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Seth Frohlich 12/31/08 tD ..... City of MIami leach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeochA.gov OFFICE OF THE CITY CLERK, Robert Parche" City Clerk TEl: 1305)673-7411, FAX: (305) 673.7254 01-18-2007 Seth Frohlich 3126 Pinetree Dr Miami Beach, Florida 33140 SUBJECT: Board of Adjustment Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending 12/31/2008. 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, City Clerk cc: Saul Frances, Parking Director Antonieta Stohl 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 We ore commjlled 10 providing excellent public service and safety to 01/ who live, work, and ploy in our vibrant, tropical, historic community lD ..... , ' . I' r, ' ! \j J city of MiomIleoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeochfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEl: (305) 673.7411, FAX: 1305} 673.7254 TO Seth Frohlich RE: Board of Adjustment 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 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 ofthe calend ryear n whi ~_ Sworn to and subscribed before me t . , 200_~ Deputy Clerk 'Please visit the City of Miami Beach website at www.miamibeachfl.gov under aty Clerk/Board and Committees for additional information regarding the Financial Disdosure Requirements. We ore commiffed to providing excellent public service and safety to all who live, work, and play in our vibranf, fropical, historic communiry m MIAMI BEACH r-;h/l'c-L Last Name HOME ADDRESS: ~1d.G No. ~S 31.2- g3!J NAME: PHONE: Home Work Address: f-j.Jd-.kP11 C cy,-h I L4 '7-')0 g rs:cc. tU2)],! JIJ No. Street Business Name: Professional License (describe) Fax lip Code Expires: Aft",,::;! -3 Cf,Joy of !he !fcem::'? 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: v~r No 0 . Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes rior No 0 . Are you a registered voter in Miami Beach: vedor No 0 . (Please check one): I am now a resident of: North Beach 0 South Beach 0 Middle Beactt6-- . 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 onlv three (3) choices will be observed bv the Citv Clerk's Office. (Regular Boards of City) o Art in Public Places Committee o Beach Preservation Board ;J,Beautification Committee I]/-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 Disability Access Committee o Fine Arts Board o Golf Advisory Committee o Health AdvisoryCommittee o Health Facilities Authority Board o Hispanic Affairs Committee o Historic Preservation Board' . Board Required ta File Stat. Disclosure fonn F:\CLER\SALL\B&C Applicatlon\B&C Application Revised 091106 jakes.doc 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 Normandy 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 1 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 2. Present participation in Youth Center aclivities by your ages, and which programs. List below: Child's name: r of Service: L! No ,'. If yes, please list the names of your children, their ge: _ Program: Child's name: Age: Program: .Have you ever been convicted of a felony: Yes 0 or No gAt. yes, please explain in detail: . Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or N~f yes, please explain in detail: . Do you currently owe the City of Miami Beach any money: Yes 0 or N . If yes, explain in detail . Are you currently serving on ap:t City ~o,a:ds or Committees: Yes 0 or No D. If yes; which board? gpo...(' '1 s>r (1dJ tlS~IlT . What organizations in the City of Miami Beach do you currently hoid member~ in? kr Name: ~0<I'Lo/~\4JjJ~",r Title: (2/Vl 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 0 or N~hiCh 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: Malt&.. Female 0 Ethn~~gin (Check one) Whit frican-American/BlaclUJ Hispanic: 0 Asian or Pacific Islander 0 American Indian or Alaskan Native 0 Emp yment Status: EmployedJ]Retired 0 Home-maker 0 Other 0 o the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, City C" onductfor ~~~C~6~IOyeeS and Ag~le~ t/, c l Date Name of Applicant (PLEASE PRINT) Please attach a copy of your resume to his application NOTE: Applicatians will remain on iii fo a period of one (1) calendar year, - Date ised 1125107 jo Received in City Clerk's Office by Name of Deputy Clerk~ Document Control Number (Assigned by the City Clerk's Office) 1 j Entered By Date 2 F:\CLER\SALL\B&C Application\B&C Application Revised 091106 jakes.doc