Elsa Orlandini 12/31/2011M
m MIAMIBEACH
•
City of Miami Beach, 1700 Convenson Center Drive, Miami Beach, Florida 33139, ~ww.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (3051 673-7411, Fax: (305) 673-7254
12/31 /2009
Elsa Orlandini
3718 Sheridan Ave
Miami Beach, Florida 33140
Miami Beach Commission For Women
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
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 Ofhce at
(305) 673-7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
Robert Parcher ~~"
City Clerk
cc: Saul Frances, Parking Director
Wanda Ortiz
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 committed to providing excellent public service and safely to all who live, work and play in our vibrant, tropical, historic community.
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m MIAMIBEACH
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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) 673-7411, Fax: (305) 673-7254
TO Elsa Orlandini
RE: Miami Beach Commission For Women
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 Cade of Ethics for Public Officers 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 calendar year on which I have served.
Elsa Orlandini
Sworn to and subscribed before me this 5 day of , 200.
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 to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
- n
NAME:
CfTY OF MIAMI B=ACH
BOARG AND COMMITTEE /aPPLICATION FORM
Last Na e r .~^ / first Name Middle Initial
HOME ADDRESS: ~ ~ I ~ 1.~~ r \ (~~ ~ - ~-
aApt No. , / / " House No.lStreet r<y State Zip Code
PHONE: J~~ ~.~`7 `e n~~
Home ork Fax n . / Email address
/C~- 1~/1 , Position: V~~I/1A~ ~ .
Business Name:
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 6: 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 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 D or No 0
• (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 0 or No ^
Please list your preferences in order of ranking (1] first choice [2] second choice, and (3] third choice. Pisase note that oniv three l3)
choices will be observed by the City Cleric's Office. (Regular Boards of City)
D Affordable Housin Adviso Committee D Housin Autho
^ Art in Public Places Committee D Loan Review Committee
^ Beaul3fication Committee D Marine Autho
^ Board of Ad'ustment" D Miami Beach Commission for Women
D Su Adviso Committee D Miami Beach Guttural Arts Council
D C ital Im rovemerrts Pro eCt5 Oversi ht Committee D Miami Beach Sister Cities Pro ram
^ Committee on the Homeless D Normand Shores Local Government Nei h. im rovement
D Committee for Qual Education in MB 0 Parks and Recreation Facilities Board
0 Commun Develo meat Adviso D Personnel Board
D Commun Relations Board D Plannin Board"
D Convention Center Adviso Board 0 Police Citizens Relations Committee
D Debarment Committee ^ Production indu Council
0 Desi n Review Board' ^ Public 5a Adviso Committee
^ Disabil Access Committee 0 Sa Committee
0 Fine Arts Beard 0 Sin le Fami Residential Review Panel
^ Ga ,Lesbian, Bisexual and Tran ender GLBT ^ Sustainabif' Committee
^ Gotf Adviso Committee ^ Trans wren Refiabil' 8~ Accountabil' Committee "TRAC"
^ Health Adviso Committee ^ Trans or'tation and Parkin Committee
D Health Faaltties Autho Board ^ Visitor and Convention Autho
D His nic Affairs Committee D Waterfront Prothction Committee
^ Historic Preservation Board D 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 participation in Youth Center activities by your children Yes_~ No =. If yes, please fist the names of your children, their
ages, and which programs. List below:
Child's name: Age: Program:
Child's name: Age: Program:
F:\~LEP.`.bAl!\aF~RMS\B~ARD AND COMMITTEES\BC Appiicotion062609 NEW.do. ~~
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.Have you ever been convicteC ~~~lony Yes e~ No I' yes, please expla~etail:
~,_.~
• Do you currently have a violation(s) of City of Miami Beach codes: Yes = or bier. 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 serrino on any City Boards or Committees: Y~r No~f yes; which board?
~~~
• What organizations in the City of Miami Beach de 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:
• I am now employed by the City of Miami Beach: Yes l orWhich depaltment~
• Pursuant to City Code Section 2-25 (bj: Do you have a parent D, spouse C, child C, brother C, or sister 0 who is employed b~~ the
City of Miami Beach? Check all that apply. Identify the department(s):
The following information is voluntary and is neRher 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: D Niale 1~emale
Ethnic Origin: Check one only (1)
^ White (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle Fist.
^ African-American/Black (Not of Hispanic Origlnj: All persons having origins in any of the Black racial groups of Africa.
ispanic: 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 Asie, the Indian Subcontinent, on
the Pacific !stands. This area includes, for example, China, India, Japan, Korea, the Philippine (stands and Somoa.
D American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain
Cultural identfficafion through tribal affiliation or community recognition.
Physically Challenged: Yes 0 or No.i~
Employment Status: Empioyed~g~Retired D Homemaker D Other ^
NOTE: If appointed,-you wilt be-required to follow certain laws which apply to city baardicommit>Uee members.
These laws include, but are not fimNoad 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 boardlcommittee 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 Geri:. '
"I hereby a eat ~ th c racy and truthfulness of the application and have received, read and wilt abide by Chapter Z.
Artic Standards of Cond ~ for ity Officers, Employees and Agency Memben;."
._ (//
can s Signet a ate Name of Applicant (PLEASE PRINT)
', Please attach a eopy of your resume to this application
NOTE: Applications will main on file for a period of one (1) calendar year.
'~j ( O
Received m the City Clerk's Office by 1~~~ ~ Date ( ~ 1200 ~ ntrol No~ Date ~_/ O~G ~ ~ (~
Name