Paul Stein 12/31/2014 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: (305)673-7411, Fax: (305)673-7254
01-21-2014
Paul Stein
510 W 50th St
Miami Beach, Florida 33140
W. 1
Parks and Recreational Facilities Board
Congratulations! You have been appointed by Mayor Philip Levine
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 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,
Rafael E. Granado
City Clerk
cc: Saul Frances, Parking Director
John Rebar
ATTACHMENTS:
Letter of Appointment
Oath
City Code/Ordinance section applicab!e 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.
MIAMIBEACF-
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfI.gov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305) 673-7254
TO Paul Stein
RE: Parks and Recreatinal Facilities Board
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 fi isclosure* requirements of
Miami-Dade County or ithe State of Florida (depending o boar or com ittee on which I serve) on
July 1, following the closing of the calendar h I serve
Paul Stein
Sworn to and subscribed before me thisdY day of //y�1 , 2014.
Maria E. Martinez
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfi.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.
MIAMIB Rui BOARD AND COMMITTEE APPLICATION FORM
Sic,I () 11
Last Name First Name iddle Initial
f E I
Home Address City State Zip Code
Home Telephone Telephone Work Telephone Cellular Telephone Email address
1 P Ginn CC)( VyW n ,., �
Business Name Occupation
Business Address fir r City State Zip Code
Professional License (describe): ?A I h �'f � 1 ` (I�fW AM 14 Z Expires: I t b C)
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 U
• Demonstrates ownership/interest in a business in iami Beach for a minimum of six months:Yes or No
Are you a registered voter in Miami Beach: Yes 10 or No
. I am now a resident of: North Beach El South Beach LJ 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 U or No
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that
onlv three 3 choices will be observed bv the City Clerk's Office.
❑Ad Hoc Charter Review and Revision Board ❑Debarment Committee ❑Miami Beach Human Rights Committee
❑Ad Hoc Committee Centennial Celebration ❑Design Review Board* ❑Miami Beach Sister Cities Program
❑Ad Hoc Committee Flooding Task Force ❑Disability Access Committee ❑Normandy Shores Local Government
Neighborhood Improvement
❑Affordable Housing Advisory Committee ❑Fine Arts Board Parks and Recreation Facilities Board
❑Art in Public Places Committee ❑Gay,Lesbian,Bisexual and Transgender ❑Personnel Board
Enhancement Committee(GLBT)
❑Beautification Committee ❑Golf Advisory Committee ❑Planning Board
❑Bicycle-Pedestrian Adviso Committee ❑Health Advisory Committee ❑Police Citizens Relations Committee
❑Board of Adjustment* ❑Health Facilities Authority Board ❑Production Industry Council
❑Budget Advisory Committee ❑Hispanic Affairs Committee ❑Safety Committee
❑Capital Improvements Projects Oversight ❑Historic Preservation Board ❑Single Family Residential Review Panel
Committee
❑Committee on the Homeless ❑Housing Authority ❑Sustainability Committee
❑Committee for Quality Education in MB ❑Loan Review Committee ❑Tennis Advisory Committee
❑Community Development Advisory Committee ❑Marine Authority ❑Transportation and Parking Committee
❑Community Relations Board ❑Miami Beach Commission for Women ❑Visitor and Convention Authority
❑Convention Center Advisory Board ❑Miami Beach Cultural Arts Council ❑Youth Center Advisory Board
❑Waterfront Protection Committee
* Board members are required to file Form 1 —"Statement of Financial Interest"with the State.
If you seek appointment to a professional seat (e.g., lawyer, architect, etc.)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 License Expiration Date
Page 1 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEESOC APPLICATION 46 BOARDS 12-16-2013.doc
I-'-' 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 IJ No L.J Dates of Service:
2. Present participation in Youth Center activities by your children:Yes U No
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 or No U If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach Code?Yes Lj or N If yes,please explain in detail:
• Do you currently owe the City of Miami Beach any money?Yes or No Ui `f yes,explain in detail:
•Are you currently serving on any City Board or Committee?Yes LD 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 ED or No
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have a parent , spouse U, child brother or sister who is
employed by the City of Miami Beach? Check all that apply.
If"Yes,"identify person(s)and 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 City diversity reporting requirements.
Gender: Male LJ Female
Race/Ethnic Categories
What is your race?
African-American/Black
ID Caucasian/White
1: Asian or Pacific Islander
�Native-American/American Indian
Q Other—Print Race:
Page 2 of 4
F:\CLER\$A LL\a FOR MS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc
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?
El No
CJ 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).
o Prohibition from contracting with the City(Miami-Dade County Code section 2-11.1).
o 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).
o Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
o 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).
o 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, EMPLOY S AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATU ACC INGL .
U S�l 11
Ap cant's Signature Date N e of Appli nt(PLEASE PRINT)
Received in the City Clerk's Office by //Z
Name of Deputy Clerk Control No. Date
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
F\CLER\$ALL\aFORMS\BOARD AND COMMITTEESOC APPLICATION 46 BOARDS 12-16-2013.doc
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamlbeachfl.gov
CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
Board Member's Name: O
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
Financial 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 they may have been recently appointed.
One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, no later than 12:00 noon of July 1, of each year.
1. A"Source of Income Statement"
For your convenience, the form is attached. The form can also be downloaded at:
http://www.miamidade.gov/elections/Library/source of income statement.pdf
2. A"Statement of Financial Interests (Form 1)"
For your convenience, the form is attached. The form can also be downloaded at-
http://www.ethics.state.fl.us/ethics/forms.htm1
3. A Copy of your 2013 Federal Income Tax Return
Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, 60 days in jail or both.
/ q
Signature Date
Updated: Monday,December 16,2013
Page 4 of 4
F\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc
I
MI MAJX
®
• SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name Initial Last Name
Disclosure
For Tax Year
Name: P"i 1 S Pi Ending:
Mailing Address: -�f 0
City/State/Zip: `' 1 ?ILI o
Social Security Number: — -7
Filing as a: 0 County Employee:
® Municipal Employee of:
Position held or sought:
Board where servin Term or Em to ment
g' Per-110 � ��,Li l�fi'� OSIC'� P Y
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: _.!�ryyt C41 08CAl ,
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:
N�Ilalw�� llr :� t>tc:otne ..,
Pibnn-inj ra U .SOUK. f3- Ql w)s�, I'An X tAcyna IRZ V
31Q/
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
Signa re of person disc Date signed