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PriscillaSchmidt 12/31/2014 City of Miami Beach, Convention Center Drive Miami Beach, Florida 33139' / opp|Cs OF THE cn,CLERK, Rafael Granada, City Clerk Tel: (385)6r3-74ll' Fax: (3O5}dr3'r254 OQ-28-2O13 Priscilla Schmidt 854O Byron Ave. #1C Miami Beeoh, Florida 33141 Sustainability Committee Congratulations! You have been appointed by Commissioner Jorge Expomito to the agency, board or committee named above for a term ending: 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 Cornnn/amion shall automatically expire on December 31 of the year the appointing elected official leaves office. |f you are unable to accept this appointment or have any questions, please call the City Clerk's Office at3O5-073-7411. Please read the enclosed materials carefully. Congratulations again and good luck. Sinmere|y, Rafael E. C3nanado City Clerk cc: Saul Frances, Parking Director Elizabeth Wheaton ATTACHMENTS: Letter ofAppointment Oath Cih/Code/Ordinonne section applicable to agenoy, board or committee City Code Section 2'22. 2'23. 2-24. 2'25' 2'20. 2-458 and 2-450 Ordinance No. 2O00'3543 '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 vve are committed to providing excellent public service and safety to all who live, work and play a our vibrant, tropical, historic community. MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miami6eachfi.gov OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk Tel: (305)673-7411, Fax: (305)673-7254 TO Priscilla C.Schmidt RE: Sustainability Committee t bear true faith loyalty and allegiance to the Government of the United do solemnly swear.or affirm o � Y Y 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- 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, l 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 serve Priscilla C. Schmidt Sworn to and subscribed before me this day of �Q , 20.13. Si via 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. i MAA I BEACH ►BOARD AND COi`PO T TEE APPLICATION FORM Last Name First Name Middle Initia �qn Avx- I L L O�IL41 Home Address �„ City State Zip Code Aq3 3nme I, C)47-3 --Pce�-r4 C LI 61 L U4 0 Home Telephone Work Telephone Cellular Telephone Emai a ddress rncrt 1. Y4e,/�-U , f E "Di c Business Name Occupation Business Address City State Zip Code Professional License(describe): Expires: Please attach a copy of currently effective professional license. Pursuant to City Code section 2-22(4)a & 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�or No Zil • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: YesTS or No El NA • Are you a registered voter in Miami Beach: Yes or No • I am now a resident of: North Beach South Beach EZI Middle Beach • I am applying for n appointment because I have special abilities knowledge and experience. Please list below: txr2 \. Q n i �Q 2 c� rvi I Q -x Ea z • Are you presently a registered lobbyist with the City of Miami Beach?Yes or 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. ❑Affordable Housing Advisory Committee ❑ Fine Arts Board ❑Normandy Shores Local Government Neighborhood Improvement ❑Art in Public Places Committee ❑Disability Access Committee ❑ Parks and Recreation Facilities Board ❑Beautification Committee ❑Gay, Lesbian, Bisexual and Transgender ❑ Personnel Board Enhancement Committee GLB ❑Bicycle-Pedestrian Advisory Committee ❑Golf Advisory Committee ❑ Planning Board ❑ Board of Adjustment* * ❑Health Advisory Committee ❑ Police Citizens Relations Committee ❑ Budget Advisory Committee ❑ Health Facilities Authority Board ❑ Production Industry Council ❑Capital Improvements Projects ❑ Hispanic Affairs Committee ❑Safety.Committee Oversight Committee ❑Committee on the Homeless ❑ Historic Preservation Board ❑Single Family Residential Review Panel ❑Committee for Quality Education in MB ❑ Housing Authority Sustainability Committee ❑Community Development Advisory ❑ Loan Review Committee ❑Tennis Advisory Committee ❑Community Relations Board ❑Marine Authority ❑Transportation and Parking Committee ❑Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Visitor and Convention Authority ❑ Debarment Committee ❑Miami Beach Cultural Arts Council ❑Youth Center Advisory Board o0 ❑ Design Review Board* ❑Miami Beach Human Rights Committee ❑Waterfront Protection Committee ❑Miami Beach Sister Cities Program Page 1 of 4 °O Note: If applying for Youth Center Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board:Yes U No L=jJ Dates of Service: 2. Present participation in Youth Center activities by your children:Yes E�J No U If yes, please list below the names of your children,their ages and the programs in which they participate: Child's name: Age: Program: Child's name: Age: Program: • Have you ever been convicted of a felony?Yes j or No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code?Yes U or Nlj�If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money?Yes or No If yes,explain in detail: •Are you currently serving on any City Board or Committee?Yes or No If yes,which board/committee? • In what organization(s) in the City of Miami Beach do you currently hold membership? Name Position Name Position • List all properties owned or in which you have an interest within the City of Miami Beach: •Are you now employed by the City of Miami Beach?Yes[Z)or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent Z, spouse , child 0' brother Ea or sister U who is employed by the City of Miami Beach?Check all that apply. If"Yes," identify person(s)and department(s): �d 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 City diversity reporting requirements. Gender: Male Female Race/Ethnic Categories What is your race? ED African-American/Black ED CaucasianANhite LD Asian or Pacific Islander I ZI Native-American/America Indian RqL C Other—Print Race: Q tM I Page 2 of 4 Do you consider yourself to be Spanish, Hispanic or Latino/a?Mark the "No"box if not Spanish, Hispanic, Latino/a. No Yes Do you consider yourself Physically Disabled? No Yes 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: • 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 the 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). • Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most meetings of boards,commissions and other governing bodies of state and local governmental agencies or authorities. • Voting conflict—Form 8B is for use by any person serving at the county, city or other local level of government on an appointed or elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. 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 MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATUTES ACCORDINGLY." Applicant's Signature Date Name of Applicant(PLEASE MINT) Received in the City Clerk's Office by �; 217P Name of Deputy Clerk Control No. bate PLEASE REMEMBER TO ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3 of 4 Priscilla Carolyn Schmidt, LMT, CPD 8540 Byron Ave#1 C Phone: (786) 301-2473 Miami Beach, FL 33141 Email:pcarolynschmidt @gmail.com Objective: To continue to grow and expand with Fertile Earth Foundation and lead it with the intention of integrating and implementing ideas of sustainability education and practice. Education: • CLEO Institute Empowering Capable Climate Communicators Training Series,Feb 2013 • Permaculture Design Course taught by Marcus Thomson: Miami,FL, Sept 2010—Dec 2010 • Massage Therapy Degree: Hollywood Institute of Beauty Careers; North Bay Village, FL September 8,2008—May 27,2009 • Associates Degree;Miami-Dade College,2008 Skills: • Excellent communication and writing skills. Published blogger on Huffington Post Green • Passionately practices and teaches others sustainable lifestyle habits such as composting, gardening,holistic medicine,and making natural beauty and cleaning products. • Licensed massage therapist actively practicing for over 4 years • Fluent in English,Portuguese,and Spanish • Enjoys professional and cooperative atmosphere • Great organizational skills Employment History: • Executive Director:Fertile Earth Foundation May 2013—Present Aided in administrative transitions such as streamlining FEF's digital information, relocating the farm and its contents, and expanding Fertile Earth Worm farm through partnership with Tree Huggers farm. Has partnered with One Love Nutrifest to create Miami's first Zero Waste music festival.-Organizes monthly meetings, newsletter, and workshops. Was guest teacher in Common Threads summer camp biology class teaching students about vermiculture. Has partnered with Dade Recycling to collect eWaste. Was the Host of UnderGROL ND Miami 2013,FEF's annual fundraiser. • Director of Development/Miss August/Volunteer:Fertile Earth Foundation March 2012—April 2013 Assisted in coordination and sourcing of silent auction items for annual fundraiser 2012 & 2013. Assisted in event planning and coordination of both fundraisers and Ladies of Manure calendar. Modeled in and edited writing for Ladies of Manure calendar. Interviewed for Herald, channel 7 & channel 10 for calendar promotion. Operated FEF booth at Fairchild's Ramble in 2012 and Pinecrest Farmer's market. Actively involved in ideas for growth and development. • Massage Therapist:Lapis Spa at the Fontainebleau March 201.1 —Present Provide therapeutic and relaxing massage for guests based on their individual requests and needs. Received training trainings in several Fontainbleau signature massages and body treatments. _ • Massage Therapist:-Kizmet Health &Healing, LLC September 2010—November 2011 Freelanced with private clients, and on film and commercial sets providing table and chair massages respectively. On sets, provided massages to talent, extras and crew, including a Nike commercial featuring NBA players such as Chris Bosh and Amare Stoudemire. References: Lanette Sobel: (786)253-2222,Judy Veraga(305)924-6038 Deanne Ziadie: (352)537-4445, Sherrie Varpula: (786)426-8589 Phil Conklin: (786)217-3973,Marcus Thomson(954)856-3775 I 1 I I MIAMI B City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139, www.miamibeachfl.aov CITY CLERK Office CityClerk @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 2-11.1(i) (2) Board Member name: n sC 61 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. Signature: ate: MI®°iADE SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name. --first Name Middle Name/Initial &Ok� T C Mailing Address—Street Number,Street Name,-or P.O.Box Ej�z-q b non A w-, - 1 (:!--, City,State,Zip ID Number 2k_"_ If your home address is your mailin address,and your home address is exempt from public records pursuant to Fla.Stat.§119.07,read instructions on the following page and check here.F-1 Filing as an Employee ❑County Employee []Municipal Employee, Name of Municipality: Position held or sought Department where employed Work address Work telephone Term began on Filing as a Board Member ❑ County Board Member (Municipal Board Member, Name of Municipality: '" f° Board where serving -1 Work address ; Work telephone Term beg a. on Ild -71 4.3 N. D4 List below every source of income you received,along with the address and the principal activity of each source.Include your public salary.Place the sources of income in descending order,with the largest source first.Also, include any source of income received by another person for your benefit. However,the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet,check here.❑ Name of Source of Income Address ,�/� Description of the Principal Business Activity Laots .J i �� ( 0�U ' �s:.� SL �' �- 5 1 Sfi --A gI101 �t c e l --bOe- )-t&- I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy Signature of person disclosing Print name Date igned OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138 SP-14 2/13