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Amparo Vargas 12/31/08 lD ~ City of Miami Beach, 1700 Convention Cantel Drive, Miami Beach, Florida 33139, www.mioiT'ibeochfl.gov OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk TEL: (305) 673-7411, FAX: (305) 673-7254 02-09-2007 Amparo Vargas 1770 79th St #215 North Bay Village, 33141 SUBJECT: Miami Beach Sister Cities Program Congratulations! You have been appointed by Mayor David Dermer to the agency, b.oard or comQ1itt~e na.JTlf:d ibove for a term ending 12/31/2008. c.A.:/r> 0e..'~ L'-"'-~ 1<-/2.' 07 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, ~~~Aih Robert Parcher City Clerk cc: Saul Frances, Parking Director Michael Aller 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 City Wide Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and We are commiffed to providmg excel/ent public service and safety to 01/ who live, work, and play in our vibrant, tropical. historic community lD ';IF city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachA.gov OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk TEl: (305) 673-7411, FAX: (305) 673-7254 TO Amparo Vargas RE: MB Sister Cities Program 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: 12/31/2007. 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 calendar year on which I have se d. Amparo Vargas Sworn to and subscribed before me this ~y of 'lC. b"O 200':1-- U~~~u 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 Disclosure Requirements. We are commiffed to providing excellent public service and safety to 01/ who live, work, and play in our vibrant, troplcol. historic community m - MLA/v\1 BEACH Var-6~ Last Name 11'7-D 7~ sTreff No. Street 300 ~Ljq~k Home Work NAME: HOME ADDRESS: PHONE: Business Name: 14m p:tRO N .f;;. i/ FL 3S4( City State Zip Code VaruCt..5 _a mp:ueo ~~ Ld11 Email address First Name Middle Initial 11- j);;(rr Fax Position: Address: No. Street Professional License (describe) City State Zip Code Expires: 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 ".nths in a business established in the city. . Resident of Miami Beach for a minimum of six (6) months: Yes I!I or No ~ . Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes Q"6r No D . Are you a registered voter in Miami Beach: Yes D or No ~ . (Please check one): I am now a resident of: North Beach D South Beach D Middle Beach D fJ /A . I am applying for an appointment because I have special abilities, knowledge, experience. Please list below: /..l4. S cI 11J Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3) choices will be observed by the City Clerk's Office. (Regular Boards of City) D Art in Public Places Committee . D Beach Preservation Board D Beautification Committee D Board of Adjustment* D Budget Advisory Committee D Committee on Homeless D Committee for Quality Education in MB D Community Development Advisory* D Community Relations Board D Convention Center Advisory Board D Debarment Committee D Design Review Board* D Disability Access Committee D Fine Arts Board D Golf Advisory Committee D Health AdvisoryCommittee D Health Facilities Authority Board ~ispanic Affairs Committee D Historic Preservation Board* * Board Required to File State Disclosure form D Housing Authority* D Loan Review Committee* D Marine Authority* D ~ami Beach Cultural Arts Council @'Miami Beach Commission on Status of Women ~iami Beach Florida Sister Cities D Normandy Shores Local Gov't Neigh. Improvement D Oversight Committee for General Obligation Bond D Parks and Recreation Facilities Board D Personnel Board* D Planning Board* D Police Citizens Relations Committee D Production Industry Council D Public Safety Advisory Committee D Safety Committee D Transportation and Parking Committee D Visitor and Convention Authority* D Youth Center Advisory Board F:\CLER\$ALL\B&C App!iciJtion\B&C J.I,pplicCltion Revisod Ofl11OfJ jakes.doc 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 No!: Years of Service: 2. Present participation in Youth Center activities by your children Yes: No!. If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: _ Program: Child's name: Age: Program: .Have you ever been convicted of a felony: Yes [J or No riyes, please explain in detail: · Do you currently have a violation(s} of City of Miami Beach codes: Yes D or No ff'lf yes, please explain in detail: · Do you currently owe the City of Miami Beach any money: Yes D or No rYffyes, explain in detail · Are you currently serving on any City Boards or Committees: Yes 0 or No iX'If yes; which board? · What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: 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 D or NO~hiCh department? · Pursuant to City Code Section 2-25 (b): Do you have a parent U, spouse J, child C, brother [J, or sister C 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: Ethnic Origin (Check one) White D African-American/Black D Hispanic: D Asian or Pacific Islander D American Indian or Alaskan Native D Employment Status: Employed D Retired D Home-maker D Other D years old Gender: Male D Female ~ "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 C. Code "Standards of Conduct for City Officers, Employees and Agency Members." t~ Dat ~~C~?!~E PRINT) Applicant's Signature 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 bv \ a !<~ ""=' Name of Deputy Clerk Document Control Number (Assigned by the City Clerk's Office) Date .2 /28 Entered By Date Revised 1/25/07 jo 2 F:\CLER\$ALL\B&C i\pplication\FH::C Applicaton Revised mJ110E i2fcsdoc fL-.. . \1 QI tlM\ 11- '/,\' )\'\;1/ \~