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Stephen G. Hertz 12/31/2015 I\AIA/Ml 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 02-19-2014 Stephen Hertz 565 North Shore Drive Miami Beach, Florida 33141 SUBJECT; Visitor and Convention Authority Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2015. 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. 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 Grisette Roque 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, 2-458 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. MIAMI BEACH 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: Stephen Hertz RE: Visitor and Convention Authority 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: 12/31/2 015. 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 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. Stephen Hertz Sworn to and subscribed before me this day of ; r , 2014 "T F-66Z —Silvia Prieto Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfi.gov under City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. We are Wfnmitted to prgviding p�cellent public.$$ervice andga, to al�who live, work ald play in our vibrant,tro?ifal,historic community. e care con?mite to provic rng F>xc�c'n•'publ;c S @lb'li G'On SC7 c'!)%to a,W.?O�!Vb', WOfC,OnC pay u,C7L!i YIblClnt, iI'OpICO; lStO(fC comrnunny. Rl= A 1-- i \A 0'!R,..1 D ACOM?N-4—T PP I i i C-N' -;-,i F'`9 RACE TZ A6� Last Name First Name Middle Initial 476-W1qR,2&e Z�*P/7/ W Home Address city State Zip Code S-,P12 Home Telephone Work Telephone Cellular Telephone Email address 4 7-7-QRA.V--Z Business Name 066-u pation Business Address city State Zip Code Professional License(describe): -Id 7-70-AA)WY Expires: 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 ownershiplinterest 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 • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes or No I-D • Are you a registered voter in Miami Beach: YesW 0 or No ZI • I am now a resident of: North Beach South Beach L—J Middle Beach • I am appl ing for an appointment because I have special abilities, knowledge and experience. Please list below: • 12� Are you presently a registered lobbyist with the City of Miami Beach?Yes�or 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. ❑Affordable Housing Advisory Committee I ❑Fine Arts Board ❑Normandy Shores Local Government I Neighborhood Improvement ❑Art in Public Places Committee ❑Disability Access Committee ❑Parks and Recreation Facilities Board 1 ❑Beautification Committee n-Gay, I esbian, Bisexual and Transgender ❑Personnel Board —Enhancement Committee(GLBT) ❑Bicycle-Pedestrian Advisory Committee ❑Golf Advisory Committee ❑Planning Board ❑Board of Adjustment's * ❑Health Advisory Committee ❑Police Citizens Relations Committee ❑Budget Advisory Committee ❑Health Facilities Authority Board ❑Production industry Council ❑Capital Improvements Projects I ❑Hispanic Affairs Committee ❑Safety Committee Oversight Committee ❑Committee on the Homeless -0 Historic Preservation Board ❑Single Family Residential Review Panel ❑Committee for Quality Education in MB ❑Housing Authority ❑Sustainability Committee ❑Community Development Advisory ❑Loan Review Committee ❑Tennis Advisory Committee ❑Communi!y Relations Board Ll Marine Authority DJransportation and Parking Committee ❑Convention Center Advisory Bo ❑Miami Beach Commission for Women isitor and Convention Authority ❑Debarment Committee ❑Miami Beach Cultural Arts Council 0 Youth Center Advisory Board '0 0 1 V A V 1. 111U 1.Protection Committee ❑Design Review Board* Cl Miami Beach Human Rights Committee laterfront Prot ❑Miami Beach Sister Cities Program 31,)1JJ0 J 6 1 :C 114d 9 7.330 E I 9Z 'D?-3 G r Page 1 of 4 MIMI®DADE SOURCE OF INCOME STATEMENT e Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 1 od� H slephey) Mailing Address—Street Number,Street Name,or P.O.Box 91t 7Y 114- ADO i1.1� City,State,Zip ID Number 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.❑ Fi >I s an Employee ❑County Employ Municipal Employee, Name of Municipality: Position held or sought Department where employed Work address telephone Term began on Filing as a Board Member ❑ County Board Member Municipal Board Member, Name of Municipality: "7&.01 - Board where serving 1z G Work address Work telephone Term began on n the principal activity of each source. Include your public salary.Place List below ever source of income you received,along with the address and p p y Y Y 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 ( / 2 7 � io�J'•it F��,/�> � C �ilG��i G �1' v y off ,4/0':i I hereby swear(or affirm)that the Information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT. ❑ Hardcopy ❑ Electronic Copy Signature of p rson disclosing ,f �� 2 1.2Y lz,�& Print name D e sig d OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: 138 SP-14 2n3 IM MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov CITY CLERK Office CityClerkCmiamibeochfl.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. /7 I understand that no later than July L 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 each year. 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 fife, according to-the Mialni-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. 014 Signature: Date: • 0' 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 __._No Dates of Service: 2. Present participation in Youth Center activities by your children:Yes ID 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 If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code?Yes or Nolf yes, please explain in detail: •Do you currently owe the City of Miami Beach any money?Yes or Nolf yes,explain in detail: •Are you currently serving on any City Board or Committee?Ye or No If yes,which board/committee? • In what organization(s)in the City of Miami Beadh do you currently hold membership? 1��L✓1i Name y Position wit l/ -" _ - f 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 or No Which department and title? • Pursuant to City Code.Section 2-25 (b): Do you have a parent 1—:1, spouse IZI, child ED brother or sister who is employed by the City of Miami Beach?Check all that apply- If"Yes,"identify person(s)and department(s): /V 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 Female Race/Ethnic Categories What is Y our race? ,frican-American/Black aucasian/White ED Asian or Pacific Islander Native-American/American Indian Zk Other—Print Race: Page 2 of 4 City of Miami Beath 1700 Convention Center Drive, Miami Beach, Florida 33139, v w.w.mismibeachfl.gov CITY CLERK'S OFFICE CityClerk@miamibeachfl.gov Telephone: 305.673.7411 Fox- 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(1) (2) Board Member's Name: ��Y`e,� 62 J ,;�> 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://mvw.miari-Cidade.gov/elections/Librarv/*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: hftp://www.ethics.state.fl.usiethics/forms.htm1 3. A Copy of your 2012 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. Signature at F:\CLER\YAL L\aFORMS\BOARD AND COMMITTEES;BC Application revised 5-22-13 FINAL.doc Updated:Tuesday,September 24 201 3 Page 4 o'14 4_ y j ra � sir ,4v i� I y. '' r+ LAW OFFICES STEPHEN G. HERTZ 767 Arthur Godfrey Road Miami Beach, Florida 33140 GENERAL PRACTICE Telephone TRIAL PRACTICE-GENERAL Dade (305) 538-2344 TRIAL PRACTICE-PERSONAL INJURY AND WRONGFUL DEATH Fax (305) 538-0419 R E S U M E RESIDENCE. 565 NORTH SHORE DRIVE, MIAMI BEACH, FLORIDA 33141 OFFICE: 767 ARTHUR GODFREY ROAD, MIAMI BEACH, FLORIDA 33140 EDUCATION: ELEMENTARY SCHOOL - NORTH BEACH ELEMENTARY MIDDLE SCHOOL - NAUTILUS HIGH SCHOOL - MIAMI BEACH HIGH SCHOOL (1958) COLLEGE - UNIVERSITY OF FLORIDA (BS-1962) LAW SCHOOL - UNIVERSITY OF MIAMI (JD-1965) OCCUPATION: ATTORNEY- PRIVATE PRACTICE OF LAW SINCE 1965 MARITAL: MARRIED TO JACQUELINE S. HERTZ CHILDREN: SCOTT; HOWARD; AND BRADLEY PROFESSIONAL: FLORIDA BAR-MEMBER OF REAL PROPERTY, PROBATE & TRUST SECTION; TRIAL LAWYERS SECTION; ELDER LAW SECTION MIAMI BEACH BAR ASSOCIATION - PRESIDENT 2003 DIRECTOR SINCE 1995 to Present DADE COUNTY TRIAL LAWYERS ASSOCIATION PAST MEMBER ASSOCIATION OF TRIAL LAWYERS OF AMERICA PAST MEMBER FLORIDA STATE GUARDIANSHIP ASSOCIATION 1. Board of Directors 8/10 - Present 2 . Membership Chair 2003-2004 3. Convention Committee 4 . By-Laws Committee SOUTH FLORIDA GUARDIANSHIP ASSOCIATION - SECRETARY 2002 - Present CIVIC DUTIES: CITY OF MIAMI BEACH PLANNING BOARD (11/89-11/93) NORMANDY SHORES HOMEOWNER' S ASSOCIATION BOARD OF DIRECTORS (1992 - Present) Vice President 2006 to 2010 Treasurer 2010 to Present NORTH SHORE IMPROVEMENT DISTRICT ADVISORY BOARD (12/93 - 1998) . CITY OF MIAMI BEACH NUISANCE ABATEMENT BOARD (2/5/98 - 6/19/02) Co-Chairman MIAMI D SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 2012 HERTZ STEPHEN G. Mailing Address—Street Number,Street Name,or P.O.Box 565 NORTH SHORE DRIVE City,State,Zip ID Number MIAMI BEACH, FLORIDA 33141 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.F1 Filing as are 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 F1 County Board Member ✓Z Municipal Board Member,Name of Municipality: Board where serving BUDGET ADVISORY COMMITTEE Work address Work telephone Term began on MIAMI BEACH CITY HALL 01/01/2013 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.n Name of Source of Income Address Description of the Principal Business Activity ANGEL CARE MANAGEMENT, INC MIAMI BEACH, FLORIDA CARE MANAGEMENT STEPHEN G. HERTZ LAW OFFICE MIAMI BEACH, FLORIDA ATTORNEY AT LAW RENTAL PROPERTY VARIOUS-NONE ON MIAMI BEACH RENTAL PROPERTY , STOCKS & BONDS VARIOUS BROKERS INVESTMENTS BANK ACCOUNTS & MORTGAGES VARIOUS BANKS & LOANS SAVINGS & INTEREST EARNINGS I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ❑Hardcopy ❑Electronic Copy Signa a of person disclosing STEPHEN Go HERTZ G Print name D sig ndd OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138 SP-14 2/13