Leslie Coller 12.31.2009t~ 3 ~.
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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
02-07-2008
Leslie Coller
5301 LaGorce Dr.
Miami Beach, Florida 33140
~riJBJECT: Miami Beach Commission For Women
Congratulations! You have been appointed by Commissioner Deede Weithorn
to the agency, board or committee named above for a term ending: 12/31/2009.
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,
~~~~- ~~~~~~~~~/sue
Robert Parcher
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, 2-458 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 a!1 who five, work and play in our vibrant, tropical, historic community.
~ ~ ~~ r i
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.QOv
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: {305) 673-7254
TO Leslie Coller
RE: Miami 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 ~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 calendar year which I have se
Leslie Colll-erg
Sworn to and subscribed before me this ( day of l ~e r(ftCl , 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 all who live, work and play in our vibrant, tropical, historic community.
JaM 16 ~t]8 11:09a Lesli~""":eller 305-961-.x.136 p.2
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NAME: ~~~ [ ~
Last Name First Namc Middle Initial
NOME aooRS_ss: ~'~I ~ ' ~+~;r'C-~-~'"~ l~%~i a~.Y~-t
No. Street City ~ State Zp Cad
PHONE=
~-
Home ~ Work
Business Name
Address.
No. Street
Professional License (descrinc}
POSitiO>7'.
'~~4
Fix
City
m2il ~ address
Stet z Zip Code
Pursuant to Gty Cade ssctlon 2-:t2(d) a and b: Merttbers of agencies, 44ards, and committees she I be ~ ffiliated with the aty; this
requirement shall be fulfilled in the following ways' a) an individual shat! have been a resident of tfi~ Cty for a minimum of six
months; or b) an individual shall de~nanstrate ownershiplinterast for a minimum of six months in a busrr~5s SstaBlished in the city.
. Resident of Miami Beaeh fora. minimum of six (t3) months' Yes~i ar Na i:i
• Demonstrate an ownership/interest in a business iyndMiami Beach for a minimum of six (ti) monl hs: Yes i " or No f7
• Are you 3 registered voter in t~giami Beach= Yes ti'I or No I
. (Please check dne): ! am now a resident of Noah BBACh f 1 $Outh Beach ^ Middle Beach /~
. I am Applying fqr an appointment because I have special abilities, knowledge, experience. PIe2 a IiSt below=
1, •~_ r~y. ~. C.~ ~ t i<~ ~! ~,-, L.~t .,t_~`:nCt~t=~~~:C,:~ ~ Y1 f~ h~ .tom ~i ,:1~ . ~J C ~ U2. C~ ,
~i i`IY1 r~~'J ~i ~_J~Y' ~ ~ ' ~ i ~ Tf'!`~fR." ", ~ `c' ~`(' ,'%-t '7 r^ ~~S r - r,,; ~'~ ~.:?.~P`•'. ~t~-'~C~~
Please list your preferences in order of ranking [ij first choice [Zj second choice, and [3J third choice. F'teasr~ note that only three l31
choices Witt 6s observed b #y he Gilr Clerk's Ica. (Regular Boards of City)
Art in Public Flares t;ommittee
Bcarri Preservation 13oard
Beautification Committee
Board of Adjustment•
~~ Budget Advisory Committee
~ Committee on Home ass
Committee for Quality Education in MB
Community Development Advisory'
~ Comrrtur~ity Rel~tigr~.c Beard
'~ Convention center Advisory Board
u Debarment Committee
u Design Review Board'
Disability Access Committee
Fine Arts Board
0 Goif Advisory Comm ttee
Health Advisory Carr rnit#aa
Health FaCiliti~5 AutFpr~y Board
L7 Hispanic Affairs Committee
Historic preservation Board'
" Bperq Roqulrea to File State DISC103ui~D corm
Heu$irtg Authority'
0 Loan Review Committee''
u Mayor's Green Ad-Hoc Committee
C Marine Authority"
Miami Beach Cultural Arts Council
(:~1~Miami Beach Commission on Status of w~~men
!~ 'Miami Beach Florida Sister Cities
u Narmar~~ly Shores Local Gov't NeigF_ Imp •ovement
r] oversight Committee for General bk ligation Bond
u parks and Recreation Facilities Boar d
n Personnel Board'
1 Planning Board"
~ Paice Citizens Relations committee
U Praduetion Industry Council
^ Public Safety Advisory Committee
~ Safety Committee
l~~Transportation and Parking Cammitt~:e
C Visitor and Convention Authority'
^ Youth Center Advisory Board
1 ~~,~
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04
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Jeri ~1B 08 11 : 09a Lesl it ~~'ol ter 3D5-861 -'~"'' 36 P~ 3
Note: If applying for Youth Advisory Qoard, ploaso indicate your affiliation with the ScetS Rakaw Youth Centc ~r~
1 Bast service an the Youth Cen[el Advisory Board: Yes I ~ No Years of Service:
2 Present participation in Youth Canter activities t>y your children Yesl No I I. If yes, please fist the nom s of your chitdrQn, thou
ages, and which programs. List below:
Child's name: Age: Program;
Child's name:
Age: nrogram:
.Have you ever been convicted of a felony: Yes ._i or No,(( If yes, please explain in detail:
. Do you currently have a violation(s) of City of Miami beach Codes: Yos ~ or No~". If yes, piE~ase explain in detail;
• ar, you currently owe the City o'' Miami Beach any money: Yes =1 or No~ If yes, explain in detai
• Are you currently serving en amp City Boards or Committees: Y~ C or No`~ If yes; which k oard ?
. What organizations in the City of Miami Beach do you currently hold membership in?
N~mg; } '~ tyy~ ~ l ~~ Title: I V
Name
'Pule:
List all properties owned or hoer, an interest in, which are located within the City of Miami BE~ach:
~~~-~.~
• I am now employed by the City ~3f Miami Beach; Yes '.: or Nol~WhiCh department?
• Pursuant to City Code Section 2-:?5 (bj: Oo you nano a parent i, spouse ~ i, child ,brother i-), or sisrer i i ~ fio is emalaye'd Dy the
City of Miami Beachh Check all that a )ply. Identify the departrnent(s)~
This section is "not required" but cesired: loge: years old Gender: Male [] Female
Ethnic Origin (Check one)
White ^ Afi~ican-American/Black C hlisparnc: ^ Asian or Pacific Islander 0 American Indian or l',lask.tn Native C
Employment Status: Employed 0 12eRire{l ^ Name-maker l7 Other C
.~_
"1 hereby aite~t tb the aac~+racy ;rnd truthfulness of the application and have rrecelved, road aril w II abide Dy Chapter 2,
Article Vu - of fhrs City, CbrJe "Stand~rdg pf arpnduct for City Officers, Employees and Agency Miembt es."
/~ I r ~ ~ ! r
ptitant'5 Signature ~pc~te - Name of A;~pIiG int (PLEASE PRINT)
Floasa atttnch a copy of your resurn~s fo this application
NOTE: Applications wilt remain on 111e tOr a poriod of one (1 j Calendar yoar.
Rr~eived in Clty Clark'c prfiCe by ~ t]c de
Name of ~Cputy'Clerk ~
DucumFnt Connor Number (asaigr,ed by the CI(y Clerk's QKGe) ~~~~~ Entered Ljy ._ Cale
ea iasro~ w
2