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Steven Chaneles 05/06/2009 Cih- olF Mior„i Moth, 1700 Convention Center Drive, Miami Beach, Fbrida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEL: (305) 673-7411, FAX: (305) 673-7254 04-29-2008 Steven Chaneles 4427 Nautilus Drive Miami Beach, Florida 33140 SUBJECTi'~'.;k Transparency Reliability and Accountability Ad Hoc Congratulations! You have been appointed by Commissioner Saul Gross to the agency, board or committee named above for a term ending: 05/06/2009. 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, Robert Parcher City Clerk P~~ cc: Saul Frances, Parking Director Robert Parcher / Patricia Walker 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 safey to all who live, work, and play in our vibrant, tropical, historic communiy Cif~- of Miami l~aeh, 1700 Convention Center Drive, Miami Beach, Fbrida 33139, vvww.miamibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk TEI: (305) 673-7411, FAX: (305) 673-7254 TO Steven Chaneles RE: Transparency, Reliability and Accountability Ad Hoc 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: 05/06/2009. 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 calend year on which I have served. Steven Chaneles Sworn to and subscribed before me this~~ day of , 200 rzL - 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 ore committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community. ~~~~~ C N~-~E1~s nram~: - NuaaiC unuai Last Name First Name HOME ADDRESS: ~"` ~lZ~ City State Zip Code No. Street E~ y~ 2 _ ~y PHONE: viJ~-~( ^ ~~~ ~ ~~~-"~l ~ ~vY ~J Jl~s - S3i ~~~B~il addre SiGl.h2~CS ~4 ~~~.SD~'~'.h~ Home Work Fa Business Name: Address: No. Professional License (describe) _ City _ Expires: State Zip Code 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; orb) an individual shall demonstrate ownership/interest for a minimu/m of six months in a business established in the city. . Resident of Miami Beach for a minimum of six (Ei) months: Yes ~br 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 e"or No ^ _._`~ . (Please circle 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: ~ N ilk ~ mnn t SS 5~~. F,f L~ ~S Please list your preferences in order of ranking [1] first choice [2] second cnoice, ana Isi mira cnou;e. r~rase ~~~« .~~a~ ~~~~. ~~~~" ~~~ choices will be observed by the Citv Clerk's Office. (Regular Boards of City) ^ Art in Public Places Committee ^ His anic Affairs Committee ^ Beach Preservation Board ^ Historic Preservation Board* ^ Beautification Committee ^ Housin Authori * ^ Board of Ad'ustment* ^ Loan Review Committee* ^ Bud et Adviso Committee ^ Marine Authori * ^ Ca ital Im rovements Oversi ht ^ Miami Beach Commission for Women ^ Committee on Homeless ^ Miami Beach Guttural Arts Council ^ Committee for Quali Education in MB ^ Miami Beach Florida Sister Cities ^ Communit Develo ment Adviso * ^ Normand Shores Local Gov't Nei h. Im rovement ^ Communi Relations Board ^ Parks and Recreation Facilities Board ^ Convention Center Adviso Board ^ Personnel Board* ^ Cultural Arts Nei hborhood District Overla CANDO ^ Plannin Board ^ Debarment Committee ^ Police Citizens Relations Committee ^ Desi n Review Board* ^ Production Indust Council ^ Disabili Access Committee ^ Public Safet Adviso Committee ^ Fine Arts Board ^ Ga Business Develo ment Ad Hoc ^ Safet Committee rans arenc Reliabili & Accountabili Committee "TRAC ^ Golf Adviso Committee ^ Trans ortation and Parkin Committee ^ Green Ad Hoc Committee ^ Visitor and Convention Authori * ^ Health Adviso Committee ^ Youth Center Adviso Board ^ Health Facilities Authori Board " Board Required to Fiie state uisciosure corm Street Position: F \CLER\SAL£.\B&C Application\B&C Application Revised 041 £30E;.doc 1 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: Age: Program: Child's name: Child's name: Age: Program: .Have you ever been convicted of a felony: Yes ^ or No D~Tf yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No f 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? • What organizations in the City of Miami Beach do you currently hold membership in? Name: Name: Title: • List all properties owned or have an interest in, which are located within the City of Miami Beach: ~~ Z~ ~ A-~.t.-r - pus D R t y~ r.~ ~ ~e-~-~ ~~~~~ c..~l . ~- 3 ~ I ~I O . I am now employed by the City of Miami Beach: Yes ^ or No~!Wliich 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): /v v This section is "not required" but desired: Age: years old Gender: Male ^ Female ^ Ethnic Origin (Check one) White ^Afrkan-American/Black ^ Hispanic: ^ Asian or Pacific Islander ^ American Indian or Alaskan Native ^ "I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Art' le VII - of the Ci Code "Standards of Conduct for City Officers, Employees and Agency Members." Applicant's Sig ature Date Name of Applicant (PLEASE PRINT) Please attach a copy of your resume to this application NOTE: Applications will remain on fi~or a period of one (1) calendar year. Fmnlovment Status: Employed 4]~ftetired ^ Home-maker ^ Other ^ Received in City Clerk's Office by Date Name of Deputy Clerk Document Control Number (Assigned by the City Clerk's Office) Entered By Date Revised 04/18/08 LH P\CLER\$ALL.AB&C ApplicationAB&C Application Revised 04'180£3 doc