Brad Fleet 12/31/2011m MIA;'v',I~EACH
City of Miami Beach, 1700 Convention Center Drive, Miami
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) b73-741 1, Fax: (305j 673-7254
12/8/2009
Brad Fleet
1457 Meridian Ave #202
Miami Beach, Florida 33139
Florida 33139)
Community Relations Board
.`
Congratulations! You have been reappointed by Com issioner Deeide Weithorn
to the above referenced agency, board or committee for a term endrng. 12/31/2011.
If you are unable to accept this appointment, please noti the City Cle k's Office at
(305) 673-7411.
Please read the enclosed material carefully. Again, tong atulations and good luck.
Sincerely,
~~~ s~
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 co mittee
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 a d Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet -Guide to the Sunshine Amendment and Code of Ethic for Public Officers and
Employees ~~
We are committed to providing excellent public service and safety to all who live, ~vvork and play in our vibrant, tropicol, historic community.
m MIAMIBEACH
01117/ Of Mta1111 BeOC~1~ 1700 Convenfion Center Drive, Miami
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (305) 673-7411, Fax: X305) 673-7254
TO Brad Fleet
RE: Community Relations Board .,
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the
United States, the State of Florida, and the City of Miami Beach, and to pert
a member of the above-mentioned board or committee of the City of Miami
been appointed for a term ending: 12/31/2011.
Florida 33.139, www.miamibeachfl:aov
emment of the
all the duties of
:h to which I have
I have been issued a copy of Section 2-11.1 of the Miami-Dade County Cod (Conflict of Interest
and Code of Ethics Ordinance), as well as theF/orida Commission on Ethics uide to the Sunshine
Amendment and Cade of Ethics for Pub/ic ~cers and Emp/ogees, and unde nd that as a member
of a City of Miami Beach Board and/or Committee, I must comply with the fi ancial disclosure" require-
ments of Miami-Dade County or the State of Florida (depending on the boa or committee on which
I serve) on July 1st, following the closing of the calendar year on which I ha a served.
~(~
rad leet
~
Sworn to and subscribed before me this ~ day f /V~/ dP 20d ~
~~~~
Silvi Prieto
Depu Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under
for additional information regarding the Financial Disclosure Requirements.
and Committees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
m ~~~~~ I r.~~~~~! ~~AC ~
NAME:
nL~ast~Name A
HDME ADDRESS: ~ ~~S'/
Apt No. House No.lStrE
PHDNE: ~ $~?OL;~ ~ S3~
Ho Work
Business Name:
K
I ctTY of tvllArnl aEacN
/~R~ AND COMMfTTEE la~,PyPLI~ CATION FORM
Name Middle Initial
~~
ity ~~,,,,,,~ ~~•~~State Zip Code
~S S3w8~.39 ~'~~~~FfL~A~/R~
Fax Email address
,: ~ dz r
Address: ~1~ ~~ `~ ~-
No. Street City State ip .Code
Professional License (describe) Expire ' Attach a copy of the license
" Pursuant to City Code section 2-22(4) a and b: Members of agencie ,boards, and co mittees shall ,be affiliated, with the city; this
requirement shalh be fulfilled •in,~the. fallowing ways: a) `an ..individual; II have' beery resicterat: of the city for a minimum of six
months; or b) an individual shall demonstrate ownershiplinterest fora inimum of six mo ths in a business established in the city.
• Resident of Miami Beach for a minimum of six (6) months: Yes ^ or o ^
• Demonstrate an ownershiplinterest in a business in Miami Beach for 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 oath Beach Middle Beach
• I am applying for an appointment because I have special abilities, kn wledge and expo 'ence. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach? es ^ or No 0
Please list your pn3fierences in order of ranking [1J first choice [2) sewn choice, and [3J ird choice. Please note that oniv three f3)
choices wilt be observed by the City Clehr's Office. (Regular Boards f City)
D Affordable Housin Adviso Committee D H usin Autho
D Art in Public Places Committee D L an Review Comm ittee
D Beautification Committee D M rine Autho '
D Board of Ad'ustmerrt' 0 M ami Beach Com lesion for Women
D Bud Adviso Committee D M ami Beach Cu I Arts Coundl
D Ca ital Im rovemer>ts Pro ects Oversi f'rt Committee D M ami Beach Sister Cities Pro ram
^ Committee on the Homeless D N m-and Shon3s ocal Gvvemmerrt Nei h. im rovement
D Committee for Qual' Education in MB 0 P rks and Recreati n Facilities Board
D Commun' Deveio meat Adviso D P rsonnel Board
B Commun Relations Board 0 Pi nnin Board'
^ Convention Center Adviso Board P lice Citizens Rel ons Committee
D Debarment Committee D P duction lndu Council
D Desi n Review Board" t! P blic 5a Advis o Committee
D Disabil' Access Committee D S Committee
D Fine Arts Board D S' n le Famit Resi ertttal Review Panel
^ Ga ,Lesbian, Bisexual and Trans ender GLBT ^ S stainabil' Comrf nittee
D GoK Adviso Committee D T ns ren Reliaf bil' & Accountabil' Committee "TRAC"
D Health Adviso Committee ^ T ns ortation and Parkin Committee
D Health Faalities Autho Board D V itor and Conve 'on Autho '
D His anic Affairs Committee ^ ater'front Protecti n Committee
D Historic Preservation Board D Y uth Center Advi o Berard
"B and Required to File State Disclosure Form
Note: If applying for Youth Advisory Board, please indicate your affiliatio with the Scott R kow Youth Center:
1. Past service on fhe'Youth Center Advisory Bdard: Yes C No ~ Years f•Service:
2. Present participation in Youth Center activities by your children Yes ~ No =. If yes, lease list the names of your children, their
ages, and which programs. List below:
Child's name: Age: Program:
Child's name: Age: Program:
F \: LER`.SALL\aFORMS\BOARD AND ~OMMITfEES\BC Appli~ation062609 Nt .do:
.Have you ever been convected of s felony: Yes e o I` yes. lease explain ir~ detail:
• Do you currently have a violation(s) .of City of Miami Beach code: Yes
1 ~ . Do you currertly ovve the`City of Miami Beach any •morrey: Yes
..,.• '~
• Are you currently serving on any City Boards or Committee .Yes
,,
•. What organizations in the City of Miami Beach do you.;currently h
Name: Title
Name: Title
• List all properties owned or have an interest in, which are locatec
14S7Men'~>i~~ , no.2.d2 . X3139 IPpS?e~C
• I am now employed by the City of Miami Beach: Yes G or ICS'
• Pursuant to City Code Section 2-25 (b): Do you have a parent D, spo
City of Miami Beach? Check all that apply, identify the department(s):
The following information is voluntary and is neither part of your appiicatlon
betrtg asked to comply with federef equal oppottuntty reporting requirements
Gender: ale ~ Female
Ethnic "gin: Check one only (1)
hlte (Not of Hispanic Origin): All persons having origins in any of the origin
^ African-AmericanlBtack (Not of Hispanic Origin): All persons having origins
O Hispanic: AR persons of Mexican, Puerto Rican, Cuban, Central or South Art
0 Asian or Pacific Istander: All persons havirrg origins in any of the original peg
the Pacific Isiantls. This area indudes, for attempts, China, India, Japan, Kon
~ American indlian or Alaskan Native: All persons having origins in any of the
Cultural identifrc~fion through tribal aftiliatton or community recognHion.
Physically Cttalienged: Yes D or tioD.
Employment Status: Employed G/Retired d Homemaker d
NOTE: If appointed, you wilt be-naquired th folCow certain taws
These taws include, but are not limited to, ttt~e:foffowing:
o Prohibition from directly or indirectly lobbying city personnel (M
o Prohibition from contracting with the city (Miami-Dade County
o Prohibition from lobbying before board/committee you have
Beach City Code section 2-26).
o Requirement to disclose oerain financial interests and gifts (Mi
(re: CMB Community Development Advisory Committee): pro
from having any interest in or receiving any benefit from Con
or those with whom you have business or immediate family ties
Upon request, copies of these laws may be obtained from the (
yes; please explain in detail:
iNe3'~~ yes expfain6in detail
o -.. If yes, which board?
membership Vin? .. ~ , , ,
within the City ~f Miami Beach:
lee D, child C, brdther C, or sister 0 who is employed by the
nor has any bearinl on your consideration for appointment. It is
I peoples of Europ ,North Africa or the Middle Fast.
in any of the Black cial groups of Africa.
:titan, or other Sp ish culture or origin, regardless of race.
pies of the Far Eas ,Southeast Asia, the Indian Subcontinent, on
i, the Philippine tsl nds and Somoa.
~rtginal peoples of otth America, and who maintain
Other 0 _
Ivhich apply to 9~ boardtcommlttee membees
ami Beach City CV de section 2-459}.
ode section 2-11 1).
trued on for peri d of one year after leaving office (Miami
mi-Dade County Code section 2-11.1).
IibiFion, during to ure and for one year after leaving office,
munity Develop ant Block Grant funds for either yourself . I
(CFR 570.611 }.
I
ity Clerk.
"I hereby attest to the accuracy and truthfulness of the appitcati and have race ved, read and will abide by Chapter 2,
A I{ - 'Standards of nduc for City Oficc Emplo ees a d Agency Members."
Z Ct~
Applican s Signature Date Name of Applica t (PLcRSE PRINT}
Please attach a copy of your resume to this appltcation
NaTE: Applications will remain on file fora eriod of one (1) tentlar year.
Received rn the City Clerk's Office by D to _' /2009 Co trot No
Name of Deputy Clerk
Date: _x_/2009