Zahara Mossman 12/31/2011~®''
City of Miami Beach, 1700 Convenfion Center Drive, Miami Beach, Florida 33139, www-miamiheachfl aov
OFFICE OF THE CITY CLERK, Robert Porcher, Ciy Clerk
Tel: 1305) 673-7411, Fax: )305) 673-7254
01-15-2010
Zahara Mossman
5555 Collins Ave.
Miami Beach, Florida 33140
'UBJEGTt.`,L Miami Beach Commission For Women
Congratulations! You have been appointed by Commissioner Jerry Libbin
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,
js~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Wanda Ortiz
ATTACHMENTS:
Letter of Appointment
Oath
City Code Ordinance section, applicable to agency, board o'r 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 committed ro providing excellent public service and safety ro all who live, work and play in our vibrant, tropical, hisroric community.
m- MIAMI BEACH
City of Miami Beaeh, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachA aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciry Clerk
iel: i305J 673-7411, Fax: J305) 673-7254
TO Zahara Mossman
RE: Miami Beach Commission For Women
I do solemnly swear or affirm to bear tme 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 Use Sunshine
Amendment and Code of Ethics for Public Officers and Employees, and understand that as a member
of a City of Miami Beach Bcard and/or Committee, I must comply with the financial disclosure' require-
ments of Miami-Dade County or the State of Flodda (depending on the board or committee on which
I serve) on July 1st, following the closing of the calendar year on whipFfT)h~ue,served.
Sworn to and subscribed before me thisJl
Deputy Clerk
*Please visit the Gty of Miami Beads website at www.miamibeadifl,govuncter Ciry gerk/BOard and Committees
for additional information regarding the Fnancial Disclosure Requirements.
We are committed ro providing excellent public service and salary ro all who live, work and play in our vibrant, tropical, hisroric community.
M I AM I ~ ~~ H . CITY OF MIAMI BEACH
- BOARD AND COMMITTEE APPLICATION FORM
NAME: Mossman Zahare
Last Name First Name Middle Initial
HOME ADDRESS: 11E 5555 Collins Ave Miami Beach FL 3s+en
Apt No. House No./Street City .State Zip Code
PHONE:. 786 348.5652 .305 675-1779 zaharemossman(a~mac.com
Home Work Fax Email Address
Business Name: Zahare Marketing, Inc. Position: President
Address: 310 Arthur Godfrey Rd. Miami Beach FL 33140
No. Stteet City State Zip Code
Professional License (describe): Real Estate Expires: 09/30/2010 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:
I'm an Internet Marketing expert and licensed Realtor. I would like to promote tourism globally for Miami Beach and
better the Image of my hometown..
• Are you presently a registered lobbyist with the City of Miami Beach? No
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three f3)
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* 1 Miami Beach Commission for Women
Bud et Advise Committee
Ca ital Im rovements Pro ecis Oversi ht Committee Miami Beach Cultural Arts Council
Miami Beach Sister Cities Pro ram
Committee on the Homeless
Committee far Quali Education in MB Normand Shores Local Gov't Nei h. Im rovement
Parks and Recreation Facilities Board
Communi Develo mentAdviso Pe noel Board
Communi Relations Board Plannin Board*
Convention Center Adviso Board Police Citizens Relations Commitfee
Debarment Committee Production Indust Council
3 Desi n Review Board*
Disabili Access Committee
Fine Arts Board Public Safe Adviso Committee
Safe Committee
Sin le Famil Residential Review Panel
Ga ,Lesbian Bisexual and Trans ender GLBT
Golf Adviso Committee
Health Adviso Committee Sustainabili Committee
Trans arenc Reliabili & Accountabili Committee "TRAC"
Trans ortation and Parkin Committee
Health Facilities Authori Board 2 Visitor and Convention Authod
His anic Affairs Committee
Historic Preservation Board Waterfront Protection Committee
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:
Have you ever been convicted o~ony: No If yes, please explai~etail:
• 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: No If yes; which 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 who is employed by the
City of Miami Beach? Check all that apply. Identity the department(s):
The following InformaNOn is voluntary and is neither part of your application nor has any bearing on your consideration 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: Other Other:
NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members.
Those 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 confracting 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, dudng 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 ,
ar 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 Clerk.
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VI! - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
I Zahara Mossman agreed to the following terms on 1/14/2010 6:08:16 PM
Received in the City Clerk's Office by:
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Date: /~ Control No~ _ 06 fate: O.i_ ~ J ~ V
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Please Print or T~
Name:
Mailing Address
city/state/zip:
Social Security I
Filing as a:
It791Ja
fax Year
ng;
Position field or sought;
Board where serving; ~O ~~4~J .,, ``rrG-Perm or Employment
~~1'Y1~ ~ ~~agan on: ~~ ~ ~ l ~
Department where employed:
Work Address:
SF your home address Fs exempt from pubitc records pursuant m
woride stawtes § 1iB.Q7 gleam: chaei; here (read instructronsj: ® Work Te:laphone:
Home Address;
Street Address
Clty
State
Zip Code
Please fist 6afow in descending order with the Largest source first, the name, addrnss and
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 desclosure period, T'he
in~me of your spouse or arty business partner Head not be disciased. If continued an a
separate sheet, check hare; ~ ~
of the
Name oF_Source of Income ~ Address
1 hereby svsr~(ry~Saffirstl) that the aforesaid
Signature of person liis:.iosing
RCE OF INCOME STATEMEtYT
is a true wind correct stet'
I ~~ lD
B to si_ ned
~ County Employee:
® Municipal Employee of: