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Rafael Trevino 12/31/2012 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeochfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-7411, Fax: (305) 673 -7254 02 -03 -2011 Rafael Trevino 1688 West Ave. #401 Miami, Florida 33139 Miami Beach Human Rights Committee Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2012. 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, Robert Parcher City Clerk cc: Saul Frances, Parking Director 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 We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. ea___ MAMIBEACH 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 Rafael Trevino RE: Miami Beach Human Rights 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: 12/31/2012. 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 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 and /or Committee, I must comply ith the financial disclosure* require- ments of Miami -Dade County or the State of Florida (depending 1 he board or committee on which I serve) on July 1st, following the closing of the calendar year o ich I -ve served. ( . oaf — r RI. - I Trevino fe Sworn to and subscribed before me this , day of u , 2011 gli 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. AAA CITY OF MIAMI BEACH TIMINIT BOARD AND COMMITTEE APPLICATION FORM NAME: Trevino Rafael 0 Last Name First Name Middle Initial HOME ADDRESS: 401 1688 West Ave Miami Beach FL 33139 Apt No. House No. /Street City State Zip Code PHONE: 3058121320 3058121320 rafael.trevino @me.com Home Work Fax Email Address Business Name: Trevino Consulting Services, Inc. Position: Owner Address: 401 1688 West Ave Miami Beach FL 33139 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 • Demonstrate an ownership /interest in a business in Miami Beach for a minimum of six (6) months: No • Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Interpreter for the Deaf and Hard of Hearing • 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) AffuIdable Huuainy Adviaui GUI! Huuaiiiy Autl iuiily Art in Public Places Committee Loan Review Committee Beautification Committee Marine Authority Board of Adjustment* Miami Beach Commission for Women I I Budget Advisory Committee Miami Beach Cultural Arts Council Capital Improvements Projects Oversight Committee Miami Beach Sister Cities Program Committee on the Homeless _ Normandy Shores Local Gov't Neigh. Improvement Committee for Quality Education in MB Parks and Recreation Facilities Board Communit Develo.mentAdviso 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 [1] Disability Access Committee Safety Committee Fine Arts Board Single Family Residential Review Panel [3] 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 [2] Hispanic Affairs Committee Youth Center Advisory Board Historic Preservation 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: No Years of Service: 2. Present participation in Youth Center activities by your children No If yes, please li our childr , their ages, and which programs. List below: Child's name: Age: Program: / , i j -2A% Child's name: Age: Program: 9 • 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 Miami Beach any money: No If yes, explain in detail • Are you currently serving on any City Boards or Committees: No 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: 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: Male Race: White Ethnic Origin: Check one only (1) Hispanic Physically Challenged: No Employment Status: Employed 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. "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 Rafael Trevino agreed to the following terms on 1/3/2011 6:10:14 PM E. , , at wit' .., a ; .t sa r € ° ` ., , . , Received in the City Clerk's Office by: ( Date: r /� _ /! L Control No. Date: // // Name of eputy Clerk RAFAEL ()SCAR TREVIIVO P. 0. Box 398963 Miami Beach, Florida 33239 Tel +1.305.812.1320 1 rafael.trevino @me.com EDUCATION Florida International University; Miami, FL B.A. in Spanish, Minor in Translation Studies p 2010 01 Certificate in Legal Translation and Court Interpreting Legal translation internship project: Translation of a 51 -page report, which had been submitted to the United Nations, on human rights violations in Nicaragua. Hillsborough Community College; Tampa, FL A.A. in Liberal Arts 2009 A.S. in Sign Language Interpreting 2006 (Award: Most Professional Student in 1999) PROFESSIONAL QUALIFICATIONS NAD -RID National Interpreter Certification: Advanced Level 2006 EXPERIENCE World Association of Sign Language Interpreters (WASLI) Translation Department Coordinator 2009 — Present Manage projects related to the translation of the newsletters and other organizational documents into other written languages so that non - English speakers can use the information. Coordinate spoken language interpreters for the 2011 Conference in South Africa. WASLI aims to improve access to Deaf and Hard of Hearing communities around the globe by improving the quality of sign language interpreting services. Sorenson Communications; Tampa, FL Video Relay Service Interpreter 2005 — 2007 Assisted in piloting the company's nationwide, Spanish -ASL video relay service. Florida Registry of Interpreters for the Deaf Secretary; Licensure Task Force Member 2004 — 2005 Actively participated on the Board of Directors. Represented trilingual interpreters on the Licensure Task Force, a joint committee between the Florida RID and the Florida Association of the Deaf. Self- employed Freelance lnterpreter for the Deaf 2003 — Present Experienced in interpreting into American Sign Language in legal, medical and educational settings for the Deaf and Hard -of- Hearing community. Also, extensive experience in interpreting for Deaf and Hard -of- Hearing clients abroad, such as Mexico, Guatemala, Nicaragua, Costa Rica and Spain. Citigroup Global Securities Services; Tampa, FL Accounts Receivables Specialist 2000 — 2003 Managed the accounts receivable for securities custody service branches in Latin America. Created Access database solutions, which improved productivity by automating various processes. (Awards: Director's Choice Award in 2001 and 2003) RAFAEL OSCAR TREVIRO PAGE 2 Zolfo Springs Police Department; Zolfo Springs, FL Administrative Assistant 1999 — 2000 Supported the police department in their interaction with the Hispanic /Latino community. Wrote and administered grants. Participated on the Finance Committee. (Award: Professionalism and Organization of the Police Department) PUBLICATIONS AND PRESENTATIONS "Examining the Challenges of Trilingual (Spanish - English -ASL) VRS Interpreting" Paper presented at the National Symposium on Interpreting via Video: The State of the Practice and Implications, Washington, D.C.; Co- presenters: Dr. David Quinto - Pozos, Kristie Casanova de Canales. (24 May 2010) "Trilingual Video Relay Service Interpreting in the United States" Interpreting in Multilingual, Multicultural Contexts, Studies in Interpretation, vol. 7; ed. Rachel Locker McKee, Jeffrey Davis; Gallaudet University Press; Authors: Dr. David Quinto - Pozos, Kristie Casanova de Canales, Rafael Trevino. (2010) "Trilingual for Everyone: Working with Deaf Consumers from Other Countries" Workshop presenter, Boca Raton, FL. (28 Jan 2010) "Managing linguistic and other ambiguities in Spanish /English /ASL video interpretation" Paper presented at the 2009 Spanish in the United States & Spanish in Contact with Other Languages Conference, Miami, FL; Co- presenter: Dr. David Quinto - Pozos. (20 Feb 2009) "Is Your Ego Too Big? Read This If You Think You Don't Need To" VIEWS; Registry of Interpreters for the Deaf; Authors: Dr. Mike Knudstrup, Rafael Trevino. (Apr 2005) "Can You Trust Your Translator ?" The Herald- Advocate, Wauchula, FL. (May 2004) I lir s M IAMBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk©miamibeochfl.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(1) (2) Board Member name: ill I All I 1 / RI S Gifrec 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 Return 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. Signature: D• te: • a MIAMI= SOURCE OF INCOME STATEMENT Please Print. or Type First Name Middle Name /initial Last Name Disclosure e, I �� v Far lax Year Name: Ending• o l0 T L Mailing Address: (89 V`ia e ce I y� City /State /Zip: V 1444k o 4 Social Security Number: — - ai Filing as a: ® County Employee: ce �� iir Municipal Employee of: m i ' k Position held or sought: Board where serving: fg L/, e 0� ,�J Term or Emplo me � Began an: Department where employed: Work Address: If your home address is exempt from public records pursuant to Florida Statutes § 119.07 please check hare (read instructions): 0 Work Telephone: Home Address: lC8 i 'r' /We, 4 ¥ 6/ / Street Address �� / kl , f G. 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 disclosed. If continued an B separate sheet, check here: Description of the Principal Na 1 e •f ource f ncome Address Bu iness Activi e ■Z1G' ' sIIMIIIMf' is . e a a : MiEft.1 sw ✓l ce-r 1 hereby s r ( ?a irm) that the aforesaid information is .a true and correct statement. j l l Signature o person disclosing Date s