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Noah Fox 12/31/2014 /S�AI'NAI 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 02-11-2013 Noah Fox 500 Lakeview Ct. Miami Beach, Florida 31140 S4 97&T­,,,'] Board of Adjustment Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term endin 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. 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 Antonieta Stohl 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.miomibeachA.aov OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk Tel: (305)673-741 1, Fax: (305)673-7254 Email CiyClerk @miamibeach.gov TO Noah Fox RE: Board Of Adjustment 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: 1213112014. 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 comply with the financial disclosure*requirements of Miami-Dade County or ithe State of Florida (depending on the board or committee on which I serve)on July 1, following the closing of the calendar year on wh I have served. Noah Fox Sworn to and subscribed before me this S day of 4-191 , 2013. � iG ! Silvia 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 safely to all who live, work and play in our vibrant, tropical, historic community. 1 ® MIAMI BEACH CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: Fox Noah Last Name First Name Middle Initial HOME ADDRESS: TH1 3801 Collins Ave Miami Beach FL 33140 Apt No. Home No./Street City State Zip Code PHONE: 3054677718 3053716421 nfox @royblack.com Home Work Fax Email Address Business Name: Black,Srebnick,Kornspan and Stumpf Position: Lawyer Address: #1300 201 S. Miami Beach FL 33131 No. Street City State Zip Code Professsional License(describe): License to practice law Expires: 9/30/13 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 owners h i ph nterest in a business in Miami Beach for a minimum of six(6)months: No •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: I am licensed lawyer with a master of accounting degree. I have participated in the developme e 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 u 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 [1] 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 [3] Planning Board' [2] 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) 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: 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) 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. "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 Noah Fox agreed to the following terms on 1/10/2013 3:37:34 PM Received in the City Clerk's Office by: Date: / /2013 Control No. Date: / /2013 Name of Deputy Clerk NOAH FOX 500 Lakeview Court Miami Beach,FL 33140 Nfox @royblack.com (305)467-7718 EDUCATION St.Thomas School of Law Miami,FL Juris Doctor, May 2008 GPA: 3.4 Honors: Deans List, Fall 2006, Fall 2007 Book Awards: Constitutional Law(Fall 2006) Tulane University New Orleans, LA Master of Accounting, 2004 GPA: 3.85 Bachelor of Science and Management, Finance, 2004 GPA: 3.4 EXPERIENCE Law offices of Black,Srebnick,Kornspan,& Stumpf P.A. Trial preparation for the matter of United States v. Castroneves,et al. Miami, FL December 2008-present FKS Realty Miami Beach, FL Real Estate Broker/Salesman 2000-Present Participated in the negotiation and sale of commercial real estate sales and leases with a fair market value in excess of$3,500,000. Dep't of Internal Auditing,Tulane University New Orleans,LA Auditing Intern 2004 Audited senior executives' expense accounts. PROFESSIONAL LICENSES Real Estate Salesperson License, State of Florida 2000- Present LANGUAGES Fluency in Spanish. _ Kc jo Z D co o :r.``.. O 0 GJ 7C, oo �:, _:: .. amm MNcob O •� vgaz-V Dmcchtj 079° W, . m m 0y Z $ T Z �! t7 cn m: O w;.. M to X a cy. .�y 71 y < � o 4'-0M0. j Z � `p -'1 ..► .a m N O o C7 O 0 i4 �'OZ C? 3 Z •i mm<a O �.. l-n ,•` a C �Dai o. 1 m g COC O �M W �A In O o cgs N w mm W o a�"gs Z � ssm OZ Om > 00 r �. r yr VAL Y•�q Q.r vc O , tLUUK, WAWN, I-L JJ1JU, :• ' �. OHONE(305)416-'1918. F4 VE YEAR OCT. 1 2011 THRU. SEP. .30" 2092 IH R FOX This iissuance e�o-f a business�c mceipftt does!/not R peRnd the hokfe to any zoning MRi of V W. City nor does it exempt the holder from any license TOTAL FEE PAID $116.00 or permits that may be required bylaw. . This d=inerd does riot constitute a certification, j that the 'holder Is qualified to engage In ft business,profession oroxupatiaii speafied herein,`: The documerd indkeites paym*of the business:: ►98-00123215 : . . : . . .� ►h+. ids-0006 `f CK SREBNICK KORNSPAN & 1 9 BISCAYNE BLVD#1300 NCE ' AGE . ATTORNEYS AT LAW: NOT A PA OR CORP. DIANA M. GOMEZ Finance Director l 6,4pE LINTY 201.E LOCAL EI:US ldl~S$TAX_R C�1I T .2() 2 ° FIRST-CLAS: )>iLDT,OR; :' : rIbiNC1At6 irOsllNTY=$.TAtE OELQII.QA= . U.S. POSTAG j kCLIi` t.$T: EX:PIKES SEPT,:86;20'12:... . ::. PAID J .':.:. :......::: MI ST. E D�RP[AY O At-PLdCE_Q. `E,L SI I-,��S : MIAMI, FL Ft13 PIR.SIJ 't!° !7 1:QQ CMAP; R -.dR 9 140 PERMIT{d0. 2 ve - - 4718-7 THIS IS NOT A BILL—DO NOT PAY RENEWAL !SS NAME I LOCATION RECEIPT NO. 681786-1 K NOAH RAMHENRI STATE# BAR66466 201 S BISCAYNE BLVD 1300 131 MIAMI I K NOAH .RAMHENRI L�ATTORNEY 'A LOCAL : RECEIPT.R ERNOT THE I JLATE ANY I ATORY OR OF THE DO NOT FORWARD i.MES. NOR :9M THE >.AFOY OTHER FOX NOAH RAMHENRI LICENSE Aw.Tmsis BLACK SREBNICK KORNSPAN STUMPF PA uea�a 201 S BISCAYNE BLVD 1300 I. MIAMI FL 33131 �vED m TAX ►'. 13/2011 J`I10000054 j° 070 . 00 1,r11,r�!!>F>'��li��ll�r„ittir,lr>lillr� ,Fll�Irir►1, �7�dfi. `�1TYCQ QIr1C '. MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www miamibeachfl.pov CITY CLERK Office CityClerk@miamibeochfi.gov Tel: 305.673.741 1 , Fax: 305.673.7254 Acknowledgement of fines/suspension for Board Mern bers for.failure to comply with Miami-Dade County Financial Disclosure Code Provision Code .Section 2-11 .1(i) .(2) Board Member name: 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 Cierk of Miami Beach, 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 Retum Failure to file, according to the Miami-Davie.County Code Chapter 1, General Provision, Section 1-5 may subject the person or firm to a f ne not to exceed . 500.00 or by imprisonment'in the county}ail fora period not to exceed sixty days, or both. Signature: Date: