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Harold Foster 12/31/2007 in ..... 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 02-21-2007 Harold Foster 3101 Indian Creek Dr. #20C Miami Beach, Florida 33140 iijIiJECI= Police Citizens Relations Committee Congratulations! You have been appointed by Commissioner Jerry Libbin to the agency, board or committee named above for a term ending: 12/31/2007. 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, ~rk;ffi.~/~ Robert Parcher City Clerk cc: Saul Frances, Parking Director Donald Delucca 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 are committed to providing excel/ent public service and safety to 01/ who live, work. and ploy in our vibrant, tropical, historic communtty in "!iiiI!F 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: (305) 673-7254 TO Harold Foster RE: Police Citizens Relations 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: 12/31/2007. 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 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 have served. ~~ Sworn Harold Foster to and subscribed befO?~f :1;_~ d. 200_0:;Z: 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 excel/ent public service and safety to 01/ who live, work, and ploy in our vibrant, tropical. historic community in ..... MIAMIBEACH BOARDS AND COMMITIEE APPLICATION FORM Pursuant to City Code section 2-22(4) 0 and b: Members of agencies, boards, and committees sholl be affiliated with the city; this requirement sholl be fulfilled in the following ways: 0) on individual sholl hove been 0 resident of the city for 0 minimum of six months; or b) on individual sholl demonstrate ownership/interest for 0 minimum of six months in 0 business establisn the city. Resident of Miami Beach for a minimum of six (6) months: Yes ~ or No [ ] Demonstrate an ownership/interest in a business in Miami Bea for a minimum of six (6) months: Yes [ I am applying for a Board appointment because I have cia I abilities, knowledge, experience: Yes [ ] My special abilities, knowledge, or experience is: Are you a registered voter in Miami Beach: Yes NAME: ~L.6.-t'\ ""0\lC~(\) Last Name First Name Home '3,1,0\ ..-,-, C(~~\<-.. ':t:f; el::JC f1I\ O-~; \~c..c~ Address: No. Street City Phone: G~cr,;)t7d-C;;":;i+- (2 Ilt~s") ,-3:Jl,'S-iL{ 6 Home Work Fax ] or No [ ] Middle Initial V l'~-:> t-~' State lip Code (Please check one): Business Name: '\ vl I am now a resident of: U()'\\'-C(~ ~~ a'" \\\.~~ ~Ol Street North Beach 0 South Beach iddle Beach 0 6~ \ JO\'<~ CQJ"~ct>/ s-~\q0 Applicant's Position: Address: L\ 000 No. '-CA..W'\ , \~e0C\J-.- f \ City State lip Code DOwner 0 Stockholder/Shareholder 0 Corporate Officer 0 Other Explain: Professional License (describe): Attach a copy of the license listed above. 1. Have you ever been convicted of a felony: Yes 0 or ./ No ~. pleo,e e'plo;n ;n delo;L Expires: 2. Do you currently have a violation(s) of City of Miami Beach codes: Yes 0 or No D. If yes, please explain in detail: 3. Do you currently owe the City of Miami Beach any money: Yes 0 or No If yes, explain in detail: 4. Are you currently serving on any City Boards or Committees: Yes 0 or No If yes; which board? What organizations in the City of Miami Beach do you currently hold membership in? Name: ~rv..A,<\\:~\C" ~.~ .~~ Jc \ Title: ('\\e~ c>-F ~I(\O<f:;C,vc, 0~ ~ Name: Title: List all properties owned or have an interest in, which are located within the City of Miami Beach: C:\DOCUMENTS AND SETTINGS\ClERGIBE\lOCAL SETTINGS\TEMPORARY INTERNET FllES\OlK14\BC APPLICATION NOV 20051.DOC I am now employed by the City of Mia. Beach, Ye, 0 oc No ~WhiCh departmeot? Pursuant to City Code Section 2.25 (b): Do you have a parent OJ, spouse OJ, child OJ, brother OJ, or sister OJ who is employed by the City of Miami Beach? Check all thot apply. Ider.tjfy the department(s): N A ~ Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. three (3) choices will be observed by the City Clerk's Office. Re ular Boards of City) o Art in Public Places Committee o l rrier Free Environment Committee o Beach Preservation Boord o Bea' ication Committee o ard of Adjustment (Flood Mono Bud et Adviso Committee o Committee on the Homeless o Committee for Quali of Education in Miami Beach o Community Development Advisory CommitteeOo o Communit Relations Boord o Convention Center Advisory Boord o Deb rment Committee o si n Review Boord .. Fine Arts Boord o Golf Adviso Committee o Health Adviso Committee o Health Facdities Authority OHispanic AHoirs Committee OHistoric Preservation Boord * Please note that only OHousin Authorit OLoan Review CommitteeOo OMarine Authority * OMiami Beach Cultural Arts Council OMiami Beach Commission on Status of Women OMiomi Beach Florida Sister Cities ONormand Shores local Gov. Nei hborhood 1m rovement ONorth Beach Youth Center Oversight Committee OOversight Committee for General Obligation Bond OParks & Recreational Facilities Boord o Person Board .. nin Boord" olice Citizens Relations Committee o Production Indust Council o Public Safe Adviso Committee o Safe Committee o Trans ortation & Parkin Committee o Visitor & Convention Authority * o Youth Center Advisory Boord *Board Required to File State Disclosure form Note: If applying f01 Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: "-' ' p . 1. Past service on the Youth Center Advisory Board: Yes 0 No 0 Years of Service 0 2. Present participation in Youth Center activities by your children Yes 0 No D. If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Child's name: Age: _ Program: Age: _ Program: Gendr:~~~;; Female 0 This section ~ot required" but desired: Age: 0 Ethnic",Oljgin (Check one) White !r African-American/Black 0 Hispanic: 0 Asian or Pacific Islander 0 Am~an Indian or Alaskan Native 0 Employment Status: Employed WRetired 0 Home-maker 0 Other 0 "1 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. " '-11.~ ,1, ) ~ ~'.'7J...T fY.iUJ' . .. . Y-I Applicant's Signature Attachment: NOTE: ppli (:l:;l jU"2:./o 1 Date Please attach a otions will remo' \ \)rdo C)~~ fd;;tr ame of Applicant (PLEASE PRINT) Y of your resume to your application. n. file for 0 period of one (l) calendar year. Received in City Clerk's Office Document Control Number (Ass, f ice) 2;Ltt Deputy Clerk Revised 11/15105 C\DOCUMENTS AND SETTINGS\CLERGIBE\LOCAL SETTINGS\TEMPORARY INTERNET FILES\OLK14\BC;J,AfPLlCAT...ION. ..NTOV 2. 0051 DOC l~yJ{(J~Ad\