following informy-f~on is voluntary and is neither part of your application nor has any bearing on your consideration for appointment It is
being asked to co ly with federal equal opportunity reporting requirements.
Gender: B' Male ^ Female
Ettlrfic Origin: Check one only (1)
hlte (Not of Hispanic Originj: All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.
^ African-American/Black (Not of Hispanic Origin): All persons having origins in any of the Black racial groups of Africa.
^ Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
^ Asian or Pacific Islander: All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, on
the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands and Somoa.
^ American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain
Cultural identification through tribal affiliation o community recognition. ~
Physically Challenged: Yes ^ or Noi~ i
Employment Status: Employed ^ Retired L4~ Homemaker ^ Other ^
NOTE: If appointed, you will be required to follow certain laws which apply to city boardlcommittee members.
These laws include, but are not limited to, the following:
o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459).
o Prohibition from contracting with the city (Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami
Beach City Code section 2-26).
o Requirement to disclose certain financial interests and gifts (Miami-Dade County Code section 2-11.1).
(re: CMB Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office,
from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself ,
or those with whom you have business or immediate family ties (CFR 570.611).
Upon request, copies of these laws may be obtained from the City Clerk.
"I hereby attest to the
Ar~iele~i/~,- of the City
Ihfulness of the application and have received, read and will abide by Chapter 2,
of Conduct for City Officers, Employees and Agency Membets'f'
Please attach opy your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in the City Clerk's Office by t'` ~ ~ bate: _/ /2009 Control Not~~~~ Date:f~ /2009 G/D