Amy Rabin 12/31/2008j} ~ f
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
01 /03/2008
Amy Rabin
331 West 28th St
Miami Beach, Florida 33140
SUBJECT: Parks and Recreational Facilities Board
Congratulations! You have been reappointed by Mayor Matti H. Bower
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.
Sincerely, n
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Kevin Smith
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 to all who live, work and play in our vibrant, tropical, historic con.
~.
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Amy Rabin
RE: Parks and Recreational Faciliries 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 Ciry of Miami Beach to which 1 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 theF/orida Commission on Ethia Guide to the Sunshine
Amendment and Code of Ethics for Public ricers 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 year on which I have serv d.
Amy Rabin
Sworn to and subscribed before me this ~~ day of , 200
. ~
Silvia Prieto
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 al! who live, work and play in our vibrant tropical, historic community.
n ~~
~, CITY OF MIAMI BEACH BOARDS AND COMMITTEE 1 (~ ~~
APPLICATION FORM ~ I
ant to City Code section 2-22(4) a and b: Membe a' oa agencies, boards, and committees shall be affiliated with the city; t is
' ual shall have been a resident of the city for a minimum of six months; or b)
Pursu
requirement shall be fulfilled in the following ways: a) an in
an individual shall demonstrate ownership/interest for a minimum of six months in a business established in t e ci
months: Yes [~ or NO [ ] or No [L~1
Resident of Miami Beach for a minimum of six (6) months: Yes [ ]
Demonstrate an ownership/interest ent because Ilhave sp B afcabi ties, knowledge, experience: Yes [~-~
I am applying for a Board appomtm ~p
My special abilities, knowledge, or experience is: or No [ ]
Are you a registered voter in Miami Beach: Yes [ ~
NAME: ~ ~~Ol--~ First Nam Middle Initial
Last Name ~ ~ S .~--- ~ i n,.,i•'Y~l ~L- 3~
~)3[ state Zip Code
Home City
Address: No. Street ~~ ~-~-Z3 ~~(,[SutJf (^
Phone: ~US ' ~3~ (~-~ Email dress ~~
Work Fax
Home
I am now a resident of:
Business Name:
North Beach [ ]South Beach [ ]Middle Beach ['~']~ `n,' ,~~_~, ~~
~~ ~ r~~
Applicant's Position:
Address: -.---
No. Street
[ ]Owner [ ]Stockholder/Shareholder [ ]Corporate Officer [
City State Zip Code
] Other Explain:
Expires:
Professional License (describe):
Attach a copy of the /icense listed above, ,, ,~ lease explain in detail: _
1. Have you ever been convicted of a felony: Yes [ ] or No [~1 i~ Yes, p
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes [ ] or No ["~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 [ ] or No [~~
If yes; which board?
What organizations in the City of Miami Beach do you currently hold membership in?
Title:_-
Name:
Title:______-
Name:
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.
Do you have a parent [ ], spouse ( ], child [ ], brother [ ], or sister [ ]who
Pursuant to City Code Section 2-25 (b):
F:\CLER\$ALL\ELIZABETIB&C\BCAPPLIC04.doc
...,
is employed by the City of Miami Beach? Check all that a I ~
PP Y Identify the department(s): 1°'\
Please list your preferences in order of ranking [1] first choice [2] second choice, and 3
only 3 choices will be observed by the City Clerk's Office.
(Regular Boards of City) [ ]third choice. Please note that
(*Board Required to File State Disclosure form)
~ ]Art in Public Places
[ ]Audit Committee ~ ]Marine Authority*
~ ]Barrier Free Environment Committee ~ ]Miami Beach Cultural Arts Council
[ ]Beach Preservation Board ~ ]Miami Beach Commission on Status of Women
~ J Beautification Committee ~ ]Miami Beach Florida Sister Cities
~ ]Board of Adjustment (Flood Mgmt.)* ~ ]Normandy Shores Local Gov't Neighborhood Improvement
L )Budget Advisory Committee ~ l North Beach Youth Center Oversight Committee
~ t ~ ]Nuisance Abatement Board*
[ ]Committee on Homeless ~ ]Oversight Committee for General Obligation Bond
~ ]Committee for Quality Education in Mg ~~'Parks and Recreation Facilities Board
~ ]Community Development Advisory* ~ ]Personnel Board*
~ ]Community Relations Board ~ ]Planning Board*
~ ]Convention Center Advisory Board ~ ]Police Citizens Relations Committee
~ ]Convention Center Capital Projects Oversight ~ ]Production Industry Council
[ ]Debarment Committee ~ ]Public Safety Advisory Committee
[ ]Design Review Board* [ ]Safety Committee
( ]Fine Arts Board ~ ]South Point Advisory Board* to Redevelopment Agency
~ ]Golf Advisory Committee ~ ] ~ ~ ~
~ ]Health Advisory Committee ~ ]Transportation and Parking Board
~ ]Health Facilities Authority ~ ]Visitor and Convention Authority*
[ ]Hispanic Affairs Committee ~ ]Youth Center Advisory Board
~ ]Historic Preservation Board*
~ ]Housing Authority*
~ )Loan Review Committee*
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Ra
Center:
kow Youth
1. Past service on the Youth Center Advisory Board: Yes [ ] No
2. Present participation in Youth Center activities b [ ] (Years of Service [ ]
children, their ages, and which programs. List below.r children Yes [ ] No
[ ]. If yes, please list the names of your
Child's name:
Child's name: A9e~ Program:
Age: Program:
This section is "not required" but desired;
Ethnic Origin (Check one) Age' [ ~~] Gender: N1
White ['' ] African-American/Black [ ] or F [ "'f
Asian or Pacific Islander [ ] Hispanic: [ ]
[ ]American Indian or Alaskan Native [ ]
Employment Status: Employed [~~Retired [ ]Home-maker [ ]Other [
I hereby attest to the accuracy and truthfulness of the application and have received
Chapter 2„Article VII - of the City Code "Standards of Conduct for City Officers Em
Member . ,read and will abide by
ployees and Agency
APPI cant's Signature ~ ~Z~ ~ ~ tl-
Date Name of Appl nt (PLEASE PRINT)
Attachment: Please attach a copy of your resume to your application.
Received in City Clerk's Off cr e Applications will remain on file for
/~/~ b eriod of one (1) calendar year.
Document Control Number (Assigned by the City Clerk's Office) __ Clerk
Rev #7- 01/08/04
F:ICLERI$ALL\EL IZABETIB& C\BCA PPLIC04. doc