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Jeffrey Rynor 12/31/2008 lD ,.,. 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 01-22-2007 Jeffrey Rynor 5385 North Bay Rd Miami Beach, Florida 33140 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, ~r-t4 ~/~JvJ 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 are committed to providing excellent public selVice and safety to all who live, work, and play in our vibrant, tropical, historic community lD ..... 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 Jeffrey Rynor RE: Oversight Committee for General Oversight 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 1 st, following the closing of the calendar year on which I hav erve. Sworn to and subscribed , 200_1 9:::JQ~ . f--------- *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 committed to providing excellent public 5elVice and safety to all who live, work, and play in our vibrant, tropical, historic community E..U '=" -- 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. . I Resident of Miami Beach for a minimum of six (6) months: Yes 1- or No - {-1;emonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes [J or No [I V I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes:J /" My special abilities, knowledge, or experience is: Are you a registered voter in Miami Beach: Yes )(Or No -=-_ ('>() NAME: ~~~lO\ C) e.:t:i:'f""'e-i Q Last me ...:") d First N me Middle Initial Home: S'3~ S- N ~o.<( ~_ No. Street WI \'.t:a '^" " City ~~'" FL State JJ:3 (l.j..f Zip Code Address: Phone: Home Work Fax Email address =:J Business Name: Applicant's Position: Address: No. Street City State Zip Code DOwner D StockholderlShareholder D Corporate Officer D Other Explain: Professional License (describe) Expires: ti:;:;jp{j -i~f (?-\/('c 1. Have you ever been convicted of a felony: Yes D or No~es, please explain in detail: 2. Do you currently have a violation(s) of City of Miami Beach codes: Yes D or N . If yes, please explain in detail: 3. Do you currently owe the City of Miami Beach any money: Yes D or N . If yes, explain in detail 4. Are you currently serving on any City Boards or Committees: Yes_ or No L:. If yes; which board? I C\ m ~ ~e.. \.J \ ZoC.Cll' a. '(V\ tA &etA. V\1 r:,Uod u..aroeA:>~ What organizations in the City of Miami Beach do you currently hold membership in? Name: C-'r1Cl\'\ -C- 'C"\l Moo f\l\ A- Title: Name: Title: List all properties owned or have an interest in, which are located within the City of Miami Beach: \. vYl'6 ~OW\e.: 'i"".~g~ N ~'() ~d. M.g. I am now employed by the City of Miami Beach: Yes D or *f yes, which department? Pursuant to City Code Section 2-25 (b): Do you have a parent D, spouse D, child D, brother D, or sister D who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): 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) Housing Authority* ] Loan Review Committee* ] Marine Authority* ] Miami Beach Cultural Arts Council D Miami Beach Commission on Status of Women C Miami Beach Florida Sister Cities [ Normandy Shores Local Gov't Neigh. Improvement ~versight Committee for General Obligation Bond 11 Parks and Recreation Facilities Board ~J Personnel Board* ] Planning Board* 1 Police Citizens Relations Committee 1 Production Industry Council 1 Public Safety Advisory Committee 1.1 Safety Committee 1 : Transportation and Parking Committee 1 Visitor and Convention Authority* Youth Center Advisory Board Art in Public Places Committee 1_ Barrier Free Environment Committee [[ Beach Preservation Board [: Beautification Committee Board of Adjustment* 1 Budget Advisory Committee 1 Committee on Homeless Committee for Quality Education in MB 1 Community Development Advisory* ] Community Relations Board Convention Center Advisory Board ~j Convention Center Capital Projects Oversight Debarment Committee Design Review Board* Fine Arts Board [ Golf Advisory Committee [ Health Advisory Committee Health Facilities Authority Board [ Historic Preservation Board* *Board Required to File State Disclosure form 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 J No Years of Service: 2. Present participation in Youth Center activities by your children Yes=: No D. 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: This section is "not required" but desired: Age: 5Q years old Ethnic Origin (Check one) WhiteJQ\frican-American/Black D Hispanic: D Asian or Pacific Islander D A.~can Indian or Alaskan Native D Employment Status: Employe~3 . d D Home-maker D Other D uracy a truthfulness of the application and have received, read and will abide by Chapter 2, ards of Conduct for City Officers, Employees and Agency Members." ~~-c-e~ ~L2rvor Name of plicant (RLEASE PRINT) Gender: Malk Female 1 1 JL 1'l!"110<;' Date Act: P e attach a copy of your resume to your application. OT : Applications will remain on file for a period of one (1) calendar year. Received in City Clerk's Office bY~ 0 Document Control Number (Assigned by the City Clerk's Office) 21 ("~ Deputy Clerk Date Datetlf 1 "Lt 0 ..., ReVised 9/11/06 Ih Entered By 1\1.- 2