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Scott A. Needelman Application and Resume M-, 1AM1 BEACH CITY OF MIAMI BEACH BOARD AND COMMITTEE APF' ICATION FORM • La tfName F' st Name Middle Initi I Home Address city State Zip Co e --N63 "3®'5-'7!0-5 AIgS5 ?�IoNET Home Telephone Work Telephone Cellular Telephone Email address Al ill . =ac, Position: Business Name k65 F?_ _53/31 Business Address City State Zip Code Professional License(describe) l6 Expires: Attach a copy of 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 for a minimum of six months. • Resident of Miami Beach for a minimum of six (6) months: Yes N or No • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six months:Yes ff"�!No Cl • Are you a registered voter in Miami Beach: Yeso or No • I am now a resident of: North Beach�J South Beach F61 Middle Beach :z • I am applying for an appointment because I have special abilities, knowledge and experience. Plea§e lis"elo -1-s co g U? 10 • Are you presently a registered lobbyist with the City of Miami Beach?Yes Ljor No Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice,7, e a note that only three 3 choices will be observed by the City Clerk's Office. (Regular Boards of City) ❑Affordable Housing Advisory Committee ❑ Fine Arts Board ❑ Normandy Shores Local Government Neighborhood Improvement ❑Art in Public Places Committee ❑Gay, Lesbian, Bisexual and Transgender ❑Parks and Recreation Facilities Board Enhancement Committee GLBT ❑Beautification Committee ❑Golf Advisory Committee ❑ Personnel Board Board of Adjustment* ❑ Health Advisory Committee ❑ Planning Board* ❑Budget Advisory Committee ❑ Health Facilities Authority Board ❑ Police Citizens Relations Committee ❑Capital Improvements Projects ❑ Hispanic Affairs Committee ❑ Production Industry Council Oversight Committee ❑Committee on the Homeless ❑ Historic Preservation Board ly ❑Safety Committee ❑Committee for Quality Education in MB ❑ Housing Authority ❑Single Family Residential Review Panel ❑Community Development Advisory ❑ Loan Review Committee ❑Sustainability Committee ❑Community Relations Board ❑ Marine Authority ❑Tennis Advisory Committee ❑Convention Center Advisory Board ❑ Miami Beach Commission for Women ❑Transportation and Parking Committee ❑ Debarment Committee ❑ Miami Beach Cultural Arts Council ❑Visitor and Convention Authority ❑ Design Review Board* ❑ Miami Beach Human Rights Committee ❑Youth Center Advisory Board ❑ Disability Access Committee ❑ Miami Beach Sister Cities Pro ram ❑Waterfront Protection Committee * Board Required to File State Disclosure Form If you seek appointment to a professional seat(e.g., lawyer, architect)on the Board of Adjustment, Design Review Board, Historic Preservation Board,or Planning Board,attach a copy of your currently-effectively license,and furnish the following information: Type of Professional License .3 �L kM C QJ"i-License Number License Issuance Date (( ? ,and License Expiration Date b-ol F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc y Note: If applying for Youth Advisory Board,please indicate your affiliation with the Scott Rakow Youth Center: V 1. Past service on the Youth Center Advisory Board:Yes LJ No U Years of Service: 2. Present participation in Youth Center activities by your children Yes No�J. 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:Yes La or No If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach codes:Yes La or No . If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money:Yes La or Nof;Kh If yes, explain in detail •Are you currently serving on any City Boards or Committees:Yes La or No M If yes;which board? •What organizations in the City of Miami Beach do you currently hold membership in? I U �- Name Title Name Title • List all properties owned or have interest in,which are located within the City of Miami Beach:64�,- y 4 411 � ue. RA • I am now employed by the City of Miami Beach:Yes Z)or No omiqu.Which department? • Pursuant to City Code Section 2-25(b): Do you have a parent L], spouse , child brother�, or sister who is employed by the City of Miami Beach?Check all that apply. Identify the de ent(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. Ethnic Origin: Check one only(1) Gender: MaleLAJ Female White (Not of Hispanic Origin):All persons having origins in any of the original peoples of Europe,North Africa or the Middle East. ZIAfrican-American/Black (Not of Hispanic Origin):All persons having origins in any of the Black racial groups of Africa. LaHispanic: All persons of Mexican,Puerto Rican,Cuban,Central or South American,or other Spanish culture or origin,regardless of race. 0 Asian or Pacific Islander:All persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,or the Pacific Islands. This area includes,for example,China,India,Japan,Korea,the Philippine Islands and Somoa. American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America,and who maintain Cultural identification through tribal affiliation or community recognition. Physically Challenged: Yes or No LM Employment Status: Employed Retired L3 Homemaker 0 Other ID Please remember to attach a current resume and a copy of any applicable professional license. Attach additional sheets, if necessary, to provide required information. F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc �r NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT 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 City Code section 2-26). • Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1). • 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 I 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." a1 (A/13 !�i�z Ajm' aA pplicant's ignature D to Name of Applicant(PLEASE P INT) Received in the City Clerk's Office by: �n�l 12- 1 Name 6f,6eputy Cler Control o. Date( F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc r c MIAMI BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov Telephone: 305.673.7411 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's 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. _�z I - I [A/�3 ��ignature I bate F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc f Scott Needelman ' 1455 Drexel Avenue #1 Miami Beach, Florida 33139 305-710-5584 305-673-1463 Education Bachelor of Science,Civil Engineering,May 1993 Florida State University,Tallahassee,Florida Graduated,Miami Beach Senior High School,June 1988 Work Experience President, SAN Development, Inc., September 2002-present Completed construction of a 2700 sq. ft. home. Property Manager, York Towers Apartments, May 1993-present Responsible for the day-to-day operation of 24 apartment units and four commercial spaces. Assistant Project Manager,Fisher Island Holdings, LLC, January 2005-May 2008 Managed the submittal and RFI processes for the construction of a 10 story luxury condominium building and oversaw various other small construction projects. Project Supervisor,Carmel at California Club Property Owners Association, September 2001-December 2001 Oversaw the repairs to 34 condominium buildings due to flooding. Project/Construction Manager, York Towers Apartments February 1995-August 2000 Conceived and executed the substantial renovation of three historic multi-family buildings,approx. 18,000 sq. ft. Oversaw,on a daily basis,the various subcontractors from concept to completion of projects. Skills Microsoft Office,AutoCAD Certifications Certified Building Contractor,State of Florida Engineer Intern, State of Florida Committees/Activities Member,Debarment Committee,City of Miami Beach January 2009-December 2010 Member,General Obligation Bond Oversight Committee City of Miami Beach,March 2003-April 2008 Member,Eleventh Judicial Circuit Grievance Committee A State of Florida,February 2001-January 2004 Member, Safety Committee,City of Miami Beach January 2002-December 2002 Member,Planning Board,City of Miami Beach January 2000-December 2001 Graduate,Miami Beach Citizens Police Academy November 2000 Member,Community Development Advisory Committee City of Miami Beach,January 1998-December 1999 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION T CONSTRUCTION INDUSTRY LICENSING BOA _ RD (850) 487 1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 NEEDELMAN, SCOTT ALAN SAN DEVELOPMENT INC 1455 DREXEL AVENUE #1 MIAMI BEACH FL 33139 STATE OF FLORIDA AUG 22372 Congratulations! With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. CBC1250381 07/24/12 12801581]; For information about our services,please log onto www.myfloridalicense.com. CERTIFIED BUILDING CONTRACTOR There you can find more information about our divisions and the regulations that j NEEDELMAN, SCOTT ALAN impact you, subscribe to department newsletters and learn more about the SAN DEVELOPMENT INC Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. IS CERTIFIED under the provisions of Ch.489 F Thank you for doing business in Florida, and congratulations on your new license! expiration date: AUG 31, 2014 L12072400845 - - ---- - — - - - - DETACH HERE - -- -- =- .. C# 6223721 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12072400845 • : - LICENSE NBR 07/24120121128015811 ICBC1250381 The BUILDING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 NEEDELMAN, SCOTT ALAN SAN DEVELOPMENT INC 1455 DREXEL AVENUE #1 MIAMI BEACH FL 33139 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY AS REQUIRED BYLAW