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Carrie Johnson 12/31/2013 MIAMI BEACH , City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.gov DEPARTMENT: City Clerk's Office Rafael E. Granada, City Clerk Telephone: 305-673-7411 FAX: 305-673-7254 Email: CityClerk @miamibeachfl.gov November 29, 2012 Carrie Johnson SUBJECT: TENNIS ADVISORY COMMITTEE Dear Ms. Johnson: Congratulations! You have been appointed by Commissioner Deede Weithorn 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, 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. Sin erely R fael E. Granado City Clerk cc: Saul Frances, Parking Director Julio Magrisso, Board Liaison 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 City Wide Permit Application - (Parking Department Form) Booklet- Guide to the Sunshine Amendment and Code of Ethics for Public Officers We are committed to providing excellent public service and safety to all who live, work,and play in our vibrant, tropical,historic community. /\A I AM I B EAC H City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfi.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: (305)673-7411, Fax: (305)673-7254 November 29, 2012 TO: CARRIE JOHNSON RE: TENNIS 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 of the above-mentioned board or committee of the City of Miami Beach to which I have been 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 Code of Ethics Ordinance), as well as the Florida 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* requirements of Miami-Dade County or the State of Florida (depending on the board or committee on which I have serve) on July 1, following the closing of the calendar year on which I have served. 1A �j Carrie Johnson Sworn to and subscribed before me this day of . 2012. F t 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. ® MIAMI BEACH CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: Johnson Carrie r Last Name First Name Middle Initial HOME ADDRESS: 210 Washington ave Miami Beach FL 33139 Apt No. Home No./Street City State Zip Code PHONE: 305-799-1047 305-604-8998 305-604-8991 carriekj7 @mac.com Home Work Fax Email Address Business Name: American Construction and Engineering Position: owner Address: 420 lincoln rd suite 402 Miami Beach FL 33139 No. Street City State Zip Code Professsional License(describe): Expires: 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: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I think I have alot of imput for the Tennis community representing school age children and act •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 Loan Review Committee Art in Public Places Committee Marine Authority Beautification Committee Miami Beach Commission for Women Board of Adjustment* Miami Beach Cultural Arts Council Budget Advisory Committee Miami Beach Human Rights Committee Capital Improvements Projects Oversight Committee Miami Beach Sister Cities Program Committee for Quality Education in MB Normandy Shores Local Gov't Neigh. Improvement Committee on the Homeless Parks and Recreation Facilities Board Community Development Advisory Personnel Board Community Relations Board Planning Board* Convention Center Advisory Board Police Citizens Relations Committee Debarment Committee Production Industry Council Design Review Board* Safety Committee Disability Access Committee Single Family Residential Review Panel Fine Arts Board Sustainability Committee Gay,Lesbian,Bisexual and Transgender(GLBT) [1] Tennis Advisory 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 Youth Center Advisory Board Housing Authority 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: I • 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: Flamingo Park Tennis Member Title: Name: Title: • List all properties owned or have an interest in,which are located within the City of Miami Beach: 210 washington ave 420 lincoln rd suite 402 • 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: 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. N 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 Carrie Johnson agreed to the following terms on 12/3/2012 6:52:56 PM Received in the City Clerk's Office by: Date: / /2012 Control No. Date: / /2012 Name of Deputy Clerk Carrie Johnson 210 Washington Ave, Miami Beach FI 33139 (C) 305-799-1047 (E) carriekj7 @mac.com Summary I am a Miami Beach Mother of three girls. My family and I have resided on South Beach for 6 years. My daughters as well as myself play tennis frequently at Flamingo Park. The girls do the afterschool clinics as well as take lessons from Greg. We own American Construction & Engineering with offices located on Lincoln Road. I am a stay at home mother for the most part but I spend my mornings at the office returning calls and doing accounting for our business. We currently employ 100 employees. Highlights s Sales and Communication a Multitasking e Accounting a English tutor Accomplishments I graduated from The Ohio State University with a Bachelors degree in English. I am 30 years old and have been married for 10 years. After college I had a child and Co- owned with my husband a furniture store in Columbus, Ohio called Global Living. We also had propertied in Miami so in 2006 decided to move to Miami and swim and play tennis and start a new venture. My husband currently owns and operates American Construction & Engineering with large renovation jobs on the beach including the Flamingo towers and Sunset Harbour. We currently employ 100 people. While I was with American Construction I negotiated a 1.37 milliion dollar stimulus package to hire and train 50 new local employees. Experience 11/2008 - Current American Construction & Engineering Miami Beach , FL Accounting and Sales, Family Business Currently employ 100 people. We were also part of the workforce one program training and employing local people as part of a job stimulus package. A program that myself worked hard in making sure was successful for us and our employees. 09/2002 -04/2006 Global Living Grandview , Ohio Owner, Buyer, Sales Flew all over the world buying and collecting eclectic furniture. Maintained great relationships with some of the best furniture companies such as Ralph Lauren, Holly Hunt, Hendredon, & Maitland Smith. Education 2005 The Ohio State University , Columbus , Ohio, USA English Bachelor of Arts �I MIAMI- O ENT OF NC E -STE � moo . so Please.Print.or Type First Fume Middle Name Initial Last Name aisCiQSUre l For Tax Year p �I. � i v Endmg�2�j.,�� Name: Mailing Address; city/state/ er: Filing as.a: ® County Employee: E3 Municipal Employee of: Position held or sought: Ter�at or:Emplayrnent Board where serving: - �S ��`/ SO r�� 'Began.on: Department-where;employed: Work Address: 'If your home address is exempt.from public records-purauant to ® Work Telephone: Florida Statutes j 119.07 please check here(ran instruetiotts); Horne Address: -Stre®t,address - City ,State dip Code e list below in descending order with the largest-source first,-the name► address any Pleas public Sala principal business activity of every source of your income .including R �' y 'The received or any_person received for your..beneft_or use during the disclosure period. inc®me.of your.spouse or,any business-partner need not:be disclosed. .If continued on e separate sheet,.check.here: Descri0on of the Principal Address Businiess AcLivitv Name of Source of.Income • � lvw S� rn, 3 T-here swear (Dr-aff, that the aforesaid information-is-a true and correct statement, :�igrrature of pars di closing Q to igned 1�,AIAAAI BEACH City of Miami Beach,, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel:305.673.741 1 , Fax: 305.673.7254 Acknowledgement of fines/suspension for Board Members for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) Board Member name: 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 Tax 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 fine not to exceed $500.00 or by imprisonment in the county jail for a period not to exceed sixty days, or both. 4111 Signature: ate: