George Castillo 12/31/2011
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, vrww miamibeachfl aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (3051 673-7411, Fax: 1305) 673-7254
3/23/2010
George Castillo
4000 Collins Ave #102
Miami Beach, Florida 33140
SUBJ ~ Golf Advisory Committee
Congratulations! You have been reappointed by Mayor Matti Herrera Bower
to the above referenced agency, board or committee for a term ending: 1213112011.
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,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Kevin Smith
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 2-11.1 -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
Employees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
MIAMI A~
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeach4l aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (305i 673-741 1, Fax: (305) 673-7254
TO George Castillo
RE: Golf Advisory 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 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 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 (dep ding on the board or committee on which
I serve) on July 1st, following the closing of the calenda~ear on which I have s~ed.
e Castillo
Sworn to and subscribed before me this o~3 day of ~, 2010.
c=~_ aa~~
t vta Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
We are commit/ed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
NAME: __~
HOME ADDRESS:
PHONE: E
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Business Na~mte:
Address: ~ (2
Professional License (describe)
BOARD AND COMMITTEE PPLICATION FORM
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Position:
~~
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 shalt be fulfilled 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 fora inimum of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six (6) months: Yes or No ^
• Demonstrate an ownership/interest in a business i iami Beach for a minimum of six (6) months: Yes ^ or No
• Are you a registered voter in Miami Beach: Yes : or No ^
• (Please circle one): I am now a resident of: North Beach South Beach Middl B a -
• I am applying for an appointment because I have special abilities, knowledge and expe/r~nce. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or No :%
Please list your preferences in order of ranking [t] first choice [2] second choice, and [3j third choice. Please note that only three 13)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
^ Affordable Housin Adviso Committee ^Housin Authorit
^ Art in Public Places Committee ^ Loan Review Committee
^ Beautification Committee ^ Marine Authorit
^ Board of Ad'ustment` ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Ca ital Im rovements Pro'ects Oversi ht Committee ^ Miami Beach Sister Cities Pro ram
^ Committee on the Homeless ^ Nor and Shores Local Government Nei h. Im rovement
^ Committee for Qualit Education in MB ^ P sand Recreation Facilities Board
^Communit Develo ment Adviso ersonnel Board
^ Communit Relations Board ^ Plannin Board`
^ Convention Center Adviso Board ^ Police Citizens Relations Committee
^ Debarment 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
^ a ,Lesbian, Bisexual and Trans ender GLBT ^ Sustainabilit Committee
Golf Adviso Committee ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC"
^ Health Adviso Committee ^ Tr ns ortation and Parkin Committee
^ Health Facilities Authorit Board isitor and Convention Authorit
^ 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: Yes ~ No ^ Years of Service:
2. Present participation in Youth Center activities by your children Yes No ~. 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:
Name
Apt No.
Work
CITY OF MIAMI BEACH
No.
l~~~m~ ~eAc~ij.i~....33~9Q
City S to Zip Cod~et,~ _
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ail address
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F:ACLER\S,ALL\arORMS\BOARD AMID COMMITTEES\BC Apolicotior,062609 NEVd.doc
oHave you ever been convicted of a felony: Yes ~ or No If yes, please explain in detail:
o Do you currently have a violation(s) of City of Miami Beach codes: Yes n or No Wf yes, please explain in detail:
o Do you currently owe the City of Miami Beach any money: Yes ~ or No '. If yes, explain in detail
o Are you currently serving on any City Boards or Committees: Yes ^ or No / If yes; which board?
o What organizations in the Ci of Miami Beach do you currently hold membership in?
Name: N ~~ Title:
Name:
o List all properties owned or have an interest in, which are located within the City of Miami Beach:
o I am now employed by the City of Miami Beach: Yes ~ or NtY~!Which department?
o pursuant to City Code Section 2-25 (b): Do you have a parent ^, spouse ^, c Ild ^, brother ^, or sister ~ who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s): t ~ ~ ~
The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is
being asked to c ply with federal equal opportunity reporting requirements.
Gender: Male ^ Female
Ethnic Origin: Check one only (1)
^ (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.
^ can-American/Black (Not of Hispanic Origin): All persons having origins in any of the Black racial groups of Africa.
Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
^ Asian or Pacific Islander: All persons having origins in any of the original peoples of the Far Easl, Southeast Asia, the Indian Subcontinent, on
the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands and Somoa.
^ American Indlan or Alaskan Natlve: All persons having origins in any of the original peoples of North America, antl who maintain
Cultural identification through tribal affiliation community recognition.
Physically Challenged: Yes o or N
Employment Status: Employed Retired ^ Homemaker ^ 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 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 taws may be obtained from the City Clerk.
"I h by atlas o e ac cy and truthfulness of the application and have received, read and will abide by Chapter 2,
Arti I II of f e ode "Standards o Cond ct for City Officers mployees a Agenc embers"
3 ( s u.o
Ap I ature Date Name o plicant (PLEASE PRINT)
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Received in the City Clerk's Office by : . ~. ~pr.~ o-t~ Date:3_/~2~010 Control No. Date: _/_/2010
Name of Deputy Clerk F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEESIBC Appiication.doc
MIAMFDADE ~,
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Position held or sought:
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Board where serving: Term or Employment
Began on:
Department where employed:
Work Address:
If your home address is exempt from public records pursuant to
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Please list below in descending order witfi 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 disclosed. If continued on a
separate sheet, check here:
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I he by swear (or ffirm) that the aforesaid information is a true and correct statement.
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Sign a of erson isclosing Date signed
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