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Jack Benveniste Application Package 2Benveniste Jack NAME: Last Name First Name Middle Initial 8075 Miami BeachHOME ADDRESS: Apt No.Home No./Street City Florida 33141 State Zip Code 3055381124 3055381124PHONE: Home Work jack@sefmss.com Email Address Miami Beach Street 8075 Noremac ave City Florida State 33141 Zip Code Address: Position:Business Name:business owner 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. YesƔ5HVLGHQWRI0LDPL%HDFKIRUDPLQLPXPRIVL[  PRQWKV Ɣ'HPRQVWUDWHDQRZQHUVKLSLQWHUHVWLQDEXVLQHVVLQ0LDPL%HDFKIRUDPLQLPXPRIVL[  PRQWKV Ɣ$UH\RXDUHJLVWHUHGYRWHULQ0LDPL%HDFK Ɣ 3OHDVHcircle one): I am now a resident of: Ɣ,DPDSSO\LQJIRUDQDSSRLQWPHQWEHFDXVH,KDYHVSHFLDODELOLWLHVNQRZOHGJHDQGH[SHULHQFH3OHDVHOLVWEHORZ Ɣ$UH\RXSUHVHQWO\DUHJLVWHUHGOREE\LVWZLWKWKH&LW\RI0LDPL%HDFK" Yes Yes North Beach No served approx 15 years on budget advisory board 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: Choice 2: Choice 3: Marine and Waterfront Protection Authority General Obligation (G.O.) Bond Oversight Committee Budget Advisory Committee No2. Present participation in Youth Center activities by your children 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: ages, and which programs. List below: if yes, please list the names of your children, their CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM * 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 _______________________ Error: Subreport could not be shown. Error: Subreport could not be shown. NoƔHave you ever been convicted of a felony:If yes, please explain in detail: ƔDo you currently have a violation(s) of City of Miami Beach codes:No If yes, please explain in detail: ƔDo you currently owe the City of Miami Beach any money:No If yes, please explain in detail: ƔAre you currently serving on any City Boards or Committees:Yes If yes, which board? police citizens ƔWhat organizations in the City of Miami Beach do you currently hold membership in? ƔList all properties owned or have an interest in, which are located within the City of Miami Beach: Error: Subreport could not be shown. ƔI am now employed by the city of Miami Beach:No Which department? Error: Subreport could not be shown. 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. MaleGender: Physically Challenged:No White Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino.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 Jack Benveniste agreed to the following terms on 12/4/2019 10:45:34 AM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Jack Benveniste 8075 Noremac Avenue Miami Beach, Florida 33141 * Born February 26, 1941 New York City, New York * Education: Attended the University of Miami * Personal: Married 50 years to Michaele 2 children 6 grandchildren • Business President of All Dade Bail Bonds – 50 years President of Southeast Florida Motorcycle Safety School 23 years (provider for Florida Department of Highway Safety and Motor Vehicles Florida Rider Training Program) President of TOAD program 11 years (Court ordered youthful offender traffic program) President of Gun Depot - 43 years President of All Florida Driver License Testing.(provider for Florida Department of Highway Safety and Motor Vehicles Driver license permit exams) 5 years President of Motorcycle and Scooter Safety Program of Florida. (Court ordered motorcycle and scooter safety program) • Community service involvement: Past member of City of Miami Beach Budget Advisory Board, Police Board, Parks and Recreation Board Currently serving as Flotilla Commander U.S. Coast Auxiliary