Barry Brodsky 12/31/2008€ ~ ~
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
TeI: (305) 673-7411, Fax: (305) 673-7254
01-18-2008
Barry Brodsky
SUBJECT: Safety Committee
Congratulations! You have been appointed by Commissioner Ed Tobin
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,
o ~ _
I
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
Clifford Leonard
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 `or Public Officers and Employee
We ara committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.oov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
TO Barry Brodsky
RE: Safety 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 ~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.
B rry Br
Sworn to and subscribed before me this l/ ~ day of ~Q ~ 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 all who live, work and play in our vibrant, tropical, historic community.
NAME:
~~~~
First Name
City
HOME ADDRESS: b C ~/ l T" ~ %l~ ~Q
NoQ. ~((~~ Street a
PHONE• ~(71D'~ ~ ~~~ ~~' ~6~~J~(/
Middle
State Zip Code
Home Work Fax address
Business Name: ~~~~/] ~~ ~,/,~. ~ ~ yK ~osition: '~j~s
Address: ~ I ~ w.-- ,
No. Street City State Zip Code'
Professional License (describe) Expires:
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; or b) 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 or 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 or No
• (Please check 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:
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
Beach Preservation Board ~ Housing Authority*
Beautification Committee ~ Loan Review Committee*
Board of Adjustment* ^ Marine Authority*
Budget Advisory Committee ~ Miami Beach Cultural Arts Council
C Committee on Homeless _ Miami Beach Commission for Women
_~ Committee for Quality Education in MB =Miami Beach Florida Sister Cities
~~ Community Development Advisory* .Normandy Shores Local Gov't Neigh. Improvement
Community Relations Board _ Oversight Committee for General Obligation Bond
Convention Center Advisory Board _ Parks and Recreation Facilities Board
Debarment Committee =Personnel Board*
Design Review Board* _ Planning Board*
Disability Access Committee =Police Citizens Relations Committee
Fine Arts Board .Production Industry Council
_ Golf Advisory Committee ~ Public Safety Advisory Committee
Health Advisory Committee ~ Safety Committee
Health Facilities Authority Board `Transportation and Parking Committee
Hispanic Affairs Committee .Visitor and Convention Authority*
Historic Preservation Board* ~ Youth Center Advisory Board
` Board Required to File State Disclosure form
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:
Child's name: Age: Program:
Child's name: Age: Program:
.Have you ever been convicted of a felony: Yes o~ If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes or ~. If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: Yes ~ . If yes, explain in detail
• Are you currently serving on any City Boards or Committees: Yes ort~. If yes; which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
Name:
Name:
Title:
Title:
. List all properties owned or have an interest in, which are located within the City of Miami Beach:
~~~
• I am now employed by the City of Miami Beach: Yes o~. 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):
This section is "not required" but desired: Age: ~b years old Gender: Maley Female =
Ethnic Origin (Check one)
Whited African-American/Black -Hispanic: ~! Asian or Pacific Islander -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 2,
Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members."
~~~ ~~~' r' ~~
Applicant's Signat re Date Name of Applicant (PLEASE INT)
Please attach a copy 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
Date ,?/~i/~l
Document Control Number (Assigned by the City Clerk's Office) '~~ Entered By ~"- ~ Date
Revised tol29/2007 L Hatfield