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Barbara Hershkowitz 12/31/2014 City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granado, City Clerk Tel: (305) 673-7411, Fax: (305)673-7254 Email CityClerk @miamibeach.gov 12/13/2012 Barbara Hershkowitz 4345 Jefferson Ave. Miami Beach, Florida 33140 SUBJECT: Waterfront Protection Committee Congratulations! You have been reappointed by Commissioner Jerry Libbin to the above referenced agency, board or committee for a term ending: 1213112014. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-7411. Please read the enclosed material carefully. Again, congratulations and good luck. Sincerely, Rafael E. Grariado City Clerk cc: Saul Frances, Parking Director Elizabeth Wheaton 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, 2-2458, 2-459 Ordinance 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 Employees 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 Granado,City Clerk Tel: (305)673-7411, Fax: (305)673-7254 Email CityClerk @miamibeach.gov TO Barbara Hershkowitz RE: Waterfront Protection 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. I 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- me nt and Code o f Ethi cs for Public Officers and Employees, and understand that as a member of a City Y 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. Wp�m I U14�ax Barbara Hershko/�witz Sworn to and subscribed before me this Prday of Q , 2012. � D 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. / CITY OF MIAMI BEACH BOARD AND COMMITTEE,APPLICATION FORM Last Name `,S First Nam� Middnjtl4 Home Addr ss. �-f C' tate Zip Codei/a,",-Pacv Home Telephone Work Telephone Cellular Telephone Em it address Position: Business Name I , Business Address City State Zip. de 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 affi ted Jh the ity; this requirement shall be fulfilled in the following ways: a. An individual shall have been a resident of the city for mi m 0 six months; or b. An individual shall demonstrate ownership/interest for a minimum of six months in a business esta sh the city for a minimum of six months. • Resident of Miami Beach for a minimum of six(6) months: Yes or No • Demonstrate an ownership/interest in a business in iami each for a minimum of six months: Yes or No • Are ou registered voter in Miami Beach: Yes or No Y g • I am now a resident of: North Beach� South Beach Middle Beach UT • I am applying for an appointment because Ihave CF special abilities knowledge and a erience. 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 only three 3 choices will be observed by the City Clerk's Office. (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 Authorit Board ❑ Police Citizens Relations Committee ❑Capital Improvements Projects ❑ Hispanic Affairs Committee ❑ Production Industry Council Oversight Committee ❑Committee on the Homeless ❑ Historic Preservation Board ❑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 ennis 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 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.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 of Service: ttvi� 2. Present participation in Youth Center activities by your children Yes No 4�. 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 ID or No If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach codes:Yes D or No If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money:Yes or No yes,explain in detail •Are you currently serving on MA i Bo ds or Committee Yes cr No . If yes;which board? r � -P,/�c7-7 •What organizations in the City of Miami Beach do you currently hold membership in? Name Title Name Title • List all properties owned o gvet inter J�n� th arre�locatgd Within the City of Miami Beach: • I am now employed by the City of Miami Beach:Yes�-=a or No Which department? • Pursuant to City Code Section 2-25(b): Do you have a parent , spouse child I.J brother or sister 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 on l 1 fiend �: Male Female 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. American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America,and who maintain Cultural identification throu h tribal affiliaY or community recognition. Physically Challenged: Yes or No Employment Status: Employed IZI Retired 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. F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc it BARBARA S. HERSKOWITZ 4345 Jefferson Avenue Miami Beach,FL 33140 305-788-8989 yalemiami(agaol.com PROFESSIONAL EXPERIENCE ACCOUNTING AND BUSINESS MANAGEMENT • Prepared monthly consolidation reports and entries • Generated 10k and annual reports • Projected forecasts for the cruise line and subsidiaries • Compiled annual budget for the entire company • Developed and wrote the General Ledger manual • Programmed the computer system • Trained company employees on the computer application • Ten years experience in all phases of accounting PROFESSIONAL PROFILE • Excellent written,oral,and interpersonal communication skills • Problem solver/team player with proven leadership qualities • Able to lead a team or work independently • Proficient in Microsoft Word • Create budget and work within paramenters of budget MANAGEMENT AND ADMINISTRATION • Manage and supervise volunteers • Deal with vendors • Handle public relations for events ORGANIZATION SKILLS AND COMMUNICATION SKILLS • Write all event invitations and literature • Identify appropriate location for events • Plan fundraising events for 500 plus attendees M I A M I•DADE SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name/Initial Last Name Disclosure For Tax Year Name: 1b-::-1-tz6AA-oWL-rz E nding: 2 Z Mailing Address: S � ��8 0 A-- City/State/Zip: '� �- 9 Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: Board where serving: wftf�--1-6to,f-I P a Term or Employment Began on: Department where employed: Work Address: If your home address is exempt from public records pursuant to Florida Statutes§119.07 please check 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 I hereby swear(or affirm)that the aforesaid information is a true and correct statement. W (4 -1 Signature of person disclo 'n Date signed - MIAMI BEACH city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www miam16eochfl.gov CITY CLERK Office CityClerkCmiamibeachfl.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--11.1("r) (2) Board Member name: I understand that no .later than July L 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-ftle,even-though you may have..been recently appointed. YOB must file One of-the-following with the City Clerk 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 lax"Return Failure to fife, according:to-the Miami-Dade:County Code Chapter 1, General Provision, Section 'I-5 may subject the.person or firm to a fine not-to exceed $500.00 or by imprisonment'in the county.jail for r-a period nc t to exceed sixty days, or.both. Date: .Signature: