HomeMy WebLinkAboutOAB ApplicationsCITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARD
NOMINATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 17, 2018 to the office of
the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (N.E.T.), at 1490 N.W. 3R11AVENUE, Suite 112-B the office of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CLERK at 3500
PAN AMERICAN DRIVE. Note: A person may recommend himself/herself
A. I nominate —Tr i rn l r i R 1h— ,5 VV lff r appointment to the Overtown Community Oversight Board. He/she
meets the eligibility requirements because he/she is 18 years of age and also meets one or more of the following qualifications:
1. Resides in the Overtown Area at j o \Ai r Pet v- IC P I ct ZC { C" r'` I l or
2. Is the current owner of property in the Overtown Area located at:
\ct dlC WA/ 5h P1 11 pi WI 5 I-'nIrtvy,t F 1 33l3cp
or
3. Is an employee or board member of community development
corporation or community based organization located in and provides services to the Overtown Area, at the address
, or
4. Owns or is an employee of a business in the Overtown Area located at:
Nominee's Info: Phone number Cell phone 78 (p 587 5' ! U
Fax number E-mail I)13 Ic dL f►7t-c70t, # Cie die l7 V
B. Please provide a short statement of qualifications of the person you are recommending for appointment:
5 r[..d tr 1G1c s,ar TR I] tt'kY u. 4-"to i `.3 v(Li ) 'tor `a 1te G{d t T 1GA.11 S
C_Auon. (k Y ar.c; cAmb,in ,;, iti.r, t- i.- c{ c L. q' c v I,# -f o `f
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Over {er+ iie s 4P c)cti,e[
L t^� a Nov I Ci !c� Ca , c..I cis S-e 1- f v i -,0 •
r
C. Please provide your contact information for the purpose of clarifying the above and sign b ow
Phone number Cell phone 7 y(a. 52.. 7r i
Fax number E-mail p3 is-.d j6 in}t /1'4igv J Qt z
� +- 3
D. Please sign here:
` Signature
Printed Name
7/Ic
Date ig4ed
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES? N N/A
RECOMMEND PERSON MEETS AGE REQUIREMENTS N N/A
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED:
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y N N/A
CITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARD
NOMINATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P,t17. on FRIDAY, AUGUST 17, 2018 to the office of
the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (1V.E. T.), at 1490 N.W. 3" AVENUE, Suite 112-B; the office of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CLERK at 3500
PAN AMERICAN DRIVE. Note: A person may recommend himself/herself
A. I nominate J)f G / for appointment to the Overtown Community Oversight Board. He/she
meets the Eligibility requirements because he/she is 18 years of age and also meets one or more of the following qualifications:
1. Resides in the Overtown Area al or
. Is the current owner of property in the Overtown Area located at:
or
3. is an employee or board member of �}; community development
cor�rration or comma ity based organization located in and prov s servic s to t Overtown Area, at the address
4. Owns or is an employee of a business in the Overtown Area located at:
c= 7
•3
5. Nominee's Info:
Phone number (7--3--- 7 r 7 i ell phone
Fax number E-mail
B. Pleas provide a short statement of qualificat ans of the person you are ecom -nding for appointment: 7' i
ti
Mir1
ifirelErOMWPRIMINIMEIrMW-
Please provide your contact information for the purpose of clarifying the abovepand sign below `
Phone number Cell hone `/`
Fax number Email
D. Please sign h
nature
Printed Name
42/
Date Sign d
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES? N N/A
RECOMMEND PERSON MEETS AGE REQUIREMENTS Ni NIA
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED: FI4L, l �f i J CO 54*
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y N N/A
CITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARDco
NOMINATION FORM FOR APPOINTED MEMBERS
I
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 1 z, 2018 tea the office of
the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (N.E.T.), at 1490 N.W. 3RD AVENUE, Suite 112-&,the ofle of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CItERK at3500
PANAMERICANDRIVE. Note: A person may recommend himself/herself.
A. I nominate 1I 41 E P SOA for appointment to the Overtown Community Oversight Board. He/she
meets the eligibility requirements be use he/she is 18 years of age and also meets one or more of the following qualifications:
1. Resides in the Overtown Area at fRie /I. (,V. f 0f4 # frtifavnJ ! �� 13 l6 or
2. Is the current
currrA rento1wner of property in the Overtown Area located at:
9 Ibiz q `peOgl' el- /I / *777.1 Tom, I ,-6 or
3. Is an employee or board member of /V /4 community development
corporation or community based organization located in and provides services to the Overtown Area, at the address
, or
4. Owns or is an employee of a business in the Overtown Area located at:
a
5. Nominee's Info:
Phone number
Fax number
98 /01 Cell phon
E-mail 4.141 ,n 817�,� J:%d • CD�I
B. Please provide a short statement of qualifications of the person you ae recommending for appointment:
OWi✓ee 6f `rq1.
L-A tit / ,1i C. DA9 to Ad FA; eS .
.T J-SEe"5-11el i (5eR✓; nn��jj� 0t) A1 40u11J denim •.0.Q
C. Please provide your contact information for the.pyrpose �fyi the above and sign below
Phone number G�Qj '1 cf. Cell phone
Fax number E-mail w7 art 6 42; ,9rra.��/Q-0 102.
/-4m,ne ZEF7-6,_20› ehho
Printed Name Date Signed
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES? N N/A
RECOMMEND PERSON MEETS AGE REQUIREMENTS N . N/A
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED: L Df ‘ ‘lQ(.S
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y N N/A
Voters
CITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARD
NOMINATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 17, 2018 to the office of
the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (NE.T.), at 1490 N.W. 3Rt' AVENUE, Suite 112-B; the office of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CLERK at 3500
PAN AMERICAN DRIVE. Note: A person may recommend himself/herself.
A. 1 nominate Ain 40 a for appointment to the Overtown Community Oversight Board. He/she
meets the eligibility requirements beca he/she is 18 years of age and also meets one or more of the following qualifications;
I. Resides in the Overtown Area at or
2. Is the current owner of property in the Overtown Area located at:
or
3. Is an employee ar board member of community development
corporation ar community based organization located in and provides services to the Overtown Area, at the address
, or
4. Owns or is an employee of a business in the Overtown Area located at;
//9 3i-d4J,e /a l fit 33(3 cr G
5. Nominee's Info: Phone number _495-7 -90S' v Cell phone Fax number E-mail pF--4_tricirece-7a'te--et eri A/� r{
B. Please provide a short statement of qualifications of the
C.
tip bedaced ee r)mu7/ _ / te r&
� r7 0 .S`eA L /es 1 2. p72 a ee/g'
Likii--;,41L flai7-11 CAW CiJ e afiti .7-J/721;,_/y
e( 11('4')i-
p/s aue re� mender al}poomn
f Y
1
Please provide your contact information for the purpose of clarify'n the above and sign below
Phone number ? c7 9' ' Cell phone r
E-mail britU1CI'r?.arewa;-&tI�9� p,y.
+1 t! ,
Fax number
fit) ,a() f,jei
Printed Name
Date
0nE7//s
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES? N N/A
RECOMMEND PERSON MEETS AGE REQUIREMENTS t► • IA j�
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED: A d lriT r�US.I Y
N N/A'
ACCREDITED INSTITUTION INSIDE BOUNDARIES
AFFIDAVIT OF BUSINESS ENIPLOYMENTIBOARD
MEMBERSHIP WITH CDC OR CBOIBUSINESS
STATE OF FLORIDA )
) SS:
COUNTY OF MIAMI-DADE
BEFORE ME,
KAMAO 1;AG-eiP
iJ
I. ._6,r-rvau Pule' i`
(Community Development Corporation) or CBO (Community Bases
J Lig°) `Lga. f kde -sot ic TC)i.street address in Overtown).
/Vl iArr-) 1 P /. 3.3
FURTHER AFFIANT SAYETH NAUGHT.
the undersigned authority, this day personally appeared
who being by me first duly sworn, upon oath, deposes and says:
, am an employee of a business/board member of a CDC
Organization) of
t—
(Employe : oard Member of a CDC or CBO Business)
SWORN TO AND SUBSCRIBED BEFORE ME this 7 day of
401• by j<0 U{ . ru I (` , who is personally known to me or
ced t' 1► ►dew 5. Lco,it j. as identification and who did:'did not take an oath.
00411C1Vek
GNATURE OF NOTARY PUBL
IC PRINTED, STAMPED OR
STATE OF FLORIDA TYPED NAME OF NOTARY
My Commission Expires:
•
King Kamau
Marketing & Sales Representative
Bottled water, Bottleless Water Gaolers. Water Filtration
S Bagged Ice
Ph. 305.985.8685
Fx. 305.513.5936
drinkmorewaterboy
Miami, FL 3315G. L:
www. wateri s go I d e n_ co m
G+
grnaiI.com
A
47'
CITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARD
NOMINATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 17, 2018 to the office of
the OVERTOWN ,NEIGHBORHOOD ENHANCEMENT TEAM (N. E. T.), at 1490 N.W. Set' AVENUE, Suite 112-B; the office of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CLERIC al 3500
PAN AMERICAN DRIVE. Note: A person may recommend himself/herself
A. I nominate i IC) 6, iy,[!/(ift'; rintment to the Overtown Community Oversight Board, He/she
meets the eligibility quirements because he/she is 18 yead Communityof age and also meets one or more of the following qualifications:
1. Resides in the Overtown Area at / €XC) Az, L.{ , '. /€..ram f or
✓ l07% - fir 2 /
2. Is the current owner of property in the Overtown Area located t ,
or
3. Is an employee or board ember of community development
corporation or community based organization located/in and provides services to the Overtown Area, at the address
, or
4. Owns or is an employee of a busitress in the Overtown Area located at:
5. Nominee's Info: Phone number
Fax number
fir — / :` (O1 ell phon �? 'CC?v(I 1
E-mail �_)tSiVWI-
B. Please provide a short statement of qualifications of the person you are re mmending for appointment:
a--
P
J
r •r
N.)
C. Please provide your contact information for the purpose of clarifying the above and sign below y`
Phone number Cell phone % 6 `(
Fax number E-mail
Signature
ase sign here: ,r�1 se 6I -,a1
L, Ref.) r i'�
/
Pr Name 6 u „tiro ?VG
r~'
Date gned
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES? N NIA
RECOMMEND PERSON MEETS AGE REQUIREMENTS Y N N/A
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED: F% t ve C S icsvice—
ACCREDITED INSTITUTION INSIDE BOUNDARIES
Y N N/A
CITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARD
NOMINATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 17, 2018 to the office of
the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (N.E.T.), at 1490 N.W. 3RD AVENUE, Suite 112-B; the office of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CLERK at 3500
PAN AMERICAN DRIVE. Note: A person may recommend himself/herself.
A. I nominate
B.
C.
for appointment to the Overtown Community Oversight Board. He/she
meets the e xgibil' requirements cause he/she is 18 years of age and also meets one or more of the following qualifications:
69/ A/ ?41--- & 2n! m/d/vJ 33/3(a
1. Resides in the Overtown Area at
2. Is the current owner of property in the Overtown Area located at:
s�
or
or
3. Is an employee or board member of t r-ilyv y2i 6;px, pmm ni y fie e upment
co oration or communitybased organization located in and prov es services to the Overt n Area, at the address
/_' j3 Ac L ,3/3(, ,or 656 .c
4. Owns or is an employee of a business in the Overtown Area located at:
5. Nominee's Info: Phone number Cell phone
Fax number E-mail
Please provide a short statement of qualifications of the person you are recommending for appointment:
k (NI -AU& Ai S fk r-rnc3 PaLlte Ala( Sol
2QSie� d P h isiderc
fke atLe - d qA )
.1r4-11 dk l .
Please provide your contact information for the purpose of clarifying the above and sign below
Phone number Cell phone 3OS
Fax number E-mail o j a
Dat
gn-elk ca')
Jc
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES?
RECOMMEND PERSON MEETS AGE REQUIREMENTS
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED:
N N/A
bin iet's Ctut �n�...
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y N N/A
CITY OF MIAMI, FLORIDA
OVERTOWN COMMUNITY OVERSIGHT BOARD
NOMINATION FORM FOR APPOINTED MEMBERS
To be completed by the RECOMMENDER and to be submitted by 4:00 P.M. on FRIDAY, AUGUST 17, 2018 to the office of
the OVERTOWN NEIGHBORHOOD ENHANCEMENT TEAM (N.E. T.), at 1490 N. W. 3RD AVENUE, Suite 112-B; the office of
the DISTRICT 5 COMMISSIONER at 3500 PAN AMERICAN DRIVE or the OFFICE OF THE CITY CLERK at 3500
PAN AMERICAN DRIVE. Note: A person may recommend himself/herself.
A. I nominate-�i()✓1 E. Liu,. (/t `NHS for appointment to the Overtown Community O ight lard. Moshe
meets the eligibility requirements because he/she is 18 years of age and also meets one or more of the follocwing gtialificatioIIs:
1. Resides in the Overtown Area at
2. Is the current owner of property in the Overtown Area located at:
0
or
--.1
or
3. Is an employee or board member of V1/'e.410(.01/) j T1ti✓ / t- c/tb coRiinunity "develchNent
corporation or community ba d organization located in and provides services to the Overtown ilea, t�jthe address
YD / /l�ln� l2 775^0er .?/!i' roi / / �L 34q,1or
4. Owns or is an employee of a business in the Overtown Area located at:
U bov A/vt) 2•-10( 4,,, 4e zl ') ij J 2 3 5f3,b
5. Nominee's Info: Phone number Cell phone 'k /% ?---3
Fax number E-mail /G w i71(�i •^-1 S e ✓►mob e; ✓i p , o✓j '
B. Please.rovide a short statement of qualifications of the person you are recommending for appointment:
p. 4 .1 �1, (� � f, h,.,e, /Le S, Wei,, f a--" it �2 c' % i-of /
iiG h o c' M1 � DV - /CI.,/r' C frirY. 5e./d A> 1 C l a 074 p-se
a/v. pp _ L,
•er
mA
cow, 11y, ,f � 1Q.e. 4tr ctiQ e- ,�1' �, 7- .1)4'--,.
C. Please provide your contact information for the purpose of clarifying the above and sign pelow - Z. b 9 - / 7 Z
Phone number Cell phone Pam —
Fax number E-mail Kc-✓iW G S e ib 4
D. Pleas
Signatide
Kam., E 't //,'0 S
Printed Name
ile7//
Date Si ed
FOR OFFICIAL USE ONLY:
RECOMMENDED PERSON'S ADDRESS INSIDE BOUNDARIES? Y N N/A
RECOMMEND PERSON MEETS AGE REQUIREMENTS �Y N . LN/
RECOMMENDED PERSON'S PROOF OF QUALIFICATION SUBMITTED:t'i , hl T
ACCREDITED INSTITUTION INSIDE BOUNDARIES Y N N/
AFFIDAVIT OF BUSINESS EMPLOYMENT/BOARD
MEMBERSHIP WITH CDC OR CBO/BUSINESS,r • 73
< c
7
s
—- 7- —.1 1
STATE OF FLORIDA )
) SS:
COUNTY OF MIAMI-DADE )
1
c
▪ o
BEFORE ME, the undersigned authority, this day personally appeared
k'P.ovi E. IA) I Hams , who being by me first duly sworn, upon oath, deposes and says:
I, ev, E. U t) / 1 fr 9 , am an employee of a business/board member of a CDC
(Community Development Corporation) or CBO (Community Bases Organization) of
aderig M Oplimoi I u b (street address in Overtown).
yo ( Nw (7 TM .41 isw+i) ff '3 3/ 3 to
FURTHER AFFIANT SAYETH NAUGHT.
(Employee/Board Member of a CDC or CBO/Business)
SWORN TO AND SUBSCRIBED BEFORE ME this % day of
, 0 /8, by I(Q.0/1 //r alas , who is personally known to me or
has produced F/Or,d t T ' 0/S U62l1.0as identifica
SIGNATURE OF NOTARY PUBLIC
STATE OF FLORIDA
My Commission Expires:
6/l4/20 20
TYPED NAME OF NOTARY