Ray E Breslin Application Package Pending Photo ' '''' IP
i MIAMI ,,;;EAc1.41) CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
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Last Name _, First Name
C (. PAININ)— D/L o \ 804 fedle4iitali it-)
Home Addres Chi _ tate Zi• Co e
Home Telephone Wo rk Telephone Cellular Telephone Email address
BP1A1O Si 11w f pit itlarAladat ion: C,0'O1i JM
Business Name
;-.41-5, i",).. 3)(w Jr . ( 1A4 33 hbt
Business Address City State Zip Code
Professional License(describe) Expires:
Attach a copy of the license
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
for a minimum of six months.
• Resident of Miami Beach for a minimum of six (6) months: Yes Fla' or No
• Demonstrate an ownership/interest in a business i► Miami Beach for a minimum of six months: Yes C-1 or No Ill
• Are you a registered voter in Miami Beach: Yes 2 or No IZI
• I am now a resident of: North Beach Zh South Beach Middle Beach wt'
• I am applyin. for a appointment because I have specia abilities, knowledge and experience. Please lis below:
1 1 .L). ) AA 0-i1 iC I 0 ( '11 _ ' AKA&: ! / rs1-:
L li)f I C, • i° . oe Cowes pe A _
• Are you presently a registered lobbyist with the-City of Miami Beach?Yes or No eiz1 -
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)
❑Affordable Housing Advisory Committee ❑ Fine Arts Board ❑ Normandy Shores Local Government
Neighborhood Improvement
❑Art in Public Places Committee ❑Gay, Lesbian, Bisexual and Transgender ❑ Parks and Recreation Facilities Board
Enhancement Committee(GLBT)
['Beautification Committee '❑Golf Advisory Committee ❑ Personnel Board
❑ Board of Adjustment* * ❑ Health Advisory Committee ❑ Planning Board**
❑Budget Advisory Committee ❑ Health Facilities Authority Board ❑ Police Citizens Relations Committee
❑Capital Improvements Projects ❑ Hispanic Affairs Committee ❑ Production Industry Council
Oversight Committee .
❑Committee on the Homeless ❑ Historic Preservation Board ❑Safety Committee
❑Committee for Quality Education in MB ❑ Housing Authority ❑Single Family Residential Review Panel
❑Community Development Advisory ❑Loan Review Committee ❑Sustainability Committee
0c
community Relations Board CI Marine Authority ❑Tennis Advisory Committee
0 Convention Center Advisory Board ❑ Miami Beach Commission for Women VC► Transportation and Parking Committee
❑ Debarment Committee ❑ Miami Beach Cultural Arts Council ❑Visitor and Convention Authority
❑ Design Review Board** ❑ Miami Beach Human Rights Committee ❑Youth Center Advisory Board
❑ Disability Access Committee ❑ Miami Beach Sister Cities Program ❑Waterfront Protection Committee
* Board Required to File State Disclosure Form
' r If you seek appointment to a professional seat(e.g., lawyer, architect)on the Board of Adjustment, Design Review Board,
Historic Preservation Board,or Planning Board,attach a copy of your currently-effectively license,and furnish the
following information:
Type of Professional License , License Number ,
License Issuance Date ,,and License Expiration Date .
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc
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11110 4111 1
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Adviso ry Board:Yes La No U Years of Service:
2. Present participation in Youth Center activities by your children Yes No U. If yes, please list the names of your children,
their ages and which programs. List below:
Child's name: Age:. Program:
Child's name: Age: Program:
•Have you ever been convicted of a felony:Yes U or No.N^ If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach codes:Yes Zi or No a If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money:Yes U or No v!' If yes, explain in detail
•Are you currently serving on y City Boards Of Committees:Yes al or No U. If yes;which board?
,M cA)-lia
•What organizations in the City of Miami Beach do you currently hold membership in?
Name Title
Name - Title • ' --��II,,cc [L
• List all properties owned or have an interes in,whic are within the City of Miami Beach: oV 11)31, TbLj
ill y - --10 W Y S 7 C41-1Yo l r'h`J
-pis borg pw 1L Y 1 / , F(, 3314'
• I am now employed by the City of Miami Beach:Yes IZi or No 1:D.Which department?
• Pursuant to City Code Section 2-25(b): Do you have a parent Zi, spouse La,child brother U,or sister LD who is
employed by the City of Miami Beach? Check all that apply. Identify the department(s): 10 r"),,-
/
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.
Ethnic Origin: Che one only(1)
Gen . Male Female
White (Not of Hispanic Origin):All persons having origins in any of the original peoples of Europe,North Africa or the Middle East.
lZh African-American/Black (Not of Hispanic Origin):All persons having origins in any of the Black racial groups of Africa.
LaHispanic: All persons of Mexican, Puerto Rican,Cuban,Central or South American,or other Spanish culture or origin,regardless of race.
IZt Asian or Pacific Islander:All persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,or
the Pacific Islands. This area includes,for example,China,India,Japan,Korea,the Philippine Islands and Somoa.
lZh American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America,and who maintain
Cultural identification throw h tribal affiliation or community recognition.
Physically Challenged: Yes or No
Employment Status: Employed 1ZI Retired Zi Homemaker IZ3 Other li ,W p )L'/\
Please remember to attach a current resume and a copy of any applicable
professional license.
Attach additional sheets, if necessary, to provide required information.
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc
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• •
NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE
MEMBERS. THESE LAWS INCLUDE,BUT ARE NOT LIMITED TO,THE FOLLOWING:
o Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459).
o Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach
City Code section 2-26).
o Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
o 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 I HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPTER 2, ARTICLE VII - OF THE CITY CODE "STANDARDS OF CONDUCT FOR CITY OFFICERS,
EMPLOYEE AND AGENCY MEMBERS."
II?ad�8 lv
Applicant's Si ature Name of Applicant(PLEASE PRINT)
T
)
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No. Date
•
•
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MIAMI It‘ E k
x CH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov
Telephone: 305.673.7411 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's Name: •
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 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 file, according to the Miami-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.
Signature Date
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application NEWLY REVISED NEW LANGUAGE.doc
Ray Breslin
2395 Lake Pancoast Drive
Miami Beach, FL 33140
P-305 772-5665,e-mail Bresaro @aol.com
Resume'
Born: February 11, 1947 in Binghamton,New York. Lived there until 1965
Education: BS in Mechanical Engineering, Rochester Institute of Technology, 1970.
Lived in Rochester, New York until 1998
Employment:
Xerox Corporation 1967-1977, Quality Control, Supervision, Field Engineering
Town Crier Real Estate 1976-1980, Broker and top producing sales agent
Home Seller's Center 1980-1982,Avant-garde flat fee real estate sales using video
Sentry Color Labs 1982-1998, Commercial photo finisher sales &production mgr.
DePrez Group of Travel Companies 1990- 2004, Outside sales (travel agent)
In 1998, I relocated to Miami Beach to open Bresaro Suites at the Mantell Plaza with
partner, Patrick Pecoraro specializing in daily, weekly and monthly rentals.
I looked at the move to Miami Beach as a transition to retirement. What I now realize is it
was just a transition in life. I got the opportunity to look at our community and see how I
could make a difference in the quality of mine and Patrick's lives and the lives of the
people around us. I feel I've made a difference and am respected within the community.
The thing I like most about myself is that when I start something, I will work tirelessly to
complete it. I am an excellent problem solver and am most frustrated by the amount of
time it takes to get things done.
The thing I like least about myself is that I can be a procrastinator in starting a project
because I know how I'll be once I start.
I am honest, trustworthy and a good team player. If I feel something is wrong, I'll say so.
I will also say how I think it can be fixed.
I have completed the City of Miami Beach's Leadership Academy, The C.E.R.T.
program, and the Citizen's Police Academy.
References:
Upon request
I