Mohammed Islam Application PackageID MIAMI BEACH
NAME: Islam Mohammed
Last Name First Name
HOME ADDRESS: 1004 Biarritz Drive #3 Miami Beach
Apt No. Home No./Street City
PHONE: (786) 303-3407 (305) 861-9911
Home Work
CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
Middle Initial
Florida 33141
State Zip Code
Mohammed Islam 1960@gmaiLcom
Email Address
Business Name: Position: Civil Engineer
Address: 1004 Biarritz Drive #3 Miami Beach Florida 33141
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: Yes
• (Please circle one): I am now a resident of: North Beach
• I am applying for an appointment because I have special abilities, knowledqe and experience. Please list below:
I am a Civil Engineer & have huge experience about Sea Wall, Flood & Drainage Systems
• 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 Citv Clerk's Office. (Regular Boards of City)
Choice 1: Normandy Shores Local Government Neighborhood Improvement
Choice 2: Personnel Board
Choice 3: Sustainability 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 Issuance Date
License Number
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
Miami Beach Democratic Club
• I am now employed by the city of Miami Beach: No
Title
Secretary
Which department?
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
Property
1004 Biarritz Drive #3, MB, FL 33141
Gender: Male
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. Other
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 Mohammed Islam agreed to the following terms on
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No. Date
RESUNIE
Mohammed RafiquI Islam (Minto)
1004, Biarritz Drive APT # 3 - Owner of the property
Miami Beach FL — 33141
Phone: 786-303-3407, Email,
Objective: To obtain a challenging and rewarding position in which my skills and exp(
be utilized to contribute to the goals of an organization which, offers growth and ad
opportunities.
FAucation: B.S. in Civil Engineering (Bangladesh)
Professional Experience: Worked as a professional engineer and build a lot of buildings, I was
involved in a big project (0am constimetion) and it was under Saudi Ministry of water &
irrigation, and got a good reputation and certificate,
Business Experience: Started grocery business in, 1997 at 71" Miami Beach area. Then, the
second business opened in 2001. at 71't Miami Beach area, The third business opened in 2003.
The name of that business was 'STOP N SAVE' located at 1.245 71"t Miami Beach FL .-- 33141.,
it used to be a 7-11. Closed that business in 2010.
Finally, I -recently opened a gas station, (Mobil) in Key Marathon. It is located at 1.3155
Overseas Highway, Marathon FL — 33050 & keep busy myself as an. owner.
Langruage Skill: Bangla, English, Spanish, Arabic, Hindi, Urdit, and. a little bit of Portuguese,
Notary Public: Since 1999 working as notary public and notarized a lot of documents such as
immigration. documents, personal papers, some time I worked as a US. Notary Public Whelp the
rnobile embassy of Bangladesh. Since 2001. in Miami Dade Country FL
Marital Status: Married
Children: One, daughter & two sons. My daughter studies at FIU, My cider son. recently got
admitted to Florida State University, Tallahassee FL. Bothiny daughter and son finished their
high. school education from MAST Academy.
Reference:
Mr. Bruce Scheinberg (Attorney at Law)
Contact: (305)538-7575
Admilson Pitterson; Ex -Employee
Since- 1997- 2010 -
Contact; (786)759-9345
l(arnrul H Khan: Business Owner
Contact- (786)380-7817
Slogan; Our Community. Our Home. Make the right choice today.
Article:
Miami Beach is a city located In Miami -Dade County Florida. With one of the largest populations in the
county, 87,779, Miami Beach has been home to a number of residents from various nationalities,
genders, social, and economic classes. With hundreds and thousands of visitors from around the world
traveling every year to tour this famous city, Miami Beach has become one of the hottest vacation spots
in recent years. Apart from its bustling economy, the city has been a community to many of us.
Everyone here has good relations with their neighbors and together as friends we help keep our
community a safe and clean place.
How I can Improve the city:
In the rainy season residents of Miami Beach face big problems with the drainage system due to
flooding which Is a major issue. As a professional, I can say that I will propose a plan to address this Issue
and will ensure that this plan is executed. Furthermore I intend to beautify our community to help
ensure a continuing influx of tourist to further maintain our growing economy. By beautifying the
community we will not only continue to attract more tourists from around the world but also create a
safe, clean place for future generations. Furthermore, I Intend to rehabilitate members of the homeless
community by providing them with food and other necessary facilities. As well as proposing a plan so
there will be less taxation for the small businesses in order to survive these hard times. With the help of
the city, I will do my best to ensure that our needs are met,
N It