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Mercedes Carlson 12/31/2015 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamlbeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granado, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 12/13/2013 Mercedes Carlson 5120 Lakeview Drive Miami Beach, Florida 33140 SUBJECT: Miami Beach Commission For Women Congratulations! You have been reappointed by Commissioner Michael Grieco to the above referenced agency, board or committee for a term ending: 12/3112015. 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. Sincere" , I - Rafael E. Granado City Clerk cc: Saul Frances, Parking Director Vacant 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 al(who live, work and play in our vibrant, tropical, historic community. ' • .- MIAMI BEAA� C ITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: Carlson Mercedes Last Name First Name Middle Initial HOME ADDRESS: 5120 Lakeview Drive Miami Beach FL 33140 Apt No. Home No./Street City State Zip Code PHONE: 7862003536 mercedescarlson @mac.com Home Work Fax Email Address Business Name: n/a Position: n/a Address: n/a Miami Beach FL n/a Street City State Zip Code 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: No •Are you a registered voter in Miami Beach: Yes •(Please circle one): I am now a resident of: 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? 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) Choice 1: Miami Beach Commission for Women Choice 2: Choice 3: 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: •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: Yes If yes,which board? Chairperson of Miami Beach Commission for Women •What organizations in the City of Miami Beach do you currently hold membership in? • 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: No Which department? The following information Is voluntary and Is nett art of your application nor has any bearing on your ideration for appointment. It Is being asked to comply with federal equal opportuw porting requirements. Gender: Female Race/Ethnic Categories What is your race?Mark one or more races to indicate what you consider yourself to be. White Other Description: Are you Spanish/Hispanic/Latino?Mark the "No" box if not Spanish/Hispanic/Latino. Yes Physically Challenged: No 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 Officers,Employees and Agency Members." I Mercedes Carlson agreed to the following terms on 12/4/2013 11:28:58 PM Received in the City Clerk's Office by: ::018 N Name of Deputy Clerk Control No. Date , J_j Mercedes Carlson T:305-864-1646 M:786-200-3536 5120 Lakeview Drive mercedescarlson0mac.com Miami Beach, FL 33140 [Website] Professional ProfileSuccessful Executive professional with 20 years of experience within the Technical and Customer Service disciplines. My career encompassed the matriculation through various organizations from a Telephone Administrator to a District Sales Manager for the South Florida and Caribbean Region.As a Marketing Communications Specialist/principally researched planned and managed meeting requirements for the Marketing and Sales Organizations of the Latom Division. l was the Owner and President for a Meeting Consultants company. Currently 1 am a private investor who seeks out and analyses business opportunities where my expertise is utilized in making a small to medium business prosper in these challenging times. Fully literate in Spanish, English, and Portuguese with some knowledge of French-These attributes help me understand the different cultures that encompass our City. Work History arig Airlines,Miami,Florida—South Florida and Caribbean Regions District Sales Manager—1974—1997 Telephone Operator/Secretary Managed calls for the entire office while ensuring all travel was necessary and cost effective. Managed all scheduling for the Executives of the office District Sales Manager Ensured all staff was alert in managing the critical issues for their customers. Managed the career development for the staff. Coached and counseled all my District staff to ensure they were aware of their customers'business issues and how they could help resolve them. Ericsson,Inc., Miami,Florida—Latin American Region Marketing Communications Manager—1997-1998 Managed varied aspects of the operational issues for the Marketing and Sales Departments. Principally researched,planned and managed the meeting requirements for the Organizations of the Latam Division which included the offices within Latin America. Single contributor who managed all aspects of the position from inception through implementation. Meetings Consultants,Miami,Florida Owner and President—1998—2000 Managed all facets of the business to ensure it remained on track and met the needs and requirements of my customers. Ensured any scheduled meeting was effectively implemented within the stated budgetary requirements. Education Barry University-Miami Shores,Florida Master of Science-Major in Human Resource Development I References Available upon request MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139, www.m is m i beachfl.cov 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: M C E b E S G A Q O A[ 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. l g Sig n a ure: Date: