Dorian Nicholson 12/31/2014r
V;IAAM BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305) 673-7254
Email CityClerk @miamibeach.gov
03-08-2013
Dorian Nicholson
6855 Abbott Ave. #701
Miami Beach, Florida 33141
SUBJECT: } Community Development Advisory Committee
Congratulations! You have been appointed by Commissioner Deede Weithorn
to the agency, board or committee named above for a term ending: 12/31/2014.
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.
Sincerely,
Rafael E. Granado
City Clerk
cc: Saul Frances, Parking Director
Brian Gillis
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 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 all who live, work and play in our vibrant, tropical, historic community.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachFl.gov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
Email CityClerk @miamibeach.gov
TO Dorian Nicholson
RE: Community Development 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 member
of the above-mentioned board or committee of the City of Miami Beach to which I have been appointed
for a term ending: 12/31/2014.
1 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 Sunshine Amend-
ment 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 co/lply with the financial disclosure* requirements of
Miami-Dade County or ithe State of Florida (deper�tling on the board or committee on which I serve)on
July 1,following the closing of the calendar year on which Ze served.
r
Dorian Nicholson
Sworn to and subscribed before me this d_day of 1V,,7g , 2013.
�C&Ci
4�_&;Silvi�rieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.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.
MIAMI BEACH CITY OF MIAMI BEACH
BOARD :AND COPYNITTEE APPUCATION FORM
NAME: Nicholson Dorian A
Last Name First Name Middle Initial
HOME ADDRESS: 701 6855 Abbott Ave Miami Beach FL 33141
Apt No. Home No./Street City State Zip Code
PHONE: 4048389205 dnicks @me.com
Home Work Fax Email Address
Business Name: David Barton Gym Position: Fitness Instructor
Address: 2323 Collins Ave Miami Beach FL 33139
No. Street City State Zip Code
Professsional License(describe): Expires: Af{ach a copra Uhe//cense
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:
•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(31
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
[2] Fine Arts Board Sustainability Committee
[3] Gay,Lesbian,Bisexual and Transgender(GLBT) Tennis Advisory Committee
Golf Advisory Committee [1] 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:
• 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: Title:
Name: Title:
• List all properties owned or have an interest in,which are located within the City of Miami Beach:
• 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: Male
Ethnic Orgin: Check one only(1)
Hispanic
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."
1(0 / -
I Dorian Nicholson agreed to the following terms on 211912013 10:16:57 AM r
Received in the City Clerk's Office by: f Date: / /2013 Control No. �O Date: / 12013
Name of Deput Clerk
DORIAN A. NICHOLSON
6855 Abbott Ave
Miami Beach,FL 33141
DNICKS @ME.COM
404-838-9205
EDUCATION
Clark Atlanta University,Atlanta,Georgia
Bachelor of Arts degree in Mass Media Arts December 2009
Concentration: Film GPA:3.5/4.0 scale
Related Courses: Cinematography,News Writing,Writing for Radio Television and Film,Fundamentals
of Film,Media Seminar
Kingsborough Community College,Brooklyn,New York
Pursued an Associate of Arts degree in Mass Communications,2004-2006
Related Courses: Film Creative Medium,Introduction to Broadcasting,Introduction to Mass Media
WORK EXPERIENCE
SALES MANAGER April,2012
UNFAMOUS TATTOO CULTURE,MIAMI TATTOO CO& FIRST CLASS TATTOO MIAMI BEACH,FL
• Key Holder
• Managing cash draws and sales
• Personal consultations with clients to fully understand their creative vision then with the artist to best execute the
idea
• Following up with appointments and account balances
TEAM LEAD/STOCK April,2008-Nov,2011
URBAN OUTFITTERS NY,NY
• Assisted customers in the selection and purchase of casual apparel and accessories.
• Created sales floor displays to enhance apparel marketability.
• Maintained the organization and replenishment of apparel on sales floor displays.
SALES ASSOCIATE/STOCK Nov,2007-Jan,2009
GAP Atlanta,Georgia
Assisted customers in the selection and purchase of casual apparel and accessories.
Created sales floor displays to enhance apparel marketability.
• Maintained the organization and replenishment of apparel on sales floor displays.
SALES ASSOCIATE July,2007-August,2007
Verizon Wireless Carle Place,New York
• Greet customers and demonstrate strong knowledge of Verizon telecommunication products
and services.
• Demonstrate cell phone functionality in efforts to assist customers in purchasing the
appropriate phone and service based on need.
PROFESSIONAL ATTRIBUTES
• Keen eye for detail.
• Effective time management,organization,and multitasking abilities.
• Editing knowledge: Final Cut Pro,Photoshop.
• Microsoft Applications:Word, Excel,Power Point.
• Basic navigation of Internet browsers.
References available upon request.
MIAMIBEACH
City of Miami Beach,
1700 Convention Canter Drive,
Miami Beach,Florida 33139,
www.miamibeochfl.aov
CITY CLERK Office Cil Clerk @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 2-1 1.1(i) �.(2)
Board Member.nome:
understand that no .later than Jul 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 meansthatthe
members of City Advisory.Boards, whose.sole or primary responsibility -is to recommend
legislation or give advice to-the City Commission,mustfile.,:even-though you mayhave.been
recently appointed.
You must rile one ofthe-following withthe.City Claris of Miami Bach, -17.00 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 maysubject the person or firm to a Tine not-to exceed
.$500..00 or by imprisonment'in the county.jail fora period not to exceed sixty
days, or both.
Signature: Date:
M I A M I-DADE
® SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name/Initial Last Name
/1 /� Disclosure For Tax
Name: l/o I v t AA) A ����JZ S0" " Ending Y�ea�r, 2
T�13
Mailing Address: (�� *,7o
City/State/Zip: ILL
C? N
O
SeevrftT-NUMbeiF:
Filing as a: ® County Employee: r
® Municipal Employee of: = 00
Position held or sought: =
ng: v�. Term or Employment
Began on: Z Zd 3
Department where employed:
Work Address: Y_tve,0LAI
If your home address is exempt from public records pursuant to
Florida Statutes§119.07 please check here(read instructions): U Work Telephone:
Home Address: h SCSI /A96 off /4-(�E# 170
Street Address
mom;