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Amy Rabin 05/31/2014 M.IAMI.BEACH :City of Miami Beach,1700 Convention Center Drive,Mlaml Beach,Florida 33139,www.mlamibeachfl.00v OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk Tel:(305)673-7411,Fax:(305)673-7254 01-22-2014 Amy Rabin 331 West-28th St Miami Beach, Florida 33140 Community Relations Board Congratulations! You have been appointed by Commissioner Joy Malakoff J to the agency, board-or committee named above for a term ending: 1V317 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, Ra V E.-Granado City Clerk cc: Saul Frances, Parking Director Lynn Bernstein 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. 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: Amy Rabin RE: Community Relations Board 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: 12/31/2 014. 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 EthicsforPublic Ofcers 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 calend year on which I have served. Amy Rabin Sworn to and subscribed before me this&day of , 2014 '0 1111111101/, ° cn Deputy Clerk o: #DD 983701 :Q .y .a 0/- eonded `oG QQ` �I SST Al 1�''��` 1 10111 *Please visit the City of Miami Beach websiVe at www.miamibeachfl.gov under City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. We aremmitted to providingFxcellenf public service and saeyy to X11 whhQ live, w�Ork a�►rd p/a�in ot�r vibrant,.trclplcal,.historic community. �'VB Ure Comm i!!C�!O PrUY'f in �?XC2�c3n!public SEJ!Y'ICf'JnC�SU safety iU Vii W U !VE', 4N0! CIl1C >!U)/;! our vi�rcrnr,1(U'�IC'U, StU(IC CU.RImUn'!'. ® Al CITY OF M11AW BEACH "0."RD AND COMMITTEE APPLICATION FORM i AM 1 B NAME: Rabin Amy L Last Name First Name Middle Initial HOME ADDRESS: 331 w 28 st Miami Beach FL 33140 Apt No. Home No./Street City State Zip Code PHONE: 3057934308 305 7934308 3055383424 amyr923 @bellsouth.net Home Work Fax Email Address Business Name: Amy Litt Rabin Position: yoga instructor Address: 331 w 28 st Miami Beach FL 33140 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: see resume please •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: Beautification Committee Choice 2: Sustainability.Committee Choice 3: Transportation and Parking Committee 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? 12/2013 termed out of parks&rec. •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: ............................................................................................... ....... Property { 331 W. 28th Street 33140 e' • I am now employed by the city of Miami 130 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: 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. 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 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 Amy Rabin agreed to the following terms on 12/10/2013A:47:03 PM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date i OBJECTIVE To serve as a member on one of the aforementioned City of Miami Beach,FL • Boards,as of January 2014 Ant Litt EXPERIENCE Rabin 2003-P resent Yoga Instructor,Green Monkey > Beautification Miami Beach Committee 2006-2013 > Sustainbility Board Member,Parks&Recreation Miami Beach Committee From inception-2006 > Transportation and GO Bond Oversight Committee Parking Committee Miami Beach > Community Relations 2006-2008 Board Executive Director Sunset Islands 3&4 HOA Details upon request 1998-2006 President&/or Board member Sunset Islands 3 &4 HOA Other Prior Experience Created the Miami Beach Kids Cultural Calendar(Sy Gelber,Mayor,Cultural Forum) North Beach Elementary,Friends of North Beach,Fun Fair Chair Miami Country Day School,Yoga Instructor,Middle&Upper Schools Yoga Instructor,SRYC Lyon Frere,Catering Sales Details upon request EDUCATION 1 1979-1983 Simmons College,Boston,MA BA,Management t 1979 graduating class Palmetto High 331 West 28th Street Miami,FL Miami Beach,FL 33140 REFERENCES 305-793-4308 References are available upon request. i amyr923 @bellsouth.net I '�l®°`ODE SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial Mailing Address—Street Number,Street Name,or P.O.Box 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.F1 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 ❑ County Board Member U,-J lunicipal Board Member, Name of Municipality: Board where serving I-- Work a -dress 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 Cj I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardeopy ❑ Electronic Copy Signature of pe son disclosing -1�� Ta �^ 31- Print name Date signed OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials: 133 SP-14 2/13 /M I AP\\,A 1 B EAC H City of Miami Beach, 1700 Convention Center Drive, iytiami Beach,Florida 33139, u�rrv.miomibeachfl.aov -----.-..- -- CITY CLERK Office CityCler<@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 2-1 1 .1 (i) (2) I r Board Member name: J 11,E 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 Disclosure Requirements. This means thatthe 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 (ai