Stuart Blumberg 12/31/2009~ ~' ,,~r~, ~ ,~, ~y~r I
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: (305J 673-741 1, Fax: (305) 673-7254
10-28-2008
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sta Blumberg
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SUBJECT: Convention Center Advisory Board
Congratulations! You have been appointed by Mayor Matti Herrera Bower
to the agency, board or committee named above for a term ending: 12/31/2009.
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,
o~~ ~-~'~/~~
Robert Parcher
City Clerk
cc: Saul Frances, Parking Director
r , ..~ ..
ATTACHMENTS~f Y~~q~So~V
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 safety to all who live, work and play in ovr vibrant, tropical, historic community.
m 11AMIBEACH
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) 673-741 1, Fax: X305) 673-7254
TO Stuart L. Blumberg
RE: Convention Center Advisory Board
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>fcers and Employees, and understand that as a member
of a City of Miami Beach Board and/or Committee, I must comply with the fir?ancial 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 Yhave se ~~
Stuart L. Blumberg
7 `~
Sworn to and subscribed before me this ~ ~ day of ~ ~' fU~1i ` , 200c~ `
i1
y~ ~
-~" 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.
~(~ ~
~~~"~ 8~~i.;,x ,d~~z ~ . ~.a~31'w:k"~ ~ ~"Mtm APPi . ~4,_ i . e
NAME: ~~ L~l"I~~Y~"~- ~~~
Last Name ~ First Name l , Middle Initial
HOME ADDRESS: •~ ~ ~~ LU~ s s r'-'t VP I~~ ~~ ~ ' ~~(v ~ ~I~ L~ ~~ ~ ~ I ~ I
No. Street City State Zip Code
PHONE: ~~~~-~fly~ C /,~' .s ~'.1 ~~~ ~~`~ J Y)L`~EI~1~~~~ ~I~n- (c-"'l
Home Work Fax Email address
Business Name: ~~ lp't'~~'i Position: ~~ ~ ~ ~ ~ ~ i
Address: `~IG~ l,l/`1C~.~/1 ~~ ~+%~ ~C~E?' ~I~MI~CdC~ ~~ ~ ~ ~ ~ ~,
- IVo. ~ / Street ~ City ~ ~ State Zip Code
Professional License (describe) ' v/~ 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 1
• Are you a registered voter in Miami Beach: Yes ^ 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:
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)
^ Affordable Housin Adviso Committee ^ Health Facilities Authorit Board
^ Art in Public Places Committee ^ His anic Affairs Committee
^ Beach Preservation Board ^ Historic Preservation Board"
^ Beautification Committee ^Housin Authorit "
^ Board of Ad'ustment" ^ Loan Review Committee"
^ Bud et Advisor Committee ^ Marine Authorit '`
^ Ca ital Im rovements Oversi ht ^ Miami Beach Commission for Women
^ Committee on Homeless ^ Miami Beach Cultural Arts Council
^ Committee for Qualit Education in MB ^ Miami Beach Florida Sister Cities
^ Communit Develo ment Adviso ^ Normand Shores Local Gov't Nei h. Im rovement
^ C munit Relations Board ^ Parks and Recreation Facilities Board
onvention 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
^ Disabilit Access Committee ^ Public Safet Adviso Committee
^ Fine Arts Board ^ Safet Committee
^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC
^ Golf Adviso Committee ^ Trans ortation and Parkin Committee
^ Green Ad Hoc Committee ^ Visitor and Convention Authorit "
^ Health Adviso Committee ^ Youth Center Adviso Board
" Board Required to File State Disclosure form
~_1G'i E=R.3;ALi ~*~~_; ~~ ~.~i._,:~.,,1'~E3&C A~~Iir~atic~~~ t~~~ 1e~' iE~;?S>CIA_drr,
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 C Years of Service:
2. Present participation in Youth Center activities by your children Yes^ No C. 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 C or No !~'If yes, please explain in detail:
• Do you currently have a violation(s) of City of Miami Beach codes: Yes ~ or No cal. If yes, please explain in detail:
. Do you currently owe the City of Miami Beach any money: Yes ~ or No t'i. If yes, explain in detail
. Are you currently serving on any City Boards or Committees: Yes ~ or Nom If yes; which board?
• What organ~izAations in the City of Miam~~Beach o you currently hold 1~be~rship in? ~ ^,,
Name: V ~~ t ~M ~ ~~~ C ~,( ~ Vl(,(.(,f~ ~~ Title: ~J~ V CJl1~.
Name: Title:
• List all properties owned or haive an,interest in, which are located within the City of Miami Beach:
I V /,~
. I am now employed by the City of Miami Beach: Yes ~ or No~!Which department?
• Pursuant to City Code Section 2-25 (b): Do you have a parent C~, spouse C, 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: ~~ ~ years old Gender: Male [~' Female ^
Ethnic Origin (Check
White C~'Qfrican- erlcan/ ack ^ Hispanic: ^ Asian or Pacific Islander ^ American Indian or Alaskan Native ^
"I hereby ttest to th accui
Article V - of the Ci Code
Si~fnature
and truthfulness of the application and have received, read and will abide by Chapter 2,
pdards of Conduct for City Officers, Employees and Agency Members."
Date
Name of
Lv,~ G
(PLEASE PRINT)
lease attach a copy of your resume to this application
OTE: Applications will remain on file period of one (1) calendar year.
E ployment Status: Employed Retired ^ Home-maker ^ Other ^
Received in City Clerk's Office by Date
Name of Deputy Clerk ~ I G~~y, ~~()
Document Control Number (Assigned by the City Clerk's Office) ~ ~ Entered By ~ ! Date l ~+' ~" O //
Revise 04/18108 LH /
~~
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