Merri Mann 12/31/08
tD
.....
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Ftorido 33139, www.miamibeachA.gov
OFFICE OF THE CITY CLERK, Robert Porcher, Oy Clerk
TEL: (305) 673-7411, FAX: (305) 673-7254
01-18-2007
Merri Mann
11 Island Ave #2102
Miami Beach, Florida 33139
1IfIII1-~i'1 Committee for Quality Education in MB
Congratulations! You have been appointed by Commissioner Saul Gross
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,
~~/li,b
City Clerk
cc: Saul Frances, Parking Director
Leslie Rosenfeld
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
We are committed to providing excellent public service and safety to all who live, work, and ploy in our vibrant, trop'col, historic community
lD
.....
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)673-7411, FAX: (305)673-7254
TO Merri Mann
RE: Committee for Quality Education in MB
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Govemment 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 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 caiendar year on which I have served.
~
Sworn to and subscribed before
Merri Mann
this k day of F-eh
b,a.
I
Deputy Clerk
;2001
*Please visit the City of Miami Beach website at WW\N.miamibeachfl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disclosure Requirements.
We ore committed 10 providing excellent public service and safety fa 01/ who live, work, and play in our vibrant, tropical, historic community
\Y)~ V' \
Last Name First Name
~ \0 l^ d A-o'<r :It;J I 0 L
Street
m
-
MI,AMI BEACH
NAME:
\Y) QV} n
HOME ADDRESS: \ \
No.
PHONE:
3DS- S'3~'lf C:2 c;-
Home
3"05-r-54-02-20
Work Fax
Business Name:
Address: ::2:L 00
Professional License (describe)
BOARDS AND
,{HAMI BEACH
.il.PPLlCATION
M D Middle Initial
D FL 3~J5C
, City State Zip Code I
me'1Y-" ~aV'\II" e
Email address.iQl.;oo , COY,
D~osition:--fJ~
rn.i Q { F'L
City
3';;)
State
Zip Code
Expires:
Atfact; <3 cup:; or lhtl licens')
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 ~ No 0
. Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes 0 or No V
. Are you a registered voter in Miami Beach: Yes ~r No 0
. (Please check one); I am now a resident of: North Beach ~ Beach 0 Middle Beach 0
. I am applying for an appointmrnt because I have special abilities, know, ledge, experience. Please list below:
'I <? \-: v E" cI -fC ?<L.>10 ~ .\.-. 15 tzt;t - +o~ u./I1' 0Y1
v.;>a.V1.IIlIl' k OVVT'- \'> ']
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that on Iv three (3)
choices will be observed bv the Citv Clerk's Office. (Regular Boards of City)
~rt in Public Places Committee
o Beach Preservation Board
o Beautification Committee
o Board of Adjustment'
o Budget Advisory Committee
o Committee on Homeless
If 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 to File State Disclosure form
o Housin9 Authority"
o Loan Review Committee'
o Marine Authority'
$Miami Beach Cultural Arts Council
o Miami Beach Commission on Status of Women
o Miami Beach Florida Sister Cities
o Nonmandy Shores Local Gov't Nei9h. 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 Application\B&C Application Revised 091106 iakes,doc
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
Years of Service:
ren Yes!J NOJ. If yes, please list the names of your children, their
1. Past service on the Youth Center Advisory Board: Y
2. Present participation in Youth Center activities
ages, and which programs. Lisl below:
Child's name:
Age: _ Program:
Child's name: Age: Program:
/
.Have you ever been convicted of a felony: Yes 0 or No ~s, please explain in detail:
. Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or No ~ please explain in detail:
. Do you currently owe the City of Miami Beach any money: Yes 0 or NolnIf~~s, explain in detail
. Are you curre:;r: n any City ~r~r Committees: Yes 0'rir No D. If yes; which board?
. What organizations in the City of Miami Beach do you currently hold membership in?
Name: ~ A. Title:
Name: Title:
. List all properties owned or have an interest in, which are located within the City of Mia
~~OO ~\S;
hich department?
. I am now employed by the City of Miami Beach: Yes 0 or N
. Pursuant to City Code Section 2-25 (b): Do you have a parent 0, spouse 0, child 0, brother 0, or sister [J who is employed by the
City of Miami Beach? Check all that apply. Identify the departmentls): t\.J C)
This section is "not required" but desired: Age: years old Gender: Male 0 Fema~
Ethnic Origin (Check one) '~
White 0 African-American/Black 0 Hispanic: 0 Asian or Pacific Islander 0 American Indian or Alaskan Native 0
EnlploymentStatus: Employed 0 Retired 0 Home-maker 0 Other 0
c... ----
"I 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 ode "Standards of Conduct for City Officers, Employees and Agency Members."
,
"11A .J~
Applicant's Signature
~k,{P
1
D7
{Y)e#YI (y/ Q V7v1
Name of Applicant (PLEASE PRINT)
Date
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in City Clerk's Office by
ame of Deputy Cle~ r f L
Document Control Number (Assigned by the City Clerk's Office) ~ Entered By
Date
Date
2
F:\CLER\SALL\B&C Appllcation\B&C AppHcation Revised 091106 jakes.doc