Ira Giller 12/31/2013 MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK,Qe4 er 2a - e6r 1r Ci
Tel: (305) 673-7411, Fax: (305) 673-7254
June 11, 2012
Ira Giller
4535 N. Meridian Ave.
Miami Beach, Fla. 33140
SUBJECT: HISTORIC PRESERVATION BOARD
Congratulations! You have been appointed by the City Commission to the above
referenced agency, board or committee for a term ending: 12/31/2013.
Pursuant to Ordinance 2006-3542, 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 material carefully.
Congratulations again and good luck.
Sincerely,
R fael E. ado
City Clerk
cc: Saul Frances, Parking Director
Thomas Mooney
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) Palm Court Building 309 23rd Street
Booklet- Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
We ore committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
r
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeacH ggy
� Jr +
OFFICE OF THE CITY CLERK, 5m Fmcl r, City Clerk
Tel: (305)673-7411,Fax: (305)673-7254
TO Ira Giller
RE: Historic Preservation Board
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: 12/31/2013.
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 co y wi a financial disclosure`'requirements of
Miami-Dade County or ithe State of Florida (depen ing on h board committee on which I serve) on
July 1, following the closing of the calendar year o whit I ave d.
Ira Gilder
Sworn to and subscribed before me this 111-4
day of d uwQ 2012.
Maria E. Martinez
Deputy Clerk
"Please visit the City of Miami Beach website at www.miamibeachfi.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.
AM MIAMI BEACH CITY OF MIAMI BEACH
+' i BOARD AND COMMITTEE APPLICATION FORM
NAME: GILLER IRA D
Last Name First Name Middle Initial
HOME ADDRESS: 4535 N. MERIDIAN Miami Beach FL 33140
AVE.
Apt No. Home No./Street City State Zip Code
PHONE: 305-205-3878 305-538-6324 305-538-5921 GILLER97 @AOL.COM
Home Work. F)EIT Email Address
Business Name: GILLER BGILLER,INC. Position: pRESI
Address: 600 975 ARTHUR GODFREY RD. Miami Beach FL 33140
No. Street City State Zip Code
Professsional License(describe): ARCHITECT Expires: 2-28-13 Attach 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: Yes
• 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: Yes
• (Please circle one): I am now a resident of: Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
President of Miami Beach's oldest Architectural firm,award-winning architect and historic'pre
•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
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
[1] 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: �C/
• 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: Jewish Museum of Florida Title: Past President, Director
Name: Miami Beach Chamber of Commerce Title: Past President
e List all properties owned or have an interest in, which are located within the City of Miami Beach:
Giller Building,The Five Apts,Gateway Bldgs.,45
e I am now employed by the city of Miami Beach: No Which department?
e 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: No
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:
• 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 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 IRA GILLER agreed to the following terms on 3/2712012 6:18:19 PM
WDate: -7 Received in the City Clerk's Office by: G Date: / /2012 Control No. / /2012 r
Name of Deputy Clerk
M 1 A M FDADE
® SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name Initial Last Name
Disclosure
D . Gt l�...L For Tax Year
Name: Ending: �1
Mailing Address:
City/State/Zip: MIAMI BEAC-H , F-L 3314-0
Social Security Number: — -
Filing as a: ® County Employee:
5 Municipal Employee of: C 1" Of, M I h M I 56-AAf4
Position held or sought: 41,gma I G �(LES � TIOlJ 5D M *A °
N X
Board where serving: Term or Employment c; c rn
Began on:
to l 1 1�2 ;-)
7, N 1
Department where employed:
Work Address: co
T,
If your home address is exempt from public records pursuant to
Florida statutes§119.07 please check here(read instructions): ® Work Telephone:
Home Address: �Cj?1rJ �' McQlPlAt'i -kyr—..
Street Address
MIA M( gmE&Cb J-=L 33 14-c
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
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I h y ar(or affirm)that the aforesaid information is a true and correct statement.
Signature of person disclosing Date signed
M SAM I BEACH
city of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www rniamlbeochfl.aov
CITY CLERK Office CityClerk�miamibeachfl..gov
Tel: 305.673.7411 , Fax:305.673.7254
Acknowledgement of fines/suspension for Board Meru bars for failure
to comply with Miami-Dade County f=inancial Disclosure Code Provision
Code Section 2-11 A U) .(2)
Board Member name:
understand that no later than.:duly '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 Disdiosure 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 1TIU5f f le 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.Statements (attached(-or]
3. A Copy of the person's current Federal Income Tax Return
Failure to file, according to the Mlami-Dade .County Code Chapter 1, General
Provision, Section 1 Z may subject the person or firm to a fi ne not to.exceed
$500.00 or by imprisonment in the county}ail for a.period not to exceed sixty
clays, or h.
6111 I I'?�
Signature: Date: