Tammy Green 12/31/08
m
City of Miami Beach, 1700 Conver.lion Center Dri'ie, Miami Beach, Flarida 33139, www miarnibeachflgov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel 305.67314 I 1, Fax 305.6737254
~.~
12-20-2006
Tammy Green
5500 Collins Ave
Miami Beach, Florida 33140
:stlsueCT: Production Industry Council
Congratulations! You have been appointed by Commissioner Michael Gongora
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 1 st, 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.
~IY'
RObert~~/b f b,
City Clerk
cc: Saul Frances, Parking Director
Graham Winick
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 (J:C : (;,.':';;,;,'\::..1 [)f' .;,-I~~.,; (-ye,:.,,:,/,,-'I;.'
t() '.'"he /;\le, ,-,vorl<. (;nd pfo~, in {_,~:! v..:bioni, .'r~")pic()l. hi~,rofic community-
m
City of Miami Beach, 1700 Convention Cenler Drive, Miami Beach, Florida 33139, www.miamibeochflgov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel 305.673.7411, Fax: 305.673.7254
TO Tammy Green
RE: Production Industry Council
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 andlor 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 whi d.
, 200!t2
*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.
\, Vf:' :-un:rruitcj prc,vidinq excr:.~.:f.ir:.-.'n;'
A:"/rce ,,-;(1(,)
'," '.',11,0 !!ve, \V()!.<. unci pia'v' in vibioni, f"~)Plco( hi5toric cornrnunii"y'
-
,......,
CITY OF MIAMI BEACH 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 [~r No [ ] _./
Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes [.-1"'" or No [ ]
I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes [....}-':'
My special abilities, knowledge, or experience is: A~, ......,.....~L.-.'\. \ i-t\. "\=. \ ""^ J \> ...-."'f'..~J ,v \ '" L... ~~
Are you a registered voter in Miami Beach: Yes [ ] or No []. I /
NAME: G ~ -L--LI\ ~ "'^" """ =t ~ .
Last Name First Name l Initial
Home 'S~oo c.....\\..-i\.S I~. ,\('r\.'~", ~J,\' ~
.
Address: No. Street City State
Phone: ~....~ . nc....JO\ c; ~
Home
,
'~dJ- s,-;t -qA~S ~~? -s3>^.....1~3'( \-~(Y\,""'~ (#) :s-c-cAv:1.~/.(~
Work Fax Email addr ss
I am now a resident of: North Beach [ ] South Beach [ ] Middle Beach [ ]
Business~e: G ~-e....c..--Y\ ~~'^ c... .l--rk)Applicant's Position: ~ -r~-, "~-....v,-~
\1.!Y6 (jjiP l <..-.;t <) \/ ~ <-x <- .
Address: \:.,,'"l~ /'>..\\"'^ 0,.,,, \- ~,~,\P;,,~ .5:L.
No. Street City State
i;>6 Owner [ ] Stockholder/Shareholder [)<f Corporate Officer [ ] Other Explain:
~?,\ ~:t
Zip Code
Professional License (describe): Expires:
Attach a copy of the license listed above.
1. Have you ever been convicted of a felony: Yes [ ] or NO,J><J If yes, please explain in detail:
i
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes [ ] or No M: If yes, please explain in detail:
3. Do you currently owe the City of Miami Beach any money: Yes [ ] or No >XJ
If yes, explain in detail:
4. Are you currently serving on any City Boards or Committ es: Yes I?<) or No [ ]
If yes; which board? -- ~ ("0 C =-,
What organizations in the City of Miami Beach do you currently hold membership in?
'\
"'-
Name: ~ iJ-? -
C-"'--~~
Title:
Name:
Title:
List all properties oymed or have an interest in, which are located within the City of Miami Beach:
\~ ~~>~-
..",
I am now employed by the City of Miami Beach: Yes [ ] or No ~ If yes, which department.
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? Check all that apply. Identify the department(s):
f-o... .,
, l ~
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note tha
only 3 choices will be observed by the City Clerk's Office.
(Regular Boards of City) (*Board Required to File State Disclosure form)
[ ] Art in Public Places
[ ] Audit Committee
[ ] Barrier Free Environment Committee
[ ] Beach Preservation Board
[ ] Beautification Committee
[ ] Board of Adjustment (Flood Mgmt.)*
[ ] Budget Advisory Committee
[ ] Committee on Homeless
[ ] Committee for Quality Education in MB
[ ] Community Development Advisory*
[ '. '] Community Relations Board
[ ] Convention Center Advisory Board
[ ] Convention Center Capital Projects Oversight
[ ] Debarment Committee
[ ] Design Review Board*
[ ] Fine Arts Board
[ ] Golf Advisory Committee
[ ] Health Advisory Committee
[ ] Health Facilities Authority
[ ] Hispanic Affairs Committee
[ ] Historic Preservation Board*
[ ] Housing Authority*
[ ] Loan Review Committee*
[ ] Marine Authority*
[ ] Miami Beach Cultural Arts Council
[ ] Miami Beach Commission on Status of Women
[ ] Miami Beach Florida Sister Cities
[ ] Normandy Shores Local Gov't Neighborhood Improvement
[ ] North Beach Youth Center Oversight Committee
[ ] Nuisance Abatement Board*
[ ] Oversight Committee for General Obligation Bond
[ ] Parks and Recreation Facilities Board
[ ] Personnel Board*
[ ] Planning Board*
[ ] ~e Citizens Relations Committee
[ -rProduction Industry Council
[ ] Public Safety Advisory Committee
[ ] Safety Committee
[ ] Transportation and Parking Board
[ ] Visitor and Convention Authority*
[ ] Youth Center Advisory Board
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 [ ] No [ ] (Years of Service [] .
2. Present participation in Youth Center activities by your children Yes [ ] No [ ]. 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 "n'ot required" but desired: Age: [lIJ.] Gender: M [ ] or F [-r-
Ethnic Origin (91eck one)'
White [~frican-American/Black [ ] Hispanic: [ ]
Asian or Pacific Islander [ ] American Indian or Alaskan Native [ ]
Employment Status: Employed [~etired [ ] Home-maker [ ] Other [
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~
4- 0i.J...s.> er . <,d)
Ap' t' ature Date Name of Applica (PLEASE PRINT)
Attachment: Please attach a copy of your resume to your application. ~ Q.-, ~
NOTE: Applications will re in on file for a period of one (1) calendar year. ~ ..,
Received in City Clerk's Office -..L i:2h fa;: by Clerk
Document Control Number (Assigned by the City C r
\ ;;'/2S/ K> "
F:\Cl.ER\SALL \ELIZABE1\B& C\BCAPPLlC04. doc
Rev #7- 01/08/04