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David Doebler 12/3/12013 /1\1/1 I 4,t,A I B E AC H 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)673-741 1, Fax: (305) 673-7254 Email CityClerk @miamibeach.gov 01-22-2013 David Doebler 33c Venitian Way#66 Miami Beach, Florida 33139 SUBJECT Sustainability Committee Congratulations! You have been appointed by Commissioner Jerry Libbin 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 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 CiyClerk @miamibeach.gov TO David J. Doebler RE: Sustainability 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 on the board or committee on which I serve)on July 1, following the closing of the calendar year on which I have served. D J. do�ebller Sworn to and subscribed before a this day of /'�"' /, 20J 3. 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 safely to all who live, work and play in our vibrant, tropical, historic community. MIAMI. SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name Initial Last Name ` Disclosure For Tax Year Name: r] V, Ending .Z Mailing Address: . 33C V e ne jic,,j Vtjy 4JLa__ City/State/Zip: 1 A- 8 L— 1 Social Security Number: _ Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: Board where serving:S V S -'A I OJA 0 I C.1 t`I Gd rho j7 Term or Employment Began on: Department where employed: Work Address: r+ISSi o,V C,(L 11f JCg L 9Y S1-110 S /3C1 ? E,q Sr- SA PLC i*�-°n . PoMt'I)rj0 If your home.address:is exempt from public records pursuant to Q EAG44, GL 33 6 Florida Statutes§119.07 please check here(read instructions): ® Work Telephone: Home Address: 3 3 C V2^ Street Address MiA ri ; 4LAC1_I 1✓� 33 �3� 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 Source of Income 'Address Business Activity (hiSS11nI d 'i')cA(_SV6r6 13y e- S7 SS4me1_6 j) L-fWO 4GV OmpAty 61; CL1 3306 r Po :I hereby swear(or affirm) that the aforesaid information is a true and correct statement. Signa of pe n disclosin Date.Signed MIAMI BEACH city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, WWW miamibeachfl.pov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.741 1 , Fax: 305.673.7254 Acknowledgement of fines/suspension for Board Mein hers for.failure to comply with Miami-Dade County Financial .Disclosure Code Provision Code Section 2-11.1(i) .(2) Board Member name: � ' r U �� j 613 C E/m I 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 means that-the members of City Advisory:Boards, whose.sole or primary responsibility is to recommend legislation or give advice to-the City Commission,mustffle,:even-though you may have.been recently appointed. YOU must file One ofthe 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 Retum Failure to fife, according to the Miami-Dade .County Code Chapter 1, General Provision, Section 14 may subject the person or firm to a f ne not to exceed .$500.00 or by imprisonment in the county jail for a period nit to exceed sixty days, or both. Sign Dote: MIAMI BEACH CITY OF WAN411 LEACH BOARD AND COMMITTEE APPLICATION FOR NAME: Doebler David J Last Name First Name Middle Initial HOME ADDRESS: 66 33c Venetian way Miami Beach FL 33139 Apt No. Home No./Street City State Zip Code PHONE: 9544157434 dave.doebler @gmail.com Home Work Fax Email Address Business Name: Mission Critical Systems Position: Director of Sales Address: 1347 East Sample Road Pompano Beach FL 33064 No. Street City State Zip Code Professsional License(describe): Expires: A.Vach a copy the fscanse 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: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: . I am a strong activist for reasonable solutions to real problems,and see a strong social and •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 f3) 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 Fine Arts Board [1] 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: • 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: ECOMB Title: member/supporter Name: SurfRider Title: supporter •List all properties owned or have an interest in,which are located within the City of Miami Beach: 833 West Ave#404,Miami Beach,33139 • 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 O71/9/2013 yy Members." I David Doebler agreed to the followings rms on / 2- /3 Received in the City Clerk's Office by: Date: / /2 13 Control No. ✓ 1 Date: ! 12013 Name of Deputy Clerk Dave Doebler 33C Venetian Way#66 a Miami Beach, FL 33139 e 954-415-7434 cell a dave.doebler @gmail.com Application for Sustainability Committee I was born in Miami and have lived in South Beach for over 10 years as a resident and home owner. I am a strong activist for reasonable solutions to real problems,and see a strong social and economic opportunities within environmental protection. I believe that we can implement logical and fiscally responsible strategies to create a more sustainable city for residents,visitors, and the business community to enjoy. Please accept my submission for a seat on the Sustainability Committee. I would enjoy the opportunity to meet with you to discuss what I can bring to the Committee. Professional Experience 2006—Present Mission Critical Systems, Director of Sales IT Security for medium and Enterprise Companies 1994—2006 Aladdin Knowledge Systems, Regional Sales Manager Anti-Virus and 2 factor authentication manufacturer for Medium and Enterprise Companies 1990-1994 Florida International University BA Business Management and BA International Business Activism Experience 2012 City of Miami Beach Leadership Academy 2008 and 2012 Voter Registration - Neighborhood Team Leader 2012 www.votewithvourwalletpromect.com 2009 to present Member of ECOMB (Environmental Coalition of Miami &the Beaches) 2010 to present Volunteer at Surfrider Foundation events 2009 to current Independent Beach and Ocean cleanups (2-3 times per month) 2008 Convinced local cafe with 2 stores to switch from Styrofoam to paper cups 2008 Convinced owners of a new fast food restaurant to switch from plastic cups to biodegradable corn plastic cups to enhance their business image. Owners ended up building a franchise and now opening 250 stores—which will all use biodegradable corn plastic cups and take-away bags. Issues I care about 1) Plastic and pollution in the Bay and Ocean 2) Economic growth through positive environmental policies 3) Efficient use of existing resources and looking for alternatives References Provided upon request