Regina Suarez 12/31/2010m MIAMI BEACH
City of Miami Beoeh, 1700 Convenfion Center Drive, Miami Beach, Florida 33139, vrww.miamibeachA aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: 13051 673-7411, Fax: 13051 673.7254
02-02-2010
Regina Suarez
4410 Alton RD.
Miami Beach, Florida 33140
UBJECtT:~' Miami Beach Commission For Women
Congratulations! You have been appointed by Commissioner Michael Gongora
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,
,~~P~-~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Wanda Ortiz
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 salary ro all who live, work and play in our vibrant, tropical, hisroric communiy.
m MIAMI BEACH
City of Miami Beaeh, 1700 Convenfion Center Drive, Miami Beath, Florida 33'139, www miamibeachfl aov
OFFICE OF THE CITY CLERK, Robert Percher, Ciy Clerk
Tel: (305) 673.7411, Fax: (305i 673-7254
TO Regina Suarez
RE: Miami Beach Commission For Women
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: 12/31/2010.
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 thel=/p~da Commission on Ethics Guide to the Sunshine
Amendment and Cade of Ethics for Public O>iia=rs 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 or committee on which
I serve) on July 1st, following the closing of the calendar year on which I have served.
Regina Suarez
Sworn to and subscribed before me this ~~ day of Q.h- , 20~~
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beads website at www.miamibeadiFl.gov under City Berk/Board and Committees
for additional information regarding the Financial Disdosure Requirements.
We are committed ro providing excellent public service and safety ro all who live, work and play in our vibrant, rroprcal, hisroric communiy.
~? IV11 AM I ~EAC N CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
NAME: Suarez Regina S
Last Name First Name Middle Initial
HOME ADDRESS: 4410 Alton Road Miami Beach FL 3a7ee
Apt No. House No./Street City State Zip Code
PHONE: 305-263-0009 regisuarezQaol.com
Home Work Fax Email Address
Business Name:
Position:
Address: FL
No. Street City State Zip Code
Professional License (describe): Expires: Attach a copy of the license
Pursuant to City 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; or b) an individual shall demonstate ownership/interest for a minimum of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six (6) months: Yes
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes
• Are you a registered voter in Miami Beach: Yes
• (Please circle one): I am now a resident of: Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
Administrative experience in the public and private sectors, MBA, Women's issues activist, Resident of MB for over 40
years
• Are you presently a registered lobbyist with the City of Miami Beach? Yes
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three 131
choices will be observed by the City Clerk's Office. (Regular Boards of City)
Art in Public Places Committee Loan Review Committee
Board of Ad'ustment' 2 Miami Beach Commission for Women
1 Bud et Adviso Committee
Ca ital Im rovements Pro'ects Oversi ht Committee
Committee on the Homeless
Committee for Quali Education in MB Miami Beach Cultural Arts Council
Miami Beach Sister Cities Pro ram
Normand Shores Local Gov't Nei h. Im rovement
Parks and Recreation Facilities Board
Communi Develo ment Adviso Personnel Board
Communi Relations Board Plannin Board'
Convention Center Adviso Board Police Citizens Relations Committee
Debarment Committee Production Indust Council
Desi n Review Board' Public Safe Adviso Committee
Disabili Access Committee Safe Committee
Fine Arts Board Sin le Famil Residential Review Panel
Ga ,Lesbian, Bisexual and Trans ender GLBT Sustainabili Committee
Golf Adviso Committee
Health Adviso Committee
Health Facilities Authori Board Trans arenc Reliabili 8 Accountabili Committee "TRAC"
Trans ortation and Parkin Committee
Visitor and Convention Authori
3 His anic Affairs Committee Waterfront Protection Committee
Historic Preservation Board Youth Center Adviso 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: No Years of Service:
2. Present participation in Youth Center activities by your children 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: S
• Have you ever been convicted of a felony: No If yes, please explain in detail:
~; ' .
• Do you currently have a violation(s) of City of Miami Beach codes: No If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: No If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes If yes; which board?
Budget Advisory Board
• 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: No Which department
• Pursuant to City Code Section 2-25 (b): Do you have a
City of Miami Beach? Check all that apply. Identify the department(s):
who is employed by the
The fallowing information is voluntary and is neither part of your app9cation nor has any bearing on your eonsidere0on for appointment. It is
being asked to comply with federal equal opportunity reporting requirements.
Gender: Female Race: White
Ethnic Origin: Check one only (1)
Hispanic
Physically Challenged: No
Employment Status: Employed 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 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 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 570.61 t ).
Upon request, copies of these laws may be obtained from the City Clerk.
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
I Regina Suarez agreed to the following terms on 12/16/2009 9:27:53 PM
Please attach a copy of yourresume to thiss application
IJOTE:.Appllcations will remain on file for a„period of onef(1) calendar~ye r
Received in the City Clerk's Office by; (, N y~rlJt 7 Y Date:~~/! '1~Control No. Date: ~~1~ ( I Q /
Name of Deputy Clerk ttt~~~ l
®~ SOURCE OF INCOME STA
Please Print or
Name:
Mailing Address; W .~XJC.f`~~ (`-~
City/State/Zip: ~ RA-~'1, a'~' 3
Disclosure
For Tax Year
Q-~Z-• Ending:_~
a~
Social Security Number; ~ ~ ~"" - ~ ~ ~ 72-•
Filing as a: ® County Employee:
® Municipal Empioyee of:
Position held or sought;
Board where serving:~s ~~ ~ Warm or Ernploymant
Hagan on:
Department where employed:
Work Address:
If your home address is exempt from puhiic rocords punauant to
Rloride Statutes § lI9.G7 please eiredc hers (reed instructions); ® Work Telephone:
Home Address: ~ ~ ~ a ,~J -Q-~.ex~ ~-
Street Address
Gty State Zip Code
Pease fist 6aiow in descending order with the largest sourre first, the name, address end
principal business activity of every source of your income including public salary you
received or any person received for your benefit or use during the disclosure period, The
income of your spouse or any business partner need not be disclosed. If continued an a
separate shack. check here; 0
Name of Source of Income
Address Description of the Principal
Business Asti
i S .In9.
S ~ SQ- -Ar rt..+J
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
~,~~ a
Signature f~person disclosing Qate signed