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Elsa Orlandini 12/31/08 It\ City of Miami Beach, 1700 Convention Centel Dlive, Miami Beach, Florida 33 i 39, www mlamibeachfl.gav OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel 305673-7411, Fax 305673-7254 12-20-2006 Elsa Orlandini 4711 Alton Rd Miami Beach, Florida 33140 (ill.J'ec-r; Miami Beach Commission on Status of Women Congratulations! You have been appointed by Mayor David Dermer to the agency, board or committee named above for a term ending: 12/31/2008. Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after January 1st, 2007, the term of board members who are directly appointed by a member of the City Commission shall automatically expire on December 31 of the year the appointing elected official leaves office. If you are unable to accept this appointment or have any questions, please call the City Clerk's Office at 305-673-7411. Please read the enclosed materials carefully. Congratulations again and good luck. Sincerely, RK~~ t,J j) City Clerk cc: Saul Frances, Parking Director Maria E. Martinez ATTACHMENTS: 1. City Code Ordinance section, applicable to agency, board or committee 2. General Provisions of Ordinance NO.97-3086 Amended by Ordinance No. 2006-3543 3. Ordinance No. 97-3105 4. Citywide parking permit application - Return completed application to the Parking Department located at Palm Court Building, 309 23rd Street, Suite 200 - Tel: 305-673- 5. Guide to the Sunshine Amendment and Code of Ethics for Public Officers and 6. Miami Beach Code Section 2-459 7. Miami-Dade County Code Section 2-11.1 ~,.'e iJre ~.-:,';':r!t:fe::j' ,;D pt'/,;.:,J,n~~ ('/(:ei/.;':n: i..','i.{.i,; 'Or :e ,,';';::: f(; "-,,,1;::) i;\II;~. '.'v:.:yk. r;;rd {.,fo'ji in '",b:'oni, rl,Jpru)!, hiYo{iC communiiy It\ City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wwwmiamibeachflgov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel 305-673-7411, Fax 305-673-7254 TO Elsa Orlandini RE: MB Commission on the Status 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: 12/31/2008. 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 theFlorida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees, and understand that as a member of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure* require- ments of Miami-Dade County or the State of Florida (depending on the board or committee on which I serve) on July 1 st, following the closing of the calendar year on which I have served. -~~ Elsa Orlandini Sworn to and subscribed before me this22~day of J::R~ 200~ ~~~ 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. i/ ve ~),'E; ,-: (y;,rni'\-"d iO rYc.v;dir:~"J ('yc(:i!t-'Ji! ~() ';:"';0 1\'0, \'V'Ork. one! pia)' in \libroni, :r~)picor. hi:.,toric communi!y'. it:. ~ "::_:,:: MIAMIBEACH BOARDS AND COMMITTEE APPLICATION FORM 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 [/ or No [ ] Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes [] or No [ ] I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes [~ My ~ special p abilities, knowledge, or I _ L '. eX6(~r!ence is: .1 ().;vy1, ~ . otk ~ 0/t'-I2 ~~~. Are you a rep{stered voter-in Miami Beach: Yes or No 0 NAME: (lLVlOJv\&(V)( E1s..~ IV) 1 Last Name ? _ Il First Nap:)e II Middle Initial Home _ ~7f IlHfon /~ v1lt~ ~'-1 B3/YU Address: No. Street City ;-L State Zip Code Phone: 3oS5~ <1lp51 Home 30 S; tf VI --)1 (P D Work ?x>s S3X'Q &5{ ..el'iJ.. P$Y~@ xo!./tuo- (O(Yl Fax Email add ess North Beach 0 South Beach 0 Middle Beach g----- (Please check one): I am now a resident of: Business Name: Applicant's Position: No. ~ street City State Zip Code Address: DOwner 0 Stockholder/Shareholder 0 Corporate Officer 0 Other Explain: professional, Licrnse (describe): ~ ~ ~(ljr..Jf\flA~. ?'I ~57~ Expires: 5~I_blp ~ Attach a copy of the license listed above. 1. Have you ever been convicted of a felony: Yes 0 or No ~es, please explain in detail: 2. Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or No ~ yes, please explain in detail: ,/ 3. Do you currently owe the City of Miami Beach any money: Yes 0 or No ~ If yes, explain in detail: 4. Are you currently serving on any City Boards or Committees: Yes 0 or No ~ If yes; which board? C:\DOCUMENTS AND SETTINGS\COMPGARJ\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OlK87\BC APPlICA TlON JAN 2006.DOC What organizations in the City of Miami Beach do you currently hold membership in? Name: n VVI e- Title: Name: Title: C:\DOCUMENTS AND SETTINGS\COMPGARJ\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLK87\BC APPLICATION JAN 2006.DOC I am now employed by the City of Miami Beach: Yes 0 or No ~ yes, which department? Pursuant to City Code Section 2-25 (b): Do you have a parent 0], spouse 0], child OJ, brother 0], or sister 0] W~yed by the City of Miami Beach? Check all that apply. Identify the department(s): 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. Reqular Boards of City) o Art in Public Places Committee DHousing Authority o Barrier Free Environment Committee DLoan Review Committee o Beach Preservation Board DMarine Authority o Beautification Committee DMiami Beach Cultural Arts Council o Board of Adjustment (Flood Management) * ~iami Beach Commission on Status of Women o Budget Advisory Committee DMiami Beach Florida Sister Cities o Committee on the Homeless DNormandy Shores Local Gov. Neighborhood Improvement o Committee for Quality of Education in Miami Beach DNorth Beach Youth Center Oversight Committee o Community Development Advisory Committee DOversiQht Committee for General Obligation Bond Community Relations Board DParks & Recreational Facilities Board o Convention Center Advisory Board !JI Personnel Board o Debarment Committee o PlannirlQ Board * o Design Review Board * ~Police Citizens Relations Committee o Fine Arts Board o Production Industry Council o Golf Advisory Committee o Public Safety Advisory Committee o Health Advisory Committee o Safety Committee t- Health Facilities Authority o TranSl2.ortation & ParkinQ Committee ~ _Hispanic Affairs Committee o Visitor & Convention Authority DHistoric Preservation Board * o Youth Center Advisory Board *Board Required to File state Disclosure form 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: Yes 0 No 0 Years of Service 0 2. Present participation in Youth Center activities by your children Yes 0 No D. If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Child's name: Age: _ Program: Age: _ Program: This section is "not required" but desired: Age: 0 ;31- Gender: Male ~ 0 Ethnic Origin (Check one) /' White 0 African-American/Black 0 Hispanic: [YI' Asian or Pacific Islander 0 Am~an Indian or Alaskan Native 0 Employment Status: Employed @"'Retired 0 Home-maker 0 Other 0 "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 M~mb~" - ~~ ..~ -6!2!?/O(P e!.f.tL lJdaf/diYi ~ iJ/03 A Icant's Signature Date Name of Applicant (PLEASE PRINT) Attachment: Please attach a copy of your resume to your application. NOTE: Applications will remain on file for a period of one (1) calendar year. C:\DOCUMENTS AND SETTINGS\COMPGARJ\LOCAL SETTlNGS\TEMPORARY INTERNET FILES\OLK87\BC APPLICATION JAN 2006.DOC , , .~ 'ffp?? Received in City Clerk's Of~i:e ~ / L~. Clerk :::It- ~ I') ~~ . ~ ? Document J&ntol Nu~ber 0SSignedD~~ the City Clerk's OfficeQ.---.,b: ntered By /,' . Date . ~. ,olf; F:\CLER\$ALL\ELlZABET\B&C\B&C Applicoti n Jon 2006.doc . Deputy C:\DOCUMENTS AND SETTINGS\COMPGARJ\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLK87\BC APPLICATION JAN 2006.DOC