Sheila Duffy-Lehrman 12/31/2010i<
~. • -
•
C117/-0f MIQIflP $eC~C~'1~ 1700 Convention Center Drive; Miami Beach, Florida.33139, www.miamibe6ch#Lgov
. OFFICE OF THE CITY CLERK; Robert Parcher, City Clerk.
'Tel: (305) 673.741 1; Fax:- X305} 673-7254 -
05-12=2010 -
.Sheila Duffy-Lehrman ~ `
-.3090 Alton Road,
'Miami 'Beach, :Florida 33140 " ~ -~ - "
_ _ .._
= SUBJECT: Committee for Quality Education in MB -
n - ,
'Congratulations! You have been appointed byi Commissioner-Jorge Exposito
to.ahe agency,,board or committee named abo~re for a term ending 1,2/31/2010.
~Pursuantto Ordinance No. 2006-3543, commencing with terms begmnmg on or after
January 1st, 2007; ,the term of'board members who are directly appointed by a member of
_ ;the:City'Commission shall, automaticafly expire on December 31. of the year the appointing
elected official leaves office.
. ~ ~ If you are unable to accept this appointment o ~ 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
" Leslie Rosenfeld-
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 Amendmentand 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.
~I
`~
m MIAMI~E}CN
City of Miami Beach, 1700 Convention Center
OFFICE OF THE CITY CLERK; Robert Parcher, Ciry Clerk
Tel: (305) 673-741 1, fax: {305) 673-7254
~, Miami Beach, floridd 33139, www.miamibeachfl.gov
TO Sheila Duffy-Lehrman
RE: Committee for Quality Education in MB
I do solemnly swear or affirm to bear true faith, loyalty and all
United States, the State of Florida., and the City of Miami Bea
a member of the above-mentioned board or committee of the
been appointed for a term ending: 12/31/2010.
3nce to the Government of the
and to perform all the duties of
y of Miami Beach to which I have
I have. been issued a copy of Section 2-11.1 of the Miami-Dade
and Code of Ethics Ordinance), as well as theF/orida Commissic
Amendment and Code of Ethics for Pub/ic Officers and Emp/oyee
of a City of Miami Beach Board and/or Committee, I must comp)
ments of Miami-Dade County or the State of Florida (depending
I serve) on July 1st, following the closing of the c~le~~year-at
ounty Code (Conflict of Interest
on Ethics Guide to the Sunshine
-and understand that as a member
with the financial disclosure'` require-
n the board or mitt eon which
l/Sheila Duffy-Lehrman
Sworn to and subscri ed before me this day of , 2010.
' ~~~~~
Silvia 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 commided to providing excellent public service and safety t~ all who live, work and play in our vibrant tropical, historic community.
NAl1AE: U
' ast Name.
;HOME ADDRESS: ~ ~~~_~~K-L~
No. Street
Home
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' °Business.Namle: J=[c~l I (,
Address: I ~'~1-~ ~ {
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Professional License{describe)
C9TY Cwe~lAl~d[ BEACFin .
~D~ ~~~ ~o~~~T~IAE ~I~I~~[C~~s®~ F®~~
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First
.Middle Init2ial /~
City State ~ Zip .Code `
.~ .7_ I ~ tea- _ _ d, t ~ I
Work Fax Email addre s '
V~S~ .
~ ion: CtA ~Q-
Street
Pursuant to City Code section 2-22(4) a and b: Members of a
requirement shall be fulfilled in~tFie following ways: a) an indrti
months; or.b) an individual shall demonstrate ownership~nterest
• Resident of Miami Beach fora minimum of six (6) montt
• Demonstrate an ownership/interest in a business in Miai
• Are you. a registered voter in Miami Beac Yes . or Nc
•(Please check one): I am now a resident of: North Beac
. I am;applying for an appointment because I have specia
Please list your preferences in order of ranking [1] first choice [2]
.choices will be observed by the Ctv Clerk's Office. (Regular B•
Art in_Public Places Committee E
Beach Preservation Board t
Beautification Committee A
Board of Adjustment* ,A
Budget Advisory Committee A
Committee on Homeless 11
' - Committee for Quality Education in MB A
_ Community Development Advisory* ~
' -Community Relations Board C
onvention Center Advisory Board F
Debarment Committee F
Design Review Board'` ~ F
Disability Access Committee F
Fine Arts Board F
Golf Advisory Committee F
Health Advisory Committee S
Health Facilities Authority Board' - T
Hispanic Affairs Committee V
Historic Preservation Board* Y
* Board Required to file State Disclosure form
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Ciiy State Zip Co e
_. Expires: Attach a copy of the license
encies; boards, and committees shall be affiliated with the city; .this
iual shall have been a resident of the city for a minimum of six
~r a minimum of six months in a business established in the aty.
s or No
li Beach for a minimum of six (6) months: Yes q o .
I South Beach Middle Beach
abilities, knowledge, experience. Please list below:
cond choice, and [3] third choice. Please note that only'three (3)
rds of City)
using Authority*
arr Review~Committee*
yor's Green Ad-Hoc Committee
nine Authority*
Imi Beach Cultural Arts Council
Imi Beach Commission on Stat of Women
Imi Beach Florida Sister Citie` a
~mandy Shores l.oca! ov a .Improvement
srsight Committee for General Obligation Bond
tcs and Recreation facilities Board -
sonnel Board*
nning Board*
ice Citizens Relations Committee
duction Industry Council,
~lic Safety Advisory Committee
ety Committee
nsportation and Parking Com~ee `,,,^~
aor and Convention Authority" I 1
~~ .
K1C51BCA licationReui I ~ r
pp sed Ju y 5 _ _ .~~
~~ .
;~~_~
{: .., ~ .
.Have you ever been convicted of a felony; Yes r No~ . If yes,..please explain in detail:
. I
Do you currently have a violation(s) of City of Miami. $each codes: Yes r No .1f yes, -please explain in detail:
• Do you currently owe he City of Miami Beach any money: Yes No . `If yes, explain in detail
~~ Are you currently serving on any City Boards or Committe's Yes or No If yes; which board? ,
~I ~ = ~~
. n
• What organizations in'the City of Miami Beach do yourcurrently hold membership in?
Name:Ill ~ t ~ 1~ J Title: ~,-C~M ~
Name: - I Title:
• ` `st 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: Yes o o.. Which department?, .
+ Pursuant to City Code Section 2-25 (b): Do you have a parent ~ ,spouse. , c 'Id ,brother , or sister .who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):.
^ 11 ~~ c~-,~
This section is not required but desired: Age: .7 V yea I old Gender.. Male /Female
Ethnic Origin (Check bne) ~ `~
• , hite African-American/Black Hispanic: Asian or Pacifieislander American Indian or Alaskan Native
Employment Status: Employed Retired -Home-maker .Other
"I hereb 'attest to the accuracy and truthfulness of the application and have received, read and wilt abide by Chapter 2,
' e.VII11- ofof the~i ~od "Sta donductforCity Officers, Employees and Agency Members." '
-'Applicant's ~ at -Da~
P ch a copy of your resume to this application
NOTE: Applications will remain on file for a period of one' (1) ca
Received in City Clerk's Office' by ~~ ~ f !~ 7 _
- N me of Deputy Clerk
Document Control Number (Assigned by the City Clerk's Office)
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.Note: If applying for Youth Advisory Board, please indicate your i ffiliation 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 childr en 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:•
YJV "'
ne of.Appli nt
I NT)
year.
Date
Entered By ~~ ~ ~V ~f7. Date ~ ~"" ~'r
1 C5\BC Application Revised Juiy 18 2007.doc `~~A
•
M®~ S®URC F YC®ME Sl'l"Et~9E~T°
Please Print or Type First Name Middle Name/Ynitial Last Mame
Name:
Mailing Address:
City/State/Zip:
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Social Security Number: ~ScT~I
Filing as a: ® County Employee:
® Municipal Employee of:
Position held orsought:
Board where serving: ~~ i, ~,~~,: ; ~~, .~,,
Department where employed: ~/
Work Address: ~~i vT,.
If your home address is exempt from public records
Florida Statutes § 119.07 please check here (read in
Home Address:
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Address
City ~ State Zip Code
Please list below in descending order with t e 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: ~
Description of the Principal
PVame of Source of Yncome Ad ress Business Activity ~
~,IMi/ .n__./._ ri M// _ lilr""A1/s'.ir'~C' r_:1..i ~.w _~_. _
I reby swear (or ~ at he afore 'nfo ation is a true and correct statement.
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ignature o p~ o closin I a agned