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CITY OF MIAMI, FLORIDA
BOARD MEMBERS' EMPLOYMENT RESTRICTION FORM
The City of Miami Code Sec. 2-884(e) states that an employee of Miami -Dade
County, Florida, or any municipality therein other than a City of Miami employee,
shall not serve on,or be appointed to any Board of the City of Miami, unless the
City Commission waives this restriction by a four -fifths affirmative vote of its
membership and the employee is a resident of the City of Miami.
Please fill out the following:
I, l V-L) S C(.
(PRINT NAME OF THE BOARD MEMBER)
am a member of the
4tDvIneA a-,..-Q 1)-sR./NeiYIWvLa tQ and
(PRINT NAME OF THE BOARD)
77 I am employed by Miami -Dade County or any other muncipality therein
'other than City of Miami
I am NOT employed by Miami -Dade County or any other municipality
therein other than City of Miami
SIGNATURE OF THE BOARD MEMBER
.S-1100-(
DATE