Rabbi Solomon Schiff 12/31/2011~.~
m MIAMIBEACH
City of Miami Becch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www_miamibeachA.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
12/15/2009
Rabbi Solomon Schiff
2443 Meridian Avenue
Miami Beach, Florida 33140
Community Relations Board
Congratulations! You have been reappointed by Mayor Matti Herrera Bower
to the above referenced agency, board or committee for a term ending: 12/31/2011.
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,
~~~-~~~~js~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Barbara Hawayek
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 commided io 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 Convenson Center Drive, Miami Beach, Florida.33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Rabbi Solomon Schiff
RE: Community Relations Board
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: 12/31/2011.
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 ~cets and Emp/oyees, and understand that as a member
of a City of Miami Beach Board and/or Committee, 1 must comply with the financial disclosure" requiCe-
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 ye~non wFj'Ich I have served. ~
Rabbi Solorrion Schiff
Sworn to and subscribed before me this ~ I day of ,// GYl/,1/l~NJ2oo _ /
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.
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HOME ADDRESS:
PHONE: / A/ .~
Home
Business Name:
CfTY Or' MIAMI BEACH
B~~D^C~O~/II^VI~{TTEE APPLICkTION FORM
~ir ame ~ .~>~4e~ Middle Isnliti~l /~
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_ ~ _ City _ State Zip Code
rax - Email address
Position:
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 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 ownershiplinterest 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 D or Na D
• Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes D or No D
• Are you a registered voter in Miami Beach: Yes ^ or No D
• (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 experienc*:. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach? Yes D or No ^
Please list your preferences in order of ranking [1j first choice (2] second choice, and [3] third choice. Please note that oniv three i'3)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
D Affordable Housin Adviso Committee 0 Housin Autho '
D Art in Public Pieces Committee D Loan Review Committee
^ Beautification Committee D Marine Autho
D Board of Ad'ustrnerrt' D Miami Beach Commission for Women
D Bud Adviso Committee D Miami Beach Guttural Arts Council
D Ca Ital Im rovements Pro et~.s Ovetsi ht Committee D Miami Beach Sister Cities Pro ram
D Committee on the Homeless D Nom-an Shores Local Govemmerrt Nei h. im rovement
0 Committee for Qual Education in MB ^ Perks and Recreation Facilities Board
0 Commun Deveio meat Adviso ^ Personnel Board
D Commun Relatons Board D Plannin Board'`
D Contention Center Adviso Board D Police Citizens Relations Committee
D Debarment Committee D Production indu Council
^ Desi n Review Board" D Public Sa Advtso Committee
^ Disabil' Access Committee 0 Safe Committee
D Fine Arts Board D Sin ie Famil Residential Review Panel
D Ga ,Lesbian, Bisexual and Trans ender GLBT ^ Sustainabii' Committee
D Golf Adviso Committee ^ Trans aren Refiabii' 8~ Accountabil' Committee "TRAC"
^ Health Adviso Committee ^ Tran ortation and Parkin Committee
D Health Facilities Autho Board 0 Visitor and Convention Autho
D His anic Affairs Committee D Waterfront Protection Committee
D Historic Preservation Board D Youth Center Adviso Board
"Beard Required to Ftie 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 G' No ~ Years of Service:
2. Present participation in Youth Center activities by your children Yes_~ No ~. If yes, please
ages, and which programs. List below:
Child's name: Age: Program:
Child's name: Age: Program:
list the names of your children, their
F'\~LEP.`.$AL.\aFORM,S\BJARD AND ~OMMITfEES\BC Application062609 NEW.do:
.Have you ever been convicted of a felony: Yes : tjriNo {` 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 ~lf yes. explain in detail
• Are you current; serving on any City Boards or,~oLmitt es: Yes " or No =. If yes', which boar ~
• What organizations in the City f Miami Beach do you currently hold membership in?
Name: Title:
Name: Title:
propert~e~ owngc~ o~ve an interest in, which are located within the City of Miami Beach:
. I am riow employed by the City of Miami Beach: Yes D or Nor~Vhich department?
• Pursuant to City Code Section 2-25 (b): Do you have a parent D, spouse C~, child G, brother C, or sister 0 who is employed by the
City of Miami Beach? Gheck all that apply. Identify the department(s):
The following information is voluntary and is nekher part of your application nor has any basting on your consideration for appointment. It is
being asked to co ply with federal squat opportunity reporting requiremerrts.
Gender: ale D Ferrate
Ethic Origin: Check one only (1)
hits (Nat of Hispanic Origin): Atl persons having origins in any of the original peoples of Europe, North Africa or the Middle East.
^ African-AmericanlBiack (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 Ameripn, or other Spanish culture or origin, regardless of recs.
^ Asian or Pacific Islander: All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Inritan SubconEinent, or
the Pacific (stands. This area includes, for example, China, fndta, Japan, Korea, the Philippine islands and Somos.
^ American Indian or Alaskan Native: Aft persons having origins in any of the original peoples of North America, and who maintain
Cultural identificarfion through tribal afitiiatton or mmunity recognftion.
Physically Challenged: Yes ^ or No~ ,
Employment Status: Employed D Retired EY Homemaker D Other D
NOTE: If appointed, you will be required to follow certain laws which apply to city boardicommltfGee members
These taws include, but ace not limited tn, 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 ProhibiEion from Lobbying before board/committee you have served on for period of one year attar 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 ar 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 taws may be obtained from the City Clerk.
"I hereby attest to the accuracy and truthfulne s f th ppiication and have received, read .and will abide by Chapter 2.
icfe - f the City d n of Co u f i Officer , Emplo ees and Agency Members."
~jb~,c~ P ~ ~ ~
p lice s Sig furs U e Name o Apoii nt (PLEASE PRINT)
Please attach a copy of your resume to this application
NdTE: Applications will remain on file for a period of one (1} calendar year.
Received in the City Clerk's Office by Date' _! /2005 :,ontrol No Date. %_/ ODE
Name of Deputy Clerk