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Liza Samuel Application PackageSamuel Liza Last Name First Name Middle Initial 4550 North Michigan Avenue Miami Beach Home Address City FL 33140 State Zip Code HomeWork lizasamuelrealty@aol.com Email Address 305-490-4717 Cellular Business Address City State Zip Code Occupation:Business Name: Realtor 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: Animal Welfare Committee BOARD AND COMMITTEE APPLICATION FORM Note:If applying for the At-Large position of the Historic Preservation Board, please answer the below questions: Have you ever resided in one of the City's Historic Districts for at least one year?No No Address in City Historic District submitted. Professional License License Number Issuance Date Expire Date Real Estate 3016631 12/11/2001 9/30/2021 Note:If you are seeking appointment to a professional seat (e.g. attorney, architect, etc.), you must attach a copy of your currently effective corresponding professional license. Pursuant to City Code section 2-22(4) a, b and c: Members of Agencies, Boards, and Committees shall be affiliated with the city. This requirement shall be fulfilled in the following ways: YesResident of the City for a minimum of six (6) months: Demonstrate an ownership interest in a business established in the City for a minimum of six (6) months:No AFFILIATION WITH THE CITY OF MIAMI BEACH a. ● I am resident of:Middle Beach Or b. "Ownership Interest" shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. c.Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months):No Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by a 4/7th vote of the Mayor and City Commission. NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation requirements of section 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they have met either (or both) of said affiliation requirements. The original affidavit shall be filled with the Office of the City Clerk prior to being sworn in as a member. Or No● Have you ever been convicted of a felony: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? ● Are you presently a registered lobbyist with the City of Miami Beach?No ● I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I sit on the board of animal rescue (Jamie's Rescue) for seven years. NOTE: IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE MEMBERS. THESE LAWS INCLUDE, 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 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). 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 - Form 8B is for use by any person serving at the county, city, or other local level of government on an appointed or elected Board, Council, Commission, Authority, or Committee. It applies equality to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143. Florida Statutes. ● In what organization(s) in the City of Miami Beach do you currently hold membership in? No Organization Information Submitted. ● List the address of all properties owned or in which you have an interest within the City of Miami Beach: Property 4550 N Michigan Ave miami beach 33140 and 9 island ave #1809 miami beach 33139 If so, which department and title?No● Are you now employed by the City of Miami Beach: ● Pursuant to City Code Section 2-25 (b): Do you have a parent, spouse, child, brother, or sister who is employed by the City of Miami Beach?No If "Yes", identify person(s) and department(s): No relative's information submitted. BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-Dade County Financial Disclosure Code Section 2-11.1(i)(2) 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. One of the following forms must be filled 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;" or 2. A "Statement of Financial Interests (Form 1)¹ ;" or 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. _____________________________ ¹ Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County’s financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. DIVERSITY STATISTICS REPORT The following information is voluntary and has no bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. OtherRace/Ethnic Categories What is your race? No details providedOther Description: Gender:Female Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino.No Physically Challenged:No I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII, 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.” I Liza Samuel agreed to the following terms on 8/1/2021 7:27:04 PM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Board and Committee Application Checklist: Please ensure you have provided all information before applying or reapplying to any Board and Committee. YES YES YES YES I have answered all questions fully. I have uploaded a current resume, photograph, and a copy of any applicable professional license. I have completed and attached the Board & Committee Financial Acknowledgment Statement. I have completed and attached the Diversity Statistics Report. If you have any questions, please contact the Office of the City Clerk via email: BC@miamibeachfl.gov or telephone: 305.673.7411 Note: Florida Statutes 119.071: The role of the Office of the City Clerk is to receive and maintain forms filed as public records. If your home address, telephone numbers, and/or photograph are exempt from disclosure and you do not wish your home address, telephone numbers, and/or photograph to be made public, please: 1) Use your office or other address for your mailing address; 2) Use your office or other telephone number for your contact number; and 3) Do not attach a photograph. CAREER OBJECTIVE To help children, teens, young adults and their parents prioritize each others happiness, maximize their abilities, solve inter-family conﬂict, and mental health issues as a licensed social worker. WORK EXPERIENCE REAL ESTATE AGENT, MIAMI BEACH, FLORIDA — 2001-PRESENT Act as an intermediary in negotiations between buyers and sellers, generally representing one or the other. Advise clients on market conditions, prices, mortgages, legal requirements and related matters. Promote sales of properties through advertisements, open houses, and participation in multiple listing services. LINE PRODUCER, FOX NEWS CHANNEL, NEW YORK CITY — 1996-2001 Select stories, music, graphics, live shots, and ideas to be produced. Coordinate the activities of all writers, directors, reporters, anchors, ﬁeld and segment producers. In charge of breaking news stories. ASSOCIATE PRODUCER, DAY & DATE CBS, NEW YORK CITY — 1995-1996 Conduct ﬁeld interviews. Help produce segments for syndicated live to tape news programing. WRITER & RADIO REPORTER, ASSOCIATED PRESS, NEW YORK CITY — 1994-1996 Write, report and investigate breaking news developments, such as disasters, crimes, or human-interest stories. FITNESS INSTRUCTOR, SCARSDALE AND NEW YORK, NEW YORK — 1990-1994 Motivate workout enthusiasts and instructors to reach new ﬁtness and health goals. Teach master classes in step, aerobics and conditioning. VOLUNTEER EXPERIENCE BOARD MEMBER, JAMIE’S RESCUE, MIAMI BEACH, FLORIDA — 2014-PRESENT Vet families to assess compatibility with puppies and dogs. Organize adoption events. Find homes for stray or unwanted animals. BOARD MEMBER, TEMPLE BETH SHOLOM, MIAMI BEACH, FLORIDA — 2017-2019 Lead monthly board meetings as Sisterhood President. Organize and create many charity events throughout the year. Act as a lay leader for the congregants; membership including 4550 North Michigan Avenue, Miami Beach, Florida 33140 305-490-4717 Liza@TheRightRealtorMatters.com LIZA SAMUEL about 4,000 people. Work with local food bank, nursing home, battered women shelter, homeless and children in need. PTA PRESIDENT & CHAIR, SOUTH POINTE ELEMENTARY, MIAMI BEACH, FLORIDA — 2008-2014 Worked closely with teachers, administration, parents and children to ﬁnd solutions to various problems including lack of funding, poor parental involvement, and poverty. Created after school programming for students. PTA PRESIDENT & BOARD MEMBER, TEMPLE BETH SHMUEL MONTESSORI , MIAMI BEACH, FLORIDA — 2006-2008 Help create programing to enhance the lives of young children in this newly developed school. SUICIDE PREVENTION HOTLINE, PURCHASE, NEW YORK — 1994 Counsel students that call in on overnight shifts under supervision of professor. EDUCATION STATE UNIVERSITY OF NEW YORK AT PURCHASE, PURCHASE, NEW YORK B.A. Political Science + Language and Culture 1994 CONNECTICUT SCHOOL OF BROADCASTING, NEW JERSEY - 1994 SKILLS Dedicated wife and mother. Raising three honorable people together. Fluent in Farsi, Spanish and French. AWARDS Miami Half Marathon Finisher 20018, 2017. Top 10% of Realtors in sales 2016. Mayor’s Ofﬁce Certiﬁcate of Recognition for outstanding dedication to the educational excellence of Miami Beach students 2009, 2010, 2011, 2013.