Daniel Nixon 12/31/2011m ~fJAMIBEACH
City of Miami Beach, 1700 Convention Center Drive; Miami:Beach, Florida 33'1:39; www.miomibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: 1305) 673-7411, Fax: (305) 673-7254
1 /13/2010
Daniel Nixon
4646 N. Bay Road
Miami Beach, Florida 33140
_ ~..,,~.
SUB ECT:: Beautification Committee
Congratulations! You have been reappointed by Commissioner Deede Weithorn
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,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
John Oldenburg
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 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.33'139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Daniel Nixon
RE: Beautification Committee
1 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/o~da Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Public O~i~rs 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.
~ ~^P t
Daniel Nixon
Sworn to and subscribed before met ' day of , 200~'O
~~
ilvia 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 ploy in our vibrant tropical, historic communiy.
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Last Name FirstnName n Middle Initial
HOME ADDRESS: "`F ~ `F ~2- w ~~ 1'~~ ~~ faa~'-'~ ~ I ~ mac. a(n ~- ~' 3 ~ ~ C~
Apt No. House No./Stneet City State Zip Code
PHONE: ~ ~
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Business Name: ~ ~l ~Q l~ `J Position:
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Address: IV Qat-
No. Street City State Zip Code
Professional License (descxibe)
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Pursuant to City Code section 2-22(4) a and b: Members of agenaes, boards, and cemmittees 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 ay for a minimum of six
months; or b) an individual shall demonstrate ownershiprnterest for a minimum of six months in a business established in the aty.
• Resident of Miami Beach for a minimum of six (6) months: Yes ~Cor No 0
• Demonstrate an ownershipffnterest in a business in Miami Beach for a minimum of sa (6) months: Yes Jgor No ^
• Are you a registered voter in Miami Beach: Yes ~ir No ^
• (Please arde one): I am now a resident of: North Beach mouth Beach ddte Bcech
• 1 am applying for an appointment because I have spedal abilities, knowledge and experience. i ow.
• Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or No+~'
riease ust your preferences in order of ranking [7] first ctroice [2] second choice, and [3] third choice. Please note that only thn3e (3)
choices wilt be observed by the City Clerk's Office. (Regular Boards of City)
^ Affordable Housin Advi Committee O Housin Autho
^ Art in Public Places Committee ^ Loan Review Committee
eautification Committee ^ Marine Ado
^ Board of Ad"ustmenY ^ Miami Beach Commission for Women
^ Bud Advi Committee ^ Miami Beach Cultural Arts Counal
^ C I Im rovemerits Pro sots Overs' Committee
^ Committee on the Homeless
^ Committee for Quay Educetion in MB ^ Miami Beach Sister Cities P ram
^ Normand Shores Local Government Nei h. Im rovement
^ Parks and Recreation Faafities Board
^ Commun' Deve meat ^ personnel Board
^ Commun' Relations Board ^ Plannin Board*
^ C~vention Center Advi Board ^ Police Citizens Relatk)nS Committee
^ Debarment Committee ^ Production Indu Counal
^ D " n Review Board'
^ Disabil' Access Committee ^ Public Safe Adviso Committee
^ Committee
^ Fine Arts Bcerd
^ G ,Lesbian, Bisexual and Tra der GLB ^ Si le Fami Residential Review Panel
^ Sustainabil' Committee
^ Golf Advi Committee
^ Health Adv~ Committee
^ Health Faalities Board ^ T r+en Reliabif & Aceourrtabil' Committee °TI2AC°
^ Trans nation and Parkin Committee
^ visitor and Convention Autho
^ Hi nic Affairs Committee
^ Historic Preservation Board ^ Waterfront Protection Committee
^ Youth Center Advi Board
"Board Required to Fite State Dlsdosure 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 partiapation 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:
F:`~,C!_EF\$~ Li'~crFORlv15~',~C)A.F,`C~ ,~i~1D COivitelll?~c5~`,8C F.pi~iicCtic,~tCiCLtiG~ P~!E~?:'.c ac
.Have you ever been convicted of a felony: Yes ^ or No~lf yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No~~lf 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 servin{g~ on any City Boards or Committees: Yes~or No ^. If yes; which board?
• What organizations in the Ciiy of Miami Beach do you currentty hold membership in?
Name: I P 7"i" P l-e. Q3.¢`3-~u ,SjnO~ ~ D VW1, Title:
Name: Title:
• List all properties owned or have an interest in, which are located within the City of M' mi Beach: ,
• I am now employed by the City of Miami Beach: Yes ^ or Nd~iWhich deparkment?
• 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):
_ ~D
The following iMonrradorr is voluntary and is neither peat of your application nor has arty bearing on your consideration for appoinbrarnt. R k
being salted to comply with federal equal opportunity reportlng requlremerrts.
Gender, j~Male ^ Female
__
Check one.ony (1)
White (Not of Hispanic Origin): All persons having origin in any of the original peoples of Europe, North Africa or the Meddle Fist.
^ African,Amerir;ardBlack (Not of Hispanic origin): Ap persons Craving origins in any of the Bladc racial groups of Afriq.
^ Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
^ Asian ~ Pacific dander. All persons having origins m any of the original peoples of the Faz East, Southeast Asia, the Indian Subcontinent, on
the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Is~nds and Somoa.
^ American Indian or Alaskan Native: All persons having origins in any of the origirrl peoples of North Amerip, and who maintain
Guttural ~errtification through tribal aifiliafion or community r~eoognition.
Physically Challenged: Yes ^ or Nom
employment Status: Employed ^ Retired Homemaker ^ Other ^
NOTE: ff 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 finanaal interests and gifts (Miami-Dade County Code section 2-11.1).
(re: CMB Commun"rty 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 tfre City Cleric.
"1 hereb to the accuracy and truthfulness of the application and have n'cetved, read and will abide by Chapter 2,
Articl 1- of the "Ste dare of Conduct for City Officers, Employees and Agency Members."
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Applicant's Signature Date Nana; of Aoolrcant (PLEASE PRrnm
Please attach a copy of your resume to
Received in the Cdy Cleric's office by
~r a period of one (1) calendar year.
Date1 I~T2Q09 Gorrb+Ol No. ___ Date: ~ 1~