Jack Benveniste 12.31.2017 MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.qov •
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
December 31, 2015
Mr. Jack Benveniste
8075 Noremac Avenue
Miami Beach, Florida 33141
SUBJECT: Police/Citizens Relations Committee
Dear Mr. Jack Benveniste:
Congratulations!You have been appointed by Commissioner Joy Malakoff to the agency, board or
committee named above for a term ending: 12/31/2017.
Pursuant to City of Miami Beach Code Section 2-22 (5)a,"Notwithstanding any other provision of the City
Code or of any resolution, commencing with terms beginning on or after January 1, 2007, the term of
every board member who is directly appointed by a member of the City Commission shall automatically
expire upon the latter of: December 31 of the year the appointing City Commissioner leaves office or
upon the appointment/election of the successor City Commission member."
If you are unable to accept this appointment, or have any questions, please call the Office of the City
Clerk at 305.673.7411. Please read the enclosed materials carefully.
Congratulations again and good luck.
Regards,
gr,770709rmx,3,rowly,
afael Granado
City Clerk
cc: Saul Frances, Parking Director
Chief Daniel Oates, City Liaison
ATTACHMENTS:
Letter of Appointment
Oath
City Code/Ordinance section applicable to agency, board or committee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Ordinance No. 2006-3543 -Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics
City Wide Permit Application - (Parking Department Form)
Booklet- Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,historic community.
MIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Mr. Jack Benveniste
RE: Police/Citizens Relations Committee
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United
States, the State of Florida, and the City of Miami Beach, and to perform all the duties of a member of the
above-mentioned board or committee of the City of Miami Beach to which I have been appointed for a
term ending: 12/31/2017.
I have been issued a copy of section 2-11.1 of the Miami-Dade County Code (Conflict of Interest and
Code of Ethics Ordinance), as well as Florida Commission on Ethics Guide to the Sunshine Amendment
and Code of Ethics for Public Officers and understand that as a member of a City of Miami Beach Board
and/or Committee, I must comply with the financial disclosure* requirements of Miami-Dade County or the
State of Florida (depending on the board or committee on which I serve) on July 1st, following the closing
of the calendar year on which I have served.
Z .1‘,// ,- 74--
Mr. Jack Benveniste
Sworn to and subscribed before me this i 2.- day of 'col , 2010
44 di bt—p dG
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical,historic community.
i
MIAMI•DADE SOURCE OF INCOME STATEMENT
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tDisclosure for Tax Year Ending Last Name First Name Middle Name/Initial.
2014
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Mailing Address—Street Number,Street Name,or P.O.Box
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City,State,Zip ID Number
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If your home address is your mailing address, and your home address is exempt from public records pursuant to Fla.Stat.§119.07,read
instructions on the following page and check here.n
Filing as7an-Fmployee
— County Employee 7 Municipal Employee, Name of Municipality:
Position held or sought
Department where employed
Work address Work telephone Term began on
Filing as e Board Member
_ County Board Member ri unicipal Board Member, Name of Municipality:
Board where serving_
I PL/ c-/7-72.F-- -f? . •
Work address
lWork telephone I Term began on
1 -Taw 12-0
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List below every source of income you received,along with the address and the principal activity of each source. Include your public salary.Place
the sources of income in descending order,with the largest source first.Also,include any source of income received by another person for your
benefit. However,the income of your spouse or any business partner need not be disclosed.If continued on a separate sheet,check here.
Name of Source of Income Address ' Description of the Principal Business Activity
..C, - "-.2./)- it7, 7VX---e)/cle rif,-475/ 2."-ef$4/t/a/, ' p/2,0vv,ofi--4_ ri-o-A_ f"1„/J •
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I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT
Q Hardcopy
- ❑ Electronic Copy
ature of person disclosing
,7-. Ae,..fd6e7r../e-- a°) -7/,‘--
Print name Date signed
OFFICE USE ONLY Accepted: Y i N Deficiency: Processed uc ell i li2 I_• Scanned Dateilnitiais:
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NAME: N ti/ /3 T ar-A
Last Name s�1 First Name Middle Initial l
HOME ADDRESS: E 0 17� A/0 LE- / /rL 'U_ `•t7/J¢jiJ $,�i52G%' Fe— $ :?
No. Street City State Zip Code
PHONE: ��.5=�` � /i�y 3 j-60-G/c- 8 v//As-v/J.7 .
Home Work Fax Email address GO
Business Name: SO, � sT G Al 0 To/c C ,e Position:
Address: if<j/ Ala/ /d-3 R7 / Tin '7/, f G:S2'
No. Street City State Zip Code
Professional License(describe) /9- 0/ v Expires: "4/51- :; t w
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.
• Resident of Miami Beach for a minimum of six(6) months: Yes No ❑
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six(6) months: Yes No ❑
• Are you a registered voter in Miami Beach: Yes or No ❑
• (Please check one): I am now a resident of:.North Beach South Beach ❑ Middle Beach ❑
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
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)
0 Art in Public Places CommitteeI-lousing Authority*
❑Beach Preservation Board ❑Loan Review Committee*
❑Beautification Committee ❑ ayor's Green Ad-Hoc Committee
01;1-Berard of Adjustment* dp a Marine Authority*
❑Budget Advisory Committee ❑Miami Beach Cultural Arts Council
❑Committee on Homeless 0 Miami Beach Commission on Status of Women
❑Committee for Quality Education in MB ❑Miami Beach Florida Sister Cities
❑Community Development Advisory* ❑Normandy Shores Local Gov't Neigh. Improvement
❑Community Relations Board 0 Oversight Committee for General Obligation Bond
❑Convention Center.Advisory Board r cs and Recreation Facilities Board
❑Debarment Committee nnel Board*
❑Design Review Board* 0 Planning Board*
0 Disability Access Committee ®- ariEee Citizens Relations Committee -; n,
0 Fine Arts Board s ❑Production Industry Council
0 Golf Advisory Committee ❑Public Safety Advisory Committee
0 Health Advisory Committee 0 Safety Committee
❑Health Facilities Authority Board 0 Transportation and Parking Committee
0 Hispanic Affairs Committee ❑Visitor and Convention Authority*
0 Historic Preservation Board* ❑Youth Center Advisory Board `0
*
Board Required to File State Disclosure form
a,,:.$),T..,. ..n and ,J,ft;6 c ;\,,m L €Ir :«'s , 3 :. } f I l'-1:'l:.:5\13;:;Application Re,sa,-i.t i i'f 18 2007.Aoc
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: Yes❑ No❑ Years of Service:
2. Present participation in Youth Center activities by your children Yes❑ No O. 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❑ or No Ga'lf yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes❑ or No k. If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ❑or No 44es, explain in detail
• Are you currently serving on any City Boards or Committees: Yes, -No D. If yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name: • Title:
Name: Title:
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
6o91- /V-0 &Ai /
• I am now employed by the City of Miami Beach: Yes❑or No hich department?
• Pursuant to City Code Section 2-25(b): Do you have a parent❑, spouse❑,child❑, brother❑, or sister❑who is employed by the
City of Miami Beach?Check all that apply. Identify the department(s):
This section is"not required" but desired: Age: 77' years old Gender: Male Female ❑
Ethnic Origin (Check one)
White frican-American/Black ❑Hispanic: ❑Asian or Pacific Islander ❑American Indian or Alaskan Native ❑
Employment Status: Employed ❑Retired ❑Home-maker ❑Other ❑
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII—of the City Code"Standards of Conduct for City Officers, Employees and Agency Members."
/ /1— /2—ga/J cT j0L/5— R,6-/l/U /t'/S'
Ap.,.cant's Signature Date Name of Applicant(PLEASE PRINT)
Please attach a copy of your resume to this application i
NOTE:Applications will remain on file for a period of one(1)calendar year.
' 7/__/1-7-1//
Received in City Clerk's Office by C./al-a D ate
Name of Deputy Clerk = - rV
Document Control Number(Assigned by the City Clerk's Office) Entered By DateLl ����
R jsed 1/25/07 jo
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\:."...3 a # .ee..:g s\c 1 £ oca. ,:.. . .".D . 1C s \B i Application - /0 " d r
Jack Benveniste
8075 Noremac Avenue
Miami Beach, Florida
(305) 538-1124
• Born February 26,1941
New York City, New York
Education:
Attended the University of Miami
Miami Beach resident: 40 years
Personal:
• Married 44 years to Michaele
2 children
5 grandchildren
• Business:
President of All Dade Bail Bonds - 45 years
President of Southeast Florida Motorcycle Safety School
(provider for DSHMV Florida Rider Training Program) - 13 years .
President TOAD Program (court ordered youthful offender traffic
program) 7years
President of Gun Depot-32 years
President All Florida Driver License Testing (provider for Florida
Department of Highway Safety and Motor Vehicles to administer the Florida
Driver License Permit exams.)
• Community service involvement:
Currently a member of City of Miami Beach Budget Advisory Board - 12 years.
Currently serving as Flotilla Commander- United States Coast Guard Auxiliary
Served on City of Miami Beach Police Citizens committee as well on Parks and
Recreation Board.
Currently Vice President of Ohev Shalom Congregation.
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N.M.-
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f 4 I I\i"i\ b E:I\(0 ,Fl
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
wv/w.m iami beachfl.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)
&,Ul- / S�
Board Member's Name: ei
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"
For your convenience, the form is attached. The form can also be downloaded at:
htto://v+rww.miamidade.gov/elections/Library/source of income statement.odf
2. A"Statement of Financial Interests (Form 1)"
For your convenience, the form is attached. The form can also be downloaded at:
httc://www.ethics.state.fl.us/ethics/forms.html
3. A Copy of your 2013 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.
/ ---
ir
Signatu" Date
Updated:Wednesday,April 09, 2014
Page 4 of 4
F:\CLER\SALL\aFORMS\BOARD AND COMMIITTEES\BC APPLICATION REVISED.docx
MIAMI iti, !
DIVERSITY STATISTICS REPORTING
Name: c. lG %vie /-
Board / Committee: �I� t-e L-Is zec►S' • £e4S=e4i C644-1,1- �AG-e
Appointment Date: V3/41,-/‘
Pursuant to City of Miami Beach Ordinance 2009-3632, the City is required to annually
prepare and present a report to the City Commission identifying the City's diversity
statistics. This form allows board and committee applicants and members to voluntarily
self-identify their race, ethnicity, disabled status and gender.
Please check the appropriate box for each category:
I I Female
Gender: Male
Race/Ethnic Categories
What is your race? .
�1 African-American/Black
aucasian/White
LJI Asian or Pacific Islander
Native-American/American Indian
IZ:h Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No"box if not
Spanish, Hispanic, Latino/a.
No
L:11 Yes
Do you consider yourself Physically Disabled?
No
1 Yes
C:\Users\CENTFraN\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\NP4J9CNX\BC minority
information form 05-20-13 FINAL.doc
Updated: Monday,January 26,2015