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David Lehrman 12/31/2007 tD ..... City of Miami "'h, 1700 Convention Center Drive, Miami Beach, Florida 33139. www.miomibeochA.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEL: (305) 673-7411, FAX: (305)673-7254 3/22/2006 Dr. David Lehrman 5660 Collins Ave #12E Miami Beach, Florida 33140 ....... Miami Beach Sister Cities Program Congratulations! You have been re-appointed bYMayor David Dermer to the above referenced agency, board or committee for a term ending: 12/31/2007. If you are unable to accept this appointment, please notify the City Clerk's Office immediately at (305) 673-7411. Please read the enclosed material carefully. Again, congratulations and good luck. Sincerely, ~UvJ p~ I f!jf Jj Robert Parcher City Clerk cc: Saul Frances, Parking Director David Dermer ATTACHMENTS: 1. City Code Ordinance section, applicable to agency, board or committee 2. General Provisions of Ordinance NO.97 -3086 3. Ordinance No. 97-3105 4. Citywide parking permit application - Return completed application to the Parking Department located at 1130 Washington Avenue, Eighth Floor. Tel: 305-673-7505 5. Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employ 6. Miami Beach Code Section 2-459 "Certain appearances are prohibited." 7. Miami-Dade County Section 2-11.1 We ore committed ro providing excellent public service and safely to 0/1 who live, work, and ploy in our vibrant, 'ropical, hisforic community tD ..... City of Miami leach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachA.gov OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk TEL: (3051673-7411, FAX: 13051 673.7254 TO Dr. David Lehrman RE: MB Sister Cities Program I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Govemment 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; 12/31/2007. 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 theFlorida 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 andlor Committee, I must comply with the financial disclosure' require- ments of Miami-Dade County or the State of Florida e board or committee on which I serve) on July 1st, following the closing of the ich I served. Dr. David Lehr Sworn to and subscribed before me this ~ day o~ I), ~~~ Deputy Clerk ./ 'Please see ~iWeQ.foM~~_~\lI~iilmil!B'lliII/I~lYl/Ililfl~i~.eW'iPar.ll il04 ~ "opicol. hislO,ic commuoi'Y for additional information regarding the Financial Disclosure Requirements. :0..."." CITY at _ .IAMI BEACH BOARDS AND CO. _.'UTTEE APPLICATION FORM Address: 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 m~s in a business established in the city. Resident of Miami Beach for a minimum of six (6) months: Yes [-1 or No [ ] ~ Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes or No [ ] I am applying for a Board appointment because I have sPllCial abilities, know~dge, erience: Yes [ My special abilities, knowledge, or experience is: I ~ --t"( ""-Q fj12. ~ f Are you a regi~tered voter in Miami Beach: Yes [ or No [ ,1---... NAME: le...\1\rYY\ 6\ V> ~ V, J_ Last Name [ I J; First Name (J. I () Middle Initial Home <:;e,bO Co (ViS -Av~/cl,c. YY\lI.\Y\III'bGtU~ fL '?,"::.(L{o Address: No. Street City r...,' rn '" State Zip Code 305' \0 <.., ~-,:s- a Phone: ~~'6~'7 '1171 sc~ ro7~S'I{S.(, '~Qr nIl Ie qt dr{ 4rl'l\<th ~bcl<a(cI-col'Y\ Home Work Fax Email address I am now a resident of: North Beach [ ] South Beach [ ] Middle Beach [ ~ Business Name~ V tJ ~~V'ItJCfu \'I.il) p~ Applicant's Position: c;;:hl.f5Ic I q h Y lG r 'YYIv-r (d (<H1 ~ ,J~; <; 0 I }'VII Gm ~Cl ~ f { No. Street City State [v6wner [ ] Stockholder/Shareholder [ ] Corporate Officer [ ] Other Explain: s~( <( 0 Zip Code Professional License (describe): ~h ~ .s:.re 1 q ~ Attach a copy of the license listed above. 1. Have you ever been convicted of a felony: Yes [ ] or ExPires:..Q.:\ No [ ~ yes, please explain in detail: 2. Do you currently have a violation(s) of City of Miami Beach codes: Yes [ ] or No [y(If yes, please explain in detail: 3. Do you currently owe the City of Miami Beach any money: Yes [ ] or No [ ~ If yes, explain in detail: 4. Are you currently serving on any City Boards of~ Committees: Yes [ v{:,r No [ ] If yes; which board? S IS: 1'.Q.o(' CI -1 What organizations In the City of Miami Beach do you currently hold membership in? Name: Sf ~ +--R." C I + '" Title: ~ ~~ r 1 Name: Title: Li,s,t all properties owned or have an interest in, which are located within the City of Miami Beach: ~ b'YYI~ I am now employed by the City of Miami Beach: Yes [ ] or No [..y.1f yes, 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): C:\CMBWEBIJOBSIBCAPPLICI.DOC