Melvyn Schlesser 12/31/2010m /V~IAMI BE~,CH
City of Miami Beach, 1700 Convenfion Center Drive, Miami $each, Florido.33139, vrww m'amibeochfl aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (3051 673-7411, Fax: (3051 673-7254
2/4!2010
Melvyn Schlesser
1300 Collins Ave.
Miami Beach, Florida 33139
SUB~JECT~~ Debarment Committee
Congratulations! You have been reappointed by Commissioner Jorge Exposito
to the above referenced agency, board or committee for a term ending: 12/31/2010.
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
~~ ~~~5~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Gus Lopez
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 2-71.1 -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 to providing excellent public service and safely b all who live, work and play in our vibrant, hopical, historic community.
m MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachA.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: i305i 673-7411, Fax: (305) 673-7254
TO Melvyn Schlesser
RE: Debarment Committee
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 theF/onda Commission on Ethics Guide to tl~e 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 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 whisk I Jyave served.
<~ Melvyn Schlesser
Sworn to and subscribed before me this ~ day of ~~, 20.0' ~~
e) ~ ~-
-Silvia Pneto
Deputy Clerk
*Please visit the City of Miami Beads website at www.miamibeachfl.gov under City gerWBoard and Committees
for additional information regarding the Fnandal Disclosure Requirements.
We are committed ro providing excellent public service and safey ro all who live, work and play in our vibrant, tropical, hisroric community.
~ I ~~~ I C~
~~. ~~
HOME ADDRESS:
PHONE:
Hon
Business Name:
Address:
Last Name
Apt
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COC~[N-
Professional License (describe)
CITY OF MIAMI REACH
EOARD ANA CC7MMIT7EE APPLICA7lC7N FORM
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Position:
/9O
~t~eGf"_ ~c - 33 r39
ly State Zip Code
lxpires:~~ Alrach a copy od 24o ttcer#ce
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; ar b) an individual shall demonstrate ownershiplnterest for a minimum of six months in a business established in the dty.
• Resident of Miami Beach for a minimum of six (6) months: Yes ~ or No ^
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes`~No
• Are you a registered voter in Miami Beach: Yes ^ or No`~G
• (Please ircle one): I am now a resident of: North Beach South Beach Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach9 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 131
choices will be observed by the Ciri Clerk's Office. (Regular Boards of City)
^ Affordable Housin Adviso Committee ^Housin Authod
^ Art in Public Places Committee ^ Loan Review Committee
^ Beautification Committee ^ Marine Authori
^ Board of Ad'ustment' ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Ca itat Im rovements Pro'ects Oversi ht Committee ^ Miami Beach Sister Cities Pro rem
^ Committee on the Homeless ^ Normand Shores Local Government Nei h. Im rovement
^ Committee for Qualit Education in MB ^ Parks and Recreation Facilities Board
^ Communit Develo ment Adviso p Personnel Board
^ Communi Relations Board ^ Plannin Board'
^ Convention Center Adviso Board ^ Police Citizens Relations Committee
barment Committee ^ Production Indust Council
^ Desi n Review Board' ^ Public Safet Adviso Committee
^ Disabilit Access Committee ^ Safe Committee
^ Fine Arts Board ^ Sin le Famil Residential Review Panel
^ Ga Lesbian Bisexual and Trans ender GLBT ^ Sustainabilit Committee
^ Golf Adviso Committee
^ Health Adviso Committee ^ Trens arenc Reliabilit & Axountabilit Committee "TRAC°
^ Trans artation and Parkin Committee
^ Health Facilities Authorit Board ^ Visitor and Convention Authorit
^ His snit Affairs Committee ^ Waterfront Protection Committee
^ Historic Preservation Board 0 Youth Center Adviso Board
'Board Required to File State Disclosure Fonn
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 YesO No o. 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
\t L:'R`.5AL1 a(C-R'^,S\Ct ^3G A:ti'vf T+Mi. ~'E \Et Ah. ::cctior:052.h04 N[V~,do
.Have you ever been convicted of a felony: Yes ^ or No~fyes, please explain in detail:
~-"4 ~o you currently have a violation(s) of City of Miami Beach codes: Yes ^ or yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ^ or NoeY Ir yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes er.Tlo ^. If yes; which board?
• What or~tg'a~nizations in the City of Miami Beach do[y[~_u currently hold membership in?
Name: 1 /v_t~4lA v1nQ vim--- rA-,w, u„ /~/,Q1-__ Title: w~~'
Name: Ti}le~
• List all properties owneed or/h~a/vYe an interest in, which are located within the City of Miami Beach:
~l)iT""~ (~ -t-. In 1 E'.' 20~~ „~, v~- Q ` l y ~ ~ Dy2 rre..r ~1ioA-
• I am now employed by the City of Miami Beach: Yes ^ or Rb6~Which department?
r!dLU4t5/t'`~e 1
• Pursuant to City Code Section 2-25 (b): Do you have a parent D, spouse 0, child ~, brother ~, or sister ~ who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s): / 1r 0/t/ ~
The following Information Is voluntary and Is neither pan of your appllcatlon nor has any beartng on your eonslderetlon for appointment. Il Is
being asked to comply with federal equal opportunity reponing requiremeMS.
Gender:
^ Female
t~lc Vngln: Check One only (1) -
hlte (Not of Hispanic Ortgin): Ail persons having odgins in any of the odginai peoples of Europe, North Afdca or the Middle East.
African-AmericaNBlaek (Not of Hispanic Odgin): All persons having odgins in any of the Black radat groups of Africa.
^ Hispania: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or ortgin, regardless of race.
^ Asian or Pacifle Islander: All persons having odgins in any of the ortginal peoples of the Far East, Southeast Asia, the Indian Subcontinent, on
the Padfic Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands and Somoa.
0 American Indian or Alaskan Native: Alt persons having odgins in any of the original peoples of North Amertca, and who maintain
Cultural idendgcadon through tribal affliadon or community recegnigon.
) Physically Challenged: Yes ^ or NoO.
Employment Status: Employed ^ Retired ^ Homemaker ^ Other D
NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members.
These laws include, but are no[ 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 570.611).
Upon request, copies of these laws may be obtained from the City Clerk.
"1 hereby attest to t t urecy and truthfuln~r~applicatlon and have received, read and will abide by Chapter 2,
Article VII/~- ode "Stand e-of Conduct for City Officers, Employees and Aganc/y /Members."
_.l(, __. 2 ~4~ir~ ~1,~?LUUL~-- S/`Gr I P S~-PR
Received in the City Clerk's Office by : ~~ ^l ` ~}~- ~~bate:~/ 7~~Control No. Date: _/_/2009
"®~ SOURCE OF INCOME STATEMENT
Please Print or Type First Name Mitltlle Name Initial Last Name
Disclosure
SC t1L E55E2. For Tax Year
Name: ~ t /U Ending:
Mailing Address: cs~ Q~
City/State/Zip: / 3 ~~
Soda) Severity Number: ~Y_ fY~3 --_
Filing as a: ® County Employee:
® Municipal Employee of:
Position~ield or sought: ~(SrgA~-t~k~i"' (~~,~,~
..... _._..~... _ _.__. ______-_ . _ ._r ___._.._ __ _ ._..
Board where serving: Term or Employment T
~.~/Aural ~/!e~ Began on: Zi~ '~ - ~i9N.
Department where employed:
Work Address:
Ir your home address is exempt hom public records pursuant to 30l /
Florida Statutes § 119.07 please check here (read Instructions): ~ Work Telephone:
Home Address:
Street Address
City
State
Zip Code
Please list below in descending order with the largest source first, the name, address and
prindpai business activity of every source of your income Including public salary you
received or any person received for your benefit or use duHng the disclosure period. The
income of your spouse or any business partner need not be disclosed. If corrtinued ort a
`separate sheet, check here: ® ~
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
,a .
~/
S of person disclosing ate sighed