Dana Turken 12/31/2011January 12, 2010
Dana Turken
108 4th Dilido Terrace
Miami Beach, Florida 33139
SUBJECT: Capital Improvements Projects Oversight Committee
Congratulations! You have been appointed by Mayor Matti Herrera Bower to the agency,
board or committee named above for a term ending: 12/31/2011.
Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after January
1st, 2007, the term of board members who are directly appointed by a member of the City
Commission shall automatically expire on December 31 of the year the appointing elected
official leaves office.
If you are unable to accept this appointment or have any questions, please call the City
Clerk's Office at 305-673-7411. Please read the enclosed materials carefully.
Congratulations again and good luck.
Sincerely,
~~
fit, C~c,l~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Charles Carreno
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, 2-458 and 2-459
Ordinance No. 2006-3543 -Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1- Conflict of Interest and Code of Ethics
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami beach, Florida.33139, ~eodnlv.miamibeachR.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Dana Turken
RE: Youth Center Advisory 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 ~c~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 ear on which I have served.
v
Dana Turken
Sworn to and subscribed before me this /2 day of u , 20d~
~.J ~ -
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 commit-ed to providing excellent public service and safey to all who live, work and play in our vibrant, tropical, historic community.
I `;i l i ;f ;,` .1/~, ! V ~~~ ~ CITY OF MiAiJII 3EACH
C BOARG AhID COMrVI1TTEE ~4PPLIC~;TIOh FOP,N
NAME:
'T-v~2.lc ~,.
Las! Name First Name Middle Initial
HOME ADDR>:SS~OQ~ ~ ~~ 4'p~~~'~/~ ~- ~ ~ 3--s~`~~
Apt No. House No.lStreet City State Zip Code
PHONE: _ ~ ~)~ ~~`3~ -S"® o~ ~9.~ :f-~~- ~8~ ~ir~ on7c~~ l ~ 6 ~~y-~~~
Home Work Fax Finail address
Business Name:
Position:
Address:
No. Street City State Zip Code
Professional License (describe) ExPims' 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 ownership/interest for a minimum of six months in a business established in the city.
. Resident of Miami Beach for a minimum of s'tx (6) months: Yes D or No ^
• Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes ^ or No 0
• 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 experience. Please fist below:
• Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or No 0
Please fist your preferences in order of ranking [1j first choice (2j second choice, and (3j third choice. Please 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
D Art in Public Places Committee D Lean Review Committee
D Beatttific~tion Committee D Marine Atrtho
^ Board of Ad'ustmerd"` D Miami Beach Commission for 1Nomen
D Bu et Adviso Committee D Miami Beach Guttural Arts Coundl
D C ital im mvemerrts P 'acts Oversi ht Committee D Miami Beach Sister Cities P ram
D Committee on the homeless D Normand Shores Local Govemmerrt Nei h. im rovement
D Committee for Qual Education in MB D Parks and Recreation Facilities Beard
0 Commun Deveio meat Advtso D Personnel Board '
D Commun Reia6ons Board D Plannin Board"
D Convention Center Adviso Board D Police Citizens Relations Committee
D Debarment Committee D Production indu Council
D Design Review Board' ^ Public 5 Adviso Committee
D Disabil' Access Committee ^ Sa Committee
p Fine Arts Board D Sin le Famii Residential Review Panel
D Ga ,Lesbian, Bisexual and Trans ender GLBT D Sustainabil~ Committee
D Golf Adviso Committee ^ Trans wren Rsiiabii' 8~ Accountabil' Committee "TRAC"
D Health Adviso Committee D Trans ortation and Parkin Commtttee
D Health Facilities Autho Board D Visitor and Convention Autho
D His anic Affairs Committee iiront Protection Committee
D Historic Preservation Board 'oath Center Adviso i3oard
"Board Required to Fiie State Disclosure Fonm
Note: If applying for Yauth Advisory Beard, please indicate your affiliation with the Scott Rakow Youth Center.
1. Past service on the Youth Center Advisory Boa . Yes ~ No ^ Years of S
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:
~: LEP.',S~AL'.\aF~RM,S~BaARD AND ~OMMrrrc~5\BC Hnoli~ation06250° N.V~'.do:
•~ave you ever been convl^tec o` s relony Yes ~/No i' vas piease explain ir, detail.
• Do you currently have 2 vioiation~s) o? City of Miami Beach codes: Yes ~ or No _ ;yes. piease expaain lr. detail.
• Do you currently owe the City of Miami Beach any money: Yes _ or No -. ~ yes. explain in detail
• Are you currently serving on any City Boards or Committees: Yes " r No -. If vas which board
`~ff~t C' c,,
• 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:
~~-_
. i am now employed by the City of Miami Beach: Yes ~~ No~~. Which tlepartment?
. Pursuant to City Cade Section 2-25 (b): Do you have a parent D, spouse ^, child ~; brother C, or sister D who is employed by the
City of Miami Beach? Check all that apply. identify the department(s):
The following information is voluntary and is nefthsr pert of your applit~tton nor has any bearing on your consideration for appointment. It is
being asked to comply with federel equal opportunity reporting requirements.
Gender: 0 NEafe emaie
one only (~ )
~hNre (Not of Hispanic Origin): All persons having origins in any of the original peoples of curope, North Africa or the Middle East.
D Afttcan-American/Black (Not of Hispanic Origin): Alf persons having origins in any of the t3lack raaal groups of Africa.
^ Hispanic: Alf persons of Mercit~n, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
Asian or Pacific Islander: Ail persons ttavhg origins in any of the original peoples of the Far `ast, Sotrtheast Asia, the Indian Subcontinen!, or
the Pacific (stands. This area includes, far axempte, China, lruita, .iapan, Korea, the F'hllippine (stands and Sonora.
J American indiian or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain
Cultural idantffrcaftonthrough tribal afltliaffon or cortrrrumtty recognflion.
Yes D or NoC.
Empioymenf Status: Employed D
Other D
NOTc: If appoittted, you will be required to follow certain laws which apply to city baardtcommtttee members.
These haws tncturie, but are not Itmltad m, the following:
o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459}.
o Prohibition from contracting w[th the ~' (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 m disclose certain financial irtbarests and gifts (Miami-Dade County Code section 2-11.1 }.
(re: CMS 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 thQSe with whom you have business or immediate family ties (CFR 57D.611).
upon request, copies of these laws may be obtained from the City Geri;.
"I hereby attest to the accuracy and truthfulness
A cte VII - of the Clty Code "standards of Condy,
A aril's Signature Gate
of the application and have received, read and wit! abide b}~ Chanter ~.
:t for City Officers, Employees and Agency Members."
/d-o io ~ r4-.J ~ ! ~R. k~
Name of Hpolicant fPL~ASE PR1NTi
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a periotl of one (1 i calendar year.
Receives rn the City Clerk's Gfflce oy Gate ~ ;20Q6 control No Gate -_/~~
Name of Deputy Clerk