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Ann Lampner 06/30/2008m MI,~MI BEACH City of Mieml Beach, 4700 Convention Centsr Drive, Miami Beach, Florida 33439, www.m+emibeachtl.aov OFFICE OF THE CITY CLERK, Hobert Parcher, City Clerk Tel: (305j 673-7411, Fax: (305) 673-7254 August 28, 2007 Ann Lampner 9281 Emerson Ave Surfside, Florida 33154 SUBJECT: Committee for Quality Education is MB Congratulations! You have been reappointed by virtue of your being a representative for the Ruth K. Broad Elementary School to the above referenced agency, Boazd and Committee for a term ending 06130/08. Pursuant to Ordinance No. ?.006-3543, commencing with terms beginning on ar after January ls`, 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, , .~~-~~ Robert E. Parcher City Clerk cc: Saul Frances, Parking Director Leslie Rosenfeld 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-Dace County ode Section ?-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 Off cers and Employees W© are committed To providing excal7QnT public service and sal©ty ro a!i who live, work and play rn our vr'brant, Tropical, historic cammuni!y. ~, ., r , Cihr of Miomi flwch, 1700 Convention Center Drive, Miami Beach, Fbrida 33139, www.miamibeochR.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEI: (305) 673-7411, FAX: (305) 673-7254 TO Ann Lampner RE: MB Committee on the Quality Education 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: 06/30/2008. 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 theF/o~ida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public ~cers 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 1st, following the closing of the Sworn to and subscribed *Please visit the City of Miami Beach website at vrww.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 all who live, work, and ploy in our vibrant, tropical, historic community. Deputy Clerk m MIA,ti, BEACH 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 Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes ~ or No Nl' I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes i~ My special abilities, knowledge, or experience is: Are you a registererdwoter i~n~M,yia~mi Beach: Yes ~ ~ or No NAME: _ i-~AY l/~v Home: Address: N~^o~ Phone: ~"~ r Home Street ,~ ~3~s_ Work 7\V'~ First Name C ~ 2- -~ ~ c~ Fax Middle Initial 'cam ~ ~31s~- State Zip Code ~ lec vh -~ ~~~ri-wla~' f Email a ress (Pit'~`„ic: i.i' {;7` !' &s?' ? . ~r:` rt a c.,i-i > L.r: t~"Vf ..E. ..4<.! .. ^ ... ~ t ,. ... .'4 L~ ,,4,, .., . ~ ~L' ~~4'. ^ Business Name: ~1 ~J ~G•~'~-In Applicant's Position:~~^'~.:~/ ~ n` Address: ~ ~"~~ ~ ~ V`1~ -S~ ~ 1" c7 ~ ~ ~ ~ `~~~ (~ ~ No. Street CJ~wner G Stockholder/Shareholder Corporate Officer ~ Other Explain: Ciiy Zip Professional License (describe) Expires: 1. Have you ever been convicted of a felony: Yes ^ or No IJ If yes, please explain in detail: 2. Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No'f If yes, please explain in detail: 3. Do you currently owe the City of Miami Beach any money: Yes ^ or No ~ If yes, explain in detail 4. Are you currently serving on any City Boards or Committees: Yes for No 0. If yes; which board? What organizations in the City of Miami Beach do you currently hold membership in? ~~ ` ~ ~ ~~ Title: fi ~ ~ Y~ Name:.. rtip• List all properties owned or have an interest in, which are located within the City of Miami Beach: I am now employed by the City of Miami Beach: Yes ^ or No~ If yes, which department? 1 F":1CLF_F21SAL~lE?&{: Al~ptirai;nrtH~C' A.i,ulicatiar7 Rc;viseci 0:?i 1uG.doc Pursuant to City Code Sect~entify he d)epartment(swe aparent spouse ,child ,brother or sister who is employed by the City of Miami Beach? Check all that app y N ~ ~r 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) Art in Public Places Committee ~, i Barrier Free Environment Committee C; Beach Preservation Board ~'~ Beautification Committee Board of Adjustment* i-~ Budget Advisory Committee Committee on Homeless Committee for Quality Education in MB ^ Community Development Advisory* G Community Relations Board ^ Convention Center Advisory Board ^ Convention Center Capital Projects Oversight ^ Debarment Committee ^ Design Review Board` ^ Fine Arts Board i; Golf Advisory Committee ^ Health Advisory Committee 0 Health Facilities Authority Board ^ Historic Preservation Board* Housing Authority ..Loan Review Committee* Marine Authority* Miami Beach Cultural Arts Council Miami Beach Commission on Status of Women Miami Beach Florida Sister Cities !: Normandy Shores Local Gov't Neigh. Improvement Oversight Committee for General Obligation Bond ~:' Parks and Recreation Facilities Board i ~ Personnel Board` i_, Planning Board* i.~ Police Citizens Relations Committee ;- Production Industry Council [7 Public Safety Advisory Committee ~ Safety Committee -i Transportation and Parking Committee :i Visitor and Convention Authority* ^ Youth Center Advisory 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 " No Years of Service: 2. Present participation in Youth Center activities by your children Yes.: !! No ~ If yes, please list the names of your children, their ages, and which programs. List below: Age: Program: Child's name: Child's name: Age: Program: / Gender: Male ^ Female ~~Y This section is "not required" but desired: Age: ~~. years old Ethnic Origin (Check one) White ^Afncan-American/Black ~ Hispanic:y Asian or Pacific Islander L American Indian or Alaskan Native Employment Status: Employed L Retired '~~ Home-maker ~, Other ~~~ "I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, cle VII - o the City o~e "Standards of Conduct for City Officers, Employees and Agency Members." ~~ Date Name of Appli nt (PLEASE P INT) icant's g a ure A chment: Please a ach a copy of your resume to your application. NOTE: Applications will remain on file for a period of one (1) calendar year. Deputy Clerk Date Received in City Clerk's Office by Document Control Number (Assigned by the City Clerk's Office) Entered By Date Revised 9/11106 Ih F \CLER\~ALL_IEiFl; r~ol_il~ afur~,k3r ~ ,t~,?'ica u.- _,~=U '~~d iJ'3 ''-'~~'+.