Keren Bajaroff 12/31/2012 ID \ 1 , 1 -- - - , ! ' .
---- i V I A I V\ 1 • ' - C ''' i
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673- 7411, Fax: (305) 673 -7254
1/5/2011
Keren B a j a roff
5500 Collins Ave. #1802
Miami Beach, Florida 33140
) Committee for Quality Education in MB
Congratulations! You have been reappointed by Commissioner Ed Tobin
to the above referenced agency, board or committee for a term ending: 12/31/2012.
If you are unable to accept this appointment, please notify the City Clerk's Office at
(305) 673-7411.
Please read the enclosed material carefully. Again, congratulations and g ood luck.
Sincerely,
ieiz.
Robert Parcher
City Clerk
cc: Frances, Parking Director
Leslie Rosenfeld
ATTACHMENTS:
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 -2458, 2-459
Ordinance 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
Employees
We are committed to providing excellent public service and safety to all who live, work and la in our vibrant, tropical, historic community.
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A° AA I AAA I EAC H
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Cit of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Robert Parcher, City Clerk
Tel: (305) 673 = 7411, Fax: (305) 673 -7254
TO Keren Bajaroff
{
RE: Committee for Quality Education in MB
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 w hich I have
been appointed for a term ending: 12/31/2012.
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 Officers and Employees, and understand that as a member
of a City of Miami Beach Board and /or Committee, I must comply with the financial 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 I have served.
Ai.
/ aw
Keren Bajagiff
Sw prn to and subscribed before me this ( 2day of jah , 2011.
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 la in our vibrant tropical, '
p y p , historic community.
CI: M I AM I BEAC H
City of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK Office CityClerk@miarnibeachfl.gov
Tel: 305.673.7411 Fax: 305.673.7254
Acknowled of fines/suspension for Board Members for i g failure f
to comply with Miami -Dade County Financial Disclosure Code Provision
Code Section 2- 11.1(1) (2)
,. ,--,.>
Board Member name: ke 1 e n Co
,
understand that no later than : Jul 1, of each year all members of :Boards Y and
Committees of the City of Miami Beach, including those of a purely advisory nature, are
required to comply with Miami -Dade County Disclosure Requirements. This means-that the
members of City Advisory Boards, whose sole or primary . responsibility is to recommend
legislation or give advice to the City Commission, must file, even though you may have been
y
recently appointed.
You MUST file one of the following with the City Clerk of Miami Beach, 1700 Convention
Center Drive, Miami Beach, Florida, by July 1 each year.
1. A "Source of Income Statement' .(attached) or •
2. A "Financial Statement" (attached( or] .
3. A Copy of the person's current Federal Income Tax Return
Failure to fife, :accordin :to the Miami -Dade County Code Chapter 9 ty p r '! , General
Provision, Section 1-5 may subject .the person or firm to a fine not to exceed
$500.00 or by imprisonment in the county jail for -a eriod not to exceed sixty
y
days, or :both.
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S ignature:
Date.
•
i
MIAMI.
COUNTY SOURCE OF INCOME STATEM ENT
Please. Print .or Type First Name Middle Name /Initial Last Name
Disclosure
For Tax Year
e' .. 14 A di:
Enng `O
Name: �/
Ma Address: 4 ahL ,
9
Ci State f Zi : --(: - 331 q 1
Social .Security Number:
Filing as a: ® County Employee:
a .Municipal Employee of:
Position held or sought:
Board where searing: Term or = Employment
.�.
Began on: ....... kL I LL . ..._
•
•
Department Where employed:
Work Address:
If your home address is exempt from public records: pursuant to
Florida Statutes § 111.07 please :check here (read instructions): 0 Work
Home Address: a cts - — di. C` .
*at/W.)
Stre Address
1-ic ____r:L,.. - 33/(4 I
City State .Zip Code
r
Please list below in descending order with the largest source first, the name, address and
principal al business activity of every source of your income including public salary you
received or any person received for your benefit or use during the disclosure period, The
income of your spouse or -any business partner need not be disclosed. If continued on a
Y
separate sheet, check .here: 0
Description of the Principal
Name of Sour e of :Ir o e Address Business Addy'
ee 17/8/ 0 , ''!I' I f 4# 3 _ •
i
•
1 hereb swear (or affirm) - that the aforesaid information is .a true and correct .statement.
/
112/(4...iidA -.11 /Lai
.Sig inure of pars n dis using / r mate signed