David Lancz 12/31/2012 m MlAMJ BEACH
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
02 -11 -2011
David Lancz
900 Bay Rd # 917
Miami Beach, Florida 33141
Budget Advisory Committee
Congratulations! You have been appointed by Commissioner Deede Weithorn
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,
/ 4
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Kathie Brooks
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 safely to all who live, work and play in our vibrant, tropical, historic community.
m MIAMI
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 David Lancz
RE: Budget Advisory 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 /or /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.
C- _
i eavi Lan
Sworn to and subscribed before me this /� day of
/ 1 --PA-07 /
, 2011.
v
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.
c
..: /v\ A/v\ B EA H CITY OF MIAMI BEACH
Itiw„ BOARDS AND COMMITTEE APPLICATION FORM
NAME: 1 1/1 r c Z vtd F
Last Name AA Fir f Middle Initial �{
HOME ADDRESS: O )( D( ,de j f 4. " 1 - 7 Alro�1 g`' -"4' FL 3) "I
)
PHONE: 30 5 N 39 Z - 3� 1 Street s - 1)y I01 q � City ^ Stal ct ( 's� > ioco
Home Work 3 Fax Email address
t
Business Name: F 1 U Lotu., S c r! oD 1 Position: PCOCC5 s Dr
Address: 1 11 - D D 5w g3h St M I S rNl 1 E(- 33 t d1
No. i Street City ` f/ State Zip Code
Professional License (describe) v1,N Expires: 'V Attach a copy of to iecensf a
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: YesXor No ❑
• Demonstrate an ownership /interest in a business in Miami Beach for a minimum of six (6) months: Yes 7 or No,
• Are you a registered voter in Miami Beach: Yes1or No ❑
• (Please check 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, experience. Please list below:
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)
❑ Art in Public Places Committee ❑ Housing Authority*
❑ Beach Preservation Board ❑ Loan Review Committee*
❑ Beautification Committee ❑ Mayor's Green Ad -Hoc Committee
❑ Board of Adjustment* ❑ Marine Authority* ‘‘
1 $budget Advisory Committee ❑ Miami Beach Cultural Arts Council ` , l ` }.
❑ Committee on Homeless ❑ Miami Beach Commission on Status of Women
❑ Committee for Quality Education in MB ❑ Miami Beach Florida Sister Cities
❑ Community Development Advisory* ❑ Normandy Shores Local Gov't Neigh. Improvement
❑ Community Relations Board ❑ Oversight Committee for General Obligation Bond
❑ Convention Center Advisory Board ❑ Parks and Recreation Facilities Board
❑ Debarment Committee ❑ Personnel Board*
❑ Design Review Board* ❑ Planning Board*
❑ Disability Access Committee ❑ Police Citizens Relations Committee
❑ Fine Arts Board ❑ Production Industry Council
❑ Golf Advisory Committee ❑ Public Safety Advisory Committee
❑ Health Advisory Committee ❑ Safety Committee
❑ Health Facilities Authority Board ❑ Transportation and Parking Committee
❑ Hispanic Affairs Committee ❑ Visitor and Convention Authority*
❑ Historic Preservation Board* ❑ Youth Center Advisory Board J►
* Board Required to File State Disclosure form j�
1
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• f .
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:
•Have you ever been convicted of a felony: Yes ❑ or NcyYlf yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ❑ or NX. If 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 No D. If yes; which board?
G , eecv) 60 id
• What organizations
v onnss in the City of Miami Beach do you currently hold membership in?
Name: C I � 60/ T 1 Title: �1 ({V )
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 1 1 or Np'N Which department?
• 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):
This section is not required" but desired: Age: 3? years old Gender: Male Female ❑
Ethnic Origin (Check one) �
White ❑ African - American /Black ❑ Hispanic: ❑ Asian or Pacific Islander ❑ American Indian or Alaskan Native ❑ ("*. r
Employment Status: Employed'etired ❑ Home -maker ❑ Other ❑
"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."
7 41 D 1
Applicant's Signature Date j Name of Applicant (PLEASE PRINT)
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in City Clerk's Office by ' Date
N me of Deputy Clerk /
Document Control Number (Assigned by the City Clerk's Office) 7 Entered By _ _: i�i Date / / i /d" r /
' - vised 1/25/07 Jo
2
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w •
DAVID LANCZ
900 Bay Drive, Apartment 917, Miami Beach, FL 33141 dlancz @fiu.edu (305) 342 -3094
EDUCATION HARVARD LAW SCHOOL, Cambridge, MA, Juris Doctor, June 1999
Activities: Career Services Committee, Financial Aid Committee,
Law School Council Representative, Westlaw Student Representative
UNIVERSITY OF FLORIDA, Gainesville, FL
Bachelor of Arts, with honors, in Political Science, May 1995
G.P.A.: 3.97 Minors: American History and Jewish Studies
Activities: Student Government Academic Affairs Cabinet Director, University
Senate, University Libraries Committee, Florida Blue Key
Honors: Spring 1995 Outstanding Male Leader, Phi Beta Kappa
EXPERIENCE FIU COLLEGE OF LAW, Miami, FL
Visiting Assistant Professor (Aug. 2009 - Present): Teach students theories about
legal research and writing; grade written memoranda and appellate briefs;
conduct oral advocacy exercises
POWERSCORE TEST PREPARATION, Coral Gables, FL
Instructor (Jan. 2005- Present): Teach students strategies for the Law School
Admissions Test (LSAT) and the Scholastic Aptitude Test (SAT)
LEVEY FILLER RODRIGUEZ, LLP, Miami Beach, FL
Of Counsel (Jan. 2009 -July 2009): Drafted appeals and other court documents
U.S. DISTRICT COURT FOR THE SOUTHERN DISTRICT OF
FLORIDA, Miami, FL, Career Law Clerk to U.S. District Judge Shelby
Highsmith (Apr. 2004 -Sep. 2008)
SONNENSCHEIN NATH & ROSENTHAL, Chicago, IL
Associate (Jan. 2003- Mar.2004)
AKERMAN SENTERFITT, Miami, FL
Associate (Nov. 2000 -Dec. 2002)
MORGAN LEWIS & BOCKIUS, Miami, FL
Associate (Sep. 1999 -Oct. 2000)
AMERICORPS FOR MATH AND LITERACY, Columbus, OH
Teacher /Coordinator (Sep. 1995 -June 1996): Taught reading and math at inner -
city elementary school; directed literacy program at a homeless shelter
AFFILIATIONS Chairman, City of Miami Beach Zoning Board of Adjustment (2010)
Vice - Chairman, CMB Zoning Board of Adjustment (2009); Member, Mayor's
Ad -Hoc Committee on Transparency, Reliability, and Accountability (2009);
Member, CMB BOA (2005- 2008); Member, CMB Community Development
Advisory Committee (2004); CMB Loan Review Committee (2001 -2002)
cr-4 MIAMIBEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamlbeachfl.gov
CITY CLERK Office CifyClerkCmiamibeachfl.gov
Tel: 305.673.741 1 , 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: k (C 2
1 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 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 fi ne not to exceed
$500.00 or by imprisonment in the county jail for a period not to exceed sixty
days, or both.
Signature: _ Date:
n
MIAMI.
COUNTY SOURCE OF INCOME STATEMENT
Please. Print.or Type First Name Middle Name /Initial Last Name
Disclosure
.--- 1-1,f)C
Name: N/N( 7 For Tax Year
Ending: D / Q
Mailing Address: I 3 691 Dr -/e p
City/State /Zip: :f (ca < /e 33 I - t
Filing as a: ® County Employee;
® Municipal Employee of:
Position held or sought: 6 J j -e+
Board where serving: Term or Emplo went
.Began on: (
Department where employed:
Work Address:
If your home address is exempt from public records pursuant to
Florida Statutes § 119.07 please check here (read instructions); El Work Telephone:
Home Address: q a 6 (-(✓ e q ` 7
�
y Street Address
M ( X 01; 1 3e 0 K,V ) R. -- 3 i
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 on e
separate sheet, check here: 0
Description of the Principal
Name of Source of Income Address �� `t Business Activity
I , . A c(no- to v - e S S 3 _
li • �� P, ✓ i( )
.Z hereb . . _ • or affirm) that the aforesaid information is . e true and correct statement,
2 - 5f - 1(
.Signature of person disclosing Date signed
1