Veronika Pozmentier 12/31/20111
m MIAMI BEACH
a
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.m'am-beachA oov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciry Clerk
Tel: (305) 673-7411, Fax: (305J 673-7254
02-10-2010
Veronika Pozmentier
1741 Cleveland Road
Miami Beach, Florida 33141
UBJ:ECT~~;;~ Miami Beach Sister Cities Program
Congratulations! You have been appointed by Mayor Matti Herrera Bower
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 Parcher
City Clerk
cc: Saul Frances, Parking Director
Diana Martinez
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 far Public Officers and Employee
We are committed b providing excellent public service and safety to all who live, work and ploy in our vibrant, tropical, hisroric community.
m- MIAMI BEACH
City of Miami Beach, 1700 Convenfion Center Drive, Miami Beach, Florida 33139, www.miamibeachB.aov
OFFICE OF THE CITY CLERK, Robert Percher, Ciy Clerk
Tel: 1305) 673-7411, Fax: 1305) 673-7254
TO Veronika Pozmentier
RE: Miami Beach Sister Cities Program
I do solemnly swear or affirm to bear true faith, IoyaRy 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-t t.t of the Miami-Dade County Code (Conflict of Interest
and Code of Ethics Ordinance), as well as theF/onda Commission on EbYicsGuide to the Sunshine
Amendment and Code ofEthics for Pub/ic ricers 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
1 serve) on July 1st, following the closing of the calendar year on which I have servec).
~~ Veronika Pozmentier
Sworn to and subscribed before me this ~ day of0 -~ ,, 20~ ~~
~_~- ~y~~ _~Gi~i
Silvia Prieto
Deputy Clerk
*Please visit the Gty of Miami Beach welxite at www.miamibeachFl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
Wa are committed to providing excellent public service and sofey to oll who live, work and play in our vibront, tropical, historic communiy.
MIAMI ~~~
CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
NAME: Pozmentier Veronika
Last Name First Name Middle Initial
HOME ADDRESS: 1741 Cleveland Road Miami Beach FL 141
Apt No. House No./Street City State Zip Code
PHONE: 786)4993591 305)865.8128 vkapoz(~gmail.com
Home Work Fax Email Address
Business Name: Amezner corp. Position: Director
Address: 1741 Cleveland Road Miami Beach FL 33141
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 shalt 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 (6) months: No
• 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: No
• (Please circle one): I am now a resident of: North Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
attorney at law -art consultant -Journalist -international network in several fields
• 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 oniv three (3)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
Art in Public Places Committee Loan Review Committee
Beautification Committee Marine Authori
Board of Ad'ustmenC Miami Beach Commission for Women
Bud et Adviso Committee Miami Beach Cultural Arts Council
Ca ital im rovements Pro'ects Oversi ht Committee 1 Miami Beach Sister Cities Pr ram
Committee on the Homeless
Committee for Quali Education in MB Nonnantl Shores Local Gov't Nei h. Im rovement
Parks and Recreation Facilities Board
Communi Develo mentAdviso Personnel Board
Communi Relations Board Plannin Board'
Convention Center Adviso Board Police Citizens Relations Committee
Debarment Committee Production Indust Counci!
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
Golf Adviso Committee
Health Adviso Committee Sustainabili Committee
Trans arenc Reliabili 8 Accountabili Committee "TRAC"
Trans ortation and Parkin Committee
Health Facilities Authori Board Visitor and Convention Authori
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: Years of Service:
2. Present participation in Youth Center activities by your children 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 •~y: If yes, please expla~ail:
• Do you currently have a violation(s) of City of Miami Beach codes: If yes, please explain in detail
• Do you currently owe the City of Miami Beach any money: If yes, explain in detail
• Are you currently serving on any City Boards or Committees: If yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership its?
Name: Title:
Name: Title:
• List all properties owned or have an interest in, which are located withi the / Miami Beach:
• I am now employed by the City of Miami Beach: Whi h pa nt?
i
• Pursuant to City Code Section 2-25 (b): Do you have a ho i employed the
City of Miami Beach? Check all that apply. Identify the departm t ~ /
V
The following information is voluntary and Is neither rt,vf your appli on nor has an a 'ng on you n ideretion for appointment. K is
being asketl to comply with federel equal opportuni reporting requfrem ts.
Gender: Race:
Ethnic Origin: Check one only (t)
Physically Challenged;
i
Employment Status: 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 servetl 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 secton 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 yourseK ,
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 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."
t Veronika Pozmentier agreed to the following terms on 2/9/2010 4:34:44 PM
- - -- - -
Please attach a copy of your resume to this applicatwn } ~ / (N
NOTE Applicatwns will remain on file for a period of one (7 calendar year, ~ 0"' ~ n
Received in the City Clerk's Office by: Date: ~/ _/ Control No. d f0 Date: ~ rS' I ~ '
•~ ,~ M I AM I B LT°4[.~ ~ ~ C)TY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
NAME: Pozmentier Veronika
Last Name First Name Middle Initial
HOME ADDRESS: 1741 Cleveland Road Mlami Beach FL 141
Apt No. House No./Street City State Zip Code
PHONE: 788) 4993591 305) 8856128 vkapoz(a?gmail.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 demonsVate 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: No
• 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: No
• (Please circle one): I am now a resident of: North Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
Attorney /Journalist /Important connection in French main cities /Link with politicians and decision maker In France
• 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 oniv three 131
choices will be observed by the Citv Clerk's Office. (Regular Boards of City)
Art in Public Places Committee Loan Review Committee
Beautification Committee Madne Authori
Board of Ad'ustment* Miami Beach Commission for Women
Bud et Adviso Committee
Ca ital Im rovements Pro'ects Oversi ht Committee 2
1 Miami Beach Cultural Arts Council
Miami Beach Sister Cities Pro ram
Committee on the Homeless
Committee for Quali Education in MB 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
GoltAdviso Committee
Health Adviso Committee
Health Facilities Authori Board
3 Sustainabili Committee
Trans aren Reliabili 8Accountabili Committee'TRAC"
Trans rtation and Parkin Committee
Visitor and Convention Authod
His anic Affairs Committee
Historic Preservation Board Waterfront Protection Committee
Youth Center Adviso Board
Board Required to Flle State Disclosure form
note: n appiymg ror room HOwsory tsoaro, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: Years of Service:
2. Present participation in Youth Center activities by your children 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 ~y: No If yes, please expla~ail:
• 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
City of Miami Beach? Check all that apply. Identify the department(s):
who is employed by the
The following information is voluntary and is neither part of your application nor has any !rearing on your conaideredon for appoimmem. his
being asked to comply with federal equal opportunity reporting requirements.
Gender: Female Race: White
Ethnic Origin: Check one only (1)
White
Physically Challenged: No
Employment Status: Retired Other: -(Miami Beach Leadership Academvl
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 bbbying city personnel (Miami Beach City Code secton 259).
o Prohibition from contracting with the city (Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before tward/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 lies (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 VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
I Veronika Pounentier agreed to the following terms on 10/28/20091:31:14 PM
Received in the City Clerk's Office by: ~ ~Y~ ~",~/~ui"~ Date: _/ _/_ Control Noi~~ Date: LL/L/! 0/D