R 9 B Honorable Mayor and Members of the City Commission (3) OCT 1 7 2018 g 1
MIAMI BEACH
COMMISSION MEMORANDUM
TO: Honorable Mayor and Members of the City Commission
FROM: Rafael E. Granado, City Clerk
DATE: October 16, 2018
SUBJECT: City Commission —At-Large Nominations for October 17, 2018— Release# 3
Below please find the City Commission At-Large Nominations received to date for the October
17, 2018 Commission Meeting. Changes made since Release # 2 are shown in red.
BOARD AND COMMITTEES:
1. AFFORDABLE HOUSING ADVISORY COMMITTEE
VACANCIES (4):
• Allison L. Stone
Nominated for appointment (Represents Employers within the Jurisdiction Category) by
Commissioner Aleman.
(Release # 1, Page 3)
• Barbara Montero
Nominated for appointment (Resides within Jurisdiction of Local Governing Body) by
Commissioner Gongora.
(Release # 2, Page 3)
2. ANIMAL WELFARE COMMITTEE
VACANCIES (2):
• Linda T. Diamond
Nominated for appointment (Sobe Cats Spay & Neuter, Inc. Category) by Sobe Cats
Spay & Neuter, Inc. and requires ratification by the City Commission.
(Release # 1, Page 11)
3. HEALTH ADVISORY COMMITTEE
VACANCIES (2):
No nominations received.
4. HEALTH FACILITIES ADVISORY BOARD
VACANCIES (0):
• Sidney Goldin
Nominated for reappointment (General Business Category) by Commissioner
Steinberg.
(Release # 1, Page 17)
5. NEXT GENERATION COUNCIL
VACANCIES (3):
• Jamie Maniscalco
Nominated for appointment (Miami Beach Chamber of Commerce Category) by Jerry
Libbin, President & CEO Miami Beach Chamber of Commerce, and Commissioner
Gongora. Application to be submitted.
(Release # 3)
6. TRANSPORTATION, PARKING AND BICYCLE-PEDESTRIAN FACILITIES COMMITTEE
VACANCIES (3):
• Anamarie Ferreira de Melo
Nominated for reappointment (Mid-Beach Neighborhood or Business Association
Category) by Commissioner Gongora.
(Release# 3, Page 3)
F:\cLER\SALL\REG\cOMMISSION MEETINGS\2018\101720181101718 RELEASE#3.docx
•
ti41A11\` r �t ` ,.\ .,�r~ BOARD AND COMMITTEE APPLICATION FORM
f EF"r- fr e1 de -lr) 4 m c •, e
Last Name First Name Middle Initial
_ A- rein, lac i0/11 P 1- 33 )16
Home Address ' pity State Zip Code
305 � -Z- rjIelZ 3 S - ZS0 5'JS s
dome Telephone Work Telephone Cellular Telephone Email address
(A'r br.:Nn c t•h-c.,n 1-1)i e_.vv, C.:AAA
Business Name Occupation
4t 2.5 I' t; 2- . 44 U t 3 13 `3-
Business Address City State Zip Code
Professional License(describe): Expires:
Please attach a copy of currently effective professional license.
Pursuant to City Code section 2-22(4)a&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 for a minimum of six months. I �
• Resident of Miami Beach for a minimum of six(6)months:Yes L br No 1.4./I
• Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months:Yes No 1, 11
• Are you a registered voter in Miami Beach:Yes 1-21br No U1
• l am now a resident of: North Beach JiSouth Beach Middle Beach
• I am applying for an appointment because I have special abilities,knowledge and experience. Please list below:
iii `a w J
r 4' _ t`es\ tia.AYa I t r h.ecx A-h )et in cd . Ya,A.j' t+ n t.nr un m.a.,n f-
• Are you presently a registered lobbyist with the City of Miami Beach?Yes 1. ..11 or No.'��1!
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 Office of the City Cleric,
Affordable Housing Advisory Committee Health Advisory Committee 1 Parks and Recreation Facilities Board°Q
ArtinPublicPlacesCommittee Health Facilities Authority Board Personnel Board
AuditCommittee Hispanic Affairs Committee PlanningBoard" r
BoardofAdjustment" * Historic Preservation Board * Police Citizens Relations Committee
Budget Advisory_Committee HousingAuthority Production Industry Council
Committeeonthel-fomeless Human Rig hts Committee SisterCitiesProgram
CommitteeforQualityEducationln MB LGBT Advisory Committee Sustainability Committee
Convention Center Advisory Board Marine&Waterfront Protection Authority Transportation, Parking, & Bicycle-Pedestrian
Facilities Committee
CulturalArtsCouncit — _ Miami Beach Commission forWomen Visitor and Convention Authority
Design ReviewBoard Normandy Shores Local Govemment Youth Commission
Neighborhood Improvement
Disability Access Committee Ad HocAntl-Bullying Task Force Ad Hoc Small Business Task Force
Board members are required to file Fomi 1 -"Statement of Financial Interest"with the State.
If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review
*Board, Historic Preservation Board or Planning Board, attach a copy of your currently-effectively license, and furnish the
following information:
Type of Professional License License Number
License Issuance Date License Expiration Date
Page 1 of4
C.'UUsers\CLERQueRll)esktop\BC APFLICATION.dccx
°o Note:If applying for the Youth Center positions of the Parks and Recreations Facilities Board Indicate your affiliation with
the Scott Rakow Youth Center and/or the North Shore Parks Youth Center. d
• Please describe your past service with the City's Youth Centers(include dates of service): /l. //1
• Present participation in Youth Center activities by your children:Yes {::1I No Vel
If yes,please list below the names of your children,their ages and the programs in which they participate: 1'
Child's name: Age: Program:
Child's name: Age: Program:
•Have you ever been convicted of a felony?Yes or No If yes,please explain in detail:
•Do you currently have a violation(s)of City of Miami Beach Code?Yes UI or NoIlf yes,please explain in detail:
• Do you currently owe the City of Miami Beach any money?Yes or No 0--If yes,explain in detail:
•Are you currently serving on any City Board or Committee?Yes UI or Noa If yes,which board/committee?
• In what organization(s)In the City of Miami Beach do you currently hold membership?
c ' c-( e.A s�c t-� �c e_s;
ame Position
Name Position
• List all properties owned or in which you have an interest within the City of Miami Beach:
A MTh Cot i r1 S /�V-� TAp-}- 2�'l a 3 1 2:1,0 2
• Are you now employed by the City of Miami Beach?Yes LJI or Noel
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have a parent , spouse CZII, child UI brother or sister Z3 who Is
employed by the City of Miami Beach?Yes No a
If"Yes,"identify person(s)and department(s):
The following Information is voluntary and is neither part of your application nor has any bearing on your consideration for
appointment.It is being asked to comply with City diversity reporting requirements.
Gender: Male I I Female fes.
Race/Ethnic Categories
What Is your race?
Ul African-American/Black
atI— h aucasian/White
E►1 Asian or Pacific Islander
Ul Native-American/American Indian
Page 2 of 4
C:Iusers\CLERQuelMesklopEIC APPLICATION.docx
� I
•
Other—Print Race:
Do you consider yourself to he Spanish, Hispanic or Latino/a7 Mark the"No"box if not Spanish,Hispanic, Latino/a.
1_..1 No
}'Yes
Do{you consider yourself Physically Disabled?
l Jl Yes
NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE
MEMBERS. THESE LAWS INCLUDE,BUT ARE NOT LIMITED TO:
o Prohibition from directly or indirectly lobbying City personnel(Miami Beach City Code section 2-459).
o Prohibition from contracting with the City(Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before the board/committee you have served on for period of one year after leaving office (Miami Beach
City Code section 2-26).
o Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
o CMB Community Development Advisory Committee: prohibition, during tenure and for one year after leaving office, from having
any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom
you have business or immediate family ties(CFR 570.611).
o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open
government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most
meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities.
o Voting conflict—Form 8B is for use by any person serving at the county,city or other local level of government on an appointed or
elected board, council, commission; authority or committee. It applies equally to members of advisory and non-advisory bodies
who are presented with a voting conflict of interest under Section 112.3143,Florida Statutes.
Upon request,copies of these laws may be obtained from the City Clerk.
I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY OFFICERS. EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATUTES ACCORDINGLY."
-• 512_p r
ADpftcant's Signature Date ( ame of App'ican[(PLEASE PRINT)
Received in the Office of the City Clerk by: �
Name of Deputy Clerk Control No. Date
ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY
APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
Page 3 of 4
C:1Users\CLERQueR\DeskloplBC APPLICATIQN.docx
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