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Dr. Ronald Shane 12/31/2011im MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, ivww.miamibeachR.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk ~ - . . Tel: 1305) 673-7411, Fax: 13051 673-7254 ~ .. 02-18-2010 Dr. Ronald Shane 2522 Fisher Island Miami Beach, Florida 33109 SUB;lECT:p'~ Debarment Committee 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, ~~/~~ 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, 2-458 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 commiHed ro providing excellent public service and safey to all who live, work and play in our vibrant, tropical, historic community. m MIAMI BEACH City of Miami Beaeh, 1700 ConvenKon Center Drive, Miami Beach, Florida.33139, vnvw.miamibecchA oov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk Tel: (305) 673-741 I, Fax: (3051 673-7254 TO Dr. Ronald Shane 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: 12/31/2011. I have been issuetl 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 Code of Ethics fog Public Officrrs 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 which I have served. Dr. Ronald S~h^anle_ Sworn to and subscribed before me thi day of 1- iLJ , 2 !:O Silvia rieto Deputy Clerk *Please visit the City of Miami Beath website at www.miamibeadiFl.gov under City Clerk/BOard and Committees for additional information regarding the Finandal Disclosure Requirements. We are committed ro providing excellent public service and safey ro all who live, work and play in our vibrant, tropical, hisroric communiy. ®~ 50URCE 0~ INCOME STATEME Please Print or Type First Name Middle Name/Initial Last Name: ~. Al.~ sttr~n+e Mailing Address; Z s' z Z G-'z sry ~~ ~s Ccr~ City/State/Zip; ~ Lcc~ w~-~- ~ ~ ~ ! 3 3 t 9 9 Disclosure For Tar. Year Ending; Social Security Number; L ~' S~ - ~-4z - ~C b ~3 Filing as a: ® County Employee; ~~pp ~ / ~.. Municipal Employee of: D"' t-+ti•.k ~. ¢-w-~- Position hi3ld or sought; /'~ .Q~ v_r „w~ @,SL.,,~ci~(-f-rem 'board where serving: ,_ Department where employed: Term or E:mpivymant Began on: Work Address: ,!L c 1 ~ ~a ~v- y ~'- Sf your home atldreea is exempt From pubR: roeortls purmrent ko worlds 9titCUtac § 17.B.Q7 please shed: bore (reed ineLruetions); ~ Work Telephone: Home Address; ~ 5'-~--~- tit i ~.~-e! ~.E.-Z ~r~~ Street Address ,n.~ ~~~ ~ ~~ ~= t ~ 3 ~ o Y City Staiffi Zip Code Pleas= list 6alaw in deso3trd'ing order with the largest source first, tie name, address and prvncipal business activity of every source of your income including public salary you received or arty person received far your benefit m use during the disclosure period. T'he income of your spouse or ar-y business partner need oat he disciorsed. If continued on a separate sheet;. check here; ~ Des~r"iPtion of the Principal kame of Source of income Address Business Activi ~e___ r ~ ~ .T ~ yy. I hereby swear (nr affirm) that the aforesaid information is z true and correct statement. / c~ ~C~e O~L.(/ ~~s~2 ~L ~c Sinnature of person des losing pate si nod