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Antonio Purrinos 12/31/2012 (2) 10 1A M� Il B A C H 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 12/23/2011 Antonio Purrinos 2899 Collins Ave #1720 Miami Beach, Florida 33140 S M�� Hispanic Affairs Committee Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson 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 good luck. Sincerely, r G Robert Parcher City Clerk cc: Saul Frances, Parking Director Nannette Rodriguez 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 play in our vibrant, tropical, historic community. MIA�IBEACH 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 TO Antonio Purrinos RE: Hispanic Affairs Committee 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 which I have been appointed for a term ending: 12/31/2012. 1 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 theFlor/da 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. Antonio Purrinos Sworn to and subscribed before me thi�E day of /1 201 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 play in our vibrant,tropical, historic community. p MIAMP Sou Please.Print.or Type First Name Middle Name initial list Flame DisCfQSUre For Tax Year p /V Ending: Name: Flailing Address: City/State/dip: 5 Der Filing as a: . El County Employee: E municipal Employee of: Position held or sought: Board wrhare serving: / �f/�/ Term or. playme tl I Began.on: Department-w-here empioyed: Work Address: if-your home address is-exempt from public-records pursuant U worli Telephone: Florida Statutes§11.9.07 pisase check here.(read instructions): Home Address: Street Address City State.. dip Code Please list.below.'in descending order with the,largest source'first, the name address.and principal business activity of every.source .of. your income .includiing pub salary you or any person received-for your.benefit or use during the disclosure period. The -received Y zincome of your spouse or.any,business partner.need not be.disclosed. Yf:contenue separate sh®et,-check here: :Description of-.the'principal Name of Source of Income Address Business AcLiVitY r o I hereby swear or Ofirm)that the-aforesaid information is:a true and c®rr®ct:statement. S 3nat re of person disclasing Date igned M [AMI BEACH city of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.QOv CITY CLERK Office CityClerkCmiamibeachfl.gov Tel:305.673.741 1 , Fax: 305.673.7254 Acknowledgement of fines/.suspension for Board Members for.failure to comply with Miami-Dade County Financial.Disclosure Code Provision Code .Section 2-11.1(1) (2) Board Member name: I understand that no .later than July L of each year all members of.Boards 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 recently appointed. YOU must file one of-the following with the City Clerk of Miami Beach, 17.00 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-file, according to the Miami-Dade.County Code Chapter 1., 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 period nc>t to exceed sixty days, or both. Signature: Date: