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Arian Adorno 12/31/2013
m MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.c v OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 02-28-2012 Arian Adorno 227 1 st Street# 6 Miami Beach, Florida 33139 ;SUBJECT , . Affordable Housing Advisory Committee Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2013. Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after January 1 st, 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, AV11L&15_f Robert Parcher City Clerk cc: Saul Frances, Parking Director Richard Bowman 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. IM AAIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139, www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 TO Arian Adorno RE: Affordable Housing 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: 12/31/2013. 1 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 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 a financial dis Ic os *require- ments of Miami-Dade County or the State of Florida (d9pen on the bard or committee on w 'ch I serve)on July 1st,following the closing of the ca dar y r on which I have s ed. Arian Adorno Sworn to and subscribed before me this day of 1-kO'` " -2012. FjQ—S is 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 B CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: ADORNO ARIAN R Last Name First Name Middle Initial HOME ADDRESS: 6 227 1ST STREET Miami Beach FL 33139 Apt No. House No./Street City State Zip Code PHONE: 3053003477 3055358009 3055358108 ARIAN@TEAMSOBE.COM Home Work Fax Email Address Business Name: NEW AGE PROPERTIES dba I Love Sobe Position: BROKER Address: 2 227 1ST STREET Miami Beach FL 33139 No. Street City State Zip Code Professional License(describe): REAL ESTATE BROKER Attach a copy of the Expires:09/3012011 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: No • 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: No • (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: Working as a Real Estate Broker in Miami Beach for over 8 years,very knowledgeable of the MB area. Recently completed the MB Leadership Academy Program. •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) [11 Affordable Housing Advisory Committee Marine Authority Art in Public Places Committee Miami Beach Commission for Women Beautification Committee Miami Beach Cultural Arts Council Board ofAd'ustment* Miami Beach Human Rights Committee Budget Advisory Committee Miami Beach Sister Cities Program Capital Improvements Projects Oversight Committee Normandy Shores Local Gov't Neigh. Improvement Committee on the Homeless Parks and Recreation Facilities Board Committee for Quality Education in MB Personnel Board 2 Community Development Advisory Planning Board* Community Relations Board Police Citizens Relations Committee Convention Center Advisory Board Production Industry Council Debarment Committee Public Safety Advisory Committee Desi n Review Board* Safety Committee DisabilitV Access Committee Sin le Famil y Residential Review Panel Fine Arts Board Sustainability Committee Ga , Lesbian, Bisexual and Trans ender GLBT Transportation and Parking Committee Golf Advisory Committee Visitor and Convention Authority Health Advisory Committee Waterfront Protection Committee Health Facilities Authority Board Youth Center Advisory Board Hispanic Affairs Committee Historic Preservation Board Housin Authority Loan Review Committee * 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: • 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: • 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 City 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 ARIAN ADORNO agreed to the following terms on 2/16/2011 10:00:23 PM Please attach a copy of your resume to this application NOTE:Applications will remain on fife for a period of one(1)!: Iar y`ar �/ Received in the City Clerk's Office by: V Date: /` Control No. Date: G/ /� l 1 me of Deputy C erk MIAMI BEACH City of Miami Beach, 1700 Convention Canter Drive, Miami Beach, Floriclo 33139, www miamlbeachfl.aov CfTY CLERK Office CltyClerl:C m i amibe0chfl..9ov Tel: 305.673.7411 , Fax:305.673.7254 Acknowledgement of fines/suspension for Board Mara bars for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-11 .1 (i) (2) Board Member name: (�G : a �fl C r-'-3 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 requiredtto 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 f le one of the following with the.City Clark 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) I A Copy.of the person's current Federal income lax 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 fl ne not to.exceed $500.00 or by imprisonment in the county,jail for a period nv't to exceed sixty days, or both. Signature: Date: h 7MIAMI,7D.CjrTYPe SOURCE D INCDME STATEMENT First Name Middle Name/Initial Last Flame Disclosure For Tax Year Name; �C � ��©r' �� Ending: j D 1 mailing address: So City/State/zip. Social.security Number: _ Filing as a: ® County Employee: ® Municipal Employee of: position held or sought: or E Board where serving: mployment .Began acc: Departmantwhere employed: Work Address: ("o- If your-home address is exempt tram public records pursuant to Florida Statutes j 119.07 please check here(reed instructions)!: 'Work Telephone, Home Address: � `si Street Address 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: Description of the Principal Name of Source of Income A dress Business Activ 2� Cwt: eC�eC des �� ter ��,t�a� �-l3}► e�.,� L��.. e I ereby swear m that the afores 'd information is:e true end =orrect statement, -Z 5� a ure af. a :lasing Date signed