Jaqueline Hertz 12/31/2009S ~ a
I ' 1 9 e~'~ t is ~ ~ ~ ~ ~'~ '~~ >
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
01-24-2008
Jaqueline Hertz
565 N. Shore Dr
Miami Beach, Florida 33141
BJECT: Visitor and Convention Authori
Congratulations! You have been appointed by the City Commission 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,
~~ ~~~ S~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Grisette Roque
ATTACHMENTS:
Letter of Appointment
Oath
Ciry 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 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 Jaqueline Hertz
RE: Visitor and Convention Authority
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 year on which I have served.
~,,_ -~
~ ~- ~ Ja ueline Hertz
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Sworn to and subscribed before me this ^~~ da of , 200'~%J~
,~~
,.
Silvia Prieto ~~ S'/l~r~ ~~1~,_~-,y
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.
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Last Name First Name Middle Initial
HOME ADDRESS: ^5 ~.:~` ~`~I:k~:~;l( ~i-}~~7~~'t-°£ ~~t-i~~~ Y~i~~~' z..~-t.f of (.-. j !+t i
No. Street City State Zip Code
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Home Work Fax Email address
Business Name:
Address:
Position:
No. Street City State Zip Code
Professional License (describe) Expires:
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 ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes or No
• Are you a registered voter in Miami Beach: Yes `yd,or No
• (Please check one): I am now a resident of: North Beach~/South Beach `'~ Middle Beach
• I am applying for an appointment because I have special abilities, knowledge, experience. Please list below:
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (31
choices will be observed by the City Clerk's Office (Regular Boards of City)
^ Art in Public Places Committee
^ Beach Preservation Board
^ Beautification Committee
^ Board of Adjustment"
^ Budget Advisory Committee
^ Committee on Homeless
^ Committee for Quality Education in MB
^ 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*
* Board Required to File State Disclosure form
^ Housing Authority*
^ Loan Review Committee*
^ Mayor's Green Ad-Hoc 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
^ Personnel Board*
^ Planning Board*
,j~Police Citizens Relations Committee
^ Production Industry Council
^ Public Safety Advisory Committee
^ Safety Committee
^ Transportation and Parking Committee
~ Visitor and Convention Authority*
^ Youth Center Advisory Board
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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 NobL, If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes _ ; or No ~ If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ~ or No~, If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes'!~or No :. If yes; which board?
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1 '
- °3 4. - ,. - ...
• What organizations in the City of Miami Beach do you currently hold membership in?
Name: r2.~.~..d~ t~~. ~~u~:1,~-S r,~c;._ Title: ~-a>_.yrc'~`L:
Name:~c~GL.~S Cra•+~+~.d*i1y 5 C~.s"''r+~-~c~w=a~?"~/ Title: ~~~=b~-.°~ ~~? 25 • r~ y,o..,r
• 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 Nd~(,, Which department?
• Pursuant to City Code Section 2-25 (b): Do you have a parent :~, spouse -~, child ;, brother __, or sister . who is employed by the
City of Miami Beach? Check all that apply. Identify the department(s):
This section is "not required" but desired: Age: years old Gender: Male 0 Female
Ethnic Origin (Check one)
White ~I.African-American/Black ^ Hispanic: ^ Asian or Pacific Islander ^ 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, read and will abide by Chapter 2,
Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
nature 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 ~-y ~ Date ~ ~~ v
Name of Deputy Clerk ~ ~/
Document Control Number (Assigned by the City Clerk's Office) ! 9~ Entered By •- `-~'r-Cr'r"`~'""`~-- Date ~~ `~ C~ ~}
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JACQUELINE S HERTZ
565 North Shore Drive
Miami Beach, Florida 33141
Tel: (305) 868-5933
Fax: (305) 868-1176
EMPLOYMENT HISTORY
1985 to Present Jacqueline Hertz & Associates
Geriatric, Disabled & Life Care Management
/Registered Professional Guardian
(In 2004 became Angel Care Management, Inc.)
1986 to Present Licensed Real Estate Salesperson
1988 to 1992 Paralegal and Legal Administrator
1998 to Present Jacqueline Hertz - Professional Guardian
2000 to Present Jacqueline Hertz-National Registered Guardian
EDUCATION
Florida State Guardianship Association & Natior~ai Guardiar~sY~iip
Foundation Compliance Examination pursuant to new Guardianship
Regulations April 2005.
National Guardianship Association - Completed educational
training and Examination as a National Registered Guardian on
August 3, 2000.
Miami-Dade College - Professional Guardian Course (in compliance
with Florida Statute 744.102(15) - Completed October 3, 1998.
(Note: Have sat for and completed over 225 Continuing Education
Credits since 1998 (Statute requirements are only 8 per year)
Miami-Dade County Adult Education - Real Estate Sales Person
Licensure Course
Florida International University - Paralegal Certification 1988
Morehead State University - Business Administration
Medical Assistant Training with - Doctor Raymond Simmons and Dr.
Lewis Lapland, Miami Beach
Miami Dade Community College - Elementary Education
Bureau of Jewish Education - Teaching certificate - Jewish Studies
PROFESSIONAL ASSOCIATIONS
Dade County Advisory Board
Advisor to former Commissioner Bruce Kaplan
with emphasis on Elder Issues)
Douglas Gardens Community Mental Health Center
Current President of the Board of Directors
Member of the Board of Directors since 1999
South Florida Guardianship Association
Current President 3i° term (since 2003)
Founding Director (1998}
AYUDA Director
ADL (Anti Defamation League)
Advisory Committee
Foundation of Jewish Philanthropies
Advisory Committee
Florida State Guardianship Association
Member of Board of Directors since 2002
National Guardianship Association
Member - Registered Guardian
The Florida Bar, Elder Law Section
Past Member
Miami Beach Bar Association
Associate Member
Association of Legal Administrators
Past Member - National and South Florida
Chapters
The Fortune Exchange Executive Business Group
Past President
Miami Jewish Home & Hospital for the Aged
Founder & Board Member
Mt. Sinai Medical Center
Founder
COMMUNITY SERVICE
42n`' Street Seniors
Founder/Director
Jewish Community Center on 42"" Street and Pine Tree
Drive, Miami Beach)
A group of active aging seniors founded by Jacqueline
Hertz for the purpose of bringing social, educational
and entertainment activities into their daily lives.
Prime Time Seniors
Founding Director -
A not-for-profit organization devoted to fostering
greater understanding and appreciation of our
community's elderly multicultural population bringing
together seniors for educational, social and special
events and community activities as well as being a
support group for the multiple problems facing the
elderly population
Commission on the Status of Women, City of Miami Beach
Past Chairperson (3 Terms)/current Member
Community Relations Board, City of Miami Beach
Past Chairperson/Member
Aids Walk Miami
Steering Committee
Orange Ribbon Day
Sponsor and Organizer
A yearly event promoting awareness of social services
available to the Seniors of Miami Beach and throughout
Dade County
Lecture Series for Seniors of Miami Beach
Lecture Topics included Safety in the Home; Financial
Abuse; Domestic Violence; Hurricane Preparedness; A
Hospital Stay - What is expected of you, your family,
your doctors, nurses, and general medical staff;
Medical and Prescription Drug Insurance Coverage; How to
Walk in Public with Self Assuredness; Getting all legal
documents into place including Wills, Trusts, Health
Care Surrogates, Living Wills, Pre-Need Funeral
Arrangements, etc.; Working with a Geriatric Care
Manager; What happens if your loved one needs a
Guardian
Seniors vs. Crime / Storefront Operations Project
Steering Committee, Miami-Dade County, in partnership
with the office of the State of Florida Attorney
General and the Miami Beach Police Department
Miami-Dade Coalition on Aging
Member
HONORS AND AWARDS
Metropolitan Dade County
Certificate of Appreciation presented May 8, 1996, for
contributions to our community
Board of County Commissioners, Miami-Dade County
Proclamation naming May 21, 1996 as Jacqueline S. Hertz Day
for the many contributions to the Dade County Community's
Elder populous
City of Miami Beach, Commission on the Status of Women
Received A Woman Worth Knowing Award in 1997
Miami Beach Jewish Community Center
Leadership Award presented July 10, 1994
The City of Miami Beach
Distinguished Citizen Award presented March 21, 2000
The Circuit Court of the State of Florida, Eleventh Judicial
Circuit, Miami-Dade County
Certificate of Appreciation presented May 26, 2000
(Elder Abuse and Exploitation Issues)
The City of Miami Beach
Proclamations naming March 15, 2000 and February 27, 2007,
as Jacqueline Hertz Day for contributions to the City of
Miami Beach's community's elderly multicultural population
Board of County Commissioners Miami-Dade County
Proclamation presented to Jacqueline Hertz naming March 9,
2000, as Prime Time Seniors Day, for contributions in
heightening public awareness of the social needs of the
community's senior populous, together with focusing on many
of the political issues of health, safety, crime and abuse
prevention
Prime Time Seniors, Inc.
Humanitarian Award presented on March 15, 2000
Junior Auxiliary of Miami Jewish Home & Hospital
Woman of the Year Award presented on February 27, 2007