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Rhonda Mitrani-Buchman 12/31/2009 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 Rhonda Mitrani-Buchman 1711 Cleveland Road Miami Beach, Florida 33141 SUBJECT: Art in Public Places Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee fora term ending: 12/31/2009. 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, ~~~-f s~° Robert Parcher City Clerk cc: Saul Frances, Parking Director 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 to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. ~ °~y ~' t ~ - - - ;~ ~ a a . w 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 Rhonda Mitrani-Buchman RE: Art in Public Places 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 0>~cers 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. Rh nda Mitrani-Bu ht'S~an Sworn to and subscribed before me this 4--3 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 Disclosure Requirements. We are committed to providing excellent public service and safety to al! who live, work and play in our vibrant, tropical, historic community. ~ MIAMIBENCH CITY OF MIAMI BEACH BOARDS A!-ID COMMITTEE APPLICATION FORM Puauant to City Code section 2-22(4) a and b: Members of agent~es, boards, and committees shall be affiliated with the city; this requiroment shall be fuMlled in the foik-wing ways: a) an individual shall have been a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownershipltriterest for a minimum of six months in a business established in the city. itesideM of Miami Beach for a minimum of six (6) months: Yes ~ or No 0 Demonstrate an ownershiplinterest in a business in Miami Beach for a minimum of six (6) months: Yes i7 or No l7 1 am applying for a Board appointment because 1 have ~ My speaal abilitbs, knowledge, or experience is:~~ Are you a rogistered voter in Miami Beach: Yes y~,pr No NAME: 1115 11 U1Y\~1m'e~7N1(.v\~r\'u,~~yl\ ,~jY~0YlU1~- i. "3~ `{Y~rINU 1~ Qu~J.. c-r"t ~ 1~M1~ g,Q..e~~~ Naffs , 331 Middb Initial Home: Y, p Address• iL~ia-N ~ ~ ~~0.W1~ ~'. ~3~~ t No. Street City State Zip Code Phone: 3oS • ~ ~2 • ~~ ~ M~~t~1nMe innarr. G61M Home Work Fax Email address {Please check one): 1 am now a resident of: North Beach [~ South f3each„P~Middle Beach ^ Business Name: Address: Z`2' .W. Z Applicants Position: 1'1~mMak~it~ 1 ~ 1Y .(,~01( ~~a~M,~ ~1. 3312 Citv State Zip Code ~QNmer ~ StockhokiedShareholder ~ Corporate Officer 0 Other Explain: Protsssbnal Licence {describe) Expires: Attach a copy of the license listed above. 1. Have you ever been convlaed of a felony: Yea 0 or No~ M yes, pbaae explain In detaB: 2. Do you aurently have a violation{a) of City of Miami Beach codes: Yea ~ or No~lf yec, Abase explain M detail: 3. Do you currently owe the City of Miami Beach any money: Yea ~ or wo~ If yes, expia&r in detaN 4. Are you cunenny serving on any City Boards or Committees: Yes ~ or No [7. ff yea; whki- twaro? Afa-~t IfseC V [~tKil~ W ~ ~i 1 CIAay-y1~G ~T u i .l i~ .._ . What oryanizations in the City of Miami Beach do you Currently hold membership ~? Name: ~~ 1AAV111 ~ L~ 01~~' ~ ~ O l.(~_ T1tb• ~'~ Name: N ~L I Q Tine: I am now empbyed by the City of Miami Beach: Yea 0 or No~. ff yes, which department? F:iCLER1$ALL~B&C Application113&C Appiiption Revised 091106.doc 1 ~~ g 2 ~_~. Pursuant to Clty Cods 8ectton 2-23 (b): Do you have a parent ^, spouse ^, child ^, brotlter ^, or sister ^ who is empbyed by the City of Miami Beach? Check all that apply. Identify the department(s): _ Please list your preferences in order of ranking [1j 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 Committer: ^ Beach Preservation Board o Beautification Committee ^ Board of Adjustment' ^ Budget Advisory Committee ^ Committee on Homeless ^ Committee for Quality Education in IJIB ^ Community Development Advisory" ^ Community Relations Board D Convention Genter 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 Boarct' ^ Housing Authority` ^ Loan Review Committee' ^ Marine Authority' ^ Miami Beach Cultural Arts Council ^ Miami Beach Commisabn 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 Requirod to File State Disclosure form Note: If applying for Youth Advisory Board, please indicate your affiliation with the Sett Rakow Youth Center. 1. Past service on the Youth Center Advisory Boars: Yes ^ No ^ Years of Service: 2. Present partiapation in Youth Center activities by your chikiren Yes^ No ^. If yea, 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: ~ years old Gender: Male ^ Female Ethnic Origin (Check one) tfvhlte ^ African-Amerlcan/Black leper ^ - Mla~nn~ 1~1~-h~k (,,,~,h(~~,~,~,,,~~~r lit {t~~~t Arlan or Pacific islander ^ American n an or Alaskan Native ^ Employment Status: Employed ^ Retired ^ Home-raker ^ Other 0 "1 hereby attest to the accuracy and truthtulness of the appNcatbn and have received, road and will abide by Chapter 2, Article VII - of the City Code "StandaMs of Conduct for City Offlcere, Employees and Agency Members." v~nn _-Z ,ZO,Qc, Rhrndu~ ~ Vut~'~ra~~ ~YV-ovv~ Applicant's Signature Date Name of Applicant (PLEASE PRINT) Attachment: Please attach a copy of your rosuma to your application. NOTE: Applications will remain on file for a pg flod of one (1) calendar year. Received in Cily Clark's Oflice y - l <_ t)sputy Clerk Date Document Control Number (Asa red by City lark' Entered By Date C '~C~ERiSAt.L\68C: Appiic:ationi6&C Application Revised 091106.doc