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Noreen Legault-Mendoza 12/31/2011Im MIAMI BEACH City of Miami Beoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibecchfl.aov OFFICE OF THE CITY CLERK, Robert Percher, Ciy Clerk Tel: 1305) 673-7411, Faz: (3051 673-7254 02-02-2010 Noreen Legault-Mendoza 16305 SW 248 St. Bechland, FI 33031 SUBJECTte'. Production Industry Council Congratulations? You have been appointed by Commissioner Jonah M. Wolfson 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, Robert Percher City Clerk cc: Saul Frances, Parking Director Graham Winick 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 committed ro providing excellent public service and salary ro all who live, vrork and play in our vibrant, tropical, hisroric community. m MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, vrww.miamibeachA.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk Tel: 13051 673-7411, Fax: 1305) 673-7254 TO Noreen Legault-Mendoza RE: Production Industry Council 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 theF/odds 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' require- ments of MiamFDade 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 yeargp which I have sew r `~-_ Sworn to and subscribed before me this ~ day of @P~[ ,, 20Q Q ~" /~%~4J Silvia Prieto Deputy Clerk •Please visit the Gty of Miami Beads vrebsite at www.miamibearhFl.gov under Gty Gerk/Board and Committees for additional Information regarding the Rnandal Disclosure Requiremer~. We are committed ro providing excellent public service and safey to all who live, work and play in our vi6ranf, hopical, historic communiy. .. PHONE: cIT~ car- i~dliA~Jll t~~arrl (3l~bARt75 ,~kND CCJEV16Sf11T"fEE a1PPLlC,4TIC7N FCIhTa~1i t~~ NCR First Name ._-. Middle Initial -.~®a i~ ~ Work City ati !~,~M /ICI ,I I ~ ~J ~ Business Name: ~'~ 1 ~- - ~.,/ 1 ~r V ~ ~ r //f"dositON /} ~/7 C 0 s ~ ~~ E „ r- ~ +I ~ r ~~© ~ y / ~n Address: ~OQ® ) ""'~)111~ t~JiTE n -, -~Ci~ /~l. r ~. /' ~ ~~/ ~C Professional License (tlescnbe) Expires: ~lEtach a copy of tRe tcense 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 fulflled 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 ownership/interest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (S) months: Yes C or No ^ • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: YesXor No ~_ • Are you a registered voter in Miami Beach: Yes C or Nox ~~ ~~ • (Please check one); I am now a resident of: North Beach O South Beach CC Middle Beach C • I am applying for an appointment because I have special abilities, knowledge, experience. Please list below: ~IG.f! aL. ~c-I~I/~ (~2oc~vcZto~l, kr~cR ,N ~~~~ °~~ Please list your preferences in order of ranking [1] first choice [2] secontl choice, and [3] third choice. Please note that only three (31 choices will be observed by the Ciri Clerk's Office. (Regular Boards of City) ^ Art in Public Places Committee ^ Beach Preservation Board ^ Beautification Committee ^ Board of Adjustment" ^ Budget Advisory Committee ^ Committee on Homeless ^ Committee for Quality Education in MB ^ Community Development Advisory' ^ Community Relations Board ^ Convention Center Advisory Board ^ Debarment Committee ^ Design Review Board" ^ Disability Access Committee ^ Fine Arts Board ^ Golf Advisory Committee ^ Health Advisory Committee ^ Health Facilities Authority Board ^ Hispanic Affairs Committee ^ Historic Preservation Board' ' Board Required to File State Disclosure form ^ Housing Authority` ^ Loan Review Committee' ^ Mayor's Green Ad-Hoc Committee ^ Marine Authority* ^ Miami Beach Cultural Arts Council ^ Miami Beach Commission on Status of Women ^ Miami Beach Florida Sister Cities ^ Normandy Shores Local Gov't Neigh. Improvement ^ Oversight Committee for General Obligation Bond ^ Parks and Recreation Facilities Board ^ Personnel Board' ^ Planning Board` ^ Police Citizens Relations Committee ',Production Industry Council ^ Public Safety Advisory Committee ^ Safety Committee scanned ^ Transportation and Parking Committee ~ Visitor and Convention Authority' ^ Youth Center Advisory Board i ~^ r<un er„s ~i ~.,. i~ne,~c~.„<r,~1,m'i.ccl ~t ng ,l rae:n,i.,rn~y lntcmv i.:.~;c,,Lfit ,.3(„~,, ,~ I,.i krvisE :,[tir 1E3 <ui: ~";.cr, .. Nate: 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 i- No ~ Years of Service: 2. Present participation in Youth Center activities by your children Yes No i:.~. 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 of a felony: Yes a or No ~ If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No~ If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes a or No Ji. If yes, explain in detail • Are you currently serving on any City Boards or Committees: Yes C or No~ If yes; which board? • What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: Name: Title: • List ail 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~,Which department? • Pursuant to City Code Section 2-25 (b): Do you have a parent ~, spouse n_, child ~~, brother v, or sister ^ who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): /O This section is "not required" but desired: Age: ~~ years old Gender: Male ^ Female Ethnic Origin (Check one) White ^Africon-American/Black ~ Hispanic: 0 Asian or Pacific Islander D American Indian or Alaskan Native 0 Employment Status: Employed 0 Retired [] Home-maker ^ Other ^ "I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, ARicl~ll -~e City C~de "Standards of Conduct for City Officers, Employees and Agency Members." ~~ of Please attach a copy of your resume to this application NOTE: Applications will remain on file for a period of one (1) calendar year. Received in City Clerk's Office by ( ~ Z r v Date Name of Deputy Cterk Document Control Number (Assigned by the Ciry Clerk's Office) ,~~ Entered By - Date ~ / v Revise01125/e]jo 2 L;:.vcurtr[_s an~i,x,:.i~cier nr rbmll.o~i~.,[i iy,U~,7.S,.,a~~ll.h9mr -irs}Ol.ti~:dC,=,.,~,i~.zfon r'gvisct 'eIr 1E3 <ti~~~.rt,r v• I®~ Please Print or Type Name: Making Address; City/State/Zip; Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: Position Meld or sought; Disclosure For Tax 'Isar Ending; Board where carving; ~ ~ , G' Term or Employment Began on: ~~_(lj a0/r~ Department where emp~oyed/~ y~/1- WorkAddress: ~/~( ~"" ~ ~~~ 3~S - 80~ Sf your home atltlreaa is exempt from puhN: records pursuant m /~ ~ ~Y Pmride Stameec § 11B.Q7 pieeee cheer. Here (reed imtructYons): ~ Work 7eiephone: Home Address; Street ,4ddty~ ~~®~ / ~ ~~-n City Stale Zip Code Please list below in deso3nding order with the Largest source first, the name, address end prindpal business activity of eweny source of your income including public salary you received or arty parson received for your benefit or use during the d'esclosure period, The income of your spouse or arty business partner need Hat be disciased. If cvrrtinuad on a separate sheet, check here: ,0 Ptame of Sources of come Address Description of the Principal- Business Activi a~ po ~l m ~-}~ ~ O affirm) that the a resaid information is z true and correct statement. ~ /o i dis:.IQSin ate signers URGE OF