Marjorie York 12/31/2018MIAMIBEACH
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
Email CityClerk@miamibeach.gov
December 02, 2016
Ms. Marjorie York
829 15th Street, APT # 10
Miami Beach, Florida 33139
SUBJECT: Miami Beach Commission For Women
Congratulations! You have been reappointed by Commissioner Kristen Rosen Gonzalezto the above
referenced, board or committee named above, for a term ending: 12/31/2018.
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 and good luck.
Regards,
Rafael Granado
City Clerk
cc: Saul Frances, Parking Director
David Zaret, 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 Ordinance
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) 673-741 1, Fax: (305) 673-7254
Email CityClerk@miamibeach.gov
TO: Ms. Marjorie York
RE: Miami Beach Commission For Women
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.
s. Marjorie York
Sworn to and subscribed before me this day of2, 2016.
amon 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.
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK'S OFFICE CiiyClerk@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: Wa d 0 r/ {'] DA?
1 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: Monday, April 20, 2015
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
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City of Miami Beach Board & Committee
Citywide Parking Application
DATE OF APPLICATION: r 2 0e/0
LAST NAME: •V0 r IL FIRST NAME: t r4,n Y'/
V r , U
NAME OF BOARDICOMMITTEE:%.Qttwe 2N 0_oi w) > S`3/ 4 0
ADDRESS:
for
WORK PHONE:
CELL PHONE:
HOME PHONE:
VEHICLE MAKE
VEHICLE MODEL
VEHICLE YEAR I TAG NUMBER
I understand that Board/Committee Citywide Parking entitles me to park at any
parking meter both on -street and off-street (metered parking lots) I further understand
that Citywide Parking is NOT AUTHORIZED AT ATTENDED LOTS OR GARAGES —
EXCEPTION: CITY HALL GARAGE (i 55 MERIDIAN AVE).
NOTE: Your license plate now serves as your "parking permit', Parking enforcement
specialists are equipped with handheld and mobile LPR devices to confirm your parking
permit status (valid/invalid).
In order to avoid any unnecessary enforcement actions, it is important that our records
reflect the most current and accurate information regarding your vehicle license plate.
Please provide us with your current vehicle information (year/make/model/license plate
number). Inaccurate and/or outdated vehicle information may lead to the issuance o
parking citation(s), and/or the towing of your vehicle.
Applicants Signature:
MIAt\/\ BEACH
DIVERSITY STATISTICS REPORTING
Name: 4 rd n r ►
Board / Committee: 01 Iwu
(6..4)7 . m SS/i>4
c„,
Appointment Date: 12 Z /iD
Pursuant to City of Mia i 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?
frican-American/Black
-.\L Caucasian/White
Asian or Pacific Islander
Native-American/American Indian
Other — Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not
Spanish, Hispanic, Latino/a,
ZiNo
{D Yes
Do you consider yourself Physically Disabled?
LOPNo
Yes
C:\Users\CENTFraN\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\NP4J9CNX\6C minority
information form 05-20-13 FINAL.doc
Updated: Monday, January 26, 2015
"v^,iAh"J BEACH
LastmeOR t�
BOARD AND COMMITTEE APPLICATION FORM
iFrstName
g',z 7 /5e4 i/'/im' i
Home Address City
30,—.‘7Y -5Y1,
Home Telephone Work Telephone
State
Middle Initial
Zip Code
Business Name
Cellular Telephone Email address
Occupation
Business Address
Professional License (describe):
City
State
Expires:
Please attach a copy of currently effective professional license.
Zip Code
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 o'nership/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 LA
• Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes Li or No r
• Are you a registered voter in Miami Beach: Yes 1N1 or No
• 1 am now a resident of: North Beach [::1 South Beach [,M- iddle Beach
• I am -pplying fora appoi tment bec-use I have specie abilities, knowledge and experier ce. Prase list bel
t j rvej,�x�1
• Are you presently a registered lobbyist with the City of Miami Beach? Yes LJ or No r
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.
J Affordable Housing Advisory Committee
0 Health Advisory Committee
0 Parks and Recreation Facilities Board eO
I 0 Art in Public Places Committee
0 Health Facilities Authority Board
0 Personnel Board
I0 Audit Committee
0 Hispanic Affairs Committee
0 Planning Board**
0 Board of Adjustment `-�,f"
0 Historic Preservation Board'{
0 Police Citizens Relations Cornmittee
0 Budget Advisory Committee
0 Committee on the Homeless
0 Housing Authority
0 Human Rights Committee
0 LGBTAdvisory Committee
0 Marine & Waterfront Protection Authority
0 Production industry Council_
0 Sister Cities Program
0 Sustainability Committee
0 Transportation, Parking, & Bicycle -Pedestrian
Facilities Committee
0 Committee for QualityEducation in MB
0 Convention Center Advisory Board
0 Cultural Arts Council
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 la Ing Board, attach a copy of your currently -effectively license, and furnish the
following information:
Type of Professional License
Yp License Number
License Issuance Date License Expiration Date
Page 1 of 4
F:\CLER\SALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx
� ° 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
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 orNoIf yes, please explain in detail:
• Do you currently have a violation(s) of City of Miarni Beach Code? Yes EZI or Noidf yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money? Yes CZ) or No UIf yes, explain in detail:
• Are you currently serving on any City Board or Committee? Yes 0 or N
44111
• In what orga ization(s) in the City of Miami Beach do you curr ntly h
-e-et,11,c; a4v
If yes, ich board/committee?
membership?
• List all properties owned or in which you have an interest within the City of Miami Beach:
• Are you now employed by the City of Miami Beach? Yes 1::3 or No [_-A
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have3 parent La spouse [j, child [Zi brother t:Z1 or sister 1:1 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 Li Female
Race/Ethnic Categories
What is your race?
[ZA,frican-American/Black
LJ CaucasianNVhite
1--:1 Asian or Pacific Islander
LD Native-American/American Indian
Page 2 of 4
FACLERULL \aFORMS \BOARD AND COMMITTEES1BD APPLICATION REVISED 06142016.docx
��
�~�Othar—Phn\Roco:
Do you consider yoursef to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a.
h
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Do you consider yourself Physically Dsab!ed?
��
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::1Yea
NOTE: IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY
MEMBERS. THESE LAWS NCLUDE, 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: pmhibitinn, during tenure and for one year after leaving office, from having
any iriterest in or receMng any benefit from Community Development Block Grant funds for either yourself, or those with whom
you have business or immediate family ties (CFR 570611).
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 — Forrn 8B is for use by any person serving at the county, city or other local level of government on an appoirited or
elected bnard, ouunci{, onmmisoion, 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.
1 HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF TI -IE APPLJCATION; AND 1 HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPTER 2, ARTICLE Vil, 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."
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App ova re
Received the Officeof the City Clerk by:
it/ot Ott
Date
te/t-k_
Name of App ican (PLgSCF/RINT)
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NameofDeputyC|erkControl No.
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Date
� A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY
ATTACH
APPLICABLE E PROFESSXONAU LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
Page 3 of 4
rACLEnxSAu‘aFommo\BoAnoAND COMMITTEES mcAPPLICATION REVISED mmmoo.dvcx
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
w"^w.miomi600c6H.Qi:Lv
OFHCE OF THE CiTY CLERK
CityC}e,k@miomi6eockH.8ov
Telephone: 335.673.7411 Fax: 305.673.7254
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-
OmdaCountyFinunoia/DisdoounuCmdeProvhaionCodaSection2-11:41(i) (2)
Board Member's Name: )eZ/„ *~'Y�ta-
I
��/�l
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 Corn0iemion, 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 ofIncome 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
ofnomore than $5UO.8Odays injail orboth.
Updated: Tuesday, October 04, 2016
Page 4 of 4
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al MIAMIBEACH
NAME: York
CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
Marjorie N
Last Name
First Name Middle Initial
HOME ADDRESS: 829 15th Street, APT # 10 Miami Beach
Florida 33139
Apt No. Home No./Street
PHONE: 305-673-5770
City
State Zip Code
Home
Business Name:
Address:
Work
Email Address
Position:
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: No
• Are you a registered voter in Miami Beach: Yes
• (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:
I am on many boards, have good connections in the community, and like to work on community events.
• 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: Miami Beach Commission For Women
Choice 2: Committee for Quality Education in Miami Beach
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:
• 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?
Name
Chamber of Commerce
Title
• 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:
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 Marjorie York agreed to the following terms on
Received in the City Clerk's Office by:
Name of Deputy Clerk
Control No. Date