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George Castell
m MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami. Beach, Florida 33139, ~v.miamibeachfl.aov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 July 28,.2010 George .Castel) SUBJECT: Personnel Board Congratulations! You have been appointed *,by virtue of your being a Representative for Group II to the agency, board or committee named above for a term ending 07/31 /2013. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-741 1. i Sincerely, ~~f~ ~~ . Robert Parcher City Clerk cc: Saul Frances, Parking .Director Ramiro Inguanzo, Human Resources Director Fele 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 2-1 i .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 arQ gommitted to~fovidin~ excellent public service and,sa~ry to qll whq live, work and play in our vibrant, tropical,, historic community. l'~.. pi'E ~iJirt;riit O tJ ~7J~ CI!?4 E'.cCB;iEni ?iiDri:: 5E-iV(CB G^U JQ a;}'!O UN, ~'t ;;~ live, '~h'Ork, OnC FtiU; in pU~ viLtC:R; ri CUE:ICCi, niS;OC:C C:~rt7r7tL'nit}~. i i ®MIAMI~EAC City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, xww.miamibeachN.aov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk ~ Tel: (305 673-7411, Fax: (305) 673-7254 TO George Castell RE: Personnel Board i 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: 7/31/2013. i 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 Pub/ic O>~ceis and Emp/oye~es, and understand that as a member of a City of Miami Beach Board and/or Committee, I must compl ' h the financial disclosure* require- ments of Miami-Dade County or the State of Florida (depen ' g on t board or ~mittee on which I serve) on July.1st, following the closing of the calendar ar on wh' I~ $er~ed. Sworn to and subscribed before me 2010. "Silvia Prieto Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under Gty Clerk/Board and Committees for additional information regarding the Fnancial Disdosure Requirements. day ofL~~~, We are committed to providing excellent public service and safey to all who live, work and play in our vibrant tropical, historic community. I m MIAMIBEACH Add v>c . f~1/Am 1 ,33 No. ~) Stre€t ~ City State Zip Code Professional License (describe) /y/~ F~cpires: ~ /7 Attach a copy of the license Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; orb) an individual shall demonstrate ownership/interest for a minimum f six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months: Yes ^ or No ~ / • Demonstrate an ownershipMterest in abusiness in Miami Beach for a minimum of six (6) months: Yes ^ or No tB' • Are you a registered voter in Miami Beach: Yes ^ or No • (Please cirGe one): I am now a resident of: North Beach South Beach Middle Beach • t am applying for an appointment because I have special abilities, knowledge and experience. Please list below: • Are you presently a registered lobbyist with the City of Miami Beach? Yes ^ or No B' ~/f cs~~LG BOARD AI NAME: C7'-G ©~~1~ L~~as``t Name..~.,. p ~F-i~rst Name HOME ADDRESS: CX>~(. ~" SOS^~ 7 ~ S~^c.~ T Apt No. House No./Street PHONE: ~5-4~ 9 6 73 78"6 -~S$-!~o/ 7 6 - Home/~,,~L ,1,~ Work ,,,, , ` Fax Business Name: C.-~/~1 d~~"//~~/ ~~~`~'G~ Position: 0~~ -~ ~ - - Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] 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 Authori ^ 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 Quali Education in MB ^ P sand Recreation Facilities Board c`~ N ^ Communi Develo ment Adviso ersonnel Board -~ ^ Communit Relations Board ^ Plannin Board* "~ ~,,,. ^ Convention Center Adviso Board ^ Police Citizens Relations Committee ` + ' ' ' ^ Debarment Committee ^ Production Indust Council rr, N ^ Desi n Review Board* ^ Public Safet Adviso Committee ^ Disabili Access Committee ^ Fine Arts Board ^ Safe Committee ^ Sin le Famil Residential Review Panel ~,..- ~ ^ Ga ,Lesbian Bisexual and Trans ender GLBT ^ Golf Adviso Committee ^ Health Adviso Committee ^ Sustainabili Committee ^ Trans arenc Reliabilit & Accountabilit ^ Trans ortation and Parkin Committee -*~ N Coaunitte "TRA'C* o ^ Health Facilities Authorit Board ^ Visitor and Convention Authori ^ His anic Affairs Committee ^ Waten`ront Protection Committee D 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: CITY OF MIAMI BEACH JD COMMITTEE APPLICATION FORM Middle Initial City State Zip Code 'S//S7 9eoor~ecaste~l~iY„Q•~/6~1 ma address E L'awp/ig,,re~ AD~ivlsr~,~-vim ~®v F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application062609 NEW.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 ^ or No . If 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 City of Miami Beach do you currently hold membersh' in? Name: Title: Name: Title: o List all~prpperties 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 No^~. Which department?~W1~jng pf,~~(,o~E~'%~/'' pZV. o 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/~~% ~~~ ~ _ v DO~~ ~ ~ ~~~~Tk~t E.JT 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 Ethnic Origin: Check one only (1) hits (Not of Hispanic Origin): All persons having origins in any of the original peoples of Europe, North Africa or the Middle East. ^ African-AmerlcaNBlack (Not of Hispanic Origin): All persons having origins in any of the Black racial groups of Africa. ispanic: 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 affilia~tion/or community recognition. Physically Challenged: Yes ^ or Noll! Emplovment Status: Emoloved I~ Retired n Hnmam~kor n nrtie. ~ 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. "I hereby st to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Article I - of th e " ndards of Con uct f r City Officers, Em loyees and Agency Members." ~8'/~ ~ £ cJ. s~ L App nY I re ate Name of Applicant (PLEASE PRINT) Please ch a copy of your resume to this application NOTE: Applications II remain on file for a period of one (f) calendar year. }~ Received in the City Clerk's Office by : Date /2010 Control No. ~~'~ 1j~ Date: _/ /2010 Name o Deputy Clerk F:\CLER\$A \aFORMS\BOARD AND COI~ijMITT-EES\BC Application.doc M I A M hDADE ~ SOURCE OF INCOME STATEMENT , Please Print or Type First Name Middle Name Initial Last Name Name: ~~~~~ ~• ~/~s ~~~~ Mailing Address: ~;.~ ,'33r city/state/zip: /~~ / ~~%¢~ ~L. ~ 3 139 Social security Number: Disclosure For Tax Year Ending:pZ~~ q ~ d Filing as a: ® unty Employee: ~~-'~~ ~nicipal Employee of: ~/~ Q~ /I~fYI~,~~i~~t5rrr° ~ Position held or sought~b~ ~~~ 1(~JC~' ~~tR,/`,uf ~~~2,q-7-a~ ~ N`~ ~~ ~ .,.~~ e Board where serving:~~~~~~ ~D~ Term or Employment's ~ Began on: ~ ~ -~ m tV Department where employed: ~ti!~~'~ ,~~,osrµrMF.vT ~F ~ti- ~ ,~/rs~~ 0 Work Address: If your home ad § ess is expempt from public re~rds pursuant) ~ ~ / ~, ~ /~0~ Florida statutes 119.07 lease check here read instructions : Work Telephone: ~j 3oS-673-~0o E1~~~ Home Address:.SOS /7~~1~f~T /7yo~/Ea~/v,~ ~~,/YFe. ~~ 6~~6 __ Street Address ~?/ia~~ ~~4~6r ~. 33 /39 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 disdosed. If continued on a j separate sheet, check here: ® J Name of Source of Income Address Description of the Principal Business Activi I f~M/qIN/ $FiS~G 1700 G'oN~ ~o~J FR M,v M~rl~ N N ~ N ~t ~~ /~. ~.~ r 5 ousE u u ~ h ~/ p swear (or ) the aforesaid information is a true and correct statement. ~.~'/ D f n disclosing to si ned TB~G