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Daniel Spring 12/31/2011~ ~ m ,r~/I IA~/11 ~ SAC H City of Miami Beach, 1700 Convention Center Drive, Miami Beach; Florida 33.139, www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk Tel: (305) 673-741 1, Fax: (305) 673-7254 12/21 /2009 Daniel Spring 4261 Alton Road Miami Beach, Florida 33140 Gay, Lesbian, Bisexual and Transgender Congratulations! You have been reappointed by Commissioner Jorge Exposito to the above referenced agency, board or committee for a term ending: 12/3112011. 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 Rebecca Wakefield 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 commiried ro 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, Florida33139, www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk Tel: (305) 673-741 1, Fax: (305) 673-7254 TO Daniel Spring RE: Gay, Lesbian, Bisexual and Transgender (GLBT) 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 ~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 alenda ar on wFy~h I have serveds Daniel Spring Sworn to and subscribed before me this~~ day of cer. , 200°t. ",L-c~ 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. `~ CAF M~~~ , NAME: ~f ~.~5 l,r~ ..s «L. ~t-~ ' Last Name First Name Middle Initial HOME ADDRESS: ~ 2-6 1 ~ t-- ~ °' ~"~ 2~ M . ~ C~_ 3 3 ~ ~'(y Apt No. House No./Street City State Zip Code PHONE: ~©S`3U-3.-~~SZ- 3oS-S31-76'Z~ 3os so 3- SZ~~ Oa~+ rj~t~. Home n Work Fax Email address t>3 ~acL. ~f ,-a,,,. Business Name: ~ `~'},'` ~°~`~ T tv c~~ Position: ~~"'~ ~-~ Address{~ ~ S t ~`~_Sc- 1 "+ (~ ~.- ~ 3 L3 ~ No. Street City State Zip Code .~, Professional License (describe) LtJS ~+~-L ~~- J Expires: Z ~ ° AtPach ~ ccapy a~f ih~ tic~rase Pursuant to City Code section 2-22(4J 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; orb) 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 (ti) months: Yes ^ or No ^ • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes ^ or No D • 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 [3J third choice. Please note that only three (31 choices will be observed by the Citv Clerk's Office. (Regular Boards of City) ^ Affordable Housin Adviso Committee ^Housin Authorit ^ Art in Public Places Committee ^ Loan Review Committee ^ Beautification Committee ^ Marine Authorit ^ Board of Ad'ustment* ^ Miami Beach Commission for Women ^ Bud et Adviso Committee D Miami Beach Cultural Arts Council ^ 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 Qualit Education in MB ^ Parks and Recreation Facilities Board ^ Communit Develo ment Adviso ^ Personnel Board ^ Communit Relations Board ^ Plannin Board* ^ Convention Center Adviso Board ^ Police Citizens Relations Committee ^ Debarment Committee ^ Production Indust Council ^ Desi n Review Board* ^ Public Safet Adviso Committee ^ Disabilit Access Committee ^ Safet Committee ^ Fine Arts Board ^ Sin le Famil Residential Review Panel ^ ^ Sustainabilit Committee Ga ,Lesbian, Bisexual and Trans ender GLBT ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC° Q Golf Adviso Committee ^ Trans ortation and Parkin Committee ^ Health Adviso Committee ^ Visitor and Convention Authorit ^ Health Facilities Authorit Board ^ Waterfront Protection Committee ^ His anic Affairs Committee ^ Youth Center Adviso Board ^ Historic Preservation Board *Board Required to Fiie 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: J 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: Age: Program: r::CLLR'~.w+`~1l``,csi'.~(:~t}~`:E`s~J~<~;;`.:~'~<i~r wvlvl?v1 .~. .~~., tti :, y_, c, iW£ 1~ d~ap!ccrlic~~uC;";fl .coc .Have you ever been convicted of a felony: Yes ^ or No rXlf yes, please explain in detail: . Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No,~:CLyes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes ^ or Nor if 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: Title: Name: Title: • List all properties owned or have an interest in, which are located within the City of Miami Beach: . 1 am now employed by the City of Miami Beach: Yes ^ or No~hich 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 information is voluntary and Is neither part of your application nor has any bearing on your consideration for appointment. it is being asked to comply with federal equal opportunity reporting requirements. Gender: pllale ^ Female Ethnic Origin: Check one only (1) ~Alhite (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle East. ^ African-AmericanBlack (Not of Hispanic Origin): Ali 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 or community recognition. Physically Challenged: Yes ^ or No^. Employment Status: Employed „~ Retired ^ Homemaker ^ Other ^ NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee 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 a by' ttes t the accu cy and truthfulness of the application and have received, read and will abide by Chapter 2, Art VII ~ f t e ity Cod `Standards of Cond ct for City Office Employees and Age y Members." _. 7 sly ~ ~,~~t ~-~ ~~s Applica Signatu Date Name of Applicant (PLEASE RINT) Ptease attach a copy of,yourresume o this application NOTE: Applications will remain ~n'file'fora; period of one (1) calendaryear. , Received in the Cfty Clerk's Office by : ~ ~-~2~ Date: _/ /2009 Control N~ ~ 6 Date: Name of Deputy erk