Loading...
Charlotte Libov 12/31/2013 MIAtOIBE:A 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: 13051 673-7411, Fax: (305)673-7254 Email CiyClerk @miamibeach.gov 04-04-2013 Charlotte Libov SUBJ, Miami Beach Sister Cities Program Congratulations! You have been appointed by Mayor Matti Herrera Bower 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, Rafa I E. Granado City Clerk cc: Saul Frances, Parking Director Diana Fontani 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. MIAMIBEACH 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 Charlotte Libov RE: Miami Beach Sister Cities Program 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 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. Charlotte Libov Sworn to and subscribed before me this c29 day of. -�c,� , 2013. 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 CITY LI MIAMI BEACH BOARD AND COMMITTEE APPLICATION FOI2PJI Last Name First N Middle Initial .0 ,,nn v rhrf/a.&P— A- Home Address City State Zip Code `7 V C" /W el;Jr cu,) Ag A� y :a is a ; 4Ozr� �! ::�?,1 3 Home Telephone Work Telephone Cellular Telephone Email address Position: Business Name Business Address City State Zip Code Professional License(describe) Expires: Attach a copy of 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 for a minimum of six months. • Resident of Miami Beach for a minimum of six (6) months: Yes I—dor No • Demonstrate an ownershipAnterest in a business"iami Beach for a minimum of six months: Yes ID or No • Are you a registered voter in Miami Beach: Yes LJ or No • I am now a resident of North Beach C3 South Beach 0 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? Yes LJor No Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that o01 o01X three 3 choices will be observed bX the Cily C erk's ice (Regular Boards of City) Affordable Housing Advisory Committee Fine Arts Board Normandy Shores Local Government Neighborhood Improvement Art in Public Places Committee Gay,Lesbian,Bisexual and Transgender Parks and Recreation Facilities Board Enhancement Committee GLBT Beautification Committee Golf Advisory Committee Personnel Board Board of Adjustment* Health Advisory Committee Planning Board Budget Advisory Committee Health Facilities Authority Board Police Citizens Relations Committee Capital Improvements Projects Hispanic Affairs Committee Production Industry Council Oversight Committee Committee on the Homeless Historic Preservation Board If Safety Committee Committee for Quality Education in MB Housing Authority Single Family Residential Review Panel Community Development Advisory Loan Review Committee Sustainability Committee Community Relations Board Marine Authority Tennis Advisory Committee Convention Center Advisory Board Miami Beach Commission for Women Transportation and Parking Committee Debarment Committee Miami Beach Cultural Arts Council Visitor and Convention Authority Design Review Board** Miami Beach Human Rights Committee Youth Center Advisory Board Disability Access Committee Miami Beach Sister Cities Program Waterfront Protection Committee * Board Required to File State Disclosure Form If you seek appointment to a professional seat(e.g.,lawyer,architect)on the Board of Adjustment,Design Review Board, Historic Preservation Board,or Planning Board,attach a copy of your currently-effectively license,and furnish the following information: Type of Professional License License Number License Issuance Date ,and License Expiration Date Macintosh HD:Users:charlotte:Documents:Microsoft User Data:Saved Attachments:BC Apprication.doc 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:Yes U No U Years Iar�l1,,of Service: I : 2. Present participation in Youth Center activities by your children Yes;__,J No�1. 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:Yes Q or No&If yes,please explain in detail: • Do you currently have a violation(s)of City of Miami Beach codes:Yes�J or No U. If yes,please explain in detail: •Do you currently owe the City of Miami Beach any money:Yes r--U l or No CJ If yes,explain in detail •Are you currently serving on any City Boards or Committees:Yes U or No�d 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:Yes 0 or No (&Which department? I�—I, II��11,, •Pursuant to City Code Section 2-25(b):Do you have a parent ZI,spouse U,child�brother Q,or sister ZI 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. Ethnic Origin:Check one only_(11 GGeend�r Male ID Female L?I White (Not of Hispanic Origin):All persons having origins in any of the original peoples of Europe,North Africa or the Middle East. African-American/Black (Not of Hispanic Origin):All persons having origins in any of the Black racial groups of Africa. Hispanic: All persons of Mexican,Puerto Rican,Cuban,Central or South American,or other Spanish culture or origin,regardless of race. Asian or Pacific Islander:All persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,or the Pacific Islands. This area includes,for example,China,India,Japan,Korea,the Philippine Islands and Somoa. ED American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America,and who maintain Cultural identification throw h tribal affil n or community recognition. Physically Challenged: Yes or No Employment Status: Employed Ue Retired I J Homemaker Other Please remember to attach a current resume and a copy of any applicable professional license. Attach additional sheets, if necessary, to provide required information. Macintosh HD:Users:chadofte:Documents:Microsoft User Data:Saved Attachments:BC Application.doc 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 RECEIVED, READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII — OF THE CITY CODE "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS." � u //a y�/3 6711 Applicant's Signature Date Name of Applicant(PLEASE PRINT) Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Macintosh HD:Users:chadotte:Desktop:BC Application[l].doc Charlotte Libov Unit#7, 745 Meridian Avenue Miami Beach,Florida, 33139 (305) 333-8844 M, (203) 702-5233 F EDUCATION Master of Science—Education University of Oregon, Eugene, Ore. Bachelor of Science—Political Science, Honors University of Connecticut, Storrs, Conn. Current Freelance Positions Medical Writer, Newsmax.com • Writer,national cardiology newsletter 100,000 subscribers • Contributing writer, Health Radar, monthly newsletter 60,000+ subscribers • Weekly contributor to Newsmax Health website 900,000 unique visitors daily • Book editor Healthy Magazine • Special Projects and Interview Editor, Healthy Valle and Healthy Miami magazines Magazine and Internet Writer • Heart.org • AARP Viva • Healthy Woman Bottom Line • Revolution Health • Everyday Health.com • Cure • WebMD • First Consult • Revolution Health • Poder magazine Book Author • A Woman's Guide to Heart Attack Recovery, Harvey Kramer, M.D. and Charlotte Libov M. Evans and Company 2007. • The Women's Heart Book: The Complete Guide to Keeping Your Heart Healthy, Fredric Pashkow, M.D, and Charlotte Libov, Revised Edition, Hyperion,2001 • Beat Your Risk Factors: A Woman's Guide to Reducing Her Risk for Cancer, Heart Disease, Stroke, Diabetes and Osteoporosis, Charlotte Libov, Plume 1999. • Migraine: 50 Essential Things To Do, Charlotte Libov, Plume, 1998. Page - 1 • 50 Essential Things To Do If The Doctor Says It's Heart Disease, Fredric J. Pashkow, M.D. and Charlotte Libov, Plume 1995. Ghost Writer Turn Back the Clock Without Losing Time: A Complete Guide to Quick and Easy Cosmetic Rejuvenation, Rhoda S. Narins, M.D. and Paul Jarrod Frank, M.D., Three Rivers Press, 2002) TV Consultant and Producer "Women's Hearts at Risk," award-winning 1995 documentary based on Libov/Pashkow book, "The Women's Heart Book"PBS (CPTV presenting station) Associate Producer, CPTV, numerous projects Monograph And Report Writing Contributor,"Health Care's Real Opportunities: Special Report: The 2011 Global Business Forum,University of Miami, 2011 Women and Heart Disease: A Special Report from the Editors of Women's Health Advisor: The Center for Women's Healthcare, Weill Medical College of Cornell University, Torstar Publications, 1999. Book Contributor • The Reader's Companion to U.S. Women's History, Houghton-Mifflin, 1999 • For Women Only, Seven Stories Press 1999 • Women's Health Advisor, Rodale, 1995 Medical Conference Coverage • Medscape • Doctor's Guide Professional Speaker on Heart Disease in Women (Partial list) • US Army War College • Toyota • Duke University Medical Center • IBM • University of Connecticut Allied Health School • American Heart Association • National Organization for Women • Ministry Health Care Media Guest Expert(Partial list) • PBS • NPR Page - 2 • Today in New York • Fox Morning News • Morning Rounds • Jim Bohannon Show • Faith Middleton Show • USA Today/Sky Radio • Prime Time Washington • The Joan Hamberg Show Interviews and/or books reviewed or excerpted (Partial List): • The New York Times • The Los Angeles Times • Woman's Day • Ladies Home Journal • Connecticut Magazine • The Washington Post • Chicago Tribune • The Plain-Dealer • Lexington Herald-Leader • Times-Picayune • Northeast Magazine • Springfield Newspapers • Baltimore Jewish Journal • Hartford Courant Staff Experience Staff Journalist, Miami Today Miami, FL Covered numerous business topics including government, real estate, finance,banking, insurance, tourism, aviation, highways, and more 2005-2007 Managing Editor Neurology Now Wolters Klewer New York,New York 2004-2005 Oversaw start-up of consumer magazine. Managed freelance staff,consulted on design, writing, blue lines, content development, interfaced with doctor experts,participated in meetings and magazine launch at the annual conference of the American Academy of Neurology Managing Editor, Maitland Publications Naugatuck, CT Duties included writing,editing, hiring and supervising freelance writers,budgeting, layout, newspaper production and more 2003-2005 Page - 3 Regular Contributor, The New York Times Covered US Sixth Congressional District, State Legislature, tourism, business, education, features, aviation,travel, environment, science and health, and more 1987-1993 Awards Finalist, America Inspired Contest, Examiner.com,2012 Regional Emmy Nominee, Women's Hearts At Risk, PBS, 1996 Bronze Award,National Mature Media Award, Media TV Division, Women's Hearts At Risk, 1996 Bronze Award,National Mature Media Award, Book Division, 50 Essential Things to Do When The Doctor Says It's Heart Disease, 1996. Will Solimene Award of Excellence,The Woman's Heart Book, The American Medical Writers Association, 1994. Skills Content Management System, Content Strategist,Digital photography,videography, Social Media, SEO, Quark Express, and Word Office Suite Listings Contemporary Authors Professional Writing Organizations American Society of Journalists& Authors National Association of Science Writers Continuing Education Social Media University, Doral, FL Page - 4 I MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, veww.miamibeachfl.QOv CITY CLERK Office Clf 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: (/ 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,mustfile,:even-though you may have.been recently appointed. you must file One of-the-following withthe City Clerk of Miami Beach, 7700 Convention Center.Drive, Miami :Beach, Florida,.by July 1 each:year. 1. A"Source of.Income Statement' (attached) or 2. A"Financial Statement' (attached( od I A Copy of the person's.current Federal income Tax Return Failure to file, according to-the Miami-Dade .County Go.de Chapter 1, General Provision, Section 1I 5 may subject the person or firm to a fine 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 INC®ME STATEMENT Please Print or Type First Name Middle Name Initial Last Name Disclosure G l J For Tax Year Name: v1'%d Ending: 0 i� Mailing Address: �l �tJ o_. 41-4 -7 City/State/Zip: Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: ��rmY� r✓c�n�� Board where serving: Y� u�� eUC� <'f Term or Employment C' ' `� Began on: Department where employed: Work Address: If your home address is exempt from public records pursuant to Florida Statutes§119.07 please chedc here(read instructions): ® Work Telephone: Home Address: 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 Activity f Id 4- .,Le. I hereby swear(or affirm)that the aforesaid information is a true and correct statement. L �_ � 1 /a9Ii�:g Signature of person disclosing Date signed