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Anthony Japour 12/31/09 tD ~ City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeochfl.gov OFFICE OF THE CITY CLERK, Robert Porcher, Gty Clerk TEL: (305) 673-7411, FAX: (305)673-7254 02/06/2007 Anthony Japour 1000 South Pointe Dr #3302 Miami Beach, Florida 33139 lIil(el:'ii Miami Beach Cultural Arts Council Congratulations! You have been appointed by the City Commission to the above referenced agency, board or committee for a term ending: 12/31/2009. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-7411. Please read the enclosed material carefully. Again, congratulations and good luck. Sincerely, ~P rcher City Clerk cc: Saul Frances, Parking Director Gary Farmer ATTACHMENTS: Letter of Appointment Oath City Code Ordinance section, applicable to agency, board or committee City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-2458, 2-459 Ordinance 2006-3543 - Amendment to City Code Section 2-22 Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance City Wide Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We ore commirted 10 providing excellent public seNice and safety 10 01/ who live, work, ond ploy in OUf vibrant, tropical, historic community tD .... CIty of Miami -..ch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachR.gov OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk TEL: 13051673.7411, FAX: (305)673.7254 TO Anthony Japour RE: MB Cultural Arts 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 theAorida 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 1st, following the closing of the calendar year on which I have served. Sworn ~~ A~ony Ja{"jur to and subscribed before me this ~"'day of ~, 200r ~c-.&u,.~ Deputy Clerk 'Please visit the aty of Miami Beach website at www.mlamibeachfl.gov under City Clerk/Board and Committees for additional information regarding the Rnancial Disclosure Requirements. We 0/8 committed 10 providing excellenl public service ond safety to all who live, work, and play in our vibrant, tropical, historic communiI)' lQ -- MIAMI BEACH ,,;; t-} 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 ,tkf( No ~,I I am applying for a Board appointment because I have special abilities, knowledge, exper}~nce: Yi's ;y'" . My special abilities, knowledge, or experience is: 4'" f / S &/ ~.ceo. II ~4-'f14~ , IIkoUl ~ Are you a registered voter in Miami Beach: Yes u or No ji ' NAME L~!m~1Z ~:!::n~ :J7 Middle Initial Home: Address: /()~O No. Home 0", . 'f4/' q..1~-$'" Work , . ~~""" R~ Pt.- 'J3/~1 City State Zip Code "J3~d- 'an 14.6ckj" u.Qt ~ . PfJ/N-re- 'br . -:; ~,~ Street Phone: Fax \'PI,~""'~ ct'j'>(/":~."""" ",n', ');;,,;' :-~ r~":ld,~pt 0'" Ni''.''1h ,"',':;,;>c',!J S,,;,;H',' S".~rj, ~ {::;,,'(i,"'-;O rete"_".",,, 0 ""'..". "0'"'0''' -' .-... ~ "'- ,. '.' ., ... .. ......, _.- _.n .........~" -~._.. iIlo';(--.,.. " >- ~.v__, Business Nam~: '!10" .r 1r'f'~6Q //~rPlicant's Position: 7>1 ~ Addresslb7nJ f. 'PD/n k 70.. ~.~. P'l-g5r:r'1 r. '\ No, Street City Stale} Zip Code ('.L. IY 0"; , ,GL, c. O&ia).. ~1c;JL.... .fC/4.J, ~ CnLtlIA. .J~ ~wner 0 Stockholder/Shareho er 0 ~rate Officer LJ 1ft!er Explain: / ,~ .f- p.1...f1,../. . ""'G , Professional License (describe) AllaCfl;; (;fJi'Ji;' i'! ijJ{:.' ii~:,,:c; ,i,h-"','. Expires: 1. Have you ever been convicted of a felony: Yes C or No ~es, please explain in detail: 2.00 you currently have a violation(s) of City of Miami Beach codes: Yes 0 or No J . f y~s, please explain in detail: 3. 00 you currently owe the City of Miami Beach any money: Yes 0 or No . If yes, explain in detail . Name: ~ list all propert~~~-(or a.J tfi.'? IV-e.. T~ ~ A~hv-- . ~~'n -AALl-u.4e<. inthJci~ ~ What organiza~ons in the City of Miami 8eadl do you cUfre Nam I am now employed by the City of Miami Beach: Yes 0 or NO~S, which department? F:\CLLOH\$ALL \B&C ,:o,pplicatioll\I::\&C P..pphcation ReVised Ot!11U6doc Pursuant to City Code Section 2-25 (b): Do you have alarent Beach? Check all that apply, Identify the department(s): J () , spouse ,child ',brother , or sister who is employed by the City of Miami 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. (Regular Boards of City) . Housing Authority" , Loan Review Committee" , . ~rine Authority" ~iami Beach Cultural Arts CouncilU) Miarni.Beach Commission on Status of Women " Miami Beach Florida Sister Cities L. Normandy Shores Local Gov't Neig~. Improvement Oversight Committee for \3eneral O!Jligation Bond . Parks and Recreation Facilities Board L.l Personnel Board" L:i Planning Board" , " iJ Police Citizens RelationS Committee " Production Industry Council D Public Safety Advisory'Coml1)ittee {l Safety Committee IJ Transportation and Parking Committee C_' Visitor and Convention Authority. [J Youth Center Advisory Board ,: Art in Public Places Committee I.; Barrier Free Environment Committee [J Beach Preservation Board o Beautification Committee ;: Board ofAdjustme'nt" [1 Budget Advisory Committee p Committee on Homeless D Committee for Quality Education in MB D Community Development Advisory" [j Community Relations Board , 0 Convention Center Advisory Board D Convention Center Capital Projects Oversight D Debarment Committee D Design Review Board" ' D Fine Arts Board o Golf Advisory Committee D Health Advisory Committee D Health Facilities Authority Board o Historic Preservation Board" .'..> ','" , '. "Board Required to File State Disclosure form Note: If applying for Youth Advisory Board, please indicate your affili,ation with the Scott'Rakow Ybuth Center: ' " 1. Past service on the Youth Center Advisory Board: Yes n No !'!"Years of Servjpl: ' 2. Present participation in Youth Center activities by your children YeSD No ,<"If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: ~ Program: Child's name: Age: _ Program: This section is "not required" but desired: Age: If 1'" years old Gender: Male Iy"" Ethnic O.Jigin (Check one) White I!I" Afrlcan.American/Black 0 Hispanic: [J Asian or Pacific Islander 0 American Indian or Alaskan Native D Employment Status: Employed ~etired LJ Home-maker 0 Other II Female CJ "I hereby attest to. the accuracy and truthfulness of the appliCation and have received, read and will abide by Chapter 2, Article V11- of the City Code "Sllindards of Conduct for City Officers, Employees and Agency Members." ~~ . OI'/~~/~L~~J"j1tt"~ Applica' n re Date Na e 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 OIIice Document Control Number (Assigned by the City Clerk's 0 Entered By Date Date Revised 9111/06lh 2 F:\CLER\SALL\B&C Applicaholi\U&C '!;"pi1ii':alln,' F~i",,;;:~ecj ()01-1(!G.doc