Robert Arkin 12/31/2008m
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 331 39, www.miamibeachfl gov
OFFICE GF THE CITY CLERK, Robert Parcher, City Clerk
Tel: 305-673-741 1, Fax: 305-673-7254
12-20-200
Robert Arkin
4205 Alton Rd
Miami Beach, Florida 33140
SUBJECT: Transportation and Parking Committee
Congratulations! You have been appointed by Commissioner Jerry Libbin
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,
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Saul Frances
ATTACHMENTS:
1. City Code Ordinance section, applicable to agency, board or committee
2. General Provisions of Ordinance No.97-3086 Amended by Ordinance No. 2006-3543
3. Ordinance No. 97-3105
4. Citywide parking permit application -Return completed application to the Parking
Department located at Palm Court Building, 309 23rd Street, Suite 200 -Tel: 305-673-
5. Guide to the Sunshine Amendment and Code of Ethics for Public Officers and
6. Miami Beach Code Section 2-459 -
7. Miami-Dade County Code Section 2-11.1
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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: 305-673-741 1, Fax: 305-673-7254
TO Robert Arkin
RE: Transportation and Parking 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 theFlorida 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
serve) on July 1st, following the closing of the calendar year on which I have served.
Sworn to and subscribed be
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/13oard and Committees
for additional information regarding the Financial Disclosure Requirements.
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m MIAMIBCaC.~1
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and `comm~ees ~ alll b affiliated with the city; this
requirement shall be fulfilled in the following ways: a) an individual shall have been ~~11f cit~~ yy~~ ''~~ii~~11qq um of six months; or
b) an individual shall demonstrate ownership/interest for a minimum of six months ina3s ~~blll~ifl~i~~city.
Resident of Miami Beach for a minimum of six (6) months: Yes or No ^ ~~~f ~~Y ~L~~K~ ~~~ ~~>~
Demonstrate an ownership/interest in a business in Miami Bea 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 ^
My special abilities, knowledge, or experience is: .~P1ir/sJn~,r~_~ y- ~~,nts~~~C~;~DJ~,,
Are you a registered voter in Miami Beach: Ye or No ^
NAME:
Last N me First Name Middle Initial
Home: `~~~ ,~1 TA~~f~~QD / ~ /
Address:~~ ~~~ ~ ~;1 dl/ ~~„~.D /L? ~ ~~ ~~/ ~~~
No. Street ~~-- Cityp tate Zip Code
Phone: "~ ~ ~`~~ f ~? G ,j L~,.~` ,~~ d "~~U ~~'~ ~ "7 ~~ ~~~t~'~'~ ~/c/Nrf~ C(~+.~
Home Work Fax Email address
{Please check ~afte); t m now a rew ent of: bh ^ ;~..~i. t..- ^ "_~ each ^
~G~11~tlTIG~ Cr~fsi/Lcc~~ ~~ ..1
Business Name: (.S`'1~1~11 " ' ~pphcant's Position: ~/"(d ~sLrr~//
,~J
Address: r~/ f' ~c~
No. ~~~~ ~ Z~~ treet City State Zip Code
~ner ^ Stockholder/Shareholder corporate Officer ^ Other Explain:
Professional License (describe)~~F~/LyL.a(/ ~~i1'r ,f~ ~% L'' C 'e Expires:
Pf~~t~ ~ coE?° -~f ze rr t%c~rr~~ ?i~~G c~ z~z~rrv~.
1. Have you ever been convicted of a felony: Yes ^ or Ny~ If yes, please explain in detail:
2. Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or N ~ -f 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: Ye~^ or No ^. If yes; which board
What organization~s'in'the City o/f~Miami Beach do you currently hold membership in?
Nam~~L,~'- /,X~
~~~ l C'G C Title:
Name: C~~i~ ` ~`, ~~ ~LJy%ff~~"~[,~ Title:
List all properties owned or have an interest in, which are located within the City of Miami Beach: ~jt/~.~
1 am now employed by the City of Miami Beach: Yes ^ or No~ If yes, which department?
F.ICLERI$Al._L\El&L ApplicationtB&C Application izevised 091106.doc
~alg~o~
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):
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
^ Barrier Free Environment 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
^ Convention Center Capital Projects Oversight
^ Debarment Committee
^ Design Review Board*
^ Fine Arts Board
^ Golf Advisory Committee
^ Health Advisory Committee
^ Health Facilities Authority Board
^ Historic Preservation Board*
^ 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
,Transportation and Parking Committee
^ Visitor and Convention Authority*
^ Youth Center Advisory Board
*Board Required to File State Disclosure form
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 fist the names of your children, their ages,
and which programs. List below:
Child's name: Age: Program:
Child's name:
This section is "not required" but desired: Age: years old
Ethnic Origin (Check one)
White~African-American/Black ^ Hispanic: ^
Asian or Pacific Islander ^ American Indian or Alaskan Native ^
Employment Status: Employed,~l Retired ^ Home-maker ^ Other ^ _
Age: Program:
"I hereby attest to the accurac ~ truthfulness of the application and have received, read and will abide by Chapter 2,
Artic - o ~e City Code " ndards onduct for City Officers, Employees and Agency Members."
izl~ l~/-~e~~-~' ~',z~=~~
App icant's i e Date Name of Applicant (PLEASE PRINT)
Attachment: Please attach a copy of your resume to your application.
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in City Clerk's Office ~ by Deputy Clerk Date
Document Control Number (assigne by the City Clerk's Office) 2/ 37 Entered By
Revise 1 Ih
Gender: Male Female ^
R.tGLER;~RLLtQ&C Applicationt8&C Rpplicatior~ Revised 0911t76.doc