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Richard Murray Kimball Application Package . . g im I AM I 3 EAcH BOARD AND COMMITTEE APPLICATION FORM K u ■KeAvy Last ame VVV First Name U w Middle Initial • WG8 Vsz_vkvts:til v� kw. . 3.l cA . Home Address City State Zip Code W I •"1 0 - '2 '73 NI 0 K1 M3 A _L. I S$c_ -off L L Home Telephone Work Telephone Cellular Telepho Email address \Q; e. j Business Name Occupation Business Address City State Zip Code Professional License(describe): 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 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 01 or No 0 • Demonstrates ownership/interest in a business in M.-mi Beach for a minimum of six months: Yes or No Q •Are you a registered voter in Miami Beach: Yes Lor No ni • I am now a resident of: North Beach South Beaca Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: •Are you presently a registered lobbyist with the City of Miami Beach?Yes or No I J 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. ❑Ad Hoc Committee Centennial Celebration ❑Health Advisory Committee 0 Parks and Recreation Facilities Board°0 0 Affordable Housing Advisory Committee ❑Health Facilities Authority Board 0 Personnel Board 0 Art in Public Places Committee ❑Hispanic Affairs Committee ❑Planning Board ❑Board of Adjustment* * / istoric Preservation Board * ❑Police Citizens Relations Committee ❑Budget Advisory Committee ' Housing Authority 0 Production Industry Council ❑Committee on the Homeless 0 Marine&Waterfront Protection Authority ❑Sustainability Committee 0 Committee for Quality Education in MB 0 Miami Beach Commission for Women o Transportation,Parking,&Bicycle-Pedestrian Facilities Committee ❑Convention Center Advisory Board ,,g )Miami Beach Cultural Arts Council ❑Visitor and Convention Authority 0 Design Review Board*-4A- 0 Miami Beach Human Rights Committee ❑Disability Access Committee ❑Miami Beach Sister Cities Program _ 0 Gay, Lesbian,Bisexual and Transgender ❑Normandy Shores Local Government Enhancement Committee(GLBT) Neighborhood Improvement * Board members are required to file Form 1 —"Statement of Financial Interest"with the State. *If you seek appointment to a professional seat(e.g., lawyer, architect, etc.) 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 License Expiration Date, ,,, -:_y,._ . . _ cr C * . !:1cI a-- Jai 11 I OZ Page 1 of 4 E � 1 i �_ ..- lk . •{. . l',-) F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx t °° Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board, please indicate your affiliation with the Scott Rakow Youth Center and/or the North Shore Parks Youth Center: • Please describe your past service with the City's Youth Centers(include dates of service): • Present participation in Youth Center activities by your children:Yes L11 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 n or No ∎11 If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach Code?Yes 1-11 or N•qi.lf yes, please explain in detail: • Do you currently owe the City of Miami Beach any money?Yes or No P If yes, explain in detail: •Are you currently serving on any City Board or Committee?Yes or No WC If yes,which board/committee? • In what organization(s)in the City of Miami Beach do you currently hold membership? 177 ea c _t _ _ - 1. . , e , . U' Name Position•MA ae-v-fin,Cke 16446,v, 17)e,»,Ace si,r s- Name Position • List all properties Awned or in which you have, n interest within the City of Mia each: Co v`w vin �. ' �:-k 3$ - ISM kgyvv ea. L 33 (3°1- (vu- AR-skaiz-ve •Are you now employed by the City of Miami Beach?Yes or No F Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent IZI}, spouse 1, child brother or sister[J who is employed by the City of Miami Beach?Check all that p If"Yes,"identify person(s)and department(s): 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 tto,comply with City diversity reporting requirements. Gender: Male Mj Female Race/Ethnic Categories What is your race? frican-American/Black l Caucasian/White 41 Asian or Pacific Islander DI Native-American/American Indian Ell Other–Print Race: Page 2 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx /l Do you consider yourself to be Spanish,Hispanic or Latino/a?Mark the"No"box if not Spanish, Hispanic, Latino/a. No LI Yes Do you consider yourself Physically Disabled? • ) No Yes 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: 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 the 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). o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities. o Voting conflict—Form 8B is for use by any person serving at the county, city or other local level of government on an appointed or elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. 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 MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR CITY OFFICERS,EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATUTES ACCORDINGLY." Applicants ignature Date ame of Applicant(PLEASE PRINT) Received in the City Clerk's Office by: D Z- Name of Deputy Clerk Control No. D..te PLEASE ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx MIAMI t 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/Committee Members for failure to comply with Miami- Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) I Board Member's Name: 1 �J Cl 1�' I " 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" 2. A"Statement of Financial Interests (Form 1)" 3. A Copy of your latest 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. ,//y -WWLW Signature ` �- D to Updated:Monday,June 02,2014 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx RICHARD M. KIMBALL—RESUME 1952—1956 Attended Oberlin College, Oberlin, Ohio Received B.A. degree from Oberlin College 1956—1959 Served in United States Army in New York City and Germany 1959—1964 Worked in music industry in New York City 1964—2011 Member of Milwaukee Symphony Orchestra 1980—1991 Principal, real estate investment partnership restoring homes in Milwaukee, WI 1988—1992 Member, City of Milwaukee Historic Preservation Commission 1990—1992 Chair, City of Milwaukee Historic Preservation Commission 2009—2014 Owned condo in Miami Beach historic art deco district, 1520 Euclid Avenue, "The Gibson," designed by Henry Holzhauser 2012—Present Resident of Miami Beach, Florida 2014—Present Resides in and owns condo in "Harriet Court,"designed by Henry Holzhauser, 1508 Pennsylvania Avenue, in Miami Beach historic art deco district Personal Reference: Josephine Manning 1460 Ocean Drive,Apartment 408, Miami Beach, FL 33139 Member, Historic Preservation Board, Miami Beach Richard M. Kimball 1508 Pennsylvania Avenue, 3B Miami Beach, FL 33139 Cell: (414) 704-2783