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Yvette Isabel Borrello 6/30/2009_ J P~ ~} ~< uw e.wa. t..w §mav". Cirp of Miami 8sach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeochA.gov OFFICE OF THE CITY CIERK, Robert Parcher, City Clerk TEL: (305) 673-741 1, FAX: (3051673-7254 August 25, 2008 Yvette Isabel Borrello 2045 North Bay Rd Miami Beach, FL 33140 SUBJECT: COMMITTEE FOR QUALITY EDUCATION IN MIAMI BEACH Dear Ms. Borrello; Congratulations! You have been appointed as a Representative for the North Beach Elementary School to the above-referenced agency, board or committee for a term ending, 6/30/2009. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-741 1. Sincerely, /~ Robert Parcher City Clerk cc: Saul Frances, Parking Director Leslie Rosenfeld, Liaison 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 2-1 1 .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 1~~ _ ~ "!ec _,.,., a c.,v:.:~~~ , ,, :~i, s~~~ ~.c ~„ ., +- c, ti ,.~, ~ n, _:v k, 7~~ ~.~; _ rrb,c. ~:;:cc, ~-o^c I• Cihr of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Robert Parcher, Ciy Clerk TEL: (305) 673-7411, FAX: (305) 673-7254 TO Yvette Isabel Borrello RE: Committee for Quality Education in MB 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: 06/30/2009. 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 calendar year on which I have served. Borrello ..isat~( SV'~e Sworn to and subscribed before me this ~ r_ day of , 200 °~ ~ 1 s .~,,r°z~-.~ ,,/tZ-tom ~t 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 safely to all who live, work, and play in our vibrant, tropical, historic community m MIAMIBEACH NAME: __ _ ~"~, HOME ADDRESS:_~ n PHONE: ~~ Home Business Name: Address: No. Street City State Zip Code Professional License (describe) E~ires: Attach a copy of the itcense 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 mihimum of six months; or b} an individual shall demonstrate ownershipfinterest for a minimu six months in a business established in the city. • Resident of Miami Beach for a minimum of six (ti) months: Yes or No ^ • Demonstrate an ownershipCnterest in a business in Miami Beach'for a minimum of six (6) months: Yes or No ^ • Are you a registered voter in.Miami Beach: Ye or No ^ ..(Please circle one): I am now a resident of: North Beach South Beach Mi h • I am applying for an appointment because 1 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 Citv Clerk's Office. (Regular Boards of City} ^ Affordable Housin Adviso Committee ^ Health Faalities Authori Board ^ Art in Public Places Committee ^ His anic Affairs Committee ^ Beach Preservation Board ^ Historic Preservation Board* ^ Beautification Committee ^Housin Autho ^ Board of Ad'ustment* ^ Loan Review Committee'` ^ Bud et Adviso Committee ^ Marine Autho • ^ Ca ital Im rovements Oversi ht ^ Miami Beach Commission for Women ^ Committee on Homeless ^ Miami Beach Cultural Arts Council f]'Gommittee for Qualit Education in MB ^ Miami Beach Florida Sister Cities ^ Communi 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 ^ Disabil' Access Committee ^ Public Safet Adviso Committee ^ Fine Arts Board O Safe Committee ^ Ga Business Develo ment Ad Hoc ^ Trans aren Reliabilit & Accountabilit Committee "TRAC ^ Golf Adviso Committee ^ Trans ortation and Parkin Committee ^ Green Ad Hoc Committee ^ Visitor and Convention Autho ^ Health Adviso Committee ^ Youth Center Adviso Board L * Board Required to File State Disclosure form F:ICLERISALL~B&C AppGcaiionlB&C Application Revised 0@1908.doc Position: GI'FY dF M]Ail~( BEACH 80ARG AItilf~ C£3MMBTTE~E ~APP'I~`'I~C'A'T~!©N F(3RE~ me First Name M~die Initial ~ aY `Y~racu ~L ~ i 4 0 Street Z C'dy State Zip Code 3 ~-~`7 ~ 7 ~v 2-16 3o s 3 - -~ R? 2- ~ ntiu ~ Work„J't ~ Fax Email a dress ~ ~Y~A ~ ~'~' ~~ 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 0. l# yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: Program: Child's Hama: Age: Program: .Have you ever been convicted of a felony: Yes ^ ar No,~lf yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ^ or No9rCf yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes ~ or N If yes, explain in detail • Are you currently serving on any City Boards or Committees: Yes ^ or No f yes; which board? • What organizations in the City of Miami Beach do you currently hold membership in? Name: Title: Name: Title: • List all properties owned or have an 'nt rest in, which are located within the City of Miam' Beach: d ~~ ur t1 ~ 3 3 ~ o ~ ~s~ ~'G° ~a~' C~~ ~ 33f~~ • I am now employed by the City Miami Beach: Yes 0 or Nich department? • Pursuant to City Code Section 2-25 (b): Do you have a parent ^, spousg~child ^, brother ^, or sister ^ who is employed by the City of Miami.Beach? Check all that apply. Identify the department(s): l(1a~~(( This section is "not required" but desired: Age: years old Gender. Male ^ Female Ethnic Origin (Check one) White ^ African-American/Black ^ Hispanic: ^ Asian or Pacific Islander ^ American Indian or Alaskan Native ^ "! hereby attest to the accuracy and truthfulness of the application and have rnceived, read and will abide by Chapter 2, Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members-."- pp' s Signature a e Name of Applicant (PLEASE PRINT) Please attach a copy of your resume to this application NOTE: Appliptions will remain on file for a period of one (T }calendar year. C....~I~..........a Oa..L..~. c..~..1.......,1 n C.:a: ~...1 n L{....1.........L.... n llsh... n ~niN~uyniant vtatua. onNwyvu u ncuicu u rivnwu~a~c~ u vuici u Received in City Clerk's Office by Date ~~ Name of Deputy Clerk ~/ ' _ i Document Control Number (Assigned by the City Clerk's Office) ~~ Entered By ~~-~'~~ Date ~ ~ /G'~ ~~ edsed 18108 LH F:1CLEi21~ALLIB8~C Applicationl6$C Application Revised 051908.doc