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20160608 RELEASE 1MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov COMMISSION MEMORANDUM TO: Mayor Philip Levine and Members of the City Commission FROM: Rafael E. Granado, City Clerk DATE: November 2, 2016 SUBJECT: City Commission At-Large Nominations for November 9, 2016 — Release # 1 Below please find the City Commission At-Large Nominations received to date for the November 9, 2016 Commission Meeting. BOARD AND COMMITTEES 1. AFFORDABLE HOUSING ADVISORY COMMITTEE VACANCY (1): No nomination received do date. 2. ART IN PUBLIC PLACES COMMITTEE VACANCY (1): No nomination received do date. 3. BUDGET ADVISORY COMMITTEE VACANCY (1): No nomination received do date. 4. BUDGET ADVISORY COMMITTEE VACANCY (1): No nomination received to date. 5. HEALTH FACILITIES AUTHORITY BOARD VACANCIES (0): POSSIBLE REAPPOINTMENTS TO BE MADE (2): No nomination received to date 1 6. HUMAN RIGHTS COMMITTEE VACANCY (1): • Francinelee Hand (Release # 1, Page 3) o Nominated for appointment by Commissioner Rosen Gonzalez. • Jesse Fleet (Release # 1, Page 13) o Nominated for appointment by Commissioner Grieco. FACLERULUREG\COMMISSION MEETINGS\2016 \11092016 \RELEASE # 1.docx 2 Jesse Fleet 3 THIS PAGE INTENTIONALLY LEFT BLANK 4 114 MIAMI BEACH CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: Fleet Jesse Last Name First Name Middle Initial HOME ADDRESS: 855 Euclid Ave Miami Beach FL 33139 Apt No. Home No./Street City State Zip Code PHONE: 3057468999 djbombjack@hotmail.com Home Work Email Address Business Name: Stirman & Fleet Position: Partner Address: 2475 NW 38th Street Miami Florida 33142 Street City State Zip Code 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 • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes • Are you a registered voter in Miami Beach: No • (Please circle one): I am now a resident of: South Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: father • Are you presently a registered lobbyist with the City of Miami Beach? No Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three13) choices will be observed by the City Clerk's Office. (Regular Boards of City) Choice 1: Human Rights Committee Choice 2: Art in Public Places Committee Choice 3: Affordable Housing Advisory Committee 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: No Years of Service: 2. Present participation in Youth Center activities by your children No if yes, please list the names of your children, their ages, and which programs. List below: • Have you ever been convicted of a felony: No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: 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: • Are you currently serving on any City Boards or Committees: No If yes, which board? • What organizations in the City of Miami Beach do you currently hold membership in? • List all properties owned or have an interest in, which are located within the City of Miami Beach: • I am now employed by the city of Miami Beach: No Which department? 5 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. Gender: none Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. none Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino. No Physically Challenged: No NOTE: If appointed, you will be required to follow certain laws which 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 Code section 2-26). o Requirement to disclose certain financial interests and gifts (Miami-Dade County Code section 2-11.1). (re: 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 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." I Jesse Fleet agreed to the following terms on 10/20/2016 1:02:45 PM Received in the City Clerks Office by: Aw)en @ve1t..1p_ ,ozolo i /0)1.07/ Name of Deputy Clerk Control No. Date 6 'STIRMAN & FLEET PSEAW I 14.7.1 DESIGN • FABRICATION • INSTALLATION Stirman Et Fleet are a full-service design, fabrication and installation company. We work with both commercial and residential properties. Our work always has an artistic angle to it, and we believe in working closely with the client to provide smooth service and a great finished product. The two partners are Rollin Stirman and Jesse DeVille Fleet. With 50+ years experience between the two, we offer a service few can replicate. We look forward to doing business with you. You can contact us at 305 746 8999 7 8 9 10 11 Granado, Rafael From: Bonini, Danila Sent: Thursday, October 27, 2016 3:41 AM To: Granado, Rafael Subject: Fwd: Board and Committee Application Submitted by Jesse Fleet Attachments: Jesse Fleet Application Package.pdf; ATT00001.htm; image001jpg; ATT00002.htm Commissioner Grieco would like to appoint Mr.Fleet to the Human Rights Committee Thank you for your attention on this matter! Sent from my iPhone Begin forwarded message: From: "Barbou, Regis" <RegisBarbou@miamibeachfl.gov> To: "Mayor's Office" <MAYO Dept@miamibeachfl.gov> Cc: "Granado, Rafael" <RafaelGranado@miamibeachfl.gov>, "Hatfield, Liliam" <LiliamHatfield@miamibeachfl.gov>, "Quezada, Ramon" <RamonQuezada@miamibeachfl.gov>, "Barbou, Regis" <RegisBarbou@miamibeachfl.gov>, "'djbombjack@hotmail.com"' <djbombjack@hotmail.com> Subject: Board and Committee Application Submitted by Jesse Fleet Honorable Mayor and Commissioners, Attached please find the Board & Committee application package submitted by Jesse Fleet, who is interested in serving on one of the following boards: Choice 1: Human Rights Committee Choice 2: Art in Public Places Committee Choice 3: Affordable Housing Advisory Committee [Cropped-for-E-signature-MiamiBeachLogo_Green250px] Regis Barbou, Office Associate V OFFICE OF THE CITY CLERK 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411 www.miamibeachfl. gov<http ://www.miamibeachfl. gov/> We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. 1 12 Francinelee Hand 13 THIS PAGE INTENTIONALLY LEFT BLANK 14 Home Telephone Work e -phone Cellular Teleph7 Email address 3o-c '&7.0700, Business Name led Occupation First Name ageltc,e, City 33teito State Zip Code SC, /iSh f r1 Cr Middle Initial Home Address Last N id0 MIAMI BEACH RD AND COMMITTEE APPLICATION FORM Business Address City State Zip Code Professional License (describe):6M MA Expires: AM/A-CV- 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 121o; No L:1 • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes 1:::1 or No lag • Are you a registered voter in Miami Beach: Yes [4l or No LA • I am now a resident of: North Beach Lji South Beach La Middle Beach [a-- • I al applying for an ,appointment because I have special abilities, knowledge and expTi t euell e er list below: NA-Q Yaebf cm c `40.4 frp a 'It I ei A) nett) or 1(6 p 11 r%1Itt, c•• TV ho , 3arSem. pefi4, eiC• v ott tP C-kev," CA/Ce itied )10,yv-ti (11( Ski Os bek; - • Are you presently a registered lobbyist with the City of Miami Beach? Yes L-.21 or No Ce—A) A-05 tc-N f coca. Ci g 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 Office of the City Clerk. 0 Affordable Housing Advisory Committee 0 Health Advisory Committee 0 Parks and Recreation Facilities Board 0° 0 Art in Public Places Committee 0 Health Facilities Authority Board 0 Personnel Board 0 Audit Committee 0 Hispanic Affairs Committee 0 Planning Board** 0 Board of Adjustment ** 0 Historic Preservation Board* 0 Police Citizens Relations Committee 0 Budget Advisory Committee 0 Housing Authority roduction Industry Council 0 Committee on the Homeless 0 Human Rights Committee ister Cities Program 0 Committee for Quality Education in MB 0 LGBT Advisory Committee Sustainability Committee 0 Convention Center Advisory Board 0 Marine & Waterfront Protection Authority 0 Transportation, Parking, & Bicycle-Pedestrian Facilities Committee ultural Arts Council 0 Miami Beach Commission for Women a. fl.-)isitor and Convention Authority Design Review Board* 0 Normandy Shores Local Government Neighborhood Improvement 0 Youth Commission 0 Disability Access Committee * 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 Page 1 of 4 FACLERVSALL1aFORMS1BOARD AND COMMITTEES \SC APPLICATION REVISED 06142016.docx 15 ca 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 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 [:j1 or No ria If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code? Yes La or Not If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money? Yes Zi or No Zir If yes, explain in detail: • Are you currently serving on any City Board or Committee? Yes Eor No 1:.3 If yes, which board/committee? C0/41 Snr evi C4 Lk 00(.6 /"-. • In what organization(s) in the City of Miami Beach do you currently hold mgmbership? ‘ SN eitio geari cdork y freptii Position Name Position • List all properties owned or in which y have an interest within the City of Miami Beach: hOntr2 3 ley A • Are you now employed by the City of Miami Beach? Yes 1:::1 or No Which department and title? • Pursuant to City Code Section 2-25 (b).::)o you haa-parent 1=1, spouse j, child F.:3 brother F.:I or sister Lji who is employed by the City of Miami Beach? Yes l_lor No If "Yes," identify person(s) and department(s): Name 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 U Female Race/Ethnic Categories What is your race? Z3 African-American/Black Caucasian/White Asian or Pacific Islander {-,-j Native-American/American Indian Page 2 of 4 FACLERVISALL\aFORMS\BOARD AND COMMITTEESSC APPLICATION REVISED 06142016.docx 16 Q i.term. Name of Deputy Clerk 10 Z.4 Control No. /0/147//‘ ate Received in the Office of the City Clerk by: icapelor) Ul Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. Ul No 1,:j Yes Do you consider yourself Physically Disabled? No EZ:11 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 ANQ, AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATU S ACCORDINGLY." I icant' ignature Date Name of Applicant ( LEASE PRINT) 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 FACLER \SALL1aFORMS \BOARD AND COMMITTEES \BC APPLICATION REVISED 06142018.docx 17 Date MIAMI BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK 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) Board Member's Name: Fr a In '41 the, 114 j 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. Updated: Tuesday, October 04, 2016 Page 4 of 4 FACLER1SALL\aFORMS \BOARD AND COMMITTEES \BC APPLICATION REVISED 06142016.docx 18 19 Granado, Rafael From: Zaret, David Sent: Monday, October 31, 2016 10:46 AM To: Granado, Rafael Cc: Rosen Gonzalez, Kristen Subject: Consideration Request Good morning Ralph: Per you request, Commissioner Rosen Gonzalez would like to submit Francinelee Hand's name to be considered for a vote by the full Commission to appoint her to the Human Rights Committee. Thank you. Best, David MIAMIBEACH David Zaret, Aide to Commissioner Rosen Gonzalez Office of the Mayor and Commission 1700 Convention Center Drive, 4th Floor, Miami Beach, FL 33139 Office: 305-673-7105 Cell: 786-459-5124 www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community A Please print only if necessary. 1 20