Sidney Goldin 12/31/08
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City of Miami lleach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.goy
OFFICE OF THE CITY CLERK, Robert Porcher, Cily Clerk
TEL 1305)673-7411, FAX: 1305) 673-7254
02/05/2007
Sidney Goldin
5415 Collins Ave. Apt.PHA
Miami Beach, Florida 33140
.71",A0:::0'<:,,' ...:(>:.....::<;jt
~1:Q,l~~ Visitor and Convention Authority
Congratulations! You have been appointed by the City Commission to the above
referenced agency, board or committee for a term ending: 12/31/2008.
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,
~~~;6JjJ
City Clerk
cc: Saul Frances, Parking Director
Grisette Roque
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 committed to providing excellent public service and safety to 011 who live, work, and ploy in our vibrant, tropical, histOlic community
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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 Porcher, Cily Clerk
TEL: 1305)673-7411, FAX: 1305)673-7254
TO Sidney Goldin
RE: Visitor and Convention Authority
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 perfonn 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 flnancial 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.
,
, 200"]
Deputy Clerk
'Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees
for additional information regarding the Financial Disdosure Requirements.
We ore committed to providing excellent public service and safety fa 01/ who live, work. and play in our vibrant, tropical, historic community
G(;>LP IN
last Name
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No. Street
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MIAMI BEACH
NAME:
CITY
BOARDS AND
BEA.CH
APPLICATION FORM
SIDNr;;x
First Name
A--l/ e- vt:j/3 .
PHONE:
Business Name:
Middle Initial
FL '3:if Ifej
State Zip Code
Fax
Emall address
Position:
Address:
No.
Street
FCVn$2
Professional License (describe)
City
State
Zip Code
Expires:
ift?;;"",:!! a r:::opy
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 ownershiplinterest 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 ~o 0
. Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes ~ 0
. Are you a registered voter in Miami Beach: Yes .~ o.
. (Please check one): I am now a resident of: North Beach 0 South Beach 0 Middle Beach ~
. I am appiying 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 [3J third choice. Please note that onlv 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 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 fonn
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 p;erSonnel 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
)(.Visitor and Convention Authority"
b Youth Center Advisory Board
1
F:\CLER\SALL\B&C Application\B&C Appli(',.ation Revised 091106 Jakes.doc
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
Child's name:
f Service:
No .1. If yes, please list the names of your children, their
1. Past service on the Youth Center Advisory Boar' Yes [J N I' Year
2. Present participation in Youth Center activiti b our ildren Ye
ages, and which programs. List below:
Child's name:
Program:
Program:
.Have you ever been convicted of a felony: Yes 0 or NO~ If yes, please explain in detail:
. Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or NO-P(lf yes, 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 ~ D. If yes; which board?
{/~A
. What organizations in the City of Miami Beach do you currently hold membership in?
Name: C ffA.- M R 131\ () F r h rCrp<.t?-Ae..[;-
Name:
Title:
. List all properties owned or have an interest in, which are located within the City of Miami Beach:
s-'l/- t 5'" ('...0 C-..L.I t'J.s> A t/ F
. I am now employed by the City of Miami Beach: Yes 0 or N~WhiCh department?
. Pursuant to City Code Section 2-25 (b): Do you have a parent 0, spouse 0, child 0, brother 0, or sister C who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):
N6
This section is "not required" but desired: Age: U years old Gender: MaleX Female 0
EthniC~igin (Check one)
White frican-American/Black 0 Hispanic: 0 Asian or Pacific Islander 0 American Indian or Alaskan Native 0
Emplo ent Status: Employed 0 Retired 1Home-maker 0 Other 0
"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 Code "Standards of Conduct for City Officers, Employees and Agency Members."
Dat
G-e:; L.~ t
Applicant ~PlEASE PRINT)
Please attach a copy of your resume to t' application
NOTE: Applications will remain on lile r period of one (1) calendar year.
Received in City Clerk's Office by
OfDePUtyCI~
's Office) ~ Entered B
2
F:\CLER\SALL\B&C AppHcation\B&C Appli{'..alJon Revised 091106 ]2kes.doc