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Michael Lantz 12/31/08 & City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wwwmiamibeachfl.gav OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel. 305-673-7411, Fax 305-673-7254 12-20-2006 Mike Lantz 3425 Collins Ave #718 Miami Beach, Florida 33140 !SUBjEcT=- ~ Disability Access Committee 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 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, ~dJfL44/1J Robert Parcher City Clerk cc: Saul Frances, Parking Director Heidi Johnson-Wright 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 v;/(~, ore ;:()m:;';;;'t~',:-d !o !)I('V;di";~; f'XCc",':lt:'r;: ,uuhJ;( :.f;'-'\'i,'.--e .,,:;nd .'~t.d\..,jl to 0// "4,.!:O live, \'\Iork.. f;nd pj{]~, in r_I~J' ;,ibi(1nl, :1~)piCC1I. hi!;t()(ic community., & MIAMI BEACH City of Miami Beach, 1700 Canventian Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk Tel 305-673-7411, Fax: 305-673.7254 TO Michael Lantz RE: Disability Access Committee 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 Flor' (depending on the board or committee on which I serve) on July 1 st, following the closing of the c len ar year on which I have served. Sworn Michael Lantz to and subscribed before me ,ay o...Jonuc::J .200"1- ~~ 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. It ,'e Off) ;:ommUtdd 10 p.rC1vid;ng e.xcei!t",'n: ,()ubli( :;(J!\'ice ,..::nd sof~:'ii to cd! ,-,,,ho iive. vvorK. oncf {Jio'y' in our \lib/onl, tropicoli historic communii'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 montti's; 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 N I am applying for a Board appointment because I have special abilitie.s, kn wle~ge, exp~rience: Yes l'><r My special abilities, knowledge, or experience is: cu. \1 sues ltc::..., Are you a registered voter in Miami Beach: Ye or No [ ] \ L NAME: ~ ~i Ke. 0:.. Last Nam First Name Middle Initial Home (~h5 Co\lin...~ A\{~ ~lo.rn'~~-Eb- Address: No. Street O@ A-pr1-\~ City State Phone:c:sc6 -(OT--3-~ C11J. 19(~~ 't?rOl1o if Home Work Fax Email address \e.. ~~ 3~ \ "'() Zip Code I am now a resident of: . North Beach [ ] South Beach [ ] Middle Beach ~ Business Name: Applicant's Position: Address: No. Street City State Zip Code [ ] Owner [ ] Stockholder/Shareholder L ] Corporate Officer [ ] Other Explain: Professional License (describe): $~ 'v\c:::L'("C~ ra.r\'\n f)'(JjJ~/-rJ( Expires: Attach a copy of the license listed above. , 1. Have you ever been convicted of a felony: Yes [ ] or No 'MIf yes, please explain in detail: 2. Do you currently have a violation(s) of City of Miami Beach codes: Yes [ ] or No "p<( If yes, please ~xplain in detail: 3. Do you currently owe the City of Miami Beach any money: Yes [ ] or NoW If yes, explain in detail: 4. Are you currently serving on any City Boards or Committees: Yes [ ] or No f)( If yes; which board? \_ t , What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: Name: Title: List all properties owned 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 [ ], ctlild [ ], brotoher [ ], or ~ister [ ] who Is employed by the City of Miami Beach? Check all that app1y. Identify the department(s):