Laura Levey 12/31/08
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City of Miami Beoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, wwwmiomibcochfigov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel 305-673-7411, Fox 305-673-7254
01-18-2007
Laura Levey
4777 Pinetree Dr
Miami Beach, Florida 33140
III.eo'1': Hispanic Affairs Committee
Congratulations! You have been appointed by Commissioner Simon Cruz
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,
~~/hYkJ'
City Clerk
cc: Saul Frances, Parking Director
Nannette Rodriguez
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: 305-673-7505
5. Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employe
6. Miami Beach Code Section 2-459
7. Miami-Dade County Code Section 2-11.1
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''l, "'e. :!\j g)!<.;-'i/ to '.\';;:.) jive. \~'()rk. CIne! (,i(1'')' in r:'Lii '.tif:')I.':'l";, ~!l)pf!~ol. histOriC communiiv
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wwwmiamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel 305-673-7411, Fax 305-673-7254
TO Laura Levey
RE: Hispanic Affairs 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 Florida (depending on the board or committee on which
I serve) on July 1st, following the closing of the calendar year on which I have served.
.~J~-
_ /-~ura L
Sworn to and subscribed before is ~ay of , 2001
*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.
:/ ",(} ort~ ,'~c::,ri:'-;t!.:::,d \.'1 ,rYC>v:Jn9 exc..:.,f/~'-'n:
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to ',.',,,ho five, \"IDrk. end pjo'l" in vJb;'(Jni, rr~)pico!, historic communJy'
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MIAMIBEACH
BOARDS AND COMMITTEE APPLICATION FORM
Pursuant to City Code section 2-22(4) 0 and b: Members of agencies, boards, and committees sholl be affiliated with the city; this requirement sholl
be fulfilled in the following ways: 0) on individual sholl hove been 0 resident of the city for 0 minimum of six months; or b) on individual sholl
demonstrate ownership/interest for 0 minimum of six months in 0 business established in the city.
Resident of Miami Beach for a minimum of six (6) months: Yes [0' or No!]
Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes [
I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes [ ]
My special obilities, knowledge, or experience is:~~:
Are you 0 registered voter in Miami Beach: Yes or No 0
l-o.v~y
Last Name
Home ~777 p~ ~ ~.
Address: No. Street
Phone: 3/53( -'61CC::,
, Home
] or No [ ]
NAME:
0Lu ro--
R.
First Name
Middle Initial
k6
City
3~I'fb
Zip Code
Les(;e.(RV} ICoG) Aol.CoVL1
Email address
f(
State'
Work
Fax
(Please check one): I am now a resident of: North Beach 0 South Beach 0 Middle Beach ~
Business Name:
~iA-
/l t
Applicant's Position:
Address:
I No. City
dOwner 0 Stockholder/Shareholder 0 Corporate Officer 0 Other Explain:
State
Zip Code
Professional License (describe):
Attach a copy of the license listed above.
1. Have you ever been convicted of a felony: Yes 0 or No [!tff yes, pleose explain in detail:
Expires:
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or No E( If 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 detoil:
4. Are you currently serving on any City Boards or Comrnittees: Yes 0 or No D.
If yes; which board?
What organizations in the City of Miami Beach do you currently hold membership in?
Name: AMtL'f'~C>>tv\. ~l.s~ C'0YY\1Y1A;tT-e... Title: \)\(Sk:.."\-or
Nome:
Title:
List all properties owned or have an interest in, which are located within the City of Miami Beach:
Lf 777 p~ irfibL 0-<'- ~ B P (
C\DOCUMENTS AND SETTINGS\CLERGIBE\LOCAL SETTINGS\ TEMPORARY INTERNET FILES\OLK14\BC APPLICATION NOV 20051 DOC
I am now employed by the City of Miami Beach: Yes 0 or No rn/';f yes, which department?
Pursuant to City Code Section 2-25 (b):
employed by the City of Miami Beach2
Do you have a parent OJ, spouse OJ, child OJ, brother OJ, or sister 0] who is
Check all thot apply. Idec"i!y th1\Ja m (,
Pleose 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 DHousin~ AuthOrity
o .\XJrrier Free Environment Committee DLoan .Review Committee*
1M Beach Preservation Board DMa'rine Authority *
o Beautification Committee DMiomi Beach Cultural Arts Council
o Boord of Adiustment (Flood Management) * DMiami Beach Commission on Status of Women
o Budqet Advisory Committee DMiami Beach Florida Sister Cities
o ..committee on the Homeless DNormandy Shores Local Gov. Neiqhborhood Improvement
lH Committee for Quality of Education in Miami Beach DNorth Beach Youth Center Oversiqht Committee
o Community Development Advisory Committee* DOversight Committee for General Obligation Bond
o Community Relations Boord DPorks & Recreational Facilities Board
o Convention Center Aavisory Board o Personnel Boord *
o Debarment Committee o Planning Board *
o Design Review Board * o Police Citizens Relations Committee
o Fine Arts Board o Production Industry Council
o Golf Advisory Committee o Public Safety Ad..-isory Committee
o Health Advisory Committee o Safety Committee
o Health Facilities Authority o Transportation & /'arkinq Committee
[gffispanic 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 Yeor~ Service 0
2. Present porticipation in Youth Center activities by your chilCJren Yes 02( N-o O. If yes, please list the names of your children,
their ages, and which programs. List below:
Child's narne:
Child's name:
~J.
~
Age: L Program: ~~
Age: _ Program:
This section is "not required" but desired: Age: 0 .Gender: Male o~
Ethnic Origin (Check one)
White 0 African-American/Black 0 Hispanic: rg/'
Asian Qr Pacific: Islander 0 American Indian or Alaskan Native 0
Employment Status: Employed 0 Retired 0 Home-maker 0 Other 0 M ~
III 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 IIStandards of Conduct for City Officers, Employees and Agency
Mem s. /I
(J-1/~ 07 ~rCL ~Q.,/
Date Name of Applicant (PLEASE PRINT)
Attachment: Please attach a c~y of your resume to your application.
NOTE: Applications will remain file for a period of one (1) calendar year.
Received in City Clerk's Office ~ by.. Deputy Clerk
Document Control Number (Assigned by the City Clerk's Revised 11/15/05
C\DOCUMENTS AND SETTINGS\ClERGIBE\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLK14\BC APPLICATION NOV 2005 JDOC