Dorian Nicholson 12/31/2014 VdAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.Qov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
1/29/2014
Dorian Nicholson
6855 Abbott Ave. #701
Miami Beach, Florida 33141
SUBJECT: Community Development Advisory Committee
Congratulations! You have been reappointed by Commissioner Deede Weithorn
to the above referenced agency, board or committee for a term ending: 12/31/2014.
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.
SinNE.
Ra nado
City Clerk -
cc: Saul Frances, Parking Director
Alex Ballina
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 all who live, work and play in our vibrant, tropical,historic community.
MIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Dorian Nicholson
RE: Community Development Advisory Committee
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.
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 Amendment and Code of Ethics for Public Officers andunderstand 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
have served.
Dorian Nicholson
Sworn to and subscribed before me this day of �f1 2014
Fb�_—Silvia Prieto
Deputy Clerk
*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.
We are mmitted to providing excellent Qubli�service,and sa ety,to�11 wh?live, w�Ork a�c��la�in oar vit�rfnt_trr�ple,l,.historic community.
L are corrmrtte o providing_exce: e n1 pu,hc sere rcc and so ely io cr who w e, war,anc p ��r,our yr ran, ro rca, rr.,.onc communrry.
MI®°ADE SOURCE OF INCOME STATEMENT
e
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
go /3 e/ coo/ -<�io
Mailing Address—Street Number,Street Name,or P.O.Box
'�53_ L/ q�41-
City,State,Zip ID Number
3S)yv
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 h1ember
❑ County Board Member Municipal Board Member, Name of Municipality:
Board where serving
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 I Address Description of the Principal Business Activity
l�F -6,49
Z 3Z C��LL�it/
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
)nature of person disclosing
AO
Print name Date signed
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Dat2/Initials:
138 SP-14 2/13
MIAMI BEA
CH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: G ez5.16) BOARD/COMMITTEE:
Appointed b :� /5���/v
PP Y DATE Or APPOINTMENT. 1
Sca o o Letter of Appointment
etter of Reappointment
oCopy of Letter of Appointment forlvarded to Committee Liaison on
Scan 0 0.Board and Committee Application (Completed)
Scan Ao ��ath
Resume/Curriculum Vitae, if available
iversity Statistics Reporting form (Concluded)
Scan
o City Code Ordinance Section applicable to the agencv, board or committee
o City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
a Ordinance 2006-35^-.3-Amendment to City Code Section 2-22
o County Code Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance
.Memorandum- Solicitation by City Board and Committee Members
�ity-VVide Permit Application (Parking Deparment Form)
o Bookie:-Guide to Sunshine Amendment & Cod;; of Ethics for Public O ricers &employees
Financial Disclosure St;cement
Sca` ckn0\N1 ,dgment of Financial Disclosure Ra quirem-'. i
r
Rece=ived on: / Signed by X
DatJ7- - Boar Commi-�ee er
Processed on : By Emplovee:
In City lerk's ?' e Staii Initials
� 2014
Scanned on : By Employee:
Date Clerk's Crice Star, Initials
CONCLUDED & RESIGNA T ION LETTERS
i Term Expired Letter Date Processed I
i Initials Scan o
Resignation Letter Date Processed I Initials Scan 0
C
Removal Letter due to absences Date processed
Initials Scan o
Scan 0 0 For,varded to Board/Committe,; Liaison on by
Date City Clerk's Office
F:ICL ERISALLISIL VIAtSoard & Committees Let ters'0&C Checkhst.doc