Mark Weithorn Rep for NBDC 12/31/07
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www miomibeochfl gOy
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel 305-673741 1, Fox 305-673-7254
01-17-2007
Mark Weithorn
1130 Stillwater Drive
Miami Beach, Florida 33141
SUBJECT: Transportation and Parking Committee
Congratulations! You have been appointed by virtue of your being a representativefor the North Beach
Development Corporation to the agency, board or committee named above for a term ending 12/31/2007.
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.
~~~~jl~
Robert ParcHer
City Clerk
cc: Saul Frances, Parking Director
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
6. Miami Beach Code Section 2-459
7. Miami-Dade County Code Section 2-11.1
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Rober! Parcher, City Clerk
Tel 305-673-7411, Fox 305-673-7254
TO Mark Weithorn
RE: Transportation and Parking 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: 12/31/2007.
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.
....-----z.--
~
Mark Weithorn
Sworn to and subscribed before me this ~y of.-....b-~ 200"3-
~~_~I~~.
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.
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in 'oI,;broni. tnJpico/, historic communii.",.
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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 [v('" or No [ ]
Demonstrate an ownership/interest in a business in Miami Beach for 0 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 abilities, knowledge, or experience is: /
Are you a registered voter in Miami Beach: Yes ~ or No 0
NAME: h.r el1'"/f.:J11 ~
Last Name
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Address: No. Street
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First Name
Middle Initial
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Phone: ]0 'f <Ii' 6..,.. C?V~ ,
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Fax Email address
North Beach ErSouth Beach 0 Middle Beach 0
(Please check one): I am now a resident of:
Applicont's Position:
Business Name:
Address:
No.
Street
City
State
lip Code
DOwner 0 Stockholder/Shareholder 0 Corporate Officer 0 Other Explain:
Professional License (describe):
Affach a copy of the license listed above.
1. Hove you ever been convicted of a felony: Yes 0 or No EIIf yes, please 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 a
If yes, explain in detail:
4. Are you currently serving on any City Boards or Committees: Yes Er or No D.
If yes; which board? -r;.P,-~?Jf "74-7,p' rr- f ~~II, ~-
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 Miomi Beach:
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C:\DOCUMENTS AND SETTINGS\CLERHERK\LOCAL SETTINGS\ TEMPORARY INTERNET FILES\OLKSD2\BC APPLICATION JAN 2006 DOC
I am now employed by the City of Miami Beach: Yes 0 or No [2(' If yes, which department?
Pursuant to City Code Section 2-25 (b): Do you hove a parent OJ, spouse OJ, child OJ, brother OJ, or sister OJ who is
employed by the City of Miami Beoch? Check all that apply. Identify the department(s):
Please list your preferences in order of ranking [1] first choice [2] second choice, ond [3] third choice. Please note that only
three (3) choices will be observed by the City Clerk's Office.
Regular 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) * DMiami 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 Obliqation Bond
o Community Relations Board DParks & Recreational Facilities Board
o Convention Center Advisory Board o Personnel Board
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 Advisory Committee
o Health Advisory Committee o S-afety Committee
o Health Facilities Authority B'Transportation & Parkinq Committee
DHispanic 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 Boord, 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 O. 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
Ethnic Origin (Check one)
White 0 African-American/Black 0 Hispanic: 0
Asian or Pacific Islander 0 American Indian or Alaskan Native 0
Employment Status: Employed 0 Retired 0 Home-maker 0 Other 0
Gender: Male or Female 0
*1 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 Members."
~~
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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.
,
Received in City Clerk's Office \(.::23/01-- by<..,__J='--k-p~---
I I Date
Document Control Number (Assigned by the City Clerk's Office) Entered By
F:\CLER\$ALL\ELlZABET\B&C\B&C Application Jan 2006.doc
Applicant's Signature
Deputy Clerk
Date
C:\DOCUMENTS AND SETTINGS\CLERHERK\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLKSD2\BC APPLICATION JAN 2006.DOC