Scott Needelman 12/31/08
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CIty of Miami leach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachR.gov
OfFICE Of THE CITY CLERK, Robert Pon:her, City Clerk
TEL: 13051673.7411, FAX: (305)673-7254
01-22-2007
Scott Needelman
1455 Drexel Ave #1
Miami Beach, Florida 33139
SUBJECT: Oversight Committee for General Obligation Bond
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,
~~~~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Jorge Chartrand
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 commined to providing excellent public service and safety to 011 who live, work, and ploy in our vibronf, tropical, historic community
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CIty of MIamI Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachR.gov
OFFICE Of THE CITY CLERK, Robert Pon:her, City Clerk
TEL: 1305)673.7411, FAX: (3051673-7254
TO Scott Needleman
RE: Oversight Committee for General Obligation Board
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 of the calendar year on which I have served.
J2dtJI
~ott Needlema
Sworn to and subscribed before me thi~ay 0
,200~
'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.
We ore commined to providing excellent public service and safety 10 all who live, work, and ploy in our vibronf, tropical. his/oric community
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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 oHilioled with the city; this requirement sh
be fulfilled in the following ways: 0) on individual shall hove been a resident of the city for a minimum of six months; or b) on individual sh
demonstrate ownership/interest for a minimum of six months in 0 business established in the city.
Resident of Miorni Beoch for 0 minimum of six (6) rnonths: Yes ~ or No I I
Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes Wl
I am applying for 0 Boord appointment becouse I have speciol obilities, knowledge, experience: Yes lCll
My speciol obilities, knawledge, or experience is:~~~<<<. ~\'c1 ~v8:t~""
Are you 0 re~i:tered ?ter in Miami Beoch: Yes" or No 0
NAME: L'-4eeJ.fl~" s.cott-
Last Name First Nome
Home J /./175" -----'J r~
Address: No. Street
or No [ ]
Ave.
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Middle Initial
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City
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State
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lip Code
Phone ~t;-~?-It{J)
Home
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Work
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Fax
SQ. ^ /LI~~1t II. tJ 51
Email oddress
(Please check one): I am now a resident of:
Business Name: Yor- ~ lOlLtr~ ~~'9i
North Beach 0 South Beach. Middle Beach 0
Applicant's Position: V,P.
Address: f l./tS")
No.
j)r-e,e( AIIt.
Street
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City
R-
State
~31~'f
lip Code
,.
DOwner 0 Stockholder/Shoreholder I!I Corporate Officer 0 Other Exploin:
Professionollicense (describe):
Attach a copy of the license listed above.
1. Have you ever been convicled of a felony: Yes 0 or No. If yes, please explain in detoil:
Expires:
2. Do you currently have 0 violation(s) of City of Miomi Beach codes: Yes 0 or No 8. If yes, pleose exploin in detoil:
3. Do you currently owe the City of Miami Beach any money: Yes 0 or No ..
If yes, explain in detail:
4. Are you currently serving on any City Boords or Committees: Yes II or No D.
If yes; which boord? G. 0, ~o...~ O\I<T~'\jk\"
What organizations in the City of Miarni Beach do you currently hold membership in?
Name: N I A Title:
Name:
Title:
interest in, which are I
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C\DOCUMENTS AND SETTlNGS\ClERGIBE\lOCAl SETTINGS\TEMPORARY INTERNET fllES\OlK14\BC APPLICATION NOV 20051.DOC
I am naw employed by the City of Miami Beach: Yes 0 or No. If yes, which deportment?
Pursuant to City Code Section 2-25 (bl: Do you hove a parent OJ. spouse OJ. child OJ. brother OJ. or sister OJ who is
employed by the City of Miami Beach? Check all that apply. Identify the deportment(s):
Please list your preferences in order of ronking [1) first choice [2J second choice, and [3J th rd choice. Pleose note that only
three (3) choices will be observed by the City Clerk's Office.
Reaulor Boards of Citv)
o Art in Public Places Committee OHousinn Authonty
o Barrier Free Envi'ronment CommiHee Oloon Review Committee-
o Beach Preservation Boord OMorin,e Authority *
G o Beautification Committee OMiomi Beach Cultural Arts Council
J. Boord of Adiustment (Flood Monogementl ' DMiomi Beach Commission on Stdt-us of Women
o Budaet Advisorv Committee OMiomi Beach Florida Sister Cities
o Committee on the Homeless ONormandv Shores local Gov. NeiQhborhood'lmnrovement
o Committee for Qualitv of Education in Miami Beach ONorth Beach Youth Center OversiQht Committee
o Communitv Development Advisory Committee- n 80versight Committee for General Obligation Bond
o Communitv Relations Board '-' DParks & Recreational Facilities Board.
o Convention Center Advisory Board o Personnel Boord *
o Debarment Committee o Plonnina Boord *
o Desion Review Board * ';, o Police Citizens Relations Committee
o Fine Arts Boord o Production Industry Council
o Golf AdvlSo,," Commiffee o Puhlic Safety Advisory Committee
o Health Advisol"\l Committee o Safety Committee
o Health Focilities Authontv o T ronsDortation & PorkinQ Committee
DHispanic Affairs Committee o Visitor & Convention Authority.
.Historic Preservation Board * o Youth Center Advisory Boord
@
'Boord Required to File State Disclosure form
Note: If opplying for Youth Advisory Boord, pleos.e in i ate your olfiliatian with the Scoff Rakow Youth
Center: IV I
1. Post service on the Youth Center Advisory Board: Yes 0 Na 0 Years of Service 0
2. Present parlicipotian in Youth Center activities by your children Yes 0 No O. If yes, please list the nomes of your children,
their ages, ond which programs. List below:
Child's nome: ~ Program:
Child's nome: --- Age: =- Program"'--
This section is "not required" but desired: Age: 1!I 36 Gender-~ Femole 0
Ethnic Origin (Check one) 'C7
White. Africon-American/Black 0 Hispanic: 0
. ..._Alillll Qr E'o,iRc Islonder 0 American Indian or Alaskan Native 0
Employment Stotus: Employed. Retired 0 Horne-maker 0 Other 0
"' hereby attest to the occuracy and truthfulness of the opplication and have received, reod ond will obide by
Chapter 2, Article V I - of the City Code "Standards of Conduct for City Officers, Employees and Agency
Me .
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Dote Name of Applicant (PLEASE PRINT)
Attochment: Pleose attoch a copy of your resume to your applicotion.
NOTE: Appli ations will remoin file for a periad of one (1) calendar year.
Applicont's Signature
Received in City Clerk's Office '2--
Document Control Number (Assigned b
Di by
the City Clerk's
Deputy Clerk
Revised 11/1 5/05
C\DOCUMENT5 AND 5ETTlNG5\ClERGIBE\lOCAl SETTING5\TEMPORARY INTERNET FllES\OlK14\BC APPLICATION NOV 20051 DOC