Frank Kruszewski 12/31/2010m /~/~ I.~,M t ~EA~ H
Cily d Miomi lsoeh, 1700 Comenrion Center Drive, Miami Booth, Fbridc 33139, viww.miamibeathfl.gov
OFFICE OF THE CITY CLERK, Robert Percher, Ciy Clerk
TEL: (305( 673-741 1, FAX: (305( 673.7254
01-27-2010
Frank Kruszewski
1800 Sunset Harbor Drive #2002
Miami Beach, Florida 33139
~~1 J6C~,a Police Citizens Relations Committee
Congratulations! You have been appointed by Commissioner Jorge Exposito
to the agency, board or committee named above for a term ending: 12/31!2010.
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,
/- ~' ~~'
Robert Percher
City Clerk
cc: Saul Frances, Parking Director
Chief Carlos Noriega
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, 2-456 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 Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet -Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employee
We are commined ro providing excellent public service and safey io oll who live, work, and play in our vibroN, Iropiml, hisroric communiy
® MIAMI BEACH
Glp of IMiand Bsaeh, 1700 Comenfion Centm Drive, Miami Beach, Fbrida 33139, www.miomibeechA.gw
OFFICE OF THE CITY CLERK, Robert Percher, Ciy Cleric
TEL: i305) 673.7411, FA%: i305i 673-7254
TO Frank Kruszewski
RE: Police Citizens Relations Committee
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 pertorm all the duties of
a member of the above-mentioned board or committee of the City of Miami Beach to which I have
been appointedforaterm ending: 12/31/2010.
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 theyorida commission on Ethics Guide to the Sunshine
Amendment and code of Ethics for Public OliScers and Employees, 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 orff~~mittee on which
I serve) on July 1st, following the closing of the calendar year on which I have fired.
Kruszewski
Sworn to and subscribed before me this ay of ~hl , 200(
Silvia Prie o
Deputy Clerk
'Please visit the Gty of Miami Beach website at www.miamibeachfl.govnnder Gty derk/BOard and Committees
for additional information regarding the Fnandal Disclosure Requirements.
We o2 commifled ro prwidirg excellent public service and solely ro oil who live, work, and pby in our vibrom, napiml, hisroric communiy.
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NAME: K~v 4 S 2 .W S
Last Nar
HOME ADDRESS: e2~
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PHONE: ~~ f GS~ ~f
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Business Name:
~;".. q~e,s~ 1 ~ CITY OF MIAi1AI BEACH
fIQARD ANL~ COMMITTEE APPLICATIOM FORM
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City
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Fax
Posdion:
Address:
No. Stre City State Zip Code
Professbnal Licence (deacrlbe)~1H1 ~-IC l~rfP ~G'~s~0 ~a LI a Expirea: Arracharapy orrha lioense
Pursuant to City Code aectlon 2-22(4) a and b: Members of agenaes, boards, and committees shall be affiliated with the city; this
requirement shall be fulled in the folknxing ways: a) an individual shall have been a resident of the cRY for a minimum of six
months; or b) an individual shall demonstrate ownershiplMerest for a~minimum of sur months in a business established in the city.
• Resident of Miami Beach for a minimum of six (8) mondrs: Yea 6~6r No ^
• Demonstrate an ownershiptinterest in a business in Mi each for a minimum of six (8) months: Yas B,of~lo ^
• Are you a registered voter in Miami Beach: Yes r No ^
• (Please ~ cLle one): I am now a resident of: North Beach South Beach Iddle Bea
• 1 am appying for an appointment because I have spedal abilities, knowledge and experien ist below:
• Are you presently a registered lobbyist with the City of Miami Beach? Yea ^ or No~^
Please list your preferences in order of ranking [1] first choice [2J second choke, and [9) third choice. Please note that only three 191
choices will be observed by Ure City Clerk's Office (Regular BoanJs of Cily)
^ Affordable Housin Committee ^ Housin Auth '
^ Art in Public Places Committee ^ Loan RevleH Committee
^ Beaulificatbn Committee ^ Marine Autho
^ Board of Ad'ustmenC ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Ca Rol Im rovements Pro eds Overef hl Committee ^ Miami Beach Sister Cites Pr ram
^ Committee on the Homeless
^ Committee for Quali Education in MB ^ Norman Shores Local Govemmant Ne' h. lm ment
^ Parks and Reaeatlon Faalifies Board
^ Communi Develo meM Adviso
^ Cotrvnun' Relations Board ^ Personnel Board
Planni Board'
^ Convention CenterAdvi Board Police Citizens Relations Committee
^ Debarment Committee
^ Desi n Review Board' ^ Production Indust Councl
D Public Safe Adviso Committee
0 Disabiti Access Committee
^ Fine Arts Board ^ Saf Committee
^ Sin le Famtl Residential Review Panel
^ Ga Lesbian Bisexual and Tran ender GLB
^ Golf Advi Committee ^ Sustainabilf Committee
^ Trans wren Reliabil' & Axountabili CommRtee'TRAC'
^ Health Advis Committee
^ Health Facilities Authori Board ^ Trans rtation and Parkin Committee
D Visitor and Convention Au
0 His anic Affairs Committee
^ Historic Preservation Board ^ Waterfront Protection Committee
^ Youth Center Adviso Board
"Board Re ufred to File State Disclosure Form
Note: if appying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth
1. Past service on the Youth Center Advisory Board: Yes ^ No ~ Years of Service: I
2. Present partidpation in Youth Center adivitiee by your children YesG No ~. If yes, please list the
ages, and which programs. List below:
Child's name:
Age: Program:
Child's name:
Age: Program:
of your children, their
F:\CLER\$ALL\cfU7,,ViS\BOARD AIJD COH1MIi7EE5i8C AppGcatiunC62609 NLW.doc ct/ ,(/
/ /A
oHave you ever been convicted felony: Yes ^ or No~:if~yes, please expl~n detail:
• Do you curcenty have a violation(s) of City of Miami Beach codes: Yes ^ w N~g,ifyes, please explain in detail:
• Do you currently owe the City of Miamf Beach any money: Yes ^ or Noyes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes~r No ^. If yes; which board?
• What organizations in the City of Miami Beach do you curcently hold membership in9
Name:
Name:
• 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 ^ or No rich department?
• PureuaM to City Code SeeUon 2-25 (b): Do you have a parent D, spouse D, d a, brother O, w sister ^ who is employed by the
Cky of Miami 8each7 Check all that apply. Identify the department(s): 1 )~~
The foflowing tMonnatlon M voluntary arM is neither part of your applkatlon norJ(aa arty bwring on your eorretdaretlon for appolMmem. k Ia
being asked to comply with federal equal opportunity reportlng requirements.
Gender. ^ ale ^ Female
Ethny~Orlgin: Check one only (1)
ke (Not of Hiapank Origin): All persona hav'sig origfna in eny of the original peoples of Europe, North Ahice w the Middle East.
^ AfAcan-AmancaNBlack (Not of Hbpenk; Odgin): All persona having origins In erry of the Bledc rectal groups o1 Akka.
^ Hiapante: All persons of Nbxican, Puerto Rken, Cuban, CeMrel or South American, w other Spardah culture w origin, regeMksa of race.
^ Aeien w Paeifle Islander. All peraorro having origins in eny of the original peoples of the Far East, SoulheaM Asia, the Indian SubeoMineM, on
the Padflc Islands. Thu area includes, Tw esempb, Chine, India, Japan, Korea, the Philippine 191ends and Somoa.
^ American IrMian w Alaskan Native: All persona having origins in erry of the original peopee of North America, end who maintain
Culture) identiflcetbn through tribal effil~iahon/or~ommunity recognition.
Physically Challenged: Yes ~ or Nbe.'
Employmerd Status: Employed dj/ Retired ^ Homemaker ^ Other ^ ~:,w'f'r ~et.~ ~~ n, to 'Tn,c
NOTE: If appointed, you will be required to follow certain laws which appy to city bosrdleommlttae members.
These laws include, Mrt are not limited to, the following:
o Prohibkion tram diredy or indirectly lobbying dry personnel (Miami Beach City Code section 2-459).
o Prohibition from contracting wkh the dty (Miami-Dade County Code section 2-11.1).
o ProhibRion from lobbying before board/committee you have served on far period of one year after leaving office (Miami
Beach City Code section 2-28).
o Requirement to disclose certain finandal interests and gifts (Miami-Dade County Code secfion 2-11.1).
(re: CMB Community Development Advisory Committee): prohibifion, during tenure and for one year after leaving office,
fran having any interest in or receiving arty beneffi from Community DevebpmeM Block Grant funds for either yourself ,
or those with whom you have business or immediate family flea (CFR 570.611).
Upon request, copies of these laws may be obtained from the Cky Clerk.
"i fault the eeurecy and truthfulness of the appliea8on and have received, read and will abide by Chapter 2,
Arty-9f~Ci Code "Standard~of~rondur:t for City Officere, Empbyeea an}d Agency Members:'
copy of your resume to MM epplleatlon
NOTE: Applieatlorre wifl remain
fw~eriod of one (1) calendar year.
Received in the City Ckrk's Office by :.. ~ir4iL Tiyi~~//ilE/1/(~ale: / 2 Control NO. ~.~t'? Data: