Jordan S. Nadel 12/31/2014 CITY OF MIAMI =A�-
AAIA�Al BEACH AD AND COMMITTEE APPLICATION ORM
NAME: Nadel Jordan S
Last Name First Name Middle Initial
HOME ADDRESS: 1665 Bay Rd.,Apt.225 Miami Beach FL 33139
Apt No. Home No./Street City State Zip Code
PHONE: 954-290-1109 305-547-0100 jnadel4@gmail.com
Home Work Fax Email Address
Business Name: Miami-Dade State Attorney's Office Position: Assistant State Attorney
Address: 1350 NW 12th Ave. Miami,FL FL 33136
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: South Beach
• I am applying for an appointment because I have special abilities,knowledge and experience. Please list below:
Assistant State Attorney with Miami-Dade State Attorney's Office
•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: Police Citizens Relations Committee
Choice 2: Community Relations Board
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: No If yes,which board?
•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 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
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. No
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 ith the city Miami-Dade County Code section 2-11.1 .
9 Y( tY )
• 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 Jordan Nadel agreed to the following terms on 1/6/201411:5Q16 PM
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No. ate
i
e
Prieto, Silvia
From: DoNotReply
Sent: Monday, January 06, 2014 6:55 PM
To: B &C Applications
Subject: A New Board &Committee Application has been submitted
Attachments: 155-resume01062014065425PM1.doc
http://reports/reportserver/Pages/ReportViewer.aspx?%2fCity+Clerk%2fBoard+and+Committees%2fApplicant
+Information&rs%3 aCommand=Render&ApplicantlnfolD=15 5
1
MIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfi.gov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Jordan S. Nadel
RE: Police Citizens Relations 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.
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 Florida Commission on Ethics Guide to the
Sunshine Amendment and Code of Ethics for Public Officers and understand that as a member of
a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure*
requirements of Miami-Dade County or the State of Florida (depending on the board or
committee on which I serve) on July 1 st, following the closing of the calendar year on which I
have served.
i`
Jo!Pan S. Nadel
Sworn to and subscribed before me this day of , 2014
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Deputy Clerk
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*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
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City of Miami Beach,
1700 Convention Center Drive,
Miani Beach,Florida 33139,
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CIiY CLERK Orrice CiyC '@mi be
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Tel:305.673.741 i ,Fax: 305.673.725
Acknowledgement of fines/suspension for Board Members for failure
to comply with Miami-Dade County Financial Disclosure Code Provision
Code Section 2-1 1 .1(i) (2)
Board Member name: 3 M Ok
understand that no later than JULY 1 OF EACH YEAR all members of Boards and
CommiiLees 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 thatt he
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 follo,,ving viith the City Clerk of Miami Beach, 1700
Convention Center Drive. Miami Beach; Florida, by July 1, 2010.
1. A'*Source of Income Statement(ai_tached) or
2. A;F inancial Statement(a—LL_a c h ed( orl
3. A Copy of the person's current Federal Income Tax Retum
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
5500.00 or by imprisonment in the county jail for a period not to exceed sixty
days, or both.
Sian re: Date:
MI®°iADE SOURCE OF INCOME STATEMENT
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
Nac,e�
Mailing Address—Street Number,Street Name,or P.O.Box
City,State,ZIP ID Number
KUM; I ea.c\',
If your home address Is your mailing 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.❑
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 f r'
i
❑ County Board Member unicipal Board Member,Name of Municipality: 'GM" BenGy
Board where serving
ce- C' &)CAt-d
Work address Work telephone Term began on
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
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I hereby swear(or affirm)that the information above Is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑Hardcopy
❑Electronic Copy
S ature of person disclosing
J�'fC(Ckr< Nac�e,�
I
Print name Date signed
OFFICE USE ONLY Accepted: Y/N Deficiency: Processed Date/initials: Scanned Date/initials:
138_SP-14 2/13