David Wieder 12/31/2011Im TJ~ I ~,IV~ i B EAR H
City of Miami Beach, 1700 Convention Confer Driva, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (305( 673-7411, Fax: (305( 673-7254
01-26-2010
David Wieder
1390 Bay Dr.
Miami Beach, Florida 33141
Historic Preservation Board
Congratulations! You have been appointed by the City Commission to the agency,
board or committee named above for a term ending: 1213112011.
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 enGosed materials carefully.
Congratulations again and good luck.
Sincerely,
d Robert Parcher
00 City Clerk
cc: Saul Frances, Parking Director
Thomas Mooney
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 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 so{ey ro all who live, work and play in our vibrant, hopical, hisroric community.
m MIAMI BEACH
City of Miami Beach, 1700 ConvenKon Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Cferk
Tel: (305) 673-7411, Fax: (3051 673-7254
January 26, 2010
TO: David Wieder
RE: Historic Preservation 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 Florida Commission on Ethics
Guide to the Sunshine Amendment and Code of Ethics for Public Officers 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' requirements o iami-Dade
County or the State of Florida (depending on theabo for tom on which I
serve) on July 1st, following the closing of the tale r y on Ic have sefved.
Wieder
Sworn to and subscribed before me thi n day of 2010.
Deputy Clerk
•Please visit the Gty of Miami Beach website at www.miamibeachFl.gov under City gerk/BOard and Committees
for additional information regartling the Finandal Disclosure Requirements.
We are commined ro providing excellent public service and sahrry ro all who live, work and play in our vibrant, tropical, hisroric communiy.
m !V~ I A/V~ i~}~B~E~CnAC H
NAME: ~! - ~~"' "" -
HOME ADDRESS:
PHONE: ~ ~
Ho a Work t I f
Business Name: ~~ l/ 17 ~ ss~~~^ osition:
Address: 1lI~J /f77
Professional License (desedbe)
CITY OF MIAMI BEACH
COMMITTEE APPLIr~ION FORM
~~
~O 6~State
J~
ry State Zip Code
Expires: Attach a copy of the license
Pursuant to Ciry Code section 2-22(4) a and b: 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; orb) an individual shall demonstrate ownershiprnterestfor aminimum 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 ownerehipliMerest in abusiness in Miami Beach for a minimum of six (6) months: Yes D or No ^
• Are you a registered voter in Miami Beach: Yes ^ or No ^
• (Please circle one): I am now a resident of. North Beach South Beach Middle Beach
• I am applying for an appointment because !have special abilifies, knowledge and experience. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or No ^
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three f31
choices will be observed by the City Clerk's Office. (Regular Boards of City)
^ Affordable Housin Adviso Committee ^Housin Autho
^ Art in Public Places Committee ^ Loan Review Committee
D Beautification Committee ^ Marine Autho '
^ Boerd of Ad'ustmenY ^ Miami Beach Commission for Women
^ Bud et Adviso Committee D Miami Beach Cultural Arts Council
0 Ca ital Im rovements Pro eels Overei ht Committee ^ Miami Beach Sister Cities P ram
D Committee on the Homeless ^ Normand Shores Local GovemmeM Nei h. Im rovement
D Committee for Qual' Education in MB ^ Perks and Recreation Facilities Board
D Communi Develo ment Adviso ^ Personnel Board
^ Communl Relations Board ^ Plannin Board"
^ Convention Center Adviso Board ^ Police Citizens Relatons Committee
^ Debarment Committee ^ Production Indus CounGl
^ Desi n Review Board" ^ Public Sa Adviso Committee
0 Disabil' Access Committee D Safe Committee
^ Fine Arts Board ^ Sin le Famil Residential Review Pansl
D Ge ,Lesbian, Bisexual and Trans ender GLBT D Sustainabil' Committee
^ Golf Adviso Committee p Trans wren Reliabil' & Accountabll' Committee'TRAC"
^ Heatth Adviso Committee ^ Trans ortafion and Parkin Committee
D Health Facilities Authori Board ^ Visitor and Convention Authori
^ anic Affairs Committee ^ Waterfront Protection Committee
istoric Preservation Board D Youth Center Atlviso 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 C. 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:\CLEP,\$ALL\aFORMS\BOARD AND COMMITTEES\BC Appfication062609 NEW.doc
•Have you ever been convicted of a felony: Yes ]fir No "= If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ~ or N ~ If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes G or N~f yes, explain in detail
• Are you currently serving on any City Boards or Committees:. Yes G or No~f yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name: rea
Name:
List all
have an interest in, which are located within the City of Miami Beach:
I am now employed by the City of Miami Beach: Yes 0 or Nt~7. Which department?
• Pursuant to Clty Code Section 2-25 (b): Do you have a parent 0, spouse C, child q brother q or sister 0 who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):
The following Inforrnatlon Is voluntary and le neither part of your applleatlon nor has any beertng on your conelderetlon for appointment. It Is
being asked to comply with federel equal opportunity reporting requlremems.
Gender: ,t'3~AOale ^ Female
ttryrrc Origin: Check one only (1)
hits (Not of Hispanic Origin): All pereons having origins in any of the original peoples of Europe, North Africa or the Middle East.
^ Afrfean-Amerfeanl8lack (Not of Hispanic Origin): All persons having origins in any of the Black reCial groups of Africa.
^ Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or Soulh Americen, or other Spanish culture or origin, regartlless of rece.
0 Asian or Paelflc Islander: Ail persons having odgins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcominent, on
the Pacific Islands. This area Inductee, for example, China, India, Japan, Korea, the Philippine Islands antl Source.
^ American Indian or Alaskan Native: All persons having odgins in any of the original peoples of North Americe, end who maintain
Cultural identification through Mbal aifiiiafion or communhy reetlgn(tion.
Employment Status: Employ ~ Retired ^ Homemaker ^ Other ^
NOTE: If appointed, yotCwlll be required to follow certain laws which apply to city boaidlcommfttae members.
These Taws 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/commtttee 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 irrterest in or receiving any benefd from Community Development Blodt Grant funtls for either yourself ,
or those with whom you have business or immediate family ties (CPR 570.611).
Upon request, copies of these laws may be obtained from the City Clerk. '
"I re st to a urecy rid ulness of the a plicatiggqnnn and have received, read and will abide by Chapter 2,
i I - f h i e " Cgnduet f~ t: Of~a(s~mployeesBpetAgancy,NjarrtbgfS.y ,~~ !~ ` /t
Please attach a copy of your resume
Received in the City Clerk's Office by :
will remain o for a periotl of one (1) calentlar year.
Date~_/ Control No. Date: ~/_20 9
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