Elsa Orlandini 12/31/09e - r _ ~ _~ g 2a~ r ~
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
12/21 /2007
Elsa Orlandini
3718 Sheridan Ave
Miami Beach, Florida 33140
SUBJECT: Miami Beach Commission For Women
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
to the above referenced agency, board or committee for a term ending: 12/31/2009.
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.
Sincerely,
Robert Parcher -~1
City Clerk
cc: Saul Frances, Parking Director
Maria E. Martinez
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 are committed to providing excellent public service and safety fo all who live, work and play in our vibrant. tropical, historic community.
m 11AMIBEACH
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 Elsa Orlandini
~'~ ~ v_•~~~t
RE: .AAai~-Beach Commission for Women
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: 12/31/2009.
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/orida 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 1st, following the closing of the calendar y which I have served.
~'
.~'' =~/
^~ Elsa Orlandini
/ / f J
Sworn to and subscribed before me this:: y' ~=~ day of ~ ~-- , 200
I
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 committed to providing excellent public service and safety to all who Live, work and play in our vibrant, tropical, historic community.
NAME:
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Last Name Fir t Name Middle Initial
HOME ADDRESS: ~~ ~ cs ~V~.~~C (~~ f ~ " ~ 1/ v1 4 CV'JV~ ~G'lC~ (t`i% ~(~U
No. Street City State Zip Code
PHONE: ~~~ ~ ~~I ~ ~ ~ `F'' C ~SUI ~ ~~~f~ (t /`~~ 1 /~c1 C r]l-r~
Home Work ~ Faux Email address
Business Name:
Address:
Professional License (describe)
Exp
Zip Code
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~No
. Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yesvor No
• Are you a registered voter in Miami Beach: Yes ~No
• (Please check one): I am now a resident of: North Beach South Beach Middle Beach c/
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
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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
Beach Preservation Board
Beautification Committee
C Board of Adjustment"'
u Budget Advisory Committee
Committee on Homeless
Committee for Quality Education in MB
C Community Development Advisory'
Community Relations Board
Convention Center Advisory Board
Debarment Committee
Design Review Board
= Disability Access Committee
Fine Arts Board
- Golf Advisory Committee
Health Advisory Committee
Health Facilities Authority Board
Hispanic Affairs Committee
Historic Preservation Board'
Housing Authority"`
~: Loan Review Committee"
Marine Authority`
Mi i Beach Cultural Arts Council
iami Beach Commission for Women
Miami Beach Florida Sister Cities
Normandy Shores Local Gov't Neigh. Improvement
Oversight Committee for General Obligation Bond
P sand Recreation Facilities Board
ersonnel Board°
Planning Board`
Police Citizens Relations Committee
~oduction Industry Council
Public Safety Advisory Committee
- Safety Committee
Transportation and Parking Committee
- 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:
Child's name: Age: Program:
Child's name: Age: Program:
.Have you ever been convicted of a felony: Yes or No '/ yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes or Not/. If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes or No ~ yes, explain in detail
• Are you cur~ntly serving on any City
or Committees: Yes ~ No If yes; which board?
• What organizations in the , ity of Miami Bea do you curve d memb rshi in?
Name: ~ v ~~~~~ ~ Q
~ ~ ~ ~` `t ~` ~' itle.__ ~l i~W l~ ~
- ,~r-
Name: Title:
. List all properties own or have an interest in, which are located within the City of Miami Beach:
,'A )
. I am now employed by the City of Miami Beach: Yes or No t!CNhich department?
• Pursuant to City Code Section 2-25 (b): Do you have a parent , spouse~hild ,brother , or sister who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s): V
This section is "not required" but desired: Age: -~~ Years old Gender: Male ~ Female _=~
Ethnic Origin (Check one)
White _-~ African-American/Black _ Ispanic: =Asian or Pacific Islander _ American Indian or Alaskan Native
Employment Status: Employed - etired ~ Home-maker ~~ Other
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article Vll--9f the,Ci Code "Staglards of Conduct for City Officers, Employees and Agency Members."
.^ ~ y
Applicant's Signature Date 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 -~ Date ' r ~ Z` ~~
Name of Deputy Clerk
Document Control Number (Assigned by the City Clerk's Office) Entered By ~ ~ ~ Date ~~' ~ ~
Revi d 10/29!2007 L. Hatfield
S ~~