Mark Balzli 12/31/2013 05-20-2013
Mark Balzli
2383 N. Bau Road
Miami Beach, Florida 33140
SUBJECT: I Community Development Advisory Committee
Congratulations! You have been appointed by Commissioner Michael Gongora
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.
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
MIAMI 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 CiyClerk @miamibeach.gov
TO Mark D. Balzli
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: 12/31/2013.
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 o rYNe board or committee on which I serve)on
July 1, following the closing of the calendar year on whic I Oave se d.
Mark D. Balzli
Sworn to and subscribed before me this day of /�/ L , 2013.
a
Silvia Prieto
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 C fY Or- MIAMI BEACH
) 111MfE
APPLICATION FORM
NAME: Balzli Mark D
Last Name First Name Middle Initial
HOME ADDRESS: 2383 N. Bay Road Miami Beach FL 33140
Apt No. Home No./Street City State Zip Code
PHONE: 3057857139 3055381765 3055381586 mark @balzli.net
Home Work Fax Email Address
Business Name: Balzli&Associates Position: President/Attorney
Address: 400 1111 Lincoln Road Miami Beach FL 33139
No. Street City State Zip Code
Professsional License(describe): Florida Bar Member#928828 Expires: n/a 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: Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
Business owner,resident and park user in Miami Beach for over 20 years
•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' [3] 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 [2] Parks and Recreation Facilities Board
Community Development Advisory Personnel Board
[1] 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) 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 Yes if yes, please list the names of your children,their / c
ages,and which programs. List below:
Child's name:Aidan Balzli Age:13 Program:All sports programs
Child's name: Age: Program:
• Have you ever been convicted of a felony: No If yes, please explain in detail:
I. .
• 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:
2383 N.Bay Road and 2301 Collins Ave.#1138
• 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."
t/
I Mark Balzli agreed to the following terms on 3/22/2013 5:12:26 PM
- 3ZZ ��l' ' 3vz' l
Received in the City Clerk's Office by: 6 Date: / /2P13 Control No3�v/Date: / /2013
Name of Deputy Clerk
i
MARK D. BALZLI.
2383 North Bay Road
Miami Beach, FL 33140
(305)538-1765
Mark(ii),Balzli.net
EDUCATION
1983 to 1987 - Graduated Cum Laude from the University of Alabama with a degree in
Corporate Finance.
1987 to 1990 - Received Juris Doctor from Washington and Lee School of Law, in Lexington
Virginia.
EARLY WORK EXPERIENCE
1987 to 1990— Summer clerkships with the U.S. Department of Justice and the U.S. House of
Representatives.
1990. to 1993 - First practiced as an attorney with the litigation firm of Lyman& Ash in
Philadelphia,Pennsylvania.
CURRENT EMPLOYMENT
1993 to Present - Mark D. Balzli, Esquire is president and lead counsel for Balzli & Associates
and has.been a practicing attorney in Miami Beach for 20 years. Balzli & Associates, located in
the heart of Miami Beach at 1 111 Lincoln Road, has been providing closing, settlement and title
services to the community since 1996, with primary focus in residential and commercial real
estate transactional law. Mark is a member of the Florida and Tennessee Bar Associations and
writes title insurance through First American Tide Insurance Company.
VOLUNTEER WORK
2004 to 2011 - Board of Directors for the Friends of.Public.Education, Lnc., dba Friends of North
Beach, which privately raises funds for teacher assistants and other personnel for North Beach
Elementary Public School in Miami Beach.
2012 to Present— Vice-President for the Lower North Bay Road Homeowner's Association in
Miami Beach.
March 2013 to Present—Recently sworn in as a Guardian Ad Litem with the Florida
Department of Children and Families. Volunteer Guardians advocate on behalf of children who
have been removed from their homes because of abuse, neglect or abandonment.
PERSONAL
Mark has been a resident of Miami Beach since- 1993. In 1996, lie bought and restored an
original 1928 Spanish Mediterranean home on North Bay Road, where he has lived ever since.
Mark and his partner Jeffrey Hearne, also an attorney,_just celebrated their 10°i anniversary. in
1993 Mark and Jeff adopted their son Aldan from Ukraine, who just celebrated his 13`1' Birthday.
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AA I AM I BEACH
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeacLE.a
CITY CLERK Office Cit/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 name: I A&& A,41_z L- /
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, 2010.
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
$500.00 or by imprisonment in the county jail for a period not to exceed sixty
days, or both.
ZS
Signature: t
i
MIA M I•DADE
SOURCE OF INCOME STATEMENT
I
Please Print or Type First Name Middle Name/Initial Last Name
Disclosure
For Tax Year/
Name: Endingi�� --�i
Mailing Address:
City/State/Zip: N L 3 3 13�
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Filing as a: ® County Employee:
® Municipal Employee of:
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Position held or sought:
Board where serving: 1,13 AIV cows- Term or Employ en
/ Began on: q1 Z 3
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Department where employed: ( n n f
Work Address: ( 1 IV-01
0 d E��iDC C7 , he.A. F&
If your home address is exempt from public records pursuant to
Florida Statutes 119.07 lease check here read instructions): u�' Work Telephone: SS I?
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Home Address: 03 N • PaY
treet Address
M (a,u,i 6 z t=L i—L 33
City State Zip Code
Please list below in descending order with the largest source first, the name, address and
principal business activity of every source of your income including public salary you
received or any person received for your benefit or use during the disclosure period. The
income of your spouse or any business partner need not be disclosed. If continued on a
separate sheet, check here:
�3 Descptlon ofthe Piriupal
r�
,Name of Source ofaIncomb q. <$r
4cldress Business.Active n _ $
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Q 37135
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I hereby sw (or affirnAthat the aforesaid information is a true and correct statement.
4f e-J t5
D to si
Signature o erson disci ned