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Gail Harris 12/31/2018MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov March 06, 2017 Ms. Gail Harris 5725 No. Bay Rd. Miami Beach, Florida 33140 SUBJECT: Personnel Board Dear Ms. Gail Harris: Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2018. 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, 52'afael Granado City Clerk cc: Saul Frances, Parking Director Michael Smith, 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 E. Granada, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov TO: Ms. Gail Harris RE: Personnel Board 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: 12/31/2018. 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. Sworn to and subscribed before me this Ms. Gail Harris o day of A 2017 6';) Ramon Quezada 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. m MIAMIBEACH NAME: Harris CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM Gail L Last Name First Name Middle Initial HOME ADDRESS: 5725 No. Bay Rd. Miami Beach Florida 33140 Apt No. Home No./Street PHONE: (305) 864-7662 City State Zip Code gailkayeharris@gmail.com Home Business Name: Gail L. Harris LCSW Work Address: 333 41 Street Suite 506 Email Address Position: Clinical Social Worker Miami Beach Florida 33140 - 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: Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I enjoy helping MB be the best place it can be. • 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 three (3) choices will be observed by the City Clerk's Office. (Regular Boards of City) Choice 1: Personnel Board Choice 2: Choice 3: • 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 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: Child Name Age 68 Program • 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? • I am now employed by the city of Miami Beach: No Which department? • List all properties owned or have an interest in, which are located within the City of Miami Beach: Property 5725 N. Bay Rd Gender: Female 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. Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. White 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 Gail Harris agreed to the following terms on Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date RESUME GAIL L. HARRIS, LCSW 5725 NORTH BAY ROAD MIAMI BEACH, FL 33140 DATE OF BIRTH: 10/19/39 TELEPHONE: HOME (305) 864-7662 WORK (305) 538-1997 Ceil(786 210 4814) Email: gailharris@the-beach.net coq:1 r rrLS 14'1 5/ 0 .torr+ EDUCATION L.C.S. W. M.S.W. M. Ed. B. Ed. PROFESSIONAL AFFILIATIONS 0 Va/c,20/3 May, 1990, Licensed Clinical Social Worker May 1987, Barry University, School of Social Work August 1966, University of Miami, School of Education;Teacher Certified -2001 June 1961, University of Miami, School of Education National Association of Social Workers Association for the Advancement of Social Work with Groups Association of Group Work Studies/Barry University Clinical Social Work Association of South Florida Association of Death Education and Counseling PROFESSIONAL: WORK EXPERIENCE May 2003- Parent Co -ordinator -Miami Dade, Fla. April 2003- Certified Family Mediator -State of Florida Fall 2000 Supervisor and Facilitator to Miami Mental Health Listener's Program to present Facilitator to Listener's Program for Miami Dade Co. Schools January 2001 Adjunct Professor/Barry University -Women's Studies March 2001 Supervisor to Kesher Program April 1995 Certified in Hypnotherapy April 1991 to present February 1989 -2000 To Present Sept. 1999 April 1995 1994 —to present May 1987 to April 1991 September 1986 Private Practice FACILITATOR FOR PROJECT RESOLVE: Facilitating groups for sexually abused women. Facilitate groups for sexually abused women in private practice Supervisor to Counseling Dept. at Miami Country Day School SUPERVISOR: Providing supervision to social work student interns- for Agency for Health Education & Counseling Mental Health Professional Leader/consultant to the March of the Living Program -Miami Dade Co. Clinical Social Worker at JEWISH FAMILY SERVICE working with individuals, children and adults, families, couples and groups (specifically self-esteem issues) with responsibilities for interviewing, assessment and diagnostic evaluations,crisis intervention, development of short and long term treatment plans and facilitating groups; collaborating with other professional and community agencies when necessary. Field Placement: JEWISH FAMILY SERVICE A clinical experience with responsibilities for the development of skills in assessment, interviewing, to present diagnostic evaluations, developing long and short term treatment plans, crisis intervention, counseling with individuals (specifically with women, ages 20-50), couples, families, adolescents and children and facilitating groups for the elderly; collaborating with ancillary professions and community agencies. September 1985 to May 1986 First year Field Placement: The GUARDIANSHIP PROGRAM OF August 1980 to June 1983 September 1961 to June 1969 DADE COUNTY, INC. Social Services related to the elderly; specifically acting as their guardians with responsibilities for assessment, discharges, placement, individual and family counseling, and performing an advocacy role for families and individuals within the court system. Developed a counseling program for families and rewrote the Professional Manual for the agency. Worked with referral agencies and developed knowledge of A.C.L.F: s, Nursing Homes, Hospitals and Foster Care Facilities within Dade County. Teacher of Compensatory Education, NORTH BEACH ELEMENTARY SCHOOL, Dade County, Florida. Taught kindergarten through grade six. Designed and implemented programming of math and reading to students with low stanines Elementary School Teacher, Dade County Public Schools, Leroy D. Feinberg Elementary, Grades Four and Two WORKSHOPS GIVEN: Feb. 09 Aoi 2 May,O', Mar,07 —Present. Oct. 05 Spring 05 Oct, 2003,05 Oct. 2003 Oct. 1997-99: June '97 From Couplehood to Parenthood, Temple Beth Sholom Stress Management....Women's Health Forum: Mt. Sinai Hospital Community Outreach Program Training workshop on Domestic Violence for Shalom Bayit Committee of JCS -Training to peers on Holocaust Survivor Group impact Transitions in Women Lives- to Group Work Association at Barry Univ. What Every Teen Should Know about Domestic Violence and Date Rape -Miami Beach Sr. High School Addressing Resilience in Children: Temple Beth Moshe Group Work Conference -Barry University (Group Work with Holocaust Survivors) June -"97 Presenter: Assoc. for Death Education Conference/Wash.,D.C./"The Affect of Revisiting the Past -Re: Holocaust Survivors) 1996 Presentation: Barry University Grp. Work Assoc.: Victims of Sexual Abuse 1995-96 Step Parenting Workshop 1993 Separation Issues Related to Parent/Child -Hebrew Academy Clinical Issues in Treating the Holocaust Survivor/ Presenter Miami Jewish Home and Hospital for the Aged Douglas Garden 1992 Maximizing Your Child's Potential /Temple Beth Shalom Maximizing One's Potential : Teaching Staff at Lehrman Day School 1991 Raising Self Reliant Children /Temple Beth Sholom 1989 Exploring Self -Esteem Issues with Adults/ Miami Dade Junior College 1988 Developing Self -Esteem with Children/Miami Dade Junior College COMMUNITYr INVOLVEMENT.40tti — c -)406 2008 City Board: Quality of Education member 2005 -07 Chair: The Commission on the Status of Women for Miami Beach 2003-06 Chair- Speaker's Bureau for Domestic Violence Greater Miami Jewish Federation -Women's Dept. 2001- 2005 Fall/2000-present- Facullitator and Supervisor: To Listener's Program/ 2000 - Appointed: City of Miami Beach/Commission on the Status of Women Chair of March of Living Task Force of Dade County 4 . ,�4 1247),' -Lo • -5-e4.0-014 2007 1999-2000 1994-97 Appointed to Newly formed Committee for March of the Living Futures Commission on Jewish Renewal: Greater Miami Jewish Federation Developed "Gesharim" Program:An interfaith program for the Greater Miami Jewish Federation 1990 MIAMI DARE COUNTY SOURCE OF INCOME STATEMENT Section 2-11.1(1) of the County Ethics Code requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July 1st of every year. Disclosure for Tax Year Ending 2016 Last Name a rrt`5 Mailing Address — Street Number Street Name, or P.0. Box 7d3.s' �✓• "&y., . City, State, ip First Name Middle Name/Initial a1/ Z. 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. 0 Filing as an Employee (check one Filing as a Board Member (check one) f'�ounty cgf Municipal: (Municipality) ec'r"'t) Board where serving Per 60 a r-oe . A-afroofj7L71--e-e- co 71/-4. //amgieSS' Alternate address (if home address is exempt) Work telephone 80.5153 eill9 Term began on/ended o / %I. //i List below every source of income you received, along with the address and therinci al activityof p p each source. Include your public salary. Place the sources of income in descending order, with the largest source first. Examples of sources of income include: compensation for services, income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. 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 se orate h t h k h Name of Source of Income Address Public Health Trust il•i is .4esid Municipal: P6ci is )4,...,4,4 chA 4 6Z:14 • County 111 * (Municipality) Department Position or Title Employee ID Number Work address Work telephone Employment began on/ended on Filing as a Board Member (check one) f'�ounty cgf Municipal: (Municipality) ec'r"'t) Board where serving Per 60 a r-oe . A-afroofj7L71--e-e- co 71/-4. //amgieSS' Alternate address (if home address is exempt) Work telephone 80.5153 eill9 Term began on/ended o / %I. //i List below every source of income you received, along with the address and therinci al activityof p p each source. Include your public salary. Place the sources of income in descending order, with the largest source first. Examples of sources of income include: compensation for services, income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. 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 se orate h t h k h Name of Source of Income Address p see , c ec ere. Description of the Principal Business Activity il•i is .4esid 3-3-h/•a.11•sTs� P6ci is )4,...,4,4 chA 4 6Z:14 • 1. (33/ice I hereby swear (or affirm) that the information above is a true and correct statement. Signature of Person Disclosing Vith alio/r Date sign RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: 138_SP-14 COE 2016 Scanned Date/Initials: BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK'S OFFICE 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: Ca t / rr/5 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. t --K 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. A4Alzeo 1/1/1/e• /4,, Sigg ature Date Updated: Monday, April 20, 2015 Page 4 of 4 F:\CLER\BALL\aFORMS\BOARD AND COMMITTEES\SC APPLICATION REVISED 06022014.docx MAW\ bE= DIVERSITY STATISTICS REPORTING Name: �p Ct it_ tict1/4--ri S ,. Board / Committee: [Dec O no .e l 80A,^0.0 Appointment Date: 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: Gender: Male Female Race/Ethnic Categories What is your race? �i A` • an-American/Black 1j CaucasianNVhite Asian or Pacific islander Native-American/American Indian 0 Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mar* the "No" box if not Spanish, Hispanic, Latino/a. o 0 Yes Do you consider yourself Physically Disabled? No Yes C:\Users\CENTFraN`AppDatalLocai\Microsoft\Windows\Ten:ooranl interne,: FiiestContent.outlook\NP4J9i'",N:C•,jr, minorily information Form 05-20-13 FINALdoc Updated: Monday, January 26, 2015