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Alexander Annunziato 12/31/2011 m MM,MI BE~~~ ~. City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florido 33139, www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk Tal: (3051 673-7411, Fax: 1305) 673-7254 01 /26/2010 Alexander Annunziato 1355 Biscayne Point Road Miami Beach, Florida 33141 Board of Adjustment Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee for a term ending: 1?J31f2011. 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, ~~a~-Wr ~~Q~ti~~ °~^ Robert Parc~ier 4 City Clerk cc: Saul Frances, Parking Director Antonieta Stohl 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 committed ro providing excellent public service and safety ro all who live, work and play in our vibrant, tropical, historic community. %~ r m MIAMI BEACH City of Miami Beaeh, 1700 ConvenAon Center Drive, Miami Beach, Florida 33139, www.miamibeachA.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 January 26, 2010 TO: Alexander Annunziato RE: Board of Adjustment 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 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 Ofhcers 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 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. Alexander Annunziato Sworn to and subscribed before me this 7 day of ~B , 2010. ~~~~~ Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees for additlonal information regarding the Financial Disclosure Requirements. We are commiMed M providing excellent public service and sa/ey to all who live, work and play in our vibrant, hopical, historic communiy. NAME: CJrvNVN Last Nart HOME ADDRESS: Apt No. PHONE: C-~Sf3~oH Home Business Name: ~Lo2t')R Address: /d // No. Professional License (describe) _ CITY CbF MIAM[ 9~EACH AND C~MM[TTEF APPf,(CATit3N FL3RM Email address yr F~cpires: Arach a copy of the ticense Pursuant to Cily 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) ah individual shall tlemdnstrate owhershipfinterest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months: Ye$&~r No ^ • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Ygs-y or No ^ • Are you a registered voter in Miami Beach: Yes • (Please cirGe one): I am now a resident of: orth Beac South Beach Middle Beach • I am applying for an appointment because 1 have speaa a i hies, knowledge and expedence. Please list below: • Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three i31 choices wifl be observed by the Citv Clerk's Office (Regular Boards of City) ^ Affordable Housin Adviso Committee ^Housin Authort ^ Art in Public Places Committee ^ Loan Review Committee ^ Beautification Committee ^ Marine Authont Board of Ad'ustment' ^ Miami Beach Commission for Women ^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council ^ Ca ital Im rovements Pro ects Oversi ht Committee ^ Committee on the Homeless ^ Miami Beach Sister Cities Pro ram ^ Normand Shores Locel Gavemment Nei h. Im rovement ^ Committee for Qualit Education in MB ^ Parks and Recreation Facilities Board ^ Communi Develo ment Adviso ^ Personnel Board ^ Communi Relations Board ^ Plannin Board' ^ Convention Center Adviso Baard ^ Police Citizens Relations Committee ^ Debarment Committee ^ Desi n Review Board' ^ Production Indust Council ^ Public Safet Adviso Committee ^ Disabili Access Committee ^ Safet Committee ^ Fine Arts Board ^ Sin le Famil Residential Review Panel D ^ Ga Lesbian Bisexual and Trans ender GLBT ^ Golf Adviso Committee ^ Health Adviso Committee ^ Health Facilities Authorit Board ^ His anic Affairs Committee D Sustainabilit Committee ^ Trans arenc Reliabilit & Accountabili Committee "TRAC" ^ Trans ortation and Parkin Committee ^ Visdor and Convention Authodt ^ Watertront Protection Committee ^ Youth Center Adviso Board ^ Historic Preservation Board *Board Required to File 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 activkies by your children Yes No D. If yes, please list the names of your children, ages, and which programs. List below: Child's name: Age: Program: Child's name: Age: Program: their 7r7 Fax '~ Position: c `.Cif_R\:~ALAaFC)RMSV60AkD ANE% COMM{?Tc_S\;iC S,uplicafion~b4.i09.dcc .Have you ever been convicted of a felony: Yes ~~ or T - "yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or I~pi~9yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes o or yes, explain in detail • Are you curr~ntl~ servingJ~n any City Boards or Committees: Yes-?~br No ~. If yes; which board? • What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: Name: • List all properties owned or have an interest in, which are located within the City of Miami '/~'7/f?.cL, r'St~NA v~ a~~{o S - / 3S'~ S . is rsc~~_y • I am now employed by the City of Miami Beach: Yes ^ or~t which department? • Pursuant to City Code Section 2-25 (b): Do you have a parent o, spouse ~, child ^, brother ~, or sister ^ who is employed by the City of Miami Beach? Chedc all that apply. Identify the department(s): The fdlowing Information is volumary and Is nefther part of your application nor has any bearing on your wnsideredon for appointment. It is being asked to comply wkh federal equal opportunity reporting requirements. Gender: ~=1APale ^ Female one ^ White (Not of Hispanic Origin): All persons having odgins in any of the original peoples of Europe, North Afica or the Middle East. ^ African-AmertcanBlack (Not of Hispanic Origin): All persons having origins in any of the Black radal groups of Africa. tgFfl5lranic: All persons of Mexican, Pueno Riran, Cuban, Central or South American, or other Spanish culture or origin, regardless of race. ^ Asian or Paefgc Islander: All persons having odgins in any of the original peoples of the Far East, Southeast Asra, the Indian Subcontinent on the Padfic Islantls. This area includes, for example, China, India, Japan, Korea, the Philippine Islands and Somoa. ^ American Indian or Alaskan Nagve: All persons having origins in any of the odginal peoples of North Amedca, and who maintain Cultural itlentification through tribal affiliation or community recognition. Employment Status: Retired ^ Homemaker ^ Other ^ NOTE: If 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 disGose 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 interest in or receiving any benefit from Community Development Blodc 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 the City Cleric. "I hereby att e-t cy and truthfulness of the a cation and have received, read and will abide by Chapter 2, Arti a-V' - ode °Standards of Condu or Officers, Emp es an ency Members." y ~ vNZ~~'%~ cans gnature to Name of Applicant (PLEASE PRINT) Please attach a copy of,your resume to this applicaflon NOTE: Applleaflons will remain on file for a pertodof one (t) calentlaryear. Received in the City Clerk's Office by : 1JH~ \'.. ~h ~ ~ Date/~`V~pntrol Na. Date: _/ /~ I~~A~MM~ Please Print ar Name; Malting Addre City/State/ZiF Disclosure For Tax Year Ending; X67 ~7 ~~55 Social Security Number; Filing as a; ® County Employee; ® Municipal Employee of: Position held or soughtw Board where sarving~ pF ~~5TFt6n~ Tenn or Ei cam--~, Began orb: Department whore employed; wort: Address; .~/7 Z. If ymv home adtlreas is exempt from puhli: reeorde pursuant m Florida Smkutec § 1I6.Q7 phmee check here (tmd ineeruC~ork Telephone; Home Address, ~a~ S • ~i ScAV Ntr 7'~az'NT ~~ ////:~~~ treat Address aJ, SAC// %[~ City State Zip Code Please fist below in descending order with the Largest source first, the name, address and principal business activity of every seance of your income including public salary qou received or arty parson received for your 6anefit or use during the disclosure period. The income of your spouse or arty business partner need net be disciQSad. If continued on a separate sheet, check here; ~ Description of the Prin©pal Name of Source of income Address Business Activ TA7L a,G ~- Q IJ ~ %4 I hereby s irm the aforesaid information es z true and correct statement. 2 v ~~ Signature of person d'esolosing B igned RCE OF INCOME STATEME~YT