Scott Needelman Application PackageMIAMI BEACH
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Last Name First Name Middle Initial
1955 Dre)-e ( Aie /11,15, F. "33/37
Home Address City State Zip Code
305— 693- /16 3 301- r?lO-55 gq 54n 1'155-4A-7-rr tt) -r
Ho e T lephone Work Telephone Cellular T lephonekl
Email address
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Business Name Occup on
IL( 6 3 bre ee ( /Le, /`h, Fc- 33/37
Business Address City StateAA // Zip Code
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Please attach a copy df cur ntly effective professional license.
Professional License (describe): ii- Expires:
BOARD AND COMMITTEE APP ICATION FORM
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 Miami Beach for a minimum of six months: Yes 0 or No
• Are you a registered voter in Miami Beach: Yes or No
• I am now a resident of: North Beach IZt South Beach 0. Middle Beach
• 1 Kri applying for an appointment beicaue I have pecial abilities, knowledge and experience. Please list below:
!/f jc4 tel e' �^ i�'islaKc c-Stt' icy/'*
• Are you presently a registered lobbyist with the City of Miami Beach? Yes LJ or No
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.
E Affordable Housing Advisory Committee
❑ Health Advisory Committee
❑parks and Recreation Facilities Board °O
S Art in Public Places Committee
❑ Health Facilities Authority Board
❑ Personnel Board
E Audit Committee
❑ Hispanic Affairs Committee
❑ Planning Board**
❑ Board of Adjustment **
•Historic Preservation Board*
❑ Police Citizens Relations Committee
❑ Budget Advisory Committee
❑ Housing Authority
D Human Rights Committee
❑ Production Industry Council
E Sister Cities Program
❑ Sustainability Committee
Ll Committee on the Homeless
❑ Committee for Quality Education in MB
❑ LGBT Advisory Committee
❑ Convention Center Advisory Board
❑ Marine & Waterfront Protection Authority
E Transportation, Parking, & Bicycle -Pedestrian
Facilities Committee
❑ Cultural Arts Council
u Miami Beach Commission for Women
❑ Visitor and Convention Authority
Design Review Board*
❑ Normandy Shores Local Government
Neighborhood Improvement
❑ Youth Commission
E 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 yLicense
Ai
Issuance Date License Expiration Date
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co Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board, pleaspindicate your affiliation with
Ai/
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
tig
If yes, please list below the names of your children, their ages and the programs in which they participate:
Child's name: Age: Program: �Q
Child's name: /" 11 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 or No[a If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money? Yes Zi or No
If yes, explain in detail:
• Are you currently serving on any City Board or Committee? Yesi21 or No La If yes, which board/committee?
• n what organi atio (s) in the City of Miami Beach do you currently hold membership?
o - f eZk o d OkSocia ro►N r i•dt,t'
Name (J Position
Name Position
• List all properties owned or in which you have an interest within the City of Miami Beach:
4410-4160 1
l(-155 Drexe( love,
• Are you now employed by the City of Miami Beach? Yes I®1 or No fin
Which department and title?
AIM
• Pursuant to City Code Section 2-25 (b): Do you have a parent U, spouse Za child brother or sister who is
employed by the City of Miami Beach? Yes IZior No
If "Yes," identify person(s) and department(s): & / / i1
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
Race/Ethnic Categories
What is your race?
African-American/Black
Caucasian/White
Asian or Pacific Islander
LA Native-American/American Indian
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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?
No
Et 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 ACCO t INGLY."
p ica't's Signature
106/1/6 5fi kle4d /K0
Da Name of pplicant (PLEASE PRINT)
Received in the Office of the City Clerk by:
(p✓e /v 3 //6/ /0/3/{
Name of Deputy Clerk Control No. ate
ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY
APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
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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: 305.673.741 1 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: /JeJryy
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.
/0-3/7/6
Signature ate
Updated: Tuesday, October 04, 2016
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Scott Needelman
1455 Drexel Avenue #1
Miami Beach, Florida 33139
305-710-5584
EDUCATION Bachelor of Science, Civil Engineering, May 1993, Florida State University,
Tallahassee, Florida
COMMITTEES/
ACTIVITIES
WORK
EXPERIENCE
Graduated, Miami Beach Senior High School, June 1988
Member, Historic Preservation Board, City of Miami Beach,
May 2015 -present
Director, Flamingo Park Neighborhood Association, August 2014 -present,
Member, January 2009 -August 2014
Member, Debarment Committee, City of Miami Beach, January 2009 -December 2010
Member, General Obligation Bond Oversight Committee, City of Miami Beach,
March 2003 -April 2008
Member, Eleventh Judicial Circuit Grievance Committee A, State of Florida,
February 2001 -January 2004
Member, Safety Committee, City of Miami Beach, January 2002 -December 2002
Member, Planning Board, City of Miami Beach, January 2000 -December 2001
Graduate, Miami Beach Citizens Police Academy, November 2000
Member, Community Development Advisory Committee, City of Miami Beach,
January 1998 -December 1999
President, SAN Development, Inc., September 2002 -present
Single-family home construction.
Property Manager, York Towers Apartments, May 1993 -present
Responsible for the day-to-day operation of 24 apartment units and four commercial spaces.
Assistant Project Manager, Fisher Island Holdings, LLC, January 2005 -May 2008
Managed the submittal and RFI processes for the construction of a ten -story luxury condominium
building and oversaw various other small construction projects.
Project Supervisor, Carmel at California Club Property Owners Association,
September 2001-December2001
Oversaw repairs to 34 condominium buildings due to flooding.
Project/Construction Manager, York Towers Apartments, February 1995 -August 2000
Conceived and executed the substantial renovation of three historic multi -family buildings,
approximately 18,000 sq. ft. Oversaw on a daily basis the various subcontractors from concept to
completion of projects.
CERTIFICATIONS Certified Building Contractor, State of Florida
Engineer Intern, State of Florida