Mathew Sarelson 12/31/2009i~ ~ { t i!
t ~ y
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
Matthew Sarelson
2001 Meridian Ave
Miami Beach, Florida 33139
SUBJECT:..: Community Development Advisory Commit~QJ
Congratulations! You have been reappointed by Commissioner Richard L. Steinber
to the above referenced agency, board or committee for a term ending: 12/37/2009.
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
City Clerk
cc: Saul Frances, Parking Director
John f]uade
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 tc the Sunshine Amendment and Code of Ethics for Public Officers and
Employees
We are committed to providing excellent public service and sa/ety to a!l who live, work and play in our vibrant, tropical, historic community.
z 1;
n /A ~ ~ -•.i fA V A'~. I Y.... f 1 \m.0 fi F
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachtl.cov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Matthew Sarelson
RE: Community Development Advisory Committee
I do solemnly swear or affirm to bear true fakh, 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/onda Commission on Ethics Guide to the Sunshine
Amendment and Code of Ethics for Puhlic O~c>°rs 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 se d.
C~Sarelson
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 Disdosure Requirements.
We are committed to providing excellent public service and salary to all who live, work and play in our vibrant, tropical, historic community.
m M I AM I B~E,r-~C H ~:'T t~ t~F f~il~~;;; uEAGH
`~_ ':st7r.tti/i~).°P ,raNi) 4.~~rvt(; 2 t rF` ts:PPt iC.ATIa'7N rGRM
NAME: ` J Cl~.r ~~ S ~ `~ ~ 1/~ t ~ " / ~ ~~
Last Name Fir
s
t Name Middle Initial
HOME ADDRESS: Z~~) t-1'PS~C%j ~~ (
~
~ IYJ~ ~ ~ ~~ ~~)3~
No. Street p H ~ 5 City State Zip Code
PHONE:JDS ~ ~-F' ~-1 gS'Z
Work
Fax
Email address
Business Name: ~QS~~50~ ~,9' ~ Position: .tV,.W'~~; , I't~of`^Q~ 2 q
Address: ~5.5 ~AfS~ ~ ~ ~ }~.•, ' j f :~ L ~ / - / ~ ~ ~ ~ Jj 3 1
No. /~ ~ Streetp City State Zip Code
Professional License (describe) "~CJd (~ U?J,^S+a O ~ g ~l Expires: V1P.J of .4'?arkr a cad.=y a£fhe {;ae>;~
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 fulflled 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 (ti) months: Yes~or No ^
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (ti) months: Yesl(1 or No ^
• Are you a registered voter in Miami Beach: Yes 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 (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
^ 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 AdvisoryCommittee
'' '; , ,°; ^lie*Ith Facilities Authority Board
~' ` ^'F~ispanic Affairs Committee
^ Historic Preservation Board*
* Board Required to File State Disclosure form
^ Housing Authority*
^ Loan Review 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*
^ Police Citizens Relations Committee
^ Production Industry Council
^ Public Safety Advisory Committee
^ Safety Committee ~..
^ Trappsl3ortation,aiW Parking CprFmittee
^ VisiEor•anti Conved'TQn klffhtYity'
^ Youth Center Advisory Board
~
F:\CLER\SALL\B&C Applicaation\B6C Application Revised o91 i(l6 jakesdoc
-';
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 i_7 No i 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 ycu ever been convicted of a felony: Yes ^ or No iP 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 C~If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes ~ or No L~If yes; which board?
• What or([g~~a~~~~niz~~ations in the City of Miami Beach do you currently hold membership in?
Name: fJt~ i~I 5 av-1'ti ~j ~(yy~ Title: ~ Q~v^~ ~~.~'
Name: ~~./~ )((l } J~vrC Title: cS N t ~~ ~Oeo.sxf' Nem,in~'
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
Zc~ t c'~es ~' cQ ~a>", Awe PN)5 ~~ 3313 ~
• I am now employed by the City of Miami Beach: Yes ~ or No~VVhich 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 Female ^
Ethnic Origin (Check one)
White~dMfrican-American/Black 0 Hispanic: ^ Asian or Pacific Islander C American Indian or Alaskan Native ^
EmlSloyment Status: Employed~etired C 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."
Applic~ natur~
Please attach a copy of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
(~~~
Name of Applicant (PLEASE PRINT)
Y`~at ~tf h ew Sc%J~-(sue
Received in City Clerk's Office
Document Control Number (Assigned by the City Clerk's Office) ~ Entered By
F:ACLER\SALLAB&L Applicat(on~B&G AppBcation Rev9sed 0917(76lakes.doc
~ h~
Date
~ 5/~~