Laurie Davis 12/31/2012 m MIAMIBEACH
Cit of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
ti
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673 -7254
12/16/2010
Laurie Davis
5965 Alton Rd
Miami Beach, Florida 33140
. * Community Relations Board
Congratulations! You have been reappointed by Jorge M. Gonzalez, City Manager
to the above referenced agency, board or committee for a term ending: 12/31/2012.
If you are unable to accept this appointment, please notify the City Clerk's Office at
(305) 673 -7411.
Please read the enclosed material carefully. Again, congratulations and good luck.
Sincerely,
Jekj icvale2A
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Lynn Bernstein
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 -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
Employees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
I
® MI AMIBEACH
Cit of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673 -7411, Fax: (305) 673 -7254
TO Laurie Davis
RE: Community Relations Board
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: 12/31/2012.
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 theFlor /da 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.
aurie Davis
Sworn to and subscribed before me this/1
his /1 t day of /i/i , 201 V
,..._____e A
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.
® MIAMI BEACH CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
NAME: Davis Laurie Kaye
Last Name. First Name Middle Initial
ROME ADDRESS: 5965 Alton Road Miami Beach FL 33140
Apt No. Home No./Street City State Zip Code
PHONE: 305.790.6404 305.868.8724 LKayeDavis @aol.com
Home Work Fax Email Address
Business Name: LKD Consulting Position: Principal
Address: 5965 Alton Road Miami Beach FL 33140
No. Street City State Zip Code
Professsional License(describe): Expires: Attach a copy 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;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
• 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: Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
Extensive experience with education initiatives both in paid positions and in volunteer positio
•Are you presently a registered lobbyist with the City of Miami Beach? No
Please list your preferences in order of ranking [1]first choice[2]second choice,and[3]third choice. Please note that only three(31
choices will be observed by the Cibf Clerk's Office.(Regular Boards of City)
Affordable Housing Advisory Committee Housing Authority
Art in Public Places Committee Loan Review Committee
Beautification Committee Marine Authority
Board of Adjustment* Miami Beach Commission for Women
Budget Advisory Committee Miami Beach Cultural Arts Council
Capital Improvements Projects Oversight Committee Miami Beach Human Rights Committee
Committee for Quality Education in MB Miami Beach Sister Cities Program
Committee on the Homeless Normandy Shores Local Gov't Neigh.Improvement
Community Development Advisory Parks and Recreation Facilities Board
Community Relations Board '�! Personnel Board
Convention Center Advisory Board Planning Board*
Debarment Committee Police Citizens Relations Committee
Design Review Board* Production Industry Council
Disability Access Committee Safety Committee
Fine Arts Board Single Family Residential Review Panel
Gay,Lesbian,Bisexual and Transgender(GLBT) Sustainability Committee
Golf Advisory Committee Transportation and Parking Committee
Health Advisory Committee Visitor and Convention Authority
Health Facilities Authority Board Waterfront Protection Committee
Hispanic Affairs Committee e;; Youth Center Advisory Board
Historic Preservation Board
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:Catherine Davis Age:17 Program:Ice Skating&Swimming
Child's name: 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 Money Beach any money: No If yes, please explain in detail:
e Are you currently serving on any City Boards or Committees: Yes If yes,which board?
Community Relations Board
•What organizations in the City of Miami Beach-do you currently hold membership in?
Name: Alton Road HOA Title: Secretary
Name: Miami Beach High PTSA Title: President
•List all properties owned or have an interest in,which are located within the City of Miami Beach:
5965 Alton Road
e 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 relative who is employed by the
City of Miami Beach?Check all that apply. Identify the department(s):
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: Female
Ethnic Orgin:Check one only(1)
White
Physically Challenged: No
Employment Status: Employed
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:
• Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459).
• Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1).
• Prohibition from lobbying before board/committee you have served on for period of one year after leaving office(Miami
Beach Code section 2-26).
• 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 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."
I Laurie Kaye Davis agreed to the following terms on 5/9/2012 :27:01 PM
WeVi I CLO I b.
Received in the City Clerk's Office by: Date: / /2012 Control No. Date: / /2012
Name of Deputy Clerk
e l - 1CITY OF MIAMI BEACH
hh��
BOARD AND COMMITTEE APPLICATION FORM
NAME: DeAA AS , e -e
Last Name pp First Name Middle Initial
HOME ADDRESS: ' J e l 6 5 &.. (A. E , Z L \'-[
Apt No. House No. /Street City State Zip Code
PHONE: 305. `a(,ti '6 05.``110 Cam' O 30S . (AS. e 0 civ c-tat.coe%
Home Work Fax Email address
Business. Name: 1-2C-fl k r ` U-C Position: p er,
Address: 5'16 S A t �■N L& fin, B e4 d- . t
No. Street City State Zip Code
Professional License (describe) Expires: 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; 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 C�or No ❑
• Demonstrate an ownership/interest in a business in iami Beach for a minimum of six (6) months: Yes (r No ❑
• Are you a registered voter in Miami Beach: Yes 4r �r No ❑
• (Please circle one): I am now a resident of: North Beach South Beach iddle Beach'
• I am applying for an appointment becaus I have s IS special abilities, knowledge and xperience. i below:
C■c4c�..5 e nn K(h - CU(F .,rru N e r.c�� - 2 a..dl � t� ✓: e...
• Are you presently a registered lobbyist with the City of Miami Beach? Yes ❑ or No l
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (32
choices will be observed by the City Clerk's Office. (Regular Boards of City)
❑ Affordable Housing Advisory Committee ❑ Marine Authority
❑ Art in Public Places Committee ❑ Miami Beach Commission for Women
❑ Beautification Committee ❑ Miami Beach Cultural Arts Council
❑ Board of Adjustment* ❑ Miami Beach Human Rights Committee
❑ Budget Advisory Committee ❑ Miami Beach Sister Cities Program
❑ Capital Improvements Projects Oversight Committee ❑ Normandy Shores Local Govemment Neigh. Improvement
❑ Committee on the Homeless ❑ Parks and Recreation Facilities Board
❑ Committee for Quality Education in MB ❑ Personnel Board •
CI Community Development Advisory ❑ Planning Board*
liCommtmity Resat omp-6oardr,, ❑ Police Citizens Relations Committee
❑ Convention Center Advisory Board ❑ Production Industry Council
❑ Debarment Committee ❑ Public Safety Advisory Committee
❑ Design Review Board* ❑ Safety Committee
❑ Disability Access Committee ❑ Single Family Residential Review Panel
❑ Fine Arts Board ❑ Sustainability Committee
❑ Gay, Lesbian, Bisexual and Transgender (GLBT) ❑ Transportation and Parking Committee
❑ Golf Advisory Committee ❑ Visitor and Convention Authority
❑ Health Advisory Committee ❑ Waterfront Protection Committee C) No
❑ Health Facilities Authority Board ❑ Youth Center Advisory Board —+
�
❑ Hispanic Affairs Committee r r c
❑ Historic Preservation Board
❑ Housing Authority rn _. 0
❑ Loan Review Committee *Board Required to File State Disclosure Fit
c n , rw .e
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: o m
l J O
1. Past service on the Youth Center Advisory Board: Yes ❑ No ❑ Years of Service: rn Cn
2. Present participation in Youth Center activities by your children Yes❑ No 0. 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:
F: \CLER \$ALL \aFORMS \BOARD AND COMMITTEES \BC Application.doc
•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 gllf yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ❑ or No N. If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes it No 0. If yes; which board?
Ca ev‘_, ax,..\:k e otk- n 3 s r
• What organizations in the City of Miami Beach do you currently hold membership in?
Name: Miun^t Q &u..1-. S -..ate Kid 1-.. P TS Title: 'I e�S k �- 4 ee1/4 ("-'
Name:Pal LO or'. Icui k Title: t=y ecA..t, J -e A Oc4-d. - S-e t-r- 4- e , ' y
• List all properties owned or have an interest in, which are located within the City of Miami Beach: /
S ct - o . adt 1. g - ct� ■
• I am now employed by the City of Miami Beach: Yes ❑ or N . ich department?
• Pursuant to City Code Section 2 -25 (b): Do you have a parent ❑, spouse ❑, child ❑, brother 0, or sister ❑ who is employed by the
City of Miami Beach? Check all that a ly. Identify the department(s):
The following information 1s 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 male
E th aic Origin: Check one only (1)
hite (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: Employed ❑ Retired ❑ Homemaker ❑ Other C
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 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."
%' 1..a Lk,-: t. e 1() aLl - 3
Applicant's Signa j / 't Date Name of Applicant (PLEASE PRINT)
Please attach a copy of your resume to this application
NOTE: • pplications will remai; on file for a period of one (1) calendar year.
Received in the C' ' — + //
' L�� � 1
�Y Clerks Office by � � Datet/11/2010 Control No. Date: _/_/2010
Name of Depu lerk
LAURIE KAYE DAVIS
5965 Alton Road
Miami Beach, Florida 33140
Phone: (305) 868 -8724
Email: LKayeDavis@aol.com
QUALIFICATIONS
Over twenty years of successful business experience in a wide spectrum of industries.
Outstanding communication, analytical, administrative and organizational skills
Managed or directed:
• Development department for a non -profit with a budget exceeding $5 million and
mentor program for a non -profit with a budget over $7 million
• Retail department with sales exceeding $1.5 million
• Sales /leasing program for $25 million mall renovation
• Sales, operations, and personnel management for an executive suite business.
WORK HISTORY
1999 - Present 11(D Consu/dngGroup
Provide consulting and business support to a wide variety of organizations including a not-
for -profit child care center, Montessori school, start -up children's clothing manufacturer
and a not - for -profit academic achievement program. Current project required
orchestrating all elements of a mentor program from concept to design to selection,
assessment, matching and orientations of mentors and mentees.
1993 - 1999 Executive Recruiter, The Farwell Group
Responsible for the client development, recruitment and placement
program for marketing and administrative positions for a recruiting firm
with billings exceeding $1 million. Conducted all interviewing, qualifying and
background checking of potential candidates for our client companies
1992 -1993 Director of Development, Children's Home Society
Volunteer role led to permanent position directing the fundraising activities
for a large social service agency providing temporary shelter for abused,
abandoned and neglected children. Devised and administered fundraising
strategies, major donor events and annual appeal campaigns with a staff of
four.
1989 -1992 Center Manager/Director of Retail Leasing The Adler Group
In charge of several different projects for a commercial real estate
developer. Initially established a retail leasing division with leasing and
management responsibility for two 100,000 square foot strip shopping
centers. Later set up the leasing and operations for an executive suite
business, increasing occupancy from 36% to 90% within nine months.
1988 -1989 Marketing Agent, Balcor Development Company (Division of American
Express Corporation)
Brought on board for a temporary position through grand opening of a
650,000 square foot mall renovation project. Successfully marketed the
Mall bringing occupancy from 65% to 95 %.
LAURIE KAYE DAVIS
Page 2
1984 Buyer; Cedars Medical Center
Administered the buying program for infant wear, children's wear and toys
for the gift shop of a 700 bed hospital. Responsible for a spending budget of
$30,000.
1982 - 1984 Sales and Purchasing, Flesta Farms
Managed sales and operations for a cut flower importer with sales grossing
$2 million.
1979 - 1982 Department Manager, Federated Department Stores
Began as a college intern in Area Research in Cincinnati and after
graduating went to Burdines of Florida as the Assistant Buyer for Men's
Sportswear. Promoted to Department Manager in the largest department
store in the USA. Responsible for the sales and merchandising program and
a sales staff of seventeen.
EDUCATION
1977 -1980 BSBA, High Honors — University of Florida
COMMUNITY SERVICE
Miami Children's Museum Advisory Committee Member Since 2003
Miami Children's Hospital Hugs & Kisses Committee Member Since 2000
St. John's Child Care Center Board Chair 1997 -2003
St. John's United Methodist Church Staff /Parish Relations Committee Chair 1995- 1999
The Daily Bread Food Bank Advisory Board Member Since 1992.
Guardian Ad Litem Volunteer Services Since 1991
Children's Home Society Infant Center Volunteer 1988 -1992
MIAMfDADE
SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name /Initial Last Name
Disdosure
For Tax Year
Name: & Y--a t otV t S Ending:
Mailing Address: S 'kC.S pq-lip — f-c.7&
City/State/Zip: iV iC ' D -ecc L(., FL 3 3 1 `E
Social Security Number:
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought: C k M ", x i yLdc 4i ^ s 6 act r
Board where serving: g , Q 2� ( Term or Employment
Began on:
Department where employed:
Work Address:
If your home address is exempt from public records pursuant to 3 ° 5 - 'Act ��
Florida Statutes § 119.07 please check here (read instructions): ® Work Telephone:
Home Address: S 1-6S 1 '0 r �cx
Street Address
"Uc.v ( Q ccs 33 l 4
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 induding 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
separate sheet, check here:
Description of the Principal
Name of Source of Income Address Business Activity
c.c.s r ✓ -� 1 tit J C Gt"-y P rof e c f d
por4r, (� r { r rt.
I hereby swear (or affirm) that the aforesaid information is a true and correct statement.
titiwCe
Signature of person disdosing Date signed
1 1:4 MIAM BEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
Acknowledgement of fines /suspension for Board Members for failure to comply with Miami -
Dade County Financial Disclosure Code Provision Code Section 2- 11.1(i) (2)
Board Member name: 1.- r.u_ke -e bag i S
I understand that no later than July 1. of each year all members of Boards and Committees of the City of
Miami Beach, including those of a purely advisory nature, are required to comply with Miami -Dade County
Disclosure Requirements. This means that the members of City Advisory Boards, whose sole or primary
responsibility is to recommend legislation or give advice to the City Commission, must file, even though you
may have been recently appointed.
You must file one of the following with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, by July 1 each year.
1. A "Source of Income Statement" (attached) or
2. A "Financial Statement" (attached( or]
3. A Copy of the person's current Federal Income Tax Retum
Failure to file, according to the Miami -Dade County Code Chapter 1, General Provision,
Section 1-5 may subject the person or firm to a fine not to exceed $500.00 or by imprisonment
in the county jail for a period not to exceed sixty days, or both.
0o,
Signature: Date:
F: \CLER\$ALL\aFORMS \BOARD AND COMMITTEES\BC Application.doc
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