Dale Stine 12/31/2010im MIAMI BEACH
City of Miami Beaeh, 1700 Convention Center Drive, Miami,Beach; Florida 33139, mvw miam'beachA aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciry Clerk
Tel: (305( 673-7411, Fax: (3051 673-7254
02-12-2010
Dale Stine
$tJBJEC,T:g~ Gay, Lesbian, Bisexual and Transgender (GLBT)
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,
~~~~~~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Rebecca Wakefield
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 to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, 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, City Clerk
Tel: i305i 673-7411, Fax: i305i 673-7254
TO Dale Stine
RE: Gay, Lesbian, Bisexual and Transgender (GLBT)
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/orida Commission on Ethics Guide to the Sunshine
Amendment and Cade of Ethics for Public t~cers and Emp/ogees, 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 ha served.
~~
Dale Stine 1
Sworn to and subscribed before me this day Of ~g_ /"~ 200~~D
rl r ~ / / . 71
Silvia Prieto
Deputy Clerk
*Please visit the Gry of Miami Beach website at www.miamibeachfl.gov under Gty Clerk/Board and Committees
for additional information regarding the Fnancial Disdowre Requirements.
We are committed ro providing excellent public service and safety to all who live, work and play in our vibran/, tropical, historic community.
m ~ , !~ ~ - f i~ ~ B SAC H
NAM°_: /p~I 'r~1~,(~ ~•`ti'ry/,
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HDMEADDR_S5:
PHONE:
business
Address:
Prpfessional License (tlescribe)
CITY O'r MIAMI BcACr•
Rv AND COMMiiii cE~+.PPLICATICN FC?.N
Expires: Anaeh a copy o! the livens
Pursuant to Ctty Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated wKh the city; this
requiremem shall be fulfilled in the following ways: a) an individual shall have: been a resident of thE'dlty~for a minimum tlf six
months; or b) an individual shall demonstrete ownershiplinterestfor aminimum of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six (6) months: Yes~'or No D
• Demonstrate an ownershiphnterest in a business in Miami Beach for a minimum of six (6) months: Yes~or No D
• Are you a registered voter in Miami Beach: Yes ~fbr No 0
• (Please circle one): I am now a resident of North Bsaeh oath Beae Middle Beach
• I am applying for an appointment because I have special ablllties, kno d experience. please list below:
• Are you preserrtly a registered lobbyist with the City of Miami Beach? Yes D or No ~
Please list your preferences in order of ranking (1j first choice [2j second choice, and [sj third choice. Please note that oniv three l3
chokes will be observed by the City Clerk's Office. (Regular Boards of City)
^ Affordable Housin Adv~o Committee D Housin Atitho
rt in Public Places Committee D Loen Review Committee
autlfi®tion Committee D Merlne Atrfho
^ Board of 'tmtrnanC D Miami Beach Commission for Women
D B Commfflee D Miami Beach Cuhurel Arts Coundl
D C Ifel I vemerrts P eGa Overs m Committee ^ Miami Beach $Irttsr Cities Pm ram
^ Commtitee on the Homeless D Nonnen Shores Looal dovemmertt Ne h. Im em
D Committee for Qua Education in MB D Parks and Reaeafion Fadilties Boani
D Commun Devel mem Aiiviso D Personnel Board
D Commun Relations Board ^ Plannin Boar'd'
D Converrtion Carder Advil Board D Police Citaens Relations Committee
D Debemrem Commibee D Production Ind Coundl
^ Desi n Review Boert!' ^ Public S Adviso Committee
Disabil Access Committee D Sa Committee
ine Arts Board D Si k Fami Residential F;eview Panel
e .Lesbian, Bwexual and Trensoender GLBT ^ Sustainabil Committee
olf Advil Commttree D Tran ran Reliabil & AcmuntebiliN Commktee 'TRAC"
^ Healtn Advso Committee D Ttarrsportation and Parkin Committee
^ Healtn Facilities Auth Board D Vlsilor and Converrtion Autho '
^ His nic Affairs Committee ^ Waterfront Protection Committee
D Historic Preservation Boanl ^ Youth Center Adviso Board
~ "Board Required m Flle State Disclosure Fonn
Note- If applying for Youth Advisory Board, please indicat° your affiliation with the Scott Rakow Youth Cemer
1. past service on the Youth Cen[er Advison,~ Board: Yes C No~Years of Service.
2. Presem partiapation in Youth Center activities by your chtloren Yes_ Nc =. If yes, please list the names of yow children, tneir
ages, and which prpgremE. List belON'
Childs nom=_~ Age: Program.
Cnild's name
Ape' Prrcprem:
Name
.:!?P'.bA!' ~o`7RM,$~674P,D ~N. ~7MMnT_25 ~B_ 4ooiicononDL260~ N°_~'.oo:
•~ave ya_ ev=~ peer co-r„•.-,_° : z ie~~onv "e=_ jt lvo ` vie oiease exolain m oe:air.
• Jo you currently nave e vlo;atlorn s; of City of Nuam~~ 3each woes Yes ..~ No _. I` yes oiease ero;alr. Ir oe:a i!.
• Oo you .:urrently owe the Chy o+ IJ~iam~. Beach any money Yes . DC No =:. R vas. exolarn In tletail
. Ore you currently sevinc or am ~np 3oards or Committees Yes qr No I` ve=_ w~1or ooard°
• What oJr~,^yanizatio/n~s Ir, the "icy ~= Mia(ni Sea/ n/d- /k-'purr=ntly note m=moj=rsn~h. In^
Name:l /l.~ ty~,/cu ~~ i LYE ~XWJ ~c Op/1P/Lt.. itle _~~IB~'~
Name 1 Title'.
• List a''li~rpro/Iperties owned or have an interest in, which are looated within the City of Miami Beach:
7~1~~
• I am now employed by the City o? Miami Beach'. Yes ~ or NOu. Which department?
• Pursuant to City Code Section 2-25 (b): Do you~heve a parent ~, spouse =~, chittl ~; brother C, or sister D who is employee ~~~ ±he
City o` Miami Beach % Check, all that apply. Identify the dapartmengs):
The following informatipn is volumnry and Is neither pen of your appf{eatfon nor has any bearing on your eonsitlerat{on for appolntmen; P, Ie
oeing asketl to comply with federal equal opportunity reporting raquhemertts.
Gender: ~' Male D Female
etnmc Origin: Check on=_ only ;l)
~Whhe (Not of Hispanic Origin): All parsons having origins in any of the original peoples of Europe, NoM Antes or me Middle cast.
Afrl~n-AmerieanlBlaek (Not of Hlapentc Origin): All persons having origins m any of the Black repel groups of Africa,
Hiepenfc All persons of Mazi~n. Pusno Rkan, Cuban, Cenhel or South Amenan, or other Spanish culture or ongtn, ragenlfass.of race
J Aden or Paetfie Iclantfer: All persons craving origins m any of the original peoples of the Far East, Southeast Avis, Me Indian SWeontinern. or
the Pacific Islenos.:.This area hteltates, for ero3mPle, Chma, India, Japan, Korea, the Pttllipptne Islands end Samoa.
LJ Amoneen indlen or Ataetten Native: Ag peramts having origins ir. any of the original peoples of Norlh Amedca, end who mevaain
Cultural klarrUflwfipn ttrrpugh tdhal atNtebon or eommmtty reeopnHlon.
Yes D or
Employment Status: Emptoyed~d Refired D Homemaker D Other D ~PJ~-~
NOTE: If appoirrtad, you will be -required to follow certain laws which apply to city baardfeotmmMYae
These taws include, but are not limited to, the following.
c Prohibition from direVtiy or indirectly lobbying city personnel i1Jilami Beach City Cotle section 2-459}
., Prohibition from contracting with the city (Miam~Dade County Cope section <"-11.1) - .
o Prohibition from lobbying before board/commtttee you have senretl on for pehotl of one year after faeving;office lMlam
Beach City Code section 2-26).
c Requirement to disclose certain financial interests ono gips (Mtam~-Dade Courny Code sacdon 2-15.1).
(re: CMB Community Development Advisory Committee): prohibition, tluring tenure and for one year after laewng ofrlce
from having any interest in or receiving any benefit from Communfty Development Block Gram tunics for either voursel'
or those with whom you have buaine~ or immediate family Pies (CFR X0.611;.
Upon request, copies of these laws may be obtained from the City Clerk,.
"! hereby atta t to a aecueaey and truthfuineas of the application antl have received, read anC will abide pp Chaote~;
Artie VII - he 1 c Cotle "Standards of Con uct for Cite Officers. Employees a Aae y~Memben;."
~-/l b ~ oT,~~1/,ice' 1/5n/~y,1 ~
Appbean 's Signature ~ e nr rn~. n" bgnnl1;r , fog cP:q= opus-,
~laase attach a cops' o' vpur resume m this epplfcetior.
NOTE: Appheatrons wm ramelo or. file for a person of one f1 i eatenoer year
n ~ _
kecewec ir. the Crty ~ien:~s ~fiice oy -y/mod fat=/1 /;2 OF ~onvo~ No
Name o' Geouty ears:
O
®~ SOURCE OF INCOME STATEME
Please Print or Type
Name:
Mailing Address;
City /State/Zip;
Social Security Nu_.___..
Filing as a: ® County Employee:
® Municipal Employee of:
Position Meld or sought:
Iosu2
fax Ysar
ng~ ~~
Board where serving: ~L (~~~ ~ Term or Smpivyment
Began an: ~ ~ ~ c~
Deipartmentwhare employed:
Work Address:
zF your 1we+e address is exempt from m+en: nuordc penatant to
plorlde SmdrYes § S19.Q7 please dreel: here Geed isatrec[lonaj: ® Work Telephone:
Home Address:
Str'eBt Address
City
Zip Code
Please list below in desoeraifing order with the targest source first, the name, address and
prindpal business activity of every sourre of your income including public salary you
received ar any parson received fm Your benefit or use during tF-e disclosure period, the
income of your spouse or airy business partner need not be disdvsed. If c9ntinued im a
separate sheet, check hare: ~
income
1 hereb}~ swear a )that the aforesaid irrforrnation is z true grad correct statement.
~r~ ~ ~~ ~v
Siwnature of p son dis:losing ate igned
DALE STINE
photographer
Dale Stine views the photographic lens through his creative, academic and
professional experiences in the performing arts. A North Cazolina native who
obtained a Master's Degree in Opera from the world-renowned Juilliazd School
(NY), Dale enjoyed a 16-yeaz run in many off-Broadway productions. Never
one to pass up an opportunity to flex various muscle groups, Dale
simultaneously pursued a dual career in personal training and fitness
instruction.
Self-taught in the fine art of digital photography, Dale quickly established
himself as one of the most sought-after photographers in Miami. Since 2001,
his photographs and images have graced countless magazines, cd covers and
websites, including Wire, Ocea» Drive, Men's Journal, Medesthetics, Home,
DAYSPA and Genre. Internationally-acclaimed DJ's, drag personas and his 18
yeaz-old cat Reba aze among his favorite clients.
Dale is one of the official photographers for the internationally-acclaimed
South Beach Wine and Food Festival as well as Aqua Gird for the Aqua Girl
Foundation, the Miami-Dade G/L Chamber of Commerce and for six years, the
Miami G/L Film Festival. Just last fall, Dale was hired to shoot
the New York City Wine and Food Festival, the only photographer from
Florida to do so.
Exhibitions have included The Diva Collection: Illusion Series, featured at the
historic Royal Palm Hotel during White Party, The Starlet Series
at Miami Beach Cinematheque, Communion Celebrates Art at the Bakehouse
Art Complex, Decline in Civilization for Art Base12006
andA D~erentAngle for Art Base12008.
"Whether I am photographing a person, an animal or a building, I do my best
to connect with the essence of the subject. By allowing the "now" to unfold, I
trust the intimacy of the moment to flourish for atl to see."
dalestine.com
305.761.3253
dale@dalestine.com
I®~
Please Print ar
Name:
Mailing Addre:
City /State/ZiF
Social Securitl
Filing as a; ® County Employee:
® Municipal Employee of:
Position held or sought;
50URCE OF INCOME STATEME
;losUre
Tax year
Y"g; ~D
&oard where serving; ~L (~~-~ ~ Term or Employment
Began on: ~ ~ ) J
Department where employed:
Work Address;
Sf your home etldreas is exempt from puhNc re:Arde pursuant to
Piuriu® SYakutec § 119.Q7 plmae cheek Mare (rued instruetionsj: ® Work Telephone:
Home Address;
Street Address
Gty
Zip Code
Please list 6afow in descending order with the Largest source first, the name, address 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 disclosure period, The
income of your spouse or any business partner need not be disciorsed. If continued on a
separate sheet, check here: ~
I hareb}~ swear a )that the aforesaid information is z true grad correct statement.
~~ ~i /~ ~v
Sinnature of lson dis:Yosing ateU igned
P