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Daniel H. Aronson Application Package Pending Photo and Resume t\At,M BOARD AND COMMITTEE APPLICATION FORM Aolose CbA N e EL. Last Name V;ev_i First Name Middle Initial 'y 0 N D . ANto.ing c IL 3 1`1G Home Address City State Zip Code 0 S— L)- 4 3f1 3G 'L'1' 1S' - S531- 7)2,,inS0►nCObr erSin erMc�N.GGM Work Telephone Cellular Telephone EriT it address1 met' e✓ v StA e✓Jhait LL.P At\--a fie Business lame Occupation t1-1 50 3 r,cicsa 11 /6k.r tSQG �(1^;a�„ 'j L 33 t 3 7- 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 K-1 or No IZ11 • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes or No • Are you a registered voter in Miami Beach: Yes ���j or No • I am now a resident of: North Beach La South Beach 1Z3 Middle Beach • I am aplyinggifor an appointment be use I have spe ial abil itieSL, knowledg and experielnc . Please list below: •pie do 5-'t 4J rC2f fit' �. re.1 a"ncr‘S :dam • Are you presently a registered lobbyist with the City of Miami Beach?Yes or No 41i Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. _Please note that onl three 3 choices will be observed b the Cit Clerk's Office. ❑Affordable Housing Advisory Committee ❑Fine Arts Board ❑Normandy Shores Local Government Neighborhood Improvement ❑Art in Public Places Committee ❑Disability Access Committee ❑Parks and Recreation Facilities Board ❑Beautification Committee ❑Gay, Lesbian, Bisexual and Transgender ❑Personnel Board Enhancement Committee(GLBT) ❑Bicycle-Pedestrian Advisory Committee ❑Golf Advisory Committee ❑Planning Board ❑Board of Adjustment* * ❑Health Advisory Committee ,Police Citizens Relations Committee ❑Budget Advisory Committee 0 Health Facilities Authority Board ❑Production Industry Council ❑Capital Improvements Projects ❑Hispanic Affairs Committee ❑Safety Committee Oversight Committee ❑Committee on the Homeless 0 Historic Preservation Board * ❑Single Family Residential Review Panel ❑Committee for Quality Education in MB ❑Housing Authority ❑Sustainability Committee ❑Community Development Advisory ❑ Loan Review Committee ❑Tennis Advisory Committee 0 Community Relations Board ❑Marine Authority ❑Transportation and Parking Committee ❑Convention Center Advisory Board 0 Miami Beach Commission for Women ❑Visitor and Convention Authority 0 Debarment Committee ❑Miami Beach Cultural Arts Council 0 Youth Center Advisory Board °° ❑Design Review Board* "' r ❑Miami Beach Human Rights Committee ❑Waterfront Protection Committee ❑Miami Beach Sister Cities Program Page 1 of 4 . S °O Note: If applying for Youth Center Advisory Board, please indicate your affiliation with the Scott Rakow Youth Cent: • 1. Past service on the Youth Center Advisory Board: Yes 1.1 No I Dates of Servic-• 2. Present participation in Youth Center activities by your : - : es IP Non If yes, please list below the names of c ildren,their ages and the programs in which they participate: Child's name: Age: Program: Chili'. me: Age: Program: • Have you ever been convicted of a felony?Yes or No If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach Code?Yes ZJ or N.M-- If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money?Yes or No 17-41 If yes, explain in detail: •Are you currently serving on any City Board or Committee?Yes or No If yes,which board/committee? • In what organization(s)in the City of Miami Beach do you currently hold membership? Name Position Name Position • List all properties owned or in which youAve an in er st within the City of M,1i,ami Beach:�L 3 , y Q �-v�rr•c -- l Lt 9® Y 1 e.w y W• N1 i a' `t�es G(� •Are you now employed by the City of Miami Beach?Yes or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent L:11, spouse child brother or sister who is employed by the City of Miami Beach?Check all that apply. NO - 140 tie 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 to comply with City diversity reporting requirements. Gender: Male M-1 Female U1 Race/Ethnic Categories What is your race? African-American/Black � 1 Caucasian/White Asian or Pacific Islander Native-American/American Indian �f Other—Print Race: Page 2 of 4 • Do you consider yourself to be Spanish, Hispanic or Latino/a?Mark the "No"box if not Spanish, Hispanic, Latino/a. No RR Yes Do you consider yourself Physically Disabled? —J 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." ( lrI li-1• o/►►� . ArOW)50✓) Applica '.ignat re Da Name of Applicant(PLEASE PRINT) • .r.SP7 //- /1. Received in the Clerk's Office by . 'r. ■ Name of Deputy Clerk Control No. D. e PLEASE REMEMBER TO ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Daniel H Aronson 1440 North View Drive Miami Beach,FL 33140-4248 Page 3 of 4