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Lee J. Zimmerman Application PackageAIAM1BEACH BEACH ksAmme_AAAL,G First Name Last Name BOAR AND COMMITTEE APPLICATION FORM Home Address e(06 IS�3 City 77;3i Cellular Telephone Home Telephone Work Telephone —T-USCea u S,k),)-e BusinesName I u Gxvu ((GI 4( 3 Business Address Middle Initial —S3111 State Zip Code �.Q��-��C� S}r'jtJ�• CUA, Email address l ctAbt CGw f-tActC(ek( Occupation 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 or No • Demonstrates ownership/interest in a business in mi Beach for a minimum of six months: Yes L or No • Are you a registered voter in Miami Beach: Yes `l or No • I am now a resident of: North Beach FZI South Beach LI 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 EZI or No ki 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. ❑ Affordable Housing Advisory Committee 0 Health Advisory Committee arks and Recreation Facilities Board °O 0 Art in Public Places Committee ❑ 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 0 Production Industry Council ❑ Committee on the Homeless 0 Human Rights Committee 0 Sister Cities Program 0 Committee for Quality Education in MB 0 LGBT Advisory Committee 0 Sustainability Committee 0 Convention Center Advisory Board 0 Marine & Waterfront Protection Authority 0 Transportation, Parking, & Bicycle -Pedestrian Facilities Committee 0 Cultural Arts Council 0 Miami Beach Commission for Women 0 Visitor and Convention Authority 0 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 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx o 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 11 If yes, please list below the names of your children, theirthages and the programs in which they participate:r(•�{_ // Child's name: 1 "�v 0-0 LuW1 att.At' /1' �(/ Age: Y/ Program: {Ol V\ ()14 (11(1 l4LII (" Child's name: /ge: Program: .W.. • Have you ever been convicted of a felony? Yes or No yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code? Yes or NoiIf yes, please explain in detail: • Do you currently owe the City of Miami Beach any money? Yes ZI or No lift yes, explain in detail: • Are you currently servirg on a y City Board or gpmmittee2 Yes r No If yes, which board/committee? Ck� .x I ---d C nc)CtlP(i • In what organization(s) in the City of Miami Beach do you currently hold membership? Name Position Name Position • List all4operties owned oraC) in is" iyou have an�Intergst withi5\\the L C4mi Beach: • Are you now employed by the City of Miami Beach? Yes L3 or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you hay a parent La, spouse La, child IrLI brother or sister ZI who is employed by the City of Miami Beach? Yes Zior No 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 Female Li Race/Ethnic Categories What is your race? rican-American/Black !,IJ Caucasian/White Asian or Pacific Islander Native-American/American Indian Page 2 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx 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 Yes Do you consider yourself Physically Disabled? 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." Applicant's Signature 12-Zz,(6 Q� tinklm etitAt4 Received in the Office of the City Clerk by: Date Name of Applicant (PLEASE PRINT) Name of Deputy Clerk Control No. Date 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 06142016.docx MIAMI BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Horida 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: 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 Tater 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. Signature Date Updated: Tuesday, October 04, 2016 Page 4 of 4 F:\CLER\$ALL1aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx LEE ZIMMERMAN 535 west 501r street Miami Beach FI.33140 lee@tuscanystone.com 305 773 3178 OBJECTIVE To serve my community of Miami Beach and make the parks the best place for our kids and all others who use our various facilites. SKILLS & ABILITIES 4 year degree from Florida State in Political Science. I know how to deal with the public and city matters and form a good plan for all. Licensed realtor in the state of Florida. EXPERIENCE PRESIDENT - TUSCANY STONE SURFACES, INC JAN i JJ PKC. Jt_N MARBLE /TILE SUPPLIER FOR RESIDENTAL, COMMERCIAL PROJECTS MANAGER BOBBY RUBINO'S RESTAURANT JUNE 1992 - SEPT 1,,c, MANAGER OF A RESTAURANT ON FISHERMAN'S WARF IN SAN FRANCISCO CALIF. EDUCATION I FLORIDA STATE UNIVERSITY. TALLAHASSEE FL. BS POLITICAL SCIENCE MAJOR, MINOR IN COMMUNICATIONS.