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Carol Housen 12/31/2014 I% A Y I BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.midmibeachfl.g_ov OFFICE OF THE CITY CLERK, Rafael Granado,City Clerk Tel: (305) 673-741 1,Fax: (305)673-7254 Email CityClerk @miamibeach.gov 2/11/2013 Carol Housen 7330 Ocean Ter#2001 Miami Beach, Florida 33141 SUBJECT. Design Review Board Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee for a term ending: 12/31/2014. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-7411. Please read the enclosed material carefully. Again, congratulations and good luck. Sincerely, R fael E. Granado City Clerk cc: Saul Frances, Parking Director Thomas Mooney ATTACHMENTS: i 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) Booklet-Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. I I h 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 , READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII — OF THE CITY CODE "STANDARDS OF CONDUCT FOR RECEIVED OFFICERS, EMPLOYEES AND AGENCY MEMBERS." L_kL�9_�Applicant's SignatureDate . Name of Applicant(PLEASE PRINT) Received in the City Clerk's Office by Name of Deputy Clerk Control No. D to F:ICLERI$ALL1aFORMSIBOARD AND COMMITTEESOC Application NEWLY REVISED NEW LANGLIAGE.doc i W a u e4OV1 1104d" P. `i.Ir.cf.,e./f,c).,�if. ,biro& c)a 6f 0-fe, Knowledge, Experience, Service and Integrity Profiles of Success and Education and Affiliations since 1993 • Member of Master brokers Forum (A distinguished network of realtor professionals recognized as leaders in the industry • G.R.I. (Graduate Realtor Institute) • C.R.S. (Certified Residential Specialist-est.4% Nationally) • C.I.P.S. (Certified International Property Specialist-specific education to work with foreign nationals) • Former Chair of Grievance with the Realtor association Miami RE • Present member on Arbitration with Realtor association Miami RE • Present mediation trained for Realtors 2012- • Served on Board of Directors of Realtor Association of Miami and the Beaches (Miami RE)from 1999 until 2008 (local) • Present serving as governor for 2012 Miami Association of Realtors • Present serve as Director with Florida Association of Realtors( FAR)(State) • Present-2012 serve as president on two Condominium Boards in Miami Beach • Present-President of North Beach Development Corporation (non for profit) • Former Chair of the Fine Arts Board for City of Miami Beach 20P and 2010 • Present serving on Miami Beach Design Review Board 2012 • Active with RPAC www.carolhousen.com 3059928163 carolhousen@)gmail.com !,Z�l 1;1 -d 4 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami.Beach,Florida 33-139, www.miami6eochfl.yov CITY CLERK Office CityClerkCmiamibeachfl.gov Tel: 305.673.741 1 , Fax: 305.673.7254 Acknowledgement of fines/suspension for Board Mern hers 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 ater-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 withthe City Cleric of Miami Beach, 17.00 Convention -Center.Drive, Miami:Beach, Florida,.by.July Leach.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 NliaM'i-Dade :County Code Chapter 1, General Provision, Section 1 Z may subject the.person or firm to a f ne not,to exceed $500:00 or by imprisonment"in the county jail for period not to exceed sixty clays, or.both: 0111. -Signature: .Dote,: M I A M I•DADE ® SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name/Initial Last Name Disclosure For Tax Year Name: �� ' l G� Ending: Mailing Address: t� City/State/Zip: Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: LAJ _ o Position held or sought: Board where serving: Term or Employment Began on: Department where employed: ='?" Work Address: w If your home address is exempt from public records pursuant to Florida Statutes§119.07 please check here(read instructions): ® Work Telephone: Home Address: S C-"D 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 Activi Oa q I hereb wear (or affirm) t t the aforesaid information is a true and correct statement. Signature of person disclosing Date signed