Zalman Bacheikov 12/31/2008
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Porcher, City Clerk
TEl: 1305} 673-7411, FAX: (305) 673-7254
03/22/2007
Zalman Bacheikov
5201 N. Bay Road
Miami Beach, Florida 33140
SUBJECT: Personnel Board
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.
JU'cerely,
~'t'\.^f"v-o\JV~'
Robert Parcher
City Clerk
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(Cr~.
cc: Saul Frances, Parking Director
Mayra Buttacavoli
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 commmed to providing excellent public service ond safety to 01/ who live, work. and ploy in our vibranf, 'ropical, historic community
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
TEL: (305)673-7411, FAX: (3051 673-7254
TO Zalman Bacheikov
RE: Personnel Board
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.
Sworn
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, . ~ :..e...(pc-&'J
- (f -bl~ Bacheik~v - ..
to and subscribed before me this 2 2 day of 11412 CH , 2007
~~rvrk h
Fernanda Sliva
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 ore committed to providing excellent public service and safety to 011 who live, work, and play in our vibrant, tropical. historic community
M1AM! BE)A~CH
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Last Name
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PHONE: :%~ebl-bbg'f 2lJr;.S32'.-(o7QS 3C>5~S32-02'O rf1t<>1ue&lkoult.
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Address: 420 L' wi,.) 1 11-215 :W4 m; b~4CH
No. Street City
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Street City I State Zip Code
03/07/2007 WED 10157 FAX
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NAME:
HOME ADDRESS:
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Professional License (describe)
~001/003
CITY OF IMI~,~\I'm BI::t\,CHI
BOARJ::IS tl,,[~m 'GOMII}!ITTCE J!M'f"'UCA'T'IOI',,1 rORM
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State
93)39
Zip Code
Expires:
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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 0
. Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) rnonths: Yes ~r No 0
. Are you a registered voter in Miami Beach: Yes Ii or No n
. (Please check one): I am now a resident of: North Beach 0 South Beach 0 Middle Beach lu/
. I am applying for an appointment because 1 have special abilities, knowledge, experience. Please list below:
Please list your preferences in order of rankIng [11 first choice [2] second choice, and [3] third choice. Please note that only three m
choices will be observed by the City Clerk'$ 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
[J 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 Advisory Committee
o Health Facilities Authority Board
o Hispanic Affairs Committee
o Historic Preservation Board'
~ Boarcl Required to ~ile State DIsclosure form
o Housing Authority.
o Loan Review Committee*
o Marine Authority.
o Miami Beach Cultural Arts Council
o Miami Beach Commission on Status of Women
D 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
)!personnel Board.
o Planning Board"
o Police Citizens Relations Committee
o Production Industry Council
o Public Safely AdYisory Committee
o Safely Committee
o Transportation and Parking Committee
o Visitor and Convention Authority.
o Youth Center Advisory Board
C:"[!()GlJrmrl1l~ F,ln.1 Se1lirl\j3lClJlnpkalslLocal S!~l,lng~;\Tel'flp(lr,;lry lnll';rn..i Filu:,',OLK~ 1 oDlBC Applica1iQn Revil;~c1 iJ!~1'1 m\ 1,-JI\f!w.d;:'t;
03/07/2007 WED 10:57 FAX
16ZI002l003
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 [J Years of Service:
2. Present participation in Youth Center activities by your children Yes(l No n. 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 0 or No ~ If yes. please explain in detail:
. Do you currently have a violation(s) of City of MiamI Beach codes: Yes n or No~. If yes, please explain in detail:
. Do you currently owe the City of Miami Beach any money: Yes u or No W. If yes, 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:l1ia 1J\ifJerLCJf ~L ~dt Title: h1ern~
Name: Title:
. List all properties owned or have an interest in, which are located within the City of Miami Beach:
~~~ 1U-kI~Uu.... -Sill' 10. ~P-J.
. 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 [J, child 0, brother 0, or sister 0 who is employed by the
City of Miami Beach? Check all thai apply. Identify the department(s):
This section is "not required" but desired: Age: K years old Gender: Male)it Female 0
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)a 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,
Artlele VII- of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
I
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Name of Applicant (PLEASE PRINT)
.4~ 3-b-07
Ap ,ant's Signature Date
Please attach a copy of your resume to this application
NOTE: Applications will remaIn on fll9 for a period of one (1) cal9ndar year.
Received in City Clerk's Office by
Date
Enteted By
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03/07/2007 WED 10157 FAX
Zalman H. Bacheikov, D.D.S., P.A.
420 Lincoln Road, Suite 215
Miami Beach, Florida 33139
Tel. 305-532-6795
Professional Profile
1980 - Present Zalman H. Bacheikov, D.D.S., P.A.
Own and operate dental practice at 2 locations in Miami-Dade County:
Lincoln Road and North Miami Beach.
1979 - 1980 Dental Associate
Jack Saban, D.D.S., P.A.
100 Pine Island Road
Plantation, Florida 33324
1978 - 1979 General Practice Dental Resident
Montefiore Hospital
3459 Fifth Avenue
Pittsburgh, Pennsylvania 15213
1 976 - 1978 Dental Assistant
Dr. Alexander Leese
4101 Brownsville Road
Pittsburgh, Pennsylvania 15213
1973 - 1975 Chief Oral Surgeon
Ambulatory Hospital
Ranka, Latvia
Professional Memberships
. Miami-Dade County Dental Research Clinic
. Florida Dental Association
. American Dental Association
. East Coast Dental Society
. Miami Beach Dental Society
. Academy of General Dentistry
Community Involvement
1984 - 1986 Miami Beach Community Development Committee
1988 - 1989 Miami Beach Homeless Committee
1992 - 1994 Miami Beach Safety Committee
1995 - 1996 Miami Beach Transportation and Parking Committee
2000 . 2006 Miami Beach Health Advisory Committee
Education
Dental Degree
High School Diploma
Medical Institute
High School
Riga, Latvia
Riga, Latvia
June 1973
June 1968
Personal
Married with three children. Resident of Miami Beach since 1980.
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