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Lee J. Zimmerman board application packageCITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM ZimmermanLeeJ NAME: First Name Last Name Middle Initial FL33140 HOME ADDRESS : 535 west 50th StreetMiami Beach Home No./StreetState Apt No.City Zip Code lee@tuscanystone.com 305 773 3178305 888 5056 PHONE : WorkEmail Address HomeFax Owner Business Name: Tuscany Stone Surfaces,Inc. Position: 400 East 10th Court HialeahFL33010 Address: State CityZip Code Street Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated requirement shall be fulfilled in the following ways: a) an indi   months; or b) an individual shall demonstrate ownership/interest Yes Yes Yes Middle Beach circle one): I am now a resident of:  grew up in MB. kids are currently in CMB parks No 123Please note that only three (3) Please list your preferences in order of ranking [] first choice [] second choice, and [] third choice. choices will be observed by the City Clerk’s Office. (Regular Boards of City) Choice 1:Parks and Recreation Facilities Board Choice 2:Youth Center Advisory Board Choice 3: Single Family Residential Review Panel Note : If applying for Youth Advisory Board, please indicate your aff 1. Past service on the Youth Center Advisory Board: No Years of Service: if yes, please list the names of your children, their Yes 2. Present participation in Youth Center activities by your chil ages, and which programs. List below: No Have you ever been convicted of a felony:If yes, please explain in detail: No Do you currently have a violation(s) of City of Miami Beach codeIf yes, please explain in detail: No Do you currently owe the City of Miami Beach any money:If yes, please explain in detail: No Are you currently serving on any City Boards or Committees:If yes, which board? What organizations in the City of Miami Beach do you currently h List all properties owned or have an interest in, which are loca No I am now employed by the city of Miami Beach:Which department? The following information is voluntary and is neither part of yo being asked to comply with federal equal opportunity reporting r Gender:Male Race/Ethnic Categories What is your race?White Mark one or more races to indicate what you consider yourself t Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spani No No Physically Challenged: NOTEIf appointed, you will be required to follow certain laws which :   These laws include, but are not limited to, the following:    Prohibition from directly or indirectly lobbying city personnel o    Prohibition from contracting with the city (Miami-Dade County Co o    Prohibition from lobbying before board/committee you have served o Beach Code section 2-26).    Requirement to disclose certain financial interests and gifts (M o (re: CMB Community Development Advisory Committee):  prohibiti from having   any interest in or receiving any benefit from Co or those with whom you have business or immediate family ties Upon request, copies of these laws may be obtained from the “I hereby attest to the accuracy and truthfulness of the applica VII – of the City Code “Standards of Conduct for City Officers, I Lee Zimmerman agreed to the following terms on 4/7/2014 2:38: Received in the City Clerk's Office by: Name of Deputy Clerk Control No.Date Hatfield, Liliam From:Lee Zimmerman <LeeZimmerman@tuscanystone.com> Sent:Tuesday, April 22, 2014 9:43 AM To:Hatfield, Liliam Cc:Granado, Rafael; Prieto, Silvia; Martinez, Maria Subject:RE: A New Board & Committee Application has been submitted - PENDING PHOTO AND SELECTION OF BOARDS Liliam, Thank you for the email. I am really just interested in the parks and rec board as I have young kids in the parks now and have gone to some commission meetings on the parks as well. The other 2 board would be Police Citizens Relations Convention Center Attached is my photo as well. Thanks, Lee Zimmerman From: Hatfield, Liliam [mailto:LiliamHatfield@miamibeachfl.gov] Sent: Tuesday, April 22, 2014 7:49 AM To: Lee Zimmerman Cc: Granado, Rafael; Prieto, Silvia; Martinez, Maria Subject: A New Board & Committee Application has been submitted - PENDING PHOTO AND SELECTION OF BOARDS Good morning, See attached and email below. At your earliest convenience, please email me a headshot along with two additional choices of boards. If you have any questions, please contact me at any time. Regards, BEACH MIAMI Liliam Hatfield, Office Associate V 1 CITY CLERK'S OFFICE 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411/ Fax: 305-673-7254 / www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. From: Hatfield, Liliam Sent: Monday, April 07, 2014 3:31 PM To: 'lee@tuscanystore.com' Cc: Granado, Rafael; Prieto, Silvia Subject: A New Board & Committee Application has been submitted - PENDING PHOTO AND SELECTION OF BOARDS Good afternoon, Lee: Your application was received today. It shows that you are interested in serving in the Parks and Recreational Facilities Board and the Youth Center Advisory Board and Single Family Residential Panel. The last two boards have been abolished. Please review the attached list of vacancies report and select two other boards from the list. You can submit the other two selections at selectaboard@miamibeachfl.gov or just reply to my email. If you need additional information, please let me know. Regards, BEACH MIAMI Liliam Hatfield, Office Associate V CITY CLERK'S OFFICE 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411/ Fax: 305-673-7254 / www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. 2