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Silvia Rotbart 12/31/2012 ID t 1 , 4 A, f\ ¢ }g 1 �i 1C fir - Cit of Miami Beach, 1700 Convention Center Drive, Miami Beach, Horida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673 -7411, Fax: (305) 673 -7254 1/27/2011 Silvia Rotbart 1675 Cleveland Rd Miami Beach Florida 33141 Beautification Committee Congratulations! You have been reappointed by Mayor Matti Herrera Bower to the above referenced agency, board or committee for a term ending: 12/31/201 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, 4- I D .S Robert Parcher City Clerk cc: Saul Frances, Parking Director John Oldenburg 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 safe to all who live work and play in P 9 P safety p y our vibrant, tropical, historic community. ti NA f X B1 A IP Cit of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www,miamibeachfl,gov OFFICE OF ITHE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673 -7411, Fax: (305) 673 -7254 TO Silvia F. Rotbart RE: Beautification 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, each, and to perform all the duties of a member of the above- mentioned board or committee of h e o 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 theFlorida Commission on Ethics Guide to the Sunshine I 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* ty p y sur e 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. '�� , % Silvi = F. Rotbart sue. Sworn to and subscribed before me this' day of 2 y r 20 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 safety to all who live, work and play in our vibrant, tropical, historic community. • rYI111YYYiw1NMY. - : ..% 0 }4' 9 5, : y, BOARD APPLICATION OARD . � ITT , FOR NAME: Rotbart Silvia F Last Name First Name Middle Initial HOME ADDRESS: ! 1675 Cleveland Miami Beach FL 33141 Apt No. House No. /Street City State Zip Code PHONE: 305 - 865 -5341 305- 674 -7034 305- 866 -1937 silvia c rotbart.com !Home Work Fax Email Address i Business Name: Rotbart & Associates Inc. Position: Real Estate Sales i Address: 1675 Cleveland Rd Miami Beach FL 33141 No. ` Street City State Zip Code Professional License (describe): Real Estate, Management Expires: 03/31/2011 Attach a coy of the I license Pursuant to City Cod 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 am mum o 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): f am now a resident of: North 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? No 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 Housing Advisory Committee Housing Authority Art in Public Places Committee Loan Review Committee [1] 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 Sister Cities Program Committee on the Homeless Normand Shores Local Gov't N ei • h. Im • rovement Committee for Quality Education in MB Parks and Recreation Facilities Board Community Development Advisory Personnel Board Community Relations Board Planning Board* Convention Center Advisory Board Police Citizens Relations Committee Debarment Committee Production Industry Council Design Review Board* Public Safety Advisory Committee Disability Access' Committee [3] Safety Committee Fine Arts Boards Single Family Residential Review Panel Gay, Lesbian, Bisexual and Transgender (GLBT) Sustainability Committee Golf Advisory Committee Transparency Reliability & Accountability Committee "TRAC" Health Advisory Committee Transportation and Parking Committee Health Facilities Authority Board Visitor and Convention Authority Hispanic Affairs Committee [2] Waterfront Protection Committee Historic Preserva " Board Youth Center Advisory Board 1 * 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: 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: Age: Program: Child's name: Age: Program: ' cr • Have liou ever been1 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 Miami Beach any money: No If yes, explain in detail • Are you currently serving on any City Boards or Committees: Yes If yes; which board? Beautification committee • What organizations in the City of Miami Beach do you currently hold membership in? Name: Biscayne Pt.Homeowners Assn Title: Name: E Title: • List all properties owned or have an interest in, which are located within the City of Miami Beach: 1675 Cleveland Rd.; 2401 Collins Ave. #612 • 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 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 Race: White Origin: Check Ethnic Ori one only g ec, o eo y( (1) Hispanic Physically Challenged: No Employment Status: Employed Other: NOTE: If appointed, you will be required to follow certain laws which apply city I to cit board /committee members. include, These laws i 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. "1 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 Silvia Rotbart agreed tolthe following terms on 12/23/2009 4:56:49 PM ease attach a copy of yaur resume to this application NOTE,: will remain on file for a iod of one (1) calendar year g e Irk' • k' ' • �w > � Received in the City C e s Office by. Date: ,� Control No. Date. � / 6 0 Name of Deputy Clerk � • • • • . • 'MIAMIBEACR •.'-.--• ..• • . City of Miami Beach, .•. . 1700 Convention Center Drive, 1 • • Miami Be Flor 33139., • . • • www. miamibeachfl .goy CITY CLERK Office • • CityClerk@miarnibeochfl.gov • • Tel: 305. Fax: 305.673.7254 Acknowledgemeflt af fines/suspenson for _ Board Mem bers for failure • . • • CFinancial Disclosure .Code • Prayson • • • • to cor ly w ith MicimiDade P Code *Section (1) •(2) . • • • . • • • . . . . . - • • • .. „..i • • • 1 • • • name: / i - o Board Member D fr I • • than an .:�yj �1 =of each y earqii •members of .Boards .and • �I undestnd tht no .later. h y . • Com rnittees of • the .City of •Miami :Beach, including those of a . purely advisory nature, :are .. a uiredto _comply l with Miami -Dade County Disclosure Requirements. This - means #hat the • r q members of City .Advisory •Boards, whose sole or primary responsibility ls to recommend • 'legislation or give advice :to City Commission, - must•file, even though you mayhave .been recently appointed. •o fthe - following livith the CIerk of Miami Beach, 1700 Convention . You must file one f 9 �Y Center •Drive MiarniBeach, Florida, by July 1 each year. • 1 A "Source - .of Income :Statement" . .or • ..2. A "Financial .Statement" (attached( or) 3. A Co py .of the .person's current Federal Income "Tax Return .Coun Code Ch a ter 1, General • Failure to �iie, according to the MiamiDade .County P i i Section 1 'ma .subject - the person or- firm to a . fi ne not fio .exceed . • • Prov�s�on, y .� p 500:.00 or by imprisonment in the 'county jail for •a : period - ri cot to exceed sixty • - days, or both. z . • . • r • .//1 • . Si .J natur . .Date.: • • M I A M I . OF INCOME STATEMENT \_ • Please. Print .or Type First Name Middle Name /Initial Last Name DisCiosure • For Tax ,,. 0.60 ,� t Ending. Blame. , egkelzd iviarldng addr ess. , city) Mate /alp. „gi , , 9/ SI ai.so-- • Social Security Number: • Filing as a: Ei County Employee: • • in Municipal Employee of: Position held or sought: Term c r / _ . , � .., i el �n or Employment Board where serving: � ,, . _ /� Began sort; • Department where employed: Work address. �. ' w � ettyk-zew* if our -home address is exempt from public records tv • 77e9 . s 1.1.9.07 lease check here (read instructions) D work Telephone: �lar�da Statute § P Home address, _ .) .Street Address #14 City State Zip Code 7 -. e largest source first, the - name, address and Please list below 6n descending order with - the largest al business activi of every source cif your income including public salary you principal • 'seteesure period, The received or any person received for your benefit or use durtn.g the dt p . .o your spouse or •an business artner need not be disclosed. If continued on . -income . of y � y � separate sheet, check hers:, 0 I Description of the Principal Narpe of . Source of inc ome Address Bu sl n1ess activity - Asa, — • 1 r� L- %,r L -'` �� rL� iii hereby swear (or that the aforesaid information is:a true .and �rarr_ect statement. Jir if.far$ - C :affirm) $igricature of ...arson discto ng . at s;i nod