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Richard Orenstein - 12/31/08 in ....... City of MicmIi leach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.micmibeachR.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEl: (305) 673-7411, FAX: (305)673-7254 02-14-2007 Richard Orenstein 3501 Keyen Ave., Villa 63 Hollywood, Florida 33021 laJICf11 Debarment Committee Congratulations! You have been appointed by Commissioner Richard L. Steinberg 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. ~~f~M Robert Parcher City Clerk cc: Saul Frances, Parking Director Gus Lopez 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, 2-458 and 2-459 Ordinance No. 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 Employee We ore committed to providing excellent public service ond safety to 01/ who live, work, ond ploy in our vibrant, tropical, historic communily in ....... City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachR.gov OFFICE OF THE CITY CLERK, Rabert Parcher, City Clerk TEl: (305)673-7411, FAX: (305) 673-7254 TO Richard Orenstein RE: Debarment Committee 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. ~-----?""'------ --- Sworn . 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 Rnandal Oisdosure Requirements. We are committed /0 providing excellent public se/Vice and safety to all who live, work, and play in our vibrant, tropical, historic community lD MIAMI BEACH NAME: Oi(eVL ,?<('e\ ~ Last Name HOME ADDRESSJJP ~ No. PHONE: Address: Professional License (describe) 55tJY( 1/ fl' LJ!a e .)':j(> Code t:?~/?5 'Yf" A"~:-(P Email address ~. 3~ -0 '>-/' Zip Code State Expires: Attach a copy (}f the ticeflse Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shail 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 ~ . Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes r6' ~ . Are you a registered voter in Miami Beac~} ......... fr'N; . (Please check one); I am now a resident of: North Beach 0 South Beach 0 Middle Beach 0 . I am applying for an appointment because I have special abilities, knowledge, experie < ';,kvt Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that on Iv three f31 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 C9A"ention Center Advisory Board ~ebarment 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 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 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 F:\CLER\$ALL\B&C Application\B&C Application Revised 091106 .1akes"doc Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: Child's name: Age: _ Program: 1. Past service on the Youth Center Advisory Board: 2. Present participation in Youth Center activities b ages, and which programs. List below: Child's name: Age: Program: .Have you ever been convicted of a felony: Yes 0 or No f yes, please explain in detail: . Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or ~s, please explain in detail: . Do you currently owe the City of Miami Beach any money: Yes 0 or ~~es, explain in detail . Are you curre serving on any City Boards or Committees: Yes :6 arm (} ;e( . What organizations in the City of Miami Beach do you currently hold membership in? /(/ /1 1 Name: Title: Name: Tille: . List all properti terest in, which are located within the City of Miami Beach: s-5i j,,,, /,;..1 r'e- . I am now employed by the City of Miami Beach: Yes 0 or N~epartment? . Pursuant to City Code Section 2-25 (b): Do you have a parent 0, spous~._ , ~ fl(j' D"'~ 0, or sister 0 who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): r y-;;e:r- This section is "not required" but desired: Age: years old Gender: Male~~- 0 Ethnic OrjQi1((Check one) White I2'African-American/Black 0 Hispanic: 0 Asian or Pacific Islander 0 American Indian or Alaskan Native 0 Employment Status: Employed 0 Retired 0 Home-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." ,: ~drd) ~~ o--vd S; Q r~5,t-~~ Date Name of Applicant (PLEASE PRINT) Please attach a copy of your resume to this application NOTE: Applications will remain on file for a period of one (1) calendar year. Entered B Date 2.=:J? () 7 Dale ~2 ?.....,O 7 Revised 1/25107 jo Received in City Clerk's Office by 2 F:\CLER\SALL\B&C AppUcation\B&C Application Revised OB1106 jakes.doc