Hope Fuller;~ ~ ~ ~ ~ ~.
Cit~- of Miami B~och, 1700 Convention Center Drive, Miami Beach, Fbrida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk
TEL: (305) 673-7411, FAX: (305) 673-7254
03-09-2007
Hope Fuller
925 N Shore Drive
Miami Beach, Florida 33141
SUBJECT: Loan Review Committee
Congratulations! You have been appointed by Commissioner Saul Gross
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. GPlease read the enclosed materials carefully.
Congratulations again and good luck..
Sincerely,
n,
D~~ ~ ~~
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, 2-458 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 ore commined to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic communiy
'~
Cih- of Miomi d~ach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeochll.gov
OFFICE OF THE CITY CLERK, Robert Porcher, Ciy Clerk
TEI: (305) 673-7411, FAX: (305) 673-7254
TO Hope fuller
RE: Loan Review 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 OfFcers 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 ave served.
1
Hope fuller
Sworn to and subscribed before me this ~ day of , 200
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 commined to providing excellent public service and sofety to all who live, work, and pby in our vibrant, tropical, historic communiy
NAME: ~ L ~C
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HOME ADDRESS: ~ , ~ ~rt? ~
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Middle Initial
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PHONE: ~(~ -~ ~-P ~ \c/~( .rJry ~ ~~ City at Zip Code
Home Work `SS ~ av' ~, C ~~~~~
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Business Name: ~~ ~ ~ ~ L L
Address: C ~~ Z position: Cl (, (~~
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No. Street L(/
Professional License (describe) City State Zip Code
Expires:
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated wi
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; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business establishedhin the Ic ty.his
• Resident of Miami Beach for a minimum of six (6) month Yes or No
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes o
• Are you a registered voter in Miami Beach: ; ~~
~'~ or No
• (Please check one): I am now a resident of: North Bea h outh Beach Middle Beach
• I am applying f~ppointment beca~lse I have s ecial iiit~es, kno led e, xperience. Please list below:
~Q ~ ~c Q ~~ ~ ~ ~ ~~~~ ~ ~o~- S 1 ~-
~ ~ Si
Please list your preferences in order of ranking (1j first choice [2j second choice, and [3] third choice. Please note that onl three 3
choices will be observed b the Cit Clerk's Office. (Regular Boards of City)
GG Art in Public Places Committee
Beach Preservation Board
Beautification Committee J Housing Authority*
Board of Adjustment* ~ Loan Review Committee*
Budget Advisory Committee ~ Marine Authority*
C Committee on Homeless =Miami Beach Cultural Arts Council
Committee for Quality Education in MB -Miami Beach Commission for Women
~' Community Development Advisor * -Miami Beach Florida Sister Cities
Community Relations Board y _=' Normandy Shores Local Gov't Neigh. Improvement
Convention Center Advisory Board =Oversight Committee for General Obligation Bond
Debarment Committee ~ Parks and Recreation Facilities Board
Design Review Board* =Personnel Board*
Disability Access Committee ~ Planning Board*
Fine Arts Board ~ Police Citizens Relations Committee
Golf Advisory Committee =Production Industry Council
Health Advisory Committee =Public Safety Advisory Committee
Health Facilities Authority Board -Safety Committee
~~ Hispanic Affairs Committee ~ Transportation and Parking Committee
Historic Preservation Board* _ Visitor and Convention Authority*
" Board Required to File State Disclosure form ~ Youth Center Advisory Board
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 ~f 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 ~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?
~~~,~~ ~~~ 9_ Title:
Name:
Title:
Name:
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
N , ~ I-~ a ~. 1~2 5r~~ ~ ~ ~c ~ l o v~ x.l S l-~z
~a~ ~
• I am now employed by the City of Miami Beach: Yes r , .Which 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):
ears old Gender: Male C Female
This section is "not required" but desired: Age: Y
Ethnic Origin (Check one)
White ~ African-American/Black -~ Hispanic: _ Asian or Pacific Islander =American Indian or Alaskan Native
Employment Status: Employed -Retired C; Home-maker ~ Other
"t 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 "Sta ards of Conduct for City Officers Emplo ees and Agency Members."
~ l~ ~ ~~ ~~
Date Name of Ap licant (PLEASE PRINT)
Applicant na re
Please attach a c y of your resume to this application
NOTE: Applications will remain on file for a period of one (1) calendar year.
Received in City Clerk's Office by Name of Deputy Clerk
Entered By
Document Control Number (Assigned by the City Clerk's Office)
Date
o Date ~ ~'f ~~ '
ao~ ed 10129/ 007 L. Hanel
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