Dov Konetz 12/31/2011•
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City of Miami Beach, 1700 Convention Center. Drive, Miami Beach, Florida 33139, wv/w.miamibeachfl.~ov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciry Clerk
Tel: (305) 673-741 1, Fax: (305) 673-7254
5/19/2010 ~. .
Dov Konetz
1602 Alton .Road #406 ~ .
Miami .:Beach, Florida 33139
:SUBJECT: ~ Police Citizens Relations Committee
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
. to the~above referenced agency, board or committee for a term ending: 12/31/2011.
If you are unable fo accept this appointment, please notify the City Clerk's Office at .
(305) 673-7411.
Paease read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
G ~ - s~°
-Robert Parcher
City Clerk
cc:-Saul Frances,-Parking Director
Chief Carlos Noriega
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 222
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~E#hics for~I?ublic Officers and
Employees
We are committed to providing excellent public service and safely to all who live, work and play in our vibrant, tropical, historic community.
• •
m ~1{IIAMIC?~~.~[~
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, ~!yyvw.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk ~ : . _ ~ _ , .
Tel: (305) 673-741 1, Fax: (305) 673-7254 ~ '~ :~>: ~:"~ _ , .. "
TO Dov Konetz
RE: Police Citizens Relations 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 andior 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
t serve) on July 1st, following the closing of the calendar year on a ~~.._- ~~~~
~~~~
Dov Konetz
Sworn to and subscribed before me thisp~U 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 committed to providing. excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
m' I~^,IAP~/~I~ACH
Cti`f ~~F Mi~fi~li B~~~F-I
Ba~R~ ~NQ car~ln~l T T EE ~PPLIC~.T'luh- FoRr~l
NAME: ~ Z ~ >n yQ,;~Z~ ~~1(~i/ /"l ~
Last Name Est-Name Middle Initial
HOME ADDRESS: /,/ Q~ .~` (~~ ~ 1°`l/~ ~ GCI ~ ,/~ ~c~ I~ctcr'I.~ ~- Z 3~ 13 ~( .
No. Street City ~ State Zip Code
PHONE: 3~~ ~~ J ~~~~ (~~~~ P~ G~c,; ~ . La-~
Home Work Fax Email address
Business Name:. Position:
Address:
No.
Professional License (describe)
Street
City
State Zip Code
Expires: Attach a cop}~ of the Iicerlse
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 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 (6) months: Yes ~or No ^
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes ~r No ^
• Are .you a registered voter in Miami Beach: Yes D or No ^
• (Please circle one): I am now a resident of: North Beach South Beach Middle Beach
• I am applying for an appointment because I have special abilities, knowledge, experience. Please Fist below:
Please list your preferences in order of ranking [1] .first choice [2] second choice, and [3] third choice. Please note that only three (3)
choices will be observed by the City 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's
^ Beautification Committee ^ Marine Authorit
^ Board of Ad'ustrnent* ^ Miami Beach Commission for Women
^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council
^ Capital Improvements 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 Committee
^ Cultural Arts Nei hborhood District Overla (CANDO) ^ Production Indust Council
^ Debarment Committee ^ Public Safet Adviso Committee
^ Desi n Review Board* ^ Safet Committee
^ Disabilit Access Committee ^ Sin le Famii Residential Review Panel
^ Fine Arts Board ^ Sustainabilit Committee
^ Ga Business Develo ment~Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC"
^ Golf Adviso Committee ^ Trans ortation and Parkin Committee
^ Health Adviso Committee ^ Visitor and Convention Authorit
^ Health Facilities Authorit Board ^ Youth Center Adviso Board
^ His anic Affairs Committee
* Board Required to Fiie State Disclosure form
. ~..,_=~i\~~:~ ~~ESGn(G ~: ~i.'"i11T~ITIEE'S~~~tiCi _ %',' y~ll~^ ~'O _, L. r' r; i 3~
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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°nam_es of your children, their.
,,
ages, and::which programs. List below:
. , .~, . yChild's name: Age:... ~ Program:: ' ,
- Child's name:' ~. ... .. Age:. Program:
• HaveV you ever been convicted of a felony: Yes. ~ or~~No ~ 'ff yes, please explain i'n detail: ~ ~ ~ -
• Do ou currentl have a violation s of Cit. of Miami Beach codes: Yes ~ orfNo'~Q If es, please ex lain '
. Y .. Y;, O Y Y p in detail:
• Do: you currently: owe the City of Miami: Beach~any.money; Yes C or No If yes, explain' in detail
.:
. x
• Are you currentiy~serving on any City Boards or Committees: Yes ~ or No if yes; which board?
V1/hat .organizati'ons in the City of Miami" $each do you currently hold. membership in? '
:. ..
~~ ~. .
~. ~.
. ~~~
Name:..l :.' ~ 4i^-Lti c~~ . 1 ~'~ ~ . Title: ~ (~` ~ ~~°~
. ... ,
'Name; ./~'~ ~ ~.>~-i ~c~,C,~ ~ ~ ~.w,~~1Z ~ G~~~ ~ Title: ~- ~~U~'. ~''~r~-'
._. _ ,
. ' ~ ..List all properties owned or have an interest. in, which are located within,the City of Miami Beach:
. , . ._ .
• l am now ~empioyed by theCity of Miami Beach: Yes D or No~i'Which department?
~ Pursuant to City'.Code Section. 2-25 {b): Do you have a parent ~, spouse ~:, child ~~, brother.J, or sister ~~ who is' employed by the
City of_Miami Beach?.Check all that apply. Identify the departi~nent(s): ~ : '
.. ~~ '
, .
;This:section'is'"not required" but desired~:'Age: ~~--c~ ..Years old Gender Male" Female ~:
Ethnic Origin (Check-one) ~ ~ ~ ~ ~ ~~
White`~African-American/Black O Hispanic: D"Asian or Pacific Islander ~ American Indian or Alaskan Native
"I hereby attest to the accuracy and truthfulness- of the application- and have received,. read- and will abide by Chapter 2,
Article VI e.City Co~ "Standards of Coriduct~for City~.Officers, Employees and Agency Members."
~ ~,
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~~,.
...:
app Icant's Si~.rtiature ~ - - Date' ' Name of Applicant {PLEASE ,
PRINT). °,~°
Please attach a copy of yourresume to-this application
'NOTE: Applications will remain on file fora .period of one (1 )`:calendar year. ~" .
Employment Status: Employed „Retired ^ Home-ma,K~r-^ Other
~< f , -~i
Received in City Cleck's Office by' • , ~ ~ Date ~ `~
Name'of Deputy Clerk. ~ >t. ~ .
' Document Control ,Number (Assigned by the,City Clerk's Office)~~ Entered By Date r
. ~ t/ .. Revised~0
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if your home address is exempt ~rorro public records pursa~ant to
Florida Statutes ~ 119.07 please check here (read instructions): ~r~ Teleph®ne°
®rne Addressor.
Street Address
pity State Zip C®de
Please list bel® in descending ®rder with the Jargest s®urce f rst, the name, address and
...principal business activi ~~ every s®urce ~~ your inc®rr~e including public Mary Y®u
received ®r any pars®n received fir Y®ur benefit ®r use during the disc)®~ure peri®dA The
inc®rne ®~' your sp®use ®r any business partner need nit be disci®sedo If continued ®n a
.separate sheet, chec4~ hares -
escripti®n ®f ,.the Principal
sore ®f S®urce ®~ Income ~ ~ Address business Activi
a hereby swear {~ arm) that the esaid int+~rrnati®n is a true and correct statement.
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grea~ure ®f peen disci®sing - ~ ®ate signed
®iscl®Si,l~'e
F®r 'Tax Year
~1'Idingo ~~~