Stephan L. Ginez {
MCITY IAMIBEAC�I OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
NAME:
Last Name/2-2/ First lame Middle Initial
HOME ADDRESS: �l C&% 6 i01''✓ ��6�0( �l �'c1i 4�R- 33/39
Apt No. House No./Street City o State Zip Code g�
PHONE: 30E- 0 �G-11YEL 9 �GY Q I L � dh
Home Work � Fax, Email address
Business Name: Position. W A/ce,
r.
Address: Q ./
No. Street 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.
• Resident of Miami Beach for a minimum-af six(6)months:Ye or No ❑
•Demonstrate an ownership/interest in a'business in Mia 'B nimum of six(6)months.Yeskor No El
•Are you a registered voter in Miami Beach:Yes ❑or No
•(Please circle one): I am now a resident of: North Beach South Bea c Middle Beach
• I am applying for an appointment because I have special abilities, kn d experience. Please list below.
•Are you presently a registered lobbyist with the City of Miami Beach?Yes❑or NOX
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 ❑Marine Authority
❑Art in Public Places Committee ❑Miami Beach Commission for Women
❑Beautification Committee ❑Miami Beach Cultural Arts Council
❑Board of Adjustment* ❑Miami Beach Human Rights Committee
❑Budget Advisory Committee ❑Miami Beach Sister Cities Program
❑Capital Improvements Projects Oversight Committee ❑Normandy Shores Local Government Neigh. Improvement
❑Committee on the Homeless ❑Parks and Recreation Facilities Board
❑Committee for Quality Education in MB ❑Personnel Board
❑Community Development Advisory ❑Planning Board*
❑Community Relations Board ❑Police Citizens Relations Committee
❑Convention Center Advisory Board ❑Production Industry Council
❑Debarment Committee ❑Public Safety Advisory Committee
❑Design Review Board* ❑Safety Committee
❑Disability Access Committee ❑Single Family Residential Review Panel
❑Fine Arts Board ❑Sustainabili Committee
Ga , Lesbian, Bisexual and Trans ender GLBT ❑Transportation and Parking Committee
❑Golf Advisory Committee ❑Visitor and Convention Authority
❑Health Advisory Committee, ❑Waterfront Protection Committee
❑Health Facilities Authority Board ❑Youth Center Advisory Board
❑Hispanic Affairs Committee
❑Historic Preservation Board
❑Housing Authority
❑Loan Review Committee *Board Required to File State Disclosure.Form
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❑No❑ Years of Service:
2. Present participation in Youth Center activities by your children Yes❑ 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:
F:\CLER\$ALL\a FORMS\BOARD AND COMMITTEES\BC Application.doc ,�
•Have you ever been convicted of a felony: Yes❑or Nk N _ If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach codes:Yes❑or No❑. 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
.t
•Are you currently serving on any City Boards or Committees: Yes❑or N . 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:
® ��lIly -cm /Iiciq 1 67)0 P,/ Focors 4116--
• I am now employed by the City of Miami Beach: Yes❑or'7 Y Which department?
• Pursuant to City Code Section 2-25(b): Do you have a parent ❑, spouse❑, child❑, brother❑,or sister❑who is employed by the
City of Miami Beach?Check all that apply. Identify the department(s):,— ff
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 ❑Female
Ethnic Origin: Check one only(1)
�N hite (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,on
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 through tribal affiliation or community recognition.
Physically Challenged: Yes❑or N
Employment Status: Employe�< Retired❑ Homemaker❑ Other❑
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 City 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.
"1 hereby e o the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article a City Code"Standards of Conduct for City Officers,Employees and Agency Mem "
2 IVE
21t- 94
Appl'&R gn ure Date Name of plicant(PLEASE PRINT)
Please attach copy of your resume to this application
NOTE:Applications will remain on file or period of one(1)calendar year.
Received in the City Clerk's Office by: 0A1,kA10W a :_/ /2010 Control No.3 Z7 Date:_/_/2010
Name of Deputy Clerk
MIAMI BEACH
City of Miami Beach,
1 700 Convention Center Drive,
Miami Beach,Florida 33139,
www.miamibeachfl.gov
CITY CLERK Office Cityclerk @miamibeachfLgov
Tel:305.673.7411 , 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(1) (2)
Board Member name: �' ;
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,
Florida,Miami Beach, o da, by July 1 each y ear.
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 riod not to exceed sixty days, or both.
Signature: Date:
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i
Stephan Ginez
1821 Michigan Avenue
Miami Beach, Fl 33139
Tel: 305 308 5770 Fax: 866 658 4019
Email: SGinez @Gmail.com
Experience:
Stef USA inc,President
Hotel Management
Howard Johnson Clearwater Beach
Quality Inn Clearwater Beach
Rodeway Inn Treasure Island,
Ramada Inn Clearwater Beach
Commercial Property management
Rental apt Complex Treasure Island Florida
Commercial Property Clearwater Beach
Residential real estate investments,
Miami Beach, Miami Shores, Miami and Hollywood
Conversion building at 1409 Lincoln Rd, Miami Beach into Gay
Boutique Motel. Purchased in 2009 and scheduled to opened end of 2013
Education:
CUED (University Center for Political Studies),Nancy,France
1984-1985
ESIAE(Business,School),Paris, France
1985-1988
Additional Experience:
Real Estate License State of Florida(active)
Solimar Real Estate—Miami Shores
Resident of Miami beach since 199 7