Outside Employment - Ricardo DopicoMAMIBEACH
CITY OF MIAMI BEACH
REQUEST FOR APPROVAL OF OUTSIDE EMPLOYMENT
TO BE COMPLETED BY EMPLOYEE — City of Miami Beach employees may accept outside employment as long as
the employment is not contrary, detrimental or adverse to the interests of the City, and as long as no City time,
equipment or material is used.
This form must be completed and approvedrp for to beginning any outside employment. Requests for approval of
outside employment must be made on a yearly basis (even if for the same outside employment that had been
previously approved).
City employees engaging in outside employment must also file an "Outside Employment Statement" form with the
Office of the City Clerk by July 1St of each year, in accordance with Section 2-11.1(k)(2) of the Miami -Dade County
Code.
INFORMATION REGARDING CITY OF MIAMI BEACH EMPLOYEE
EMPLOYEE'S NAME: LAST NAME, FIRST NAME, MIDDLE NAME:
EMPLOYEE ID NUMBER:
Dopico, Ricardo J.
24344
JOB TITLE:
HOME TELEPHONE NUMBER:
First Assistant City Attorney
DEPARTMENT/DIVISION:
WORK TELEPHONE NUMBER:
Office of the City Attorney
(305) 673-7000 ext. 24254
SUPERVISOR'S NAME:
CELLULAR TELEPHONE NUMBER:
Rafael Paz
(305) 608-4380
NORMAL WORK DAYS AND TIMES:
Monday - Friday, gam - 5pm
INFORMATION REGARDING OUTSIDE EMPLOYMENT
NAME OF BUSINESS, ORGANIZATION OR INDIVIDUAL HIRING CMB EMPLOYEE:
Estefan Enterprises, Inc.
ADDRESS OF OUTSIDE EMPLOYER:
420 Jefferson Avenue
TELEPHONE NUMBER:
(305) 695-7000
JOB TITLE THAT CMB EMPLOYEE WILL HOLD:
Legal Consultant
NAME OF OUTSIDE EMPLOYMENT SUPERVISOR:
Emilio Estefan/Gloria Estefan
NORMAL WORK DAYS AND TIMES:
Variable - estimate 15 hours per month
DESCRIPTION OF DUTIES:
Assist new General Cousel with transition; assist other Estefan Enterprises employees and consultants as needed,***
WHAT DUTIES MIGHT BE A CONFLICT OF INTEREST WITH YOUR CMB POSITION?
None
WILL YOUR PROPOSED OUTSIDE EMPLOYER RELEASE YOU IF AND WHEN YOU ARE CALLED FOR EMERGENCY SERVICE BY THE CITY?
Q YES ❑ NO
***solely with regard to matters not involving the City or the Estefans' business or property interests in Miami Beach.
This form has 2 pages — be sure to complete both pages.
Employee signature required on page 2.
CITY OF MIAMI BEACH
REQUEST FOR APPROVAL OF OUTSIDE EMPLOYMENT - CONTINUED
PAGE 2 of 2
By signing below, I certify that all of the information given on page one (1) of this document is true, accurate, and
complete to the best of my knowledge. I understand that all information is subject to investigation and that falsification,
omission, or misrepresentation is sufficient cause for disciplinary action, up to and including termination. I also
understand that I am responsible for informing my supervisor in writing if any information about my outside employment
changes, especially if there arises any possible conflict of interest. Failure to do so may lead to disciplinary action,
including termination of employment with the City of Miami Beach. This request for approval of outside employment will
be made on a yearly basis.
EMPLOYEE NAME: EMPLOYEE ID NUMBER:
Ricardo Dopico 24322
EMPLOYEE SIGNATURE: DATE:
TO BE COMPLETED BY EMPLOYEE'S SUPERVISOR, DIVISION DIRECTOR, DEPARTMENT DIRECTOR,
ASSISTANT CITY MANAGER AND CITY MANAGER
NAME OF SUPERVISOR
PLEASE CIRCLE ONE:
SUPERVISOR SIGNATURE & DATE
APPROVED DISAPPROVED
NAME OF DIVISION DIRECTOR
PLEASE CIRCLE ONE:
DIVISION DIRECTOR SIGNATURE & DATE
APPROVED DISAPPROVED
NAME OFDEPARTMENTDIRECTOR
PLEAS CIRCLE ONE:
DEPARTMENT DIRECTOR SIGNATURE & DATE
APPROVED DISAPPROVED
Z- -
HUMAN RESOURCES DIRECTOR
-PtEASS CIRCLE ONE:
DEPARTMENT DIRECTOR SIGNATURE & DATE
APPROVED DISAPPROVED
ASSISTANT CITY MANAGER
PLEASE CIRCLE ONE.
ASSISTANT CITY MANAGER SIGNATURE & DATE
APPROVED DISAPPROVED
CITY MANAGER
PLEASE CIRCLE ONE:
CITY MANAGER SIGNATURE & DATE
APPROVED DISAPPROVED
If you have any questions regarding outside employment, please contact the Human Resources Department at
305.673.7524.
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