F. Michael M. Steffens board applicationCITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
SteffensFrancisM
NAME:
First Name
Last Name
Middle Initial
FL33146
HOME ADDRESS
:
822 Jeronimo DrCoral Gables
Home No./StreetState
Apt No.City
Zip Code
mike@nevillesteffens.com
3056085952305-448-5299305-444-0842
PHONE
:
WorkEmail Address
HomeFax
principal
Business Name:
F. Michael Steffens PA
Position:
316 miracle mile
Coral GablesFL33134
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
No
No
No
circle one): I am now a resident of: Middle Beach
Architect with extensive Historic Preservation Expsrience
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 Clerks Office.
(Regular Boards of City)
Choice 1:Historic Preservation Board
Choice 2:Design Review Board*
Choice 3:
Board of Adjustment*
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
No
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:
Do you currently have a violation(s) of City of Miami Beach code No If yes, please explain in detail:
Do you currently owe the City of Miami Beach any money:No 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
I am now employed by the city of Miami Beach:No 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?
Mark one or more races to indicate what you consider yourself t White
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 Francis Steffens agreed to the following terms on 12/6/2014 11
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No.Date
Hatfield, Liliam
From:Mike Steffens <mike@nevillesteffens.com>
Sent:Sunday, December 07, 2014 12:01 AM
To:Hatfield, Liliam; LaRosa, Clara
Subject:HPB application for the MDPL seat
Attachments:IMG_0740.jpg; IMG_1209.jpg
Enclosed is a photograph. Sorry I don’t have any professional head shots.
F. Michael Steffens, P.A.
ARCHITECTURE AA 0002904
INTERIOR DESIGN IB 26000576
316 MIRACLE MILE
CORAL GABLES, FL, 33134
305.448.5299 Voice
305.608.5952 Mobile
305.444.0842 Fax
mike@nevillesteffens.com
Statement of Privilege and Confidentiality: This e-mail is covered by the Electronic Communications Privacy Act, 18
U.S.C. 2510-2521 and is legally privileged. The contents of this e-mail message and any attachments are intended solely
for the party or parties addressed and named in this message. This communication and all attachments, if any, are
intended to be and to remain confidential, and it may be subject to the applicable attorney - client and or work product
privileges. If you are not the intended recipient of this message, or if this message has been addressed to you in error,
please immediately alert the sender by reply e-mail and then delete this message and its attachments. Do not deliver,
distribute, or copy this message and or any attachments if you are not the intended recipient. Do not disclose the
contents or take any action in reliance upon the information contained in this communication or any attachments.
Although this e-mail and any attachments are believed to be free of any virus or other defect that might affect any
computer system into which it is received and opened, it is the responsibility of the recipient to ensure that it is virus
free and no responsibility is accepted by F. Michael Steffens P.A for damage arising in any way from its use.
Statement of Infringements. The enclosed documents / computer data files are instruments of service and shall remain
the property of F. Michael Steffens P.A, whether the project for which they were prepared is executed or not. They are
not to be used in any manner on other projects or extensions to this project except by agreement in writing and with the
appropriate compensation to F. Michael Steffens P.A. Reproduction or distribution, in any manner to a third party, of
documents / computer data files, without the written consent of F. Michael Steffens P.A are prohibited. Use of these
files, including modifications is at the sole risk and liability of the user. The user shall to the fullest extend of the law hold
F. Michael Steffens P.A harmless from any claims, liabilities, damages, losses, judgments, cost and expenses including
legal fees that may be incurred by F. Michael Steffens P.A as a result of the document / computer data file including but
not limited to, any alterations, modifications, deviations from additions to the document / computer data file. Failure to
adhere to these conditions is grounds for legal action by F. Michael Steffens P.A. All printed and/or published versions of
these documents / computer files must contain the corporate logo of F. Michael Steffens P.A.
1