Shaheen A. Wirk 12/31/201103-29-2010
Shaheen Wirk
1508 400 Alton Road
Miami Beach, Florida 33139
'~~ ~~~; Health Advisory Committee
Congratulations! You have been appointed by the City Commission 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,
p ~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Cliff Leonard
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
m ~J~IAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wv.~w.miamibeachH.aov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
Tel: (305) 673-7411, fax: (305) 673-7254
TO Shaheen Wirk
RE: Health 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 (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.
~W
Shaheen Wirk
Sworn to and subscribed before me thi day of ~, 2
Silvia rieto
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 committed ro providing excellen- public service and safety to all who live, work and play in our vibrant, tropical, hisroric community.
C11``f C7F M{AM4 BEAGFf
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NAME: Wirk Shaheen A
Last Name First Name Middle Initial
HOME ADDRESS: 1508 400 Alton Road Miami Beach FL 33139
No. Street City State Zip Code
PHONE: 917-593-1296 786-276-2465 212-918-0759 saw9@alumni.duke.edu
Home Work Fax Email address
Business Name: Bridger Management Position: Healthcare Analyst
Address: 400 1111 Lincoln Road Miami Beach FL 33139
No. treet Ity fate ip o e
Professional License (describe)
Expires:
APtach a crpy of Phe ticerisa
Pursuant to City Code section 2-224) 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 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 (li) months: Yes
• 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: Yes
• (Please circle one): I am now a resident of: South Beach
. Are you a politically or registered lobbyist with the City of Miami Beach: No
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
I have a background, education, and knowledge of both healthcare and business and would like to do
something for the city in this regard.
Please list vour oreferences in order of ranking l11 first choice l21 second choice,
choices will be observed by the Citv Clerk's Office. (Regular Boards of City)
Affordable Housin Adviso Committee Historic Preservation Board*
Art in Public Places Committee Housin Authorit
Beach Preservation Board 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 Oversi ht Miami Beach Florida Sister Cities
Committee on Homeless Normand Shores Local Gov't Nei h. Im rovement
Committee for Qualit Education in MB Parks and Recreation Facilities Board
Communit Develo ment Adviso * Personnel Board*
Communit Relations Board Plannin Board
Convention Center Adviso Board Police Citizens Relations Committe
Cultural Arts Nei hborhood District Overla CANDO Production Indust Council r "
Debarment Committee Public Safet Adviso Committee ? i /
Desi n Review Board* Safet Committee
Disabilit Access Committee Sin le Famil Residential Review Panel
Fine Arts Board Sustainabilit Committee
Ga Business Develo ment Ad Hoc Trans arenc Reliabilit & Accountabili Committee "TRAC"
Golf Adviso Committee ~ ~ ~ - ~:l ,; ' ' 1 Trans ortation and Parkin Committee
1 Health Adviso Com i ee Visitor and Convention Authorit *
2 Health Facilities Auth a Youth Center Adviso Board
His anic Affairs Committee
' ~.! ~ . ~ ~' -^ ~ *Board Required to File State Disclosure form
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_ _ L
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: No Years of Service:
2. Present participation in Youth Center activities by your children? No. If yes, please list the names of your children, their ages,
and which programs. List below:
Child's name:
Child's name:
Age: Program:
Age: Program:
.Have you ever been convicted of a felony: No If yes, please explain in detail:
• 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
o 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:
400 Alton Road, Apt 1508
• 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 who is employed by the City of Miami Beach? Check all that apply.
Identify the department(s):
Gender: Male
Ethnic Origin (Check one)
Asian or Pacific Islander
Race:
Physically Challenged: No
""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."
The City Clerk's Office reserves the right to contact you for verification purposes.
I Shaheen Wirk agreed to the following terms on 4/8/2009 7:48:30 PM
_ _ _.
Please attach a copy of your resume to thi§ application
NOTE: Applications will remain on,file for a period of one (1) calendar,year:
Fmnlovment Status. Emoloved
r~thar
1~
Received in City Clerk's Office by d ~ ~~~ Date 7
Name of Deputy Clerk I [/~J,,~~ ~~ ~ O
Document Control Number (Assigned by the City Clerk's Office) Entered By ~_~~-~"'~ Date `
Revised 09/02/08 LH
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SHAHEEN WIRK
400 Alton Road, # t 508
Miami, FL 33139
(917)593-129b
saw9@alumni.duke.edu
Employment BR[DGER MANAGEMENT, New York, NY !Miami, FL
2001 -present Healthcare Analyst: Evaluate novel drugs, procedures, and devices that impact the pharmaceutical, biotechnology,
hospital, and medical device industries with an eye towards novel, innovative, or disruptive technologies. Focus on
underlying science, markets, competitive dynamics, intellectual property, and reimbursement. Follow the scientific
literature, interact with experts, and attend medical conferences to support the investment decision making process.
2000 - 2001 MERCURY MD, Durham, NC
Business Development Associate: Aided senior management in developing and executing corporate strategy to target
investors and clients, completed due diligence on various projects, and overhauled business plan which was then
distributed to potential investors securing additional capital investments.
1998 - 2001 KAPLAN TESTING CENTERS, Durham, NC
Teacher: Taught biology, chemistry, math, and verbal sections to over 150 MCAT, DAT, and GMAT students.
Education DUKE UNIVERSITY, The School of Medicine /The Fuqua School of Business, Durham, NC
1998 - 2003 Joint degree of Doctor of Medicine, Master of Business Administration (MD !MBA), May 2003. Health Sector
Management concentration. Awarded Fuqua Fellowship and Thomas F. Frist, M.D. Scholarship.
1994 - 1998 DUKE UNIVERSITY, Durham. NC
Bachelor of Science, Biology. with minors in Chemistry and Religion, May 1998. Magna Cum Laude. Robert C.
B}Td Scholar. Duke Student Gavemment Legislator. Freshmen Advisory Counselor Program Board Member.
Rothermere Scholar, New College. Oxford University, England. Studied at Duke Marine Laboratory, Beaufort, NC.
1990 - 1994 CARROLL HIGH SCHOOL. Dayton, OH
Graduated Valedictorian, June 1994
Activities ROBERTSON SCHOLARS PROGRAM, Durham and Chapel Hill, NC
2002 -present Selection Committee .Member: Aid in the selection and interviewing of potential scholarship recipients.
2006-present DUKE UNIVERSITY ALUMNI ADMISSIONS, Miami, FL
Interviex~er: Interview and evaluate local undergraduate applicants to Duke University.
2002 - 2003 MEDICAL SCHOOL JUDICIAL BOARD, Durham, NC
Judicial Board Representative: Evaluated cases of academic dishonesty. Participated in honor code revisions.
2001 - 2002 MEDICAL SCHOOL ADM ISSIONS COMMITTEE, Durham, NC
Executive Committee Member: Screened, interviewed, and evaluated applicants with voting privileges at biweekly
meetings. Recruited and coordinated admissions volunteers. Alarmed recruiting weekend for admitted applicants.
2001 - 2003 DAVISON COUNCIL, Durham, NC
Representative: Served as liaisons between the administration and the medical school student body and aided in
ongoing projects or initiatives through participation in task forces or ad hoc committees.
Research DUKE UNIVERSITY SCHOOL OF MEDICINE, Durham, NC
2001 - 2004 Publication: Oxygen Transport Dynamics After Resuscitation With a Conjugated Hemoglobin Solution. Arch Surg.
2004;139:55-60. Co-authored paper with Dr. Steven Vaslef.
Summer 1997 THE UNIVERSITY OF TEXAS M.D. ANDERSON CANCER CENTER, Houston, TX
Project title: Effect of Vazious Stressors on Expression of Cell Surface Proteins in Human Tumor Cells. Data
presented at 25"' Annual San Antanio Breast Cancer Symposium in October 2006.
Fall 1996 DUKE UNIVERSITY MARINE LABORATORY, Beaufort, NC
Project Title: How the Sand Fiddler Crab Finds Its Burrow: An Example of Idiothetic Orientation.
Summer 1996 RABIN MEDICAL CENTER, Petach Tikvah, Israel
Project title: Assessment of.Allelic Loss of Chromosome 18q in Colorectal Carcinomas.
~DADE SOURCE OF INCOME STATEMENT
Please Print or Typ
Name:
Mailing Address:
City/State/Zip:
e First Name Middle Name/Initial Last Name
S E ZlC-
l~~i ~~ ~, ~,~ ~ s ~ goo
Social Security Number:
Disclosure
For Tax Year
Ending: `~q
Filing as a: ~ County Employee:
~ Municipal Employee of:
Position held or sought:
Board where servin Term or Em to ment
g ~ ~~~/ `~ ~`lSDre~®n,,~~~ Began on: ~ y Z / v
Department where employed:
Work Address: 1~7 Ni
If your home address is exempt from public records pursuant to 'z ~ 2 ~~'~/- 2 ~
Florida Statutes § 119.07 please check here (read instructions): ® Work Telephone: ZO
Home Address: ~ ~p ~~~ ~ , ~T ~ ~`~~
Street Address
~~1-~~ ~~a- ~~ ~ 3 ~3~
City State Zip Code
Please list below 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 disclosed. If continued on a
`separate sheet, check here: 0
Description of the Principal
Name of Source of I//n'~ co~me Address /~ Business Activi
N (aol6
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
~l~ ~ / o
Signature of person disclosing Date signed