Andrew Feuerstein 12/31/2012 ® MIAMI EACH
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
05-07-2012
Andrew Feuerstein
2501 Brickell Avenue
Miami, Florida
ISUB ECT' Disability Access Committee
Congratulations! You have been appointed by Commissioner Jerry Libbin
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 1, 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,
R fael E. Granado
City Clerk
cc: Saul Frances, Parking Director
Duane Knecht
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.
m 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 Andrew S. Feuerstein
RE: Disability Access 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 appoint
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 an
Code of Ethics Ordinance), as well as the Florida Commission on Ethics Guide to the Sunshine Amend-
ment and Code of Ethics for Public Officers and Employees, and understand that as a member of a Cit
of Miami Beach Board and/or Committee, I must comply with the financial disclosure* requirements of
Miami-Dade County or ithe State of Florida (depending on the board or committee on which I serve)on
July 1, following the closing of the calendar year on which I have served.
(jVIC
Andrew S. Feuerstein
Sworn to and subscribed before me this ;77 day of 12012.
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Comm
for additional information regarding the Financial Disclosure Requirement
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
G MIAMI BEACH ��k � �� ,�����r���[ �[�.�,RW
NAME: Feuerstein Andrew S
Last Name First Name Middle Initial
HOME ADDRESS: 403 2501 Brickell Avenue Miami FL 33129
Apt No. Home No./Street City State Zip Code
PHONE: 305-285-9686 305-285-9687 feuersteinlaw @aol.com
Home Work Fax Email Address
Business Name: Feuerstein Law,P.A. Position: President
Address: 403 2501 Brickell Avenue Miami FL 33129
No. Street City State Zip Code
Professsional License(describe): Florida Bar Expires: N/A Allach a copy 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: 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:
I am a disability lawyer
•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
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 Human Rights Committee
Committee for Quality Education in MB Miami Beach Sister Cities Program
Committee on the Homeless Normandy Shores Local Gov't Neigh. Improvement
Community Development Advisory Parks and Recreation Facilities Board
Community Relations Board Personnel Board
Convention Center Advisory Board Planning Board'
Debarment Committee Police Citizens Relations Committee
Design Review Board* Production Industry Council
[1] Disability Access Committee Safety Committee
Fine Arts Board Single Family Residential Review Panel
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
Hispanic Affairs Committee Youth Center Advisory Board
Historic Preservation Board
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 Money Beach any money: No If yes,please 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 relative 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
Ethnic Orgin: Check one only(1)
White
Physically Challenged: Yes
Employment Status: Employed
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 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 maybe 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."
-/ 11
I Andrew Feuerstein agreed to the following terms on 4/26/2012 11:43:42 AM LION dx . .
Received in the City Clerk's Office by /J�K� Date: / /2012 Control No. Date: / /2P12 L
Name of Deputy Clerk
OM SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name/Initial Last Name
Disclosure
N �l� �(/ �S //U Ending:Year
Name:
Mailing Address:
City/State/Zip:
Social Security Number:
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought:
Board where serving: �s��r �}eee! Term or Employment
Began on: s 7 / �-
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): ® Work Telephone:
Home Address:
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 a
separate sheet, check here:
Description of the Principal
Name of Source of Income Address Business Activity
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
l
Signature of person disclosing ate Igned