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Francine Leibman 12/31/2007 in ,.,. City of Miami leach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeochfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEl: (305) 673-7411, FAX: (305) 673-7254 03-08-2007 Francine Leibman 1000 Venetian Way Miami, Florida 33139 SUBJECT: Public Safety Advisory Committee Congratulations! You have been appointed by Commissioner Matti H. Bower 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, n n O' ~ ~kH7~)6?b Rbbert Parcher City Clerk cc: Saul Frances, Parking Director Floyd Jordan 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 ore committed to providing excellent public 5eNice ond safety to 01/ who live, work, and ploy in our vibrant, tropical, historic community in ..... city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachR.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEl: (305)673-7411, FAX: (305) 673-7254 TO Francine Leibman RE: Public Safety 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: 12/31/2007. 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 bard or committee on which I seNe) on July 1 st, tollowing the Clos;ng of the c~ :ea, on wille ~ have seNed. ~ ancine Leibman Sworn to and subscribed before me this ,~ day of jJa..f'C...,~ ,2003- -~~~_.- 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 5eNice and safety to 01/ who live, work, and ploy in our vibrant, tropical, historic community ~N Last Name ~ . ~rst Name HOME ADDRESS: \ C?OO U~{\ ~ \l..LJ 00... J No. Street ~ PHONE: ~') ~ 7=t....:~:)'r \ >>1- 5:"~ ~o tvj Work in Mli\tV\I BEAC NAME: Lf-/~ Home Business Name: Soc..crh.. &-4c.-~ f1~~ Address: L 1-10 tv( ( ( ; C\ Gv~ No. Street Professional License (describe) f'\~ fL ()C{ Mir Initial ~:3 (3 ( State Zip Code I SOl.(--fft &-ac1, k4l~ti~ Email address City 3c.?) - 55tevrl Fax Position: ~ l1y ~~ ~ State 'tee ~~~1 Zip Code Expires: Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and cOl):1mittees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual sha have be a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a m m ix months in a business established in the city. · Resident of Miami Beach for a minimum of six (6) month . Ye or No ~ · Demonstrate an ownershlp/lnterest in a business In Miami Bea~~inimum of six (6) months: Yes~o 0 . Are you a registered voter in Miami Beach: Yes 0 or No ~. · (Please check one): I am now a resident of: North Beach ~th Beach 0 Middle Beach 0 · I am applying for an appointment because I have special 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 onlv three (3) choices will be observed bv 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 o 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 e-Health AdvisoryCommittee D-Realth Facilities Authority Board o Hi~anic Affairs Committee O)ifstoric Preservation Board* * Board Required to File 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 o 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 o Personnel Board* o Planning Board* o Police itizens Relations Committee o Pr: uction Industry Council ublic Safety Advisory Committee o Safety Committee o Transportation and Parking Committee o Visitor and Convention Authority* o Youth Center Advisory Board F:\CLER\SALL\B&C Application\8&C Application Revised 0911Of3 iakcsdoc 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 Servi~ I 2. Present participation in Youth Center activities by your children Yes. NcY'('lf yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: _ Program: Child's name: 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 No . If yes, please explain in detail: . Do you currently owe the City of Miami Beach any money: Yes 0 or No . / · Are you currently serving \3 any City ~oards or Committees: Yes or No D. If yes; which board? 4. ~ \ ~ l.S~ {~ +'1- . 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: \:rf1r (oJ. ( (k . I am now employed by the City of Miami Beach: Yes 0 or No · Pursuant to City Code Section 2-25 (b): Do you have a parent], spouse lJ, child l', brother 0, or sister iJ 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: ~years old Gender: Male 0 Female ~/ Ethnic Origin (Check one) . White 0 African-American/Black 0 ~nic: 0 Asian or Pacific Islander 0 American Indian or Alaskan Native 0 Employment Status: Employed ~eti;~-d 0 Home-maker 0 Other 0 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 , b:-\.(:P~ ...J 'Nar\1e of Deputy ~Ie~ Document Control Number (Assigned by the City Clerk's Offic~, y.~ I Date 3{loID1-' - -}: "/ Revised 1/25/07 jo . ..-;/ Entered By /;/ . , . \,. Date 2 F:\CLER\$ALL\B&C; .l\pplic8tion\8&C Application Revised OD1106 jiikcsdoc r tV\. M~t<1. ?J~ L~-(il