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Harold Foster 12/31/2013 ® MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miomibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel: (305) 673-7411, Fax: (305)673-7254 02/28/2012 Harold Foster 3100 Collins Ave #404 Miami Beach, Florida 33140 S_0 E-C� Health Advisory Committee Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee for a term ending: 12/31/2013. 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, Robert Parcher City Clerk cc: Saul Frances, Parking Director Cliftonf Leonard 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. MIAMIBEACH' 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 Harold Foster RE: Health 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 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 1 st,following the closing of the calendar year on which I have served. Harold Foster Sworn to and subscribed before me t ,i DK day of Y�VZ 20 (:6k Silvia veto 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. /\\4 1 ANA I BEACH Git-y of Miami Beoeh, 1700 Convention Center Drive, Miami Beach, Florido 33139, www miamtbeochfl.aov CITY CLERK Office CltyClerk�miamibeachfl.gov Tel: 305.673.7,411 , Fax: 305.673.7254 Acknowledgement of fines/suspension for Board Merin hers for failure to comply with.Miami-Dade County Financial Disclosure Code Provision Code Section 2-11.1 (i) .(2) Board Member name; A understand that no later than Ady '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-meansthat 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 maybeve been recently appointed. You mustfle one of the following with the.City Cierk of Miami Beach, 1700 Convention Canter 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 Cnpy.of the person's current Federal income Tax Return 'Failure to file, according to the Miami Bade .County Code Chapter 1, General Provision, Section 1-5 may subject the person or firm to a #i ne not to.exceed $00.00 or by imprisonment in the county jail for a.period nDt to exceed sixty days, or both. 5i.gnature: pate: h M® SOURCE ICE INCOME STATEMENT -please.Print.or Type First Name Muddle Name/Initial last Name Disclosure For Tax'Year 1 Endin%; 24// Name: �" Mailing Address; C3A city/state/zip: Social Security Number: — -- Filing as a: ® county Employee: ® Municipal Employee of: Position held or sought: I r G ` Term or.Employment Board where serving: ,C U Zegan on: Department-where arrOoVed: Work Address: if your-home address is exempt tMm puhlic records pursuant is work Tais l CD�lS: piarid® Statutes¢ 115.07 please check here(read instructivns); P Horne Address: Street Address city State .Zip Code Please.list below in descending order with'the largest source first, the name, dress and principal business actiAtg of every source of your income inciue ing public you roc®load or any person received for your banefiit or use during the disclosure period, The -income of your spouse or any business; partner need not be disclosed. If continued on e s separate sheet, check here: Description of the Principal Name of 5vurce of Income Address Busaness Activ �' I hereby swear (or affirm) that the aforesaid information is:e true and correct statement, Tnc> 6L sianature of.parson disclQSing .Date sinned