Tara West 12/31/2008
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city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachR.gov
OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk
TEl: (305) 673-7411, FAX: (3051 673-7254
02-20-2007
Tara West
1330 West Ave
Miami Beach, Florida 33139
ISUSJECT:-' Community Development Advisory Committee
Congratulations! You have been appointed by Commissioner Michael Gongora
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 1 st, 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,
~~/blb
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Thomas Urriola
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 commi"ed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community
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MIAMI BEACH
city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachR.gov
OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk
TEl: (305) 673-7411, FAX: (3051 673-7254
TO Tara West
RE: Community Development Advisory 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 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 1 st, following the closing of the calendar year on which I have served.
~O. JJ-
Tara West
Sworn to and subscribed before me this L day of n1Ci.A.~ ,2007
-JC>.-~"-.
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 commi"ed to providing excellent public service and safety to all who live, work, and play in our vibront, tropical, historic community
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MIAMI BEACH
NAME:
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Last Name
CITY OF MIAMI BEACH
BOARDS AND COMMITTEE APPLICATION FORM
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First Name
().
Middle Initial
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City I State Zip Code
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Email address
HOME ADDRESS: 7~CO CGt/tVlS
No.
~fA.~ + 'to'!
Street
PHONE: 305-90)' - ra.~3
Home Work
Business Name: -:I" J1/l-:;: i.. ( ~' VI d-
Fax
Position:
I~ Eskl-e
Address:
No.
State Zip Code
Professional License (describe)
f(c~ Street
City
Expires:
Attacfl a copy of the license
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~ or No D
. Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes~ or No D
. Are you a registered voter in Miami Beach: Yes ~ or No D
. (Please check one): I am now a resident of: North Beach D South BeaChfi Middle Beach D
. I am applying for an appointment because I have spycial abilities, knowledge, experience. Please list below:
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)
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
~ 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
D Housing Authority*
D Loan Review Committee*
D Marine Authority*
o Miami Beach Cultural Arts Council
D Miami Beach Commission on Status of Women
D Miami 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
o Safety Committee
D Transportation and Parking Committee
o Visitor and Convention Authority*
o Youth Center Advisory Board
F:ICLERISALL\B&C ApplicationlB&C Application Revised 091106 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 0 No r.Y Years of Service:
2. Present participation in Youth Center activities by your children YeJ'i N~ If yes, please list the names of your children, their
ages, and which p~rams. List below: r (, ~ U--b
Child's name: 0fAfAOV fAJe.S Age:~Program: .J:'C.ltd-~ ~, ~I4(MCI(,
, 0
Child's name:
Age:
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 NoAl. If 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
or;J 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:
ri> 7 roo ~!J-1"-5 kuv..e . /l1lt>......I!::..c.J. "41.....
~ /3'30 ~ 1fve:V1.c..t..€.{ I rt{(~. ~,t ~
· I am now employed by the City of Miami Beach: Yes 0 or NO~ Which department?
· Pursuant to City Code Section 2-25 (b): Do you have a parent 0, spouse 0, child 0, brother 0, or sister 0 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: 'to years old
Ethnic Origin (Check one)
White ~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
Gender: Male 0
Female ~
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
ArliCI{- of the City Code "Standard. of Conduct for City Ollicers, Employee. and Agency Members."
- CJ.. ~ 0/?/tJ7 ~A... O. IAJe s+-
A'PiJt(c"ant's Signature I 0 te 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.
Received in City Clerk's Office by l<:;
Name of Deputy Ca
Document Control Number (Assigned by the City Clerk's Office) C[). (p
2
Date ~-9" o'":}.
Entered By
Date
F:\CLER\$ALL\B&C Application\B&C Application Revised 091106 jakes.doc
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