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Deborah Castillo 12/31/201006-29-2010 Deborah Castillo 10221 E. Broadview Drive Bay Harbor, Florida ~~~~ SUBJEC~~~~T y~ Visitor and Convention Authority Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2010. 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, ~~~ S~ Robert Parcher City Clerk cc: Saul Frances, Parking Director Grisette Roque 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 MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachA.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk - Tel: (305) 673-7411, Fax: (305) 673-7254 TO Deborah A. Castillo RE: Visitor and Convention Authority 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 fora term ending: 12/31/2010. 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 Emp/ogees, and ersta d that as a member of a City of Miami Beach Board and/or Committee, I must comply wi the finan ial disclosure" re ire- ments of Miami-Dade County or the State of Florida (depending o the board o committee on hich I serve) on July 1st, following the closing of the c d~r~year on hich I have erved. Sworn to and subscribed me thi ~ day o , 2010. 1 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 sofefy to all who live, work and ploy in our vibrant tropical, historic community. ~__ try V t~ ~ ~t l~! `~ (~ ~e ] ~ i .. t_; r :t: i ~ ,~~; ~,~ i :`: ~'. ,~ : i_ NAME: ~J~ I ~ ~/ 1 ~©L ~T `" ~- HOME ADDRESS: _ ~OoZo2./ ~ • ~Iro~.t (,C (n 1~i(~.C"~ ~e~ ~- l Apt No. House No./Street O " _ ~ ~ Ci ` PHONE: 5F/-\~ Hom Work Fax 'mail Business Na/me: ~/0~-e .S sition: Address: ~~a>f ( ~ ~ / n )_ S 11/~ ~ /~/~. /~ -/-'~ No. Professional License (describe) Middl 'Nal ^--, 1 ita Zip 3d~~ I -~ y - State Zip Code Expires: rrf; ra r,:~;°, ..:r r~,,: '~c~ ,:., 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 ^ 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 Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. 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 [1] first choice [2] second choice, and [3] third choice. Please note that only three f3) choices will be observed by the Citv 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 ^ Normand Shores Local Government 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 ^ 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 ^ Ga ,Lesbian, Bisexual and Trans ender GLBT ^ Sustainabilit Committee ^ Golf Adviso Committee ^ Health Adviso Committee ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC" ^ Trans ortation and Parkin Committee ^ Health Facilities Authorit Board isitor and Convention Authorit ^ His anic Affairs Committee ^ aterfront 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: r i.,_`:,~~'~ ~.:^~r ( _ rJ PI~v C{iP rl,:i l`(_ _ 'F, '._rr~ . ~.Jq h ~ti~ •_le. .Have you ever been convicted of a felony: Yes ^ or No~If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No,~lf yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes ^ or No If yes, explain in detail • Are you currently serving on any City Boards or Committees: Yes ^ or N~ 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: . I am now employed by the City of Miami Beach: Yes ^ or N Which department? e Pursuant to City Code Section 2-25 (b): Do you have a parent ^, spouse ^, child ^, brother ^, or sister ^ who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): a 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 comply with federal equal opportunity reporting requirements. Gender: ^ Male Female E~tnic Origin: Check one only (1) White (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle East. ^ African-AmericanlBlack (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 East, Southeast Asia, the Indian Subcontinent, on the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands and Somoa. ^ American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America, and who maintain Cultural identification through tribal affiliation or community recognition. Physically Challenged: Yes ^ or No^. Employment Status: Employe 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 laws may be obtained from the City Clerk. test the a curacy an truthfulness of the application and have received, read and will abide by Chapter 2, oft City de "Sta ards of Conduct for City Officers, loyees and Agency bers." ignature Date N e of Applicant (PLEASE PRINT) a copy of your resume to this application NOTE: Applications will remain on file for a period of one (t) calendar year. in th City Clerk's Office by : Date: _/ /2010 Control No. Date: _/ /2010 Name of Deputy Clerk F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application.doc I A M I•DADE ~ SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name/Initial Last Name Disclosure I~,2~ ~~/`~ For Tax Year Name: K~ ,. ~ ~ Ending:/~~ Mailing Address: ~ 022 ~ ~ 1''O(,~ ~ ~ ~:~C.~ 1~ !/ City/State/Zip: ~ ~/ ~ q /~ -{-~ 3 3 S~ Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: Board where serving: ~ ~/1 ~ Term or Employ ent Began on: (o D Department where employed: Work Address: ~ (p D ~ ~ b ~ ~ ~~ ~ ,~L 33~ L If your home address is exempt from_public records pursuant to ~~ S` ~ ~ '~ Florida Statutes § 119.07 please check here (read i ructions): ® Work^T~ One: Home Address: ~ ~_ ~ ~ rOCc lJl ~hN~. treet Address v C1~ City State 3.3/5 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: ~ Description of the Principal Name of Source of Inco a ddress Bu iness Activi Signature r (or affir tha the aforesaid information is a true and correct statement. n ~ Date signed