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Debra Scholl 12/31/2008 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 Debra Scholl 803 E. Dilido Drive Miami Beach, Florida 33139 SUBJECT: Convention Center Advisory Board Congratulations! You have been appointed by Commissioner Saul Gross to the agency, board or committee named above for a term ending: 12/31/2008. 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, Lj '~~,2 ~ . Cc'1-C.,~t.c2.2.- Robert Parcher City Clerk cc: Saul Frances, Parking Director Clara Larosa ,,,.__ ATTACHMENTS: Letter of Appointment Oath .y ,.:,~ r, ,/, ~ a 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 excellent public service and safety to alt who live, work and play in our vibrant, tropical, historic community. 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 Dabra Scholl RE: Convention Center AdvisoryBoard 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: 12/31/2008. 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 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 year on which I have served. Sworn to and subscribed before me this ~ day of 00 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 all who live, work and play in our vibrant, tropical, historic community. .~ 1 ~ ~! ~ , CITY O~ r ~ IMhBEACH BOARDS AND COMr ~'EE r 1 ~j APPLICATION FORM ~ V ~ ~ D fJ , t~ Pursuant to (Sty Code section 2-22(4) a and b: Members of agenaes, boards, and committees shall be aff'il'iated with the lily; this requirement Srlaii be fulfilled in the fdbwing ways: a) an individual shall have been a resident oP the city for a minimum of six months; orb) an individual shall derr~onsb'abe ownership/interest for a minimum of six montiis in a business established in the city. Resident of Miami Beach for a minimum of six (6) months: Yes [~/]~ or No [ ] Demonsbabe an ownership/interest in a business in Miami Beach for a minimum ~ sbc (6) months: Yes [~/]~or No [ ] I am applying for a Board appointment because I ' i bil ' edge, experience: Yes [~,]~ My special abilities, knowledge, or experience is: S~ y~Ss ~S a ~ Are you a registered voter in Miami Beach: Yes [ or No [ ] NAME: ~C ~~'Ot~-- I~it P~ ~,.ll~ S last Name First Name Middle Initial Nome ~ ~- .I~.~L~Dn ~~--~-~~. l~V~~19-17`+~ ~~~--C~ ~ ~J.~_~~ Address: No. Street Gty S'~ code ©11~~c~ ~ Phone: ~oS - S 3 I -006 3~s - (~ (~a -~1~~ ~s - S 3~-~~~ Q Home Work Fax Email address i am now a rosident ot: North Beach![ ]South Beadt [~ddie Beach I Business Na i7 / ~1'i ~/es icarlt's Position • ~ i'e S f ~ e-n ~' ` ~~ ~d,~ ~.! ~ 3 l ~ Address: No. Street City State Zip Code [ ~~' [ ] Steer/Shareholder [ l Corporate Officer [ ]Other Explain: Professional Ucense (describe): Expires: At~t a copy or the /k+erae llst+sd ab~v~ro 1. Have you ever been convicted of a felony: Yes [ Jar No [ If yes, please explain in detail: z. 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: Yese' ] or No [ ] If yes; which boarp}?,~ ; ~ Pt) h ~~ C- ~II~CeS - ~1' a ~~~ MP r~ pT What organizations in the City of Miami Beach do you currently hold membership in? Name: Name: Title: Title: list~,Rropertip~ qwn~ c~ _ fvy~ interest in, which ~ r~ Iocai~~W~ ~ qty pf Miami Beach: I am now emplo'yed~ by the.. City of Miami Beach: Yes [ ] or No If yes, which department. Pursuant to City Code Section 2-25 (b): Do you have a parent [ 1, spouse [ ], child L ], brother [ 1, or sister [ ]who F:\CLER\~ALLIELIZABE'i1B8cC\BCAPPLIC04.dce ..... ~~ ~, is employed ~ the City of Miami .,... ' Check all that apply. Identify the dep- .(s): ~- Please list your preferences in order of ranking [3] first thoioe [2] second choice, and [3] third choice. Please nobs that only 3 dwices will be observed by the City Clerk's ONlice. (Regular Boards of City) (*Board Required to Fie State Discbsure form) ] Art in Public Plates ] Aunt Corrrnltbee ] Barrier Free Erlvironmerrt ConttrMttee ] Beach Preservation Board ] Beaudfk~tlon Committee ] Board of Adjustment (Flood Mgmt.)* ] Budget Advisory Committee ] ] Committee on Florrleless ] CArranitbee for Quality Education in MB ] Community Development A~dvisory* ] Community Relations Board Convention Center Advisory Board ] Convenrtion Center Capital Projects Oversight ] Debamrent Committee ] Design Review Board* ] Fine Arts Boarcl ] Goff Advisory Committee ] Healtft ~~'Y C.dnrrdtbee ] Health Fadlitles Autfiority ] Hispanic Affairs Committee ] Histork Preservation BoaM* ] Housing A„n,omy* ] Loan Review Committee* [ ]Marine Authority* [ ]Miami Beach Guttural Arts Council [ ]Miami Beach Conmlission on Status of Worrlerl [ l Miarr~ Beactl Fkxkla Sister (Sties [ ] Normandy Shores Local Govt Neighborhood Improvement [ ]North Beach Youth Center Over~ght Committee [ ]Nuisance Ababem~t Board* [ ] ~9ht ~~ for General ObRgatbn Bond [ ]Parks and Recreation r-aa'litfes Board [ ] ~~~ Board* [ ] n9 ~ro* [ ] PoUoe Cttlzens Relations Committee [ ] ~~~'- Industry Council Public Safety Advisory Committee safety Corraretbee ] South Point Advisory Board* bo Redevelopment Agency [ ] [ Transportation and Parking Board V~sibor and Convention Authority* [ ]Youth Center Advisory Board Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: i. 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' This se~cNon is "not required" but ABe: [~' ] Gender: M [ ] ~ F ~I Ethnk O~M~,9in (Check one) IAihit~e [xl Afrkan-American/Black [ ] Hispank: [ ] Asian p~Pacific Islander [ I American Indian or Alaskan Native [ I Employrrlent Status: Employed [~ Retired [ ]Home-maker [ ]Other [ I hereby attest tQ the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Artide VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." _ ~ y ~ s .~ l / Appl Y Date _ Name of Applicant (PLEASE PRINT) Attachment: Please attach a copy of your resume bo your application. NOTE: ~pi~~ion~t~ in on le for a period of one (1) calendar year~~ Received in City Clerk's Office / / b Document Control Number (Assigned by the City s Office) ~ ~ Rev #7- 01/08/04 F:\CLER\SALL\ELIZABEIIB&CIBCAPPLIC04.doc