Jay Schrarer 12/31/08
~
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www,miamibeochll,gov
OFFICE OF THE CITY ClERK, Robert Porcher, City Clerk
Tel 305~673~7411, Fax 305~6731254
01-08-2007
Jay Schrarer
1617 W. 22nd Street
Miami Beach, Florida 33140
"ie/li Golf Advisory 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,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Kevin Smith
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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:BEA,CH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY ClERK, Robert Porcher, City Clerk
Tel 305~673~7 411, Fa" 305-673-7254
TO Jay Scharer
RE: Golf Advisory Committee
I do solemnly swear or affinm 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 f' ancial sclosure' require-
ments of Miami-Dade County or the State of Florida (dependin9 on the bo d or co mlttee on which
I serve) on July 1st, following the closing of the caiendar year on which I h e se d.
rer
Sworn to and subscribed before me this.3:::f'" day ofo-...b.:r,uJi 200)-
~01s
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.govunderCityClerk/Board and Committees
for additional infonnation regarding the Financial Disdosure Requirements.
\:'/e ~Ire ;_ot)1mh,d ;'0 p'()v,;ding ('xc".,,'.!,,,,.,t pd<c ,.(!IV,,:'''' .,:;nd soleii 10 o/i who iiwol, work, and play in OUf vibi(..1nJ, tropico( historic communiiy.
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Street ( City
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MIAMI BEACH
NAME:
HOME ADDRESS: --1(g 7
No.
PHONE:
Work
Fax
Home
Business Name:
BOA!xDS AND
BEi\CH
APPLICATION
Middle Initial
Zip Code
Position:
Address:
No.
Street
Zip Code
Professional License (describe)
City
State
Expires:
A!tactr ':0PY ()f tn~; JiC€/nS&
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 followin9 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 minimu~ six months in a business established in the city.
. Resident of Miami Beach for a minimum of six (6) months: Yes o-6r' No 0
. Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes 0 or No ~
. Are you a registered voter in Miami Beach: Yes ~ 0
. (Please check one): I am now a resident of: North Beach 0 South Beach 0 Middle Beach /
. I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that on Iv three 131
choices will be observed bv the Citv Clerk's Office. (Regular Boards of City)
o Art in Public Places Committee
o Beach Preservation Board
o Beautification Committee
o Board of Adjustment"
o Budget Advisory Committee
o Committee on Homeless
o Committee for Quality Education in MB
o Community Development Advisory"
o Community Relations Board
o Convention Center Advisory Board
o Debarment Committee
o Design Review Board"
o Disabili ss Committee
o Fi rts Board
olf Advisory Committee
o Health AdvisoryCommittee
o Health Facilities Authority Board
o Hispanic Affairs Committee
o Historic Preservation Board"
" Board Required to File State Disclosure form
o Housing Authority"
o Loan Review Committee"
o Marine Authority"
o Miami Beach Cultural Arts Council
o Miami Beach Commission on Status of Women
o Miami Beach Florida Sister Cities
o Nomnandy Shores Local Gov't Neigh. Improvement
o Oversight Committee for General Obligation Bond
o Parks and Recreation Facilities Board
o Personnel Board"
o Planning Board"
o Police Citizens Relations Committee
o Production Industry Council
o Public Safety Advisory Committee
o Safety Committee
o Transportation and Parking Committee
o Visitor and Convention Authority"
o Youth Center Advisory Board
F:\CLER\$ALL\B&C Applicatlon\B&C Application Hevised 091106 jakes,doc
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 II No I j Years of Service:
2. Present participation in Youth Center activities by your children Yesl: No IJ. 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:
.Have you ever been convicted of.a felony: Yes 0 or No If yes, please explain in detail:
A
. Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or NO~S, please explain in detail:
. Do you currently owe the City of Miami Beach any money: Yes 0 or No . If yes, explain in detail
/
. Are you currently serving on any City Boards or Committees: Yes ~NO D.
{'~c-F
If yes; which board?
. 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:
Jbl Z (J), ~;Jttd Sf ---
. I am now employed by the City of Miami Beach: Yes 0 or NO~department?
. Pursuant to City Code Section 2.25 (b): Do you have a parent 0, spouse 0, child 0, brother 0, or sister 0 who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):
This section is "not required" but desired: Age: years old Gender: Male 0 Female 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: E ploye 0 Retired 0 Home-maker 0 Other 0
cy and truthfulness of the application and have received, read and will abide by Chapter 2,
'Standards of Conduct for City Officers, Employees and Agency Members."
Date
Name of Applicant (PLEASE PRINT)
Please attach a co of your resume to th application
NOTE: Application will remain on Iile fo a period of one (1) calendar year.
Received in City Clerk's Office by
Name of Oeputy C1rJir.-J
Document Control Number (Assigned by the City Clerk's Office) ~ Entered By
Oatsl
Date
2
F:\CLER\SALL\B&C Appllcation\B&C Application Revised O~111 06 ,jakes.doc
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