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Mercedes Carlson 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 November 15, 2016 Ms. Mercedes Carlson 5120 Lakeview Drive Miami Beach, Florida 33140 SUBJECT: Miami Beach Commission For Women Congratulations! You have been reappointed by Commissioner Michael Grieco to 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.miainibeachfl.aov OFFICE OF THE CITY CLERK, Rafael Granado, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 TO: Ms. Mercedes Carlson 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. l(11 Ms. Mercedes Carlson Sworn to and subscribed before me this Zx d day of )e C , 2016. 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. MIAMI BEACH Name: DIVERSITY STATISTICS REPORTING Board / Committee: U1aA44- 6 ► rrti tS St Z5-? Appointment Date: L l 6/0 Pursuant to City of Miami each 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 P Female Race/Ethnic Categories What is your race? frican-American/Black Caucasian/White P Asian or Pacific Islander P Native-American/American Indian P Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. 'Yes Do you,consider yourself Physically Disabled? No D 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 CA MIAMIBEACH NAME: Carlson Mercedes CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM Last Name First Name Middle Initial HOME ADDRESS: 5120 Lakeview Drive Miami Beach Florida 33140 Apt No. Home No./Street PHONE: (305) 864-1646 City State Zip Code mercedescarlson@mac.com Home Business Name: N/A Address: N/A Work Position N/A Email Address Retired N/A N/A 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: 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? 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: Choice 3: 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 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? • List all properties owned or have an interest in, which are located within the City of Miami Beach: Property 5120 Lakeview Drive • I am now employed by the city of Miami Beach: No Which department? 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: Female 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. Yes 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. "1 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 Mercedes Carlson agreed to the following terms on Received in the City Clerk's Office by: i� e Cie Lk, z4 Name of Deputy Clerk /0Z(//C( Control No. /0/z/% Date Vercedes Car 5120 Lakeview Drive Miami Beach, FL 33140 T 305-864-1646 M 786-200-3536 mercedescarlson@mac com so Profile Successful Executive professional with 20 years of experience within the Techni- cal and Customer Service disciplines. My career encompassed the matriculation through various organizations from a Telephone Administrator to a District Sales Manager for the South Florida and Caribbean Region. As a Marketing Communi- cations Specialist I principally researched planned and managed meeting re- quirements for the Marketing and Sales Organizations of the Latam Division. I was the Owner and President for a Meeting Consultants company. Currently I am ma private investor who seeks out and analyses business opportunities where my expertise is utilized in making a small to medium business prosper in these chal- lenging times. Fully literate in Spanish, English, and Portuguese with some knowledge of French - These attributes help me understand the different cultures that encompass our City. Experience Varig Airlines, Miami, Florida - South Florida and Caribbean Regions District Sales Manager -1974 -1997 • Telephone Operator/Secretary o Managed calls for the entire office while ensuring all travel was necessary and cost effective. o Managed all scheduling for the Executives of the office • District Sales Manager o Ensured all staff was alert in managing the critical issues for their customers. o Managed the career development for the staff o Coached and counseled all my District staff to ensure they were aware of their customers' business issues and how they could help resolve them. 5120 Lakeview Drive Miami Beach, FL 33140 T 305-864-1646 M 786-200-3536 m eacar aon®iliac.oQm Ericsson, Inc., Miami, Florida — Latin American Region Marketing Communications Manager —1997 -1998 • Managed varied aspects of the operational issues for the Marketing and Sales Departments. Principally researched, planned and managed the meeting requirements for the Organizations of the Latam Division which included the offices within Latin America. Single contributor who managed all aspects of the position from incep- tion through implementation. Meetings Consultants, Miami, Florida Owner and President —1998 — 2000 • Managed all facets of the business to ensure it remained on track and met the needs and requirements of my customers. • Ensured any scheduled meeting was effectively implemented within the stated budgetary requirements. Education Barry University - Miami Shores, Florida Master of Science - Major in Human Resource Development Referrals Available upon request 1 9 ) ANL' BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK'S OFFICE CityClerk@miamibeachfl.gov Telephone: 305.673.7411 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‘ C e6a �l5-6),03 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. l Signatulre ok-LA) (}v Updated: Monday, April 20, 2015 Page 4 of 4 F:\CLER\$ALL1aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx Date