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Andrea Lisa Travaglia 12/31/2012 Z\ City of Miami Beach 1n0 Convention Center Drive,Miami Beach, Florida 33139' OFFICE CF THE CITY CLERK, Rafael Granada, City Clerk Tel: (3O5)67374l l' Fox: (305)673-7254 O9-28-2O12 Andrea Lisa Tnawsg|ia 50 South Pointe Drive, Apt. 3201 Miami Beach, Florida 3313Q Disability Access Committee Congratulations! You have been appointed by Commissioner Jorge ExposUto to the agency, board orcommittee 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 et3O5-873-7411. Please read the enclosed materials carefully. Congratulations again and good luck. 8inCena|y. ^~~� Rafael E. Gnanado City Clerk cc: Saul Frances, Parking Director Duane Knecht ATTACHMENTS: Letter ofAppointment Oath City Code/Ordinance section applicable to agency, board orcommittee City Code Section 2'22, 2'23, 2'24, 2'25, 2'20. 2'458 and 2-458 Ordinance No. 2000'3543 '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 a//who live, work and play a our vibrant, tropical, historic community. /\AIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.0ov OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk Tel: (305)673-7411, Fax: (305)673-7254 TO: Andrea Lisa Travaglia RE: Disability Access Committee 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 the Florida Commission on Ethics Guide to the 1 Sunshine Amendment and Code of Ethics for Public Officers and Employees, and understand that as a member e ber of a City of Miami Beach Board and/or Committee, I must c ply with the financial disclosure* requirements of Miami-Dade County or the State of FJqrida (d ndin the b and or committee on which I serve) on July 1, following the closin the calen a ye o hic have served. Andr a Lisa Travaglia Sworn to and subscribed before me this 15 day of ,0 o�lEi/1,-2012. 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 Requirement. We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. ® MIAMI BEACH IT MA CH C)A,V, AND ON AH' � ; APPLICATION s NAME: TRAVAGLIA ANDREA L Last Name First Name Middle Initial HOME ADDRESS: 3201 50 SOUTH POINTE Miami Beach FL 33139 DRIVE Apt No. Home No./Street City State Zip Code PHONE: 917.834.0901 786.768.2170 561.491.265EE`"x 4aa ATRAVAGLIA@AOL.COM Home Work Email Address Business Name: LEE&MARIES CAKERY COMPANY Position: OWNER Address: 108 40 SOUTH POINTE DRIVE Miami Beach FL 33139 No. Street City State Zip Code Professsional License(describe): Expires: attach a copy ithe ficense 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: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I CREATE BUSINESSES THAT EMPLOY ADULTS WITH ASD(AUTISM SPECTRUM DISORDER) •Are you presently a registered lobbyist with the City of Miami Beach? Yes 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 [2] 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) [3] 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 [1] 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: Chamber of Commerce Title: Name: Title: • List all properties owned or have an interest in,which are located within the City of Miami Beach: Continuum S&N,YC Portofino&Cosmopolitan: 10apts • 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: Female Ethnic Orgin:Check one only(1) White Physically Challenged: No Employment Status: self 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 ANDREA TRAVAGLIA agreed to the following terms on 9/26/2012 1:10:29 PM Received in the City Clerk's Office by: Date: / /2012 Control No. Date: / /2012 Name of Deputy Clerk i Andrea Lisa Travaglia 50 South Pointe Drive, Apt 3201 , Miami, Florida 33139 Cell: 9178340901 : atravaglia @aol.com Professional Summary SOCIAL ENTREPRENEUR: Since 2008 1 have created 3 "for profit" businesses that enhance the quality of life for adults diagnosed with Autism Spectrum Disorder (ASD). We hire them to fill many jobs, depending on their talents and interests. My business model will create awareness for this underemployed and undervalued population and demonstrate the positive effect these opportunities will have on an entire community. 2008- Present Created Exclusive Miami Rentals (exclusivemiamirentals.com) I bought, designed and decorated 9 apartments located South of Fifth, Miami. I formed 3 LLCs that incorporate all the properties, Chelsea Property Group, Chelsea's Places and George, Charlie & Rocco. They are short and long term rentals. In the off season we invite families and care givers who work and live with children who are diagnosed with ASD. 2010-Present Co-Founded and Owner VITACARE (vitacareworld.com & facebook.com/vitacareworld), an oral care company. The products are vitamin infused toothpaste, mouthwash, gum and biodegradable toothbrushes. We are currently sold in all of the Whole Foods throughout the US and UK, 3000 drug and vitamin chains in the US, 750 stores in Australia and many internet sights. 2010-Present Founded Lee & Marie's Cakery Company (facebook.com/leeandmaries) in Miami and New York, as well as designed the retail stores. We create jobs and employ adults with ASD. We help guide them on a path to greater independence, so they can achieve their highest potential and enhance their quality of life. We work with Deborah Chin and Dr Michael Alessandri from UM NSU CARD who train our"adults" as well as our other employees for an easy transition into the work place. L&M opened their doors on September 14th, 2012. 1985-1987 Owned and Operated "Tieland", (Men's Tie Shop), Woodbury Commons, Harriman NY 1979-1983 NW Ayer, Advertising Agency. Group Assistant to Project Manager in Qualitative Marketing in New Product Development. Worked on De Beers Diamonds, Gillette, 7 up and US Army, I also ran focus groups and edited commercials for clients. Education The Dalton School 1974 New York, New York, USA High School Diploma 1964-1974 Middle School and High School Marymount Manhattan College New York, New York, Usa Arts Therapy 1976 Summer Program Studied Arts Therapy , received a certificate.. Jean Erdman Dance Studio, Manhattan School of Dance, American Dance Center(Alvin Allely) New York, New York, USA Dance 1960-1968 Jean Erdman Dance Studio, studied Modern Dance with dancer and choreographer Jean Erdman. 1968-1972 Manhattan School of Dance, studied Ballet with Margaret.Craske 1972-1977 Alvin Ailey American Dance Theatre, formely known as "American Dance Center" studied Jazz with Nat Horne and Pepsi Bethel and Ballet with Trudy Gasparanetti The Stella Adler Acting Studio of Acting and Herbert Berghof Studio New York, New York, USA 1 �J Acting 1977-1979 The Stella Acting Studio, studied Acting and Scene Study with Stella Adler 1979 Herbert Berghof, studied Acting with Austin Pendleton Professional Affiliations 2012 Member of Miami Beach Chamber of Commerce 2011 Founder of the First Annual Tennis Clinic, Flamingo Park, Miami . A day of tennis and fun for children and their families dealing with ASD. The children and adults with ASD were able to learn how to play tennis with professional tennis players, Janko Tipsarevic, #8 in the world was one of the many players who donated their time during the Sony Ericsson. UM CARD invited the families, Lee and Marie's Cakery donated lunch, HEAD supplied rackets and balls. 1999-2008 Chaired and Co-Chaired many committees for the Trevor Day School, a private school in NYC where my daughters attended and graduated. 2003-2004 Paul Taylor Dance Company, Board Member and New York Season Gala Committee. Provided and Designed a Dancer's Lounge for the Company 2003-2005 Behind The Book, Board Member, Fund Raiser and Designed the Logo. Bringing Contemporary Authors and their books to children in the Public Schools, NYC. JS Lei- • -= i eee ; o 40 SoluthTbihte 0 oe o •Q1 e o e e M I A M hDADE SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name Initial Last Name Disclosure For Tax Year Name: ^5t3` ` �rrG4G *C?— Ending:z all Mailing Address: V 74 1'�e•�rckcg City/State/Zip: Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: ti�k Board where serving: Term or Employment Began on: IG Department where employed: r v S Work Address: ?U 74qAzk If your home address is exempt from public records pursuant to Florida Statutes§119.07 please check here(read instructions): ® Work Telephone: Home Address: � �^ �o1�Co . 44:320 k Street Address -3-��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 N me of Source of Income Address Business Activi e; C4 v w FVC r hoof I hereby swear(or Irm)th the/aforesaid information is a true and correct statement. i /Z Z Signature'dFffierson disclo g Date signed 1AM I BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.Aoy CITY CLERK Office CityClerkCrn i arnibeochfi.gov Tel: 305.673.741 1 , Fax:305.673.7254 Acknowledgement of fines/suspension for Board Mernbers for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) Board Member name: AIJP ' S� _L, (/ I 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 file 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 lax Return Failure to fie, according to the Miami-Dade-County Code Chapter 1, General Provision, Section 1-5 may subject the person or firm to a fine not to exceed $500,00 or by imprisonment in the county Jail for a period not to exceed sixty days, or.both. Sign u Date: