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Joseph Conway 12/31/2008~ i Z 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 02-20-2008 Joseph Conway 140 Jefferson Ave Miami Beach, Florida 33139 ~5~1~,JECT: Public Safety Advisory Committee Congratulations! You have been appointed by Commissioner Jonah M. Wolfson 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, 7 ~~ Robert Parcher City Clerk cc: Saul Frances, Parking Director Ed DelFavero 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 all who live, work and play in our vibrant, tropical, historic community. k '~ I ./~i: ~ <r 'i € . ~ ~ ~ ~,.~ 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 Joseph Conway RE: Public Safety Advisory Committee 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 Olfcers 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. .losep onway Sworn to and subscribed before me this ~~ay of F,~B ~Q , 2008. . i - ~.:- - 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. F~2/12/20F~8 15:29 3s3S-531„x„903 PA~~E ~1/G~2 4 1 °~~ ~~~ ~~ CTTY OF MIAMI BEACH BOARDS AND COMMITTEE APPLICATION FORM Pursuant to City Code section 2-Z2(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 dty for a minimum of six months; orb) 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 j~ or No [ ] Demonstrate an ownership/Interest in a business in Miami Beach for a minimum of six (6} months: Yes (~ or No [ ] I am applying for a Board appointment because I have special abilities, knowledge, experience: Yes Q(] My special abilities, knowledge, or experience is: Are you a registered voter in Miami Beach: Yes j>(J or No [ ] ~,s~~ ,l NAME: ~O~'r~A,y FIrsC Name Middlve Initial .Last Name ~ ~ L ~~ ~ Home /5~G ~~ ~ r'-,~,F°s~./ ..4 ~/~. ~-'Ji.~ "~ ~ -~ ~. City State Zip Code Address: No. Street ~ ,~ ~ ,y~ov~/~~'® s 305 - ~3 i - 7tyoo 3o S - .53~ /.z z.7 ,3v5'~ 3 ~ ~3 Phone: Work Fax ~rnail address 1[1-3'%,u~~.Co.~ Home I am now a resident of: North Beach j ]South Beach ~ Middle Beach [ ] Business Name: / Applicant's Position: Address: No. Street City [x] Owner [ ]Stockholder/Shareholder [ ]Corporate Officer [ ]Other 6cplain: ~ 3~.~g State Zip Code ) ~ C` G i ~ /~r~~-~~ 6 _ Expires: .~.2 Ov Professional License (describe ~#itach a copy of the //tense listed above. 1. Have you ever been convicted of a felony: Yes [ ] or No (~(] If yes, please explain in detail: 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 ~J If yes, explain in detail: 4. Are you currently serving on any Clty Hoards or Committees: Yes [ ] or No [,~(] If yes; which board? What organizations in the City of Miami Beach do you currently hold membership in? Name: G`ye ~ ~~ f ~ G6° ~~~~ ~~~ Title: f iL r.- a !E- ,S'/N~4/ Title: ~~~~'~- Name: ./~ List all propertl caned or have an interest in, which are located within the City of Miami Beac ~~~~: ~r I am now employed by the City of Miami Beach: Yes [ ] or No [)Q. If yes, which department. Pursuant to City Code Section 2-25 (b): Do you have a parent [ ], spouse [ ], child [ ], brother [ ], or sister [ ]who F ~\CLf_Ft~S~.'V-UELI7.ABET~B&.C~BCAt'PLIC~A.doc r~ 02i'12%2~0$ 15:29 305-°'..:.:,.$003 '" PAGE 02/02 ,~ is employed by the Ciry of Mlaml Beach? Check all that apply. Identify the department(s): Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only 3 choices will be observed by the City Clerk's Office. (Regular Boards of City) ('Board Required to Fite State Disclosure form) ) Art in Public Places ] Audit Committee ] Barrier Free Environment Committee ] Beach Preservation Board ] Beautification Committee ] Board of Adjustment (Flood Mgmt.)* ] Budget Advisory Committee ] ] Committee on Homeless ] Committee for Quality Education in MB ] Community Development Advisory ] Community Relations Board ] Convention Center Advisory Board ] Convention Center Capital Projects Oversight ] Debarment Committee ] Design Review Board` ] Fine Arts Board ] Golf Advisory Committee ] Health Adv'~sory Committee ] Health Fadllties Authority ] Hispanic Afi`alrs Committee ) Historic Preservation Board* ] Housing Authority= loan Review Commlttee* [ ]Marine Authority* [ ]Miami Beach Cultural Arts Council [ ]Miami Beach Commission on Status of Women [ ] Mlamf Beach Florida Sister Gties [ ]Normandy Shores Local Gov't Neighborhood Improvement [ ]North Beach Youth Center CnrersighC Committee [ ]Nuisance Abatement Board* [ ]Oversight Committee for General Obligation Bond [ ]Parks and Recreation Facilities Board [ ]Personnel Board* [ ]Planning Board" [ ]Police Citizens Relations Committee ( ]Production Industry Council [ x ] Public Safety Advisory Committee [ ]Safety Committee [ j South Point Advisory Boardi to~R[edevelopm~.ent Agtyency [- J Transportation and Parking Board [ ]Visitor and Convention Authority* [ ]Youth Center Advisory Board Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: A 1. Past service on the Youth Center Advisory Board; Yes [ ] No Q~ (Years of Service [ ] 2. Present participation in Youth Center activities by your children Yes [u] No [ ]. If yes, please list the names of your children, their ages, and which programs. List below. Child's name: Child's name: Age: Program: Age; Program: This section is "not required" but desired: Age: [~~] Gender: M [X] or F [ ] Ethnic Origin (Check one) White [~ African-American/Black [ ] Hispanic: [ ] Asian or Pacific Yslander [ ]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 Z, Article VII - of the City Code "Standards of Conduct for City Officers/, 'Employees and Agency Member ~- c S ~ ~} .~ C, ~./r,i.a ~/ ~~~-"' d2, 1,/2/ 08 / Applicant's Signatur Dare Name of Appllgnt (PLEASE PRINT) Attachment: Please attach a copy of your resume to your application. NOTE: Applications will remain on fi{e for a perlod,of one (1) calendar year. Received in Gry Clerk's Office _ /_ /_ by Clerk Document Control Number (Assigned by the City Clerk's OfFce~~~ ~ ~ Rev #7- 01/08/04 F:',CLERI~AJ.L1t;.L1ZABET~A&C'B[APPL1C04. doe ~y,~~~~ ~~f S