Elisa Leone 06/30/2013 City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael Granada, City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
August 8, 2012
Elisa Leone
SUBJECT: Committee for Quality Education in MB
Congratulations! You have been appointed as a Representative of the PTA for Biscayne
Elementary to the above referenced agency, board or committee for a term ending,
06/3 0/2 013.
If you are unable to accept this appointment, please notify the City Clerk's Office at (305)
673-7411 .
Sincerely,
Rafael E. Granado
City Clerk
cc: Saul Frances, Parking Director
Leslie Rosenfeld, Liaison
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.
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
TO: Elisa Leone
RE: Committee For Quality Education In Miami Beach
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 06/30/2013.
1 have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Code of
Ethics Ordinance), as well as the Florida 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* requirements of Miami-Dade County or the State of Florida (depending on the board or
committee on which I serve) on July 1, following the closing of the calendar year on which I have
served. Y7
Elisa Leone
Sworn to and subscribed before me this da Y of jCjjj'0wk, 2012.
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 Requirement.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
*Have you ever been convicted of a felony:Yes❑or No g If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach codes: Yes❑or No VIf yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money:Yes❑or No V If yes, explain in detail
•Are you currently serving on any City Boards or Committees: Yes❑or No V If yes; which board?
•What organizations in the City of Miami Beach do you currently hold membership in?
Name: Title:
Name: Title:
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
• I am now employed by the City of Miami Beach: Yes❑or No[VWhich 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):
The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is
being asked to comply with federal equal opportunity reporting requirements.
Gender: ❑ Male B'Female
Ethnic Origin: Check one only(1)
❑White (Not of Hispanic Origin):All persons having origins in any of the original peoples of Europe,North Africa or the Middle East.
V Hfi frican-American/Black (Not of Hispanic Origin):All persons having origins in any of the Black racial groups of Africa.
spanic: All persons of Mexican,Puerto Rican,Cuban,Central or South American,or other Spanish culture or origin,regardless of race.
❑Asian or Pacific Islander:All persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,on
the Pacific Islands. This area includes,for example,China,India,Japan,Korea,the Philippine Islands and Somoa.
❑American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America,and who maintain
Cultural identification through tribal affiliation or community recognition.
Physically Challenged: Yes El or Nolk''
Employment Status: Employed 9 Retired❑ Homemakers Other❑
NOTE. If appointed,you will be required to follow certain laws which apply to city board/committee members.
These laws include,but are not limited to,the following:
• Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459).
• Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1).
• Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami
Beach City Code section 2-26).
• Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
(re: CMB Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office,
from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself,
or those with whom you have business or immediate family ties(CFR 570.611).
Upon request,copies of these laws may be obtained from the City Clerk.
"I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2,
Article VII—of the City Code"Standards of Conduct for City Officers,Employees and Agency Members."
Apple ignature Date Name of Applicant(PLEASE PRINT)
Received in the City Clerk's Office by: r Dat /;0% 10 Control No. Date: /_/2010
me of Deputy erk
MIAMI- E
® SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name Initial Last Name
Disclosure
LCO For Tax Year
Name: S Ending:
Mailing Address: 3 'h 0 �L) �--
City/State/Zip:
Social Security Number: �-
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought:
Board where serving: �'� Term or Employment
< Began on: ,&)P Jd+ 20(P.
Department where employed:
Work Address:
If your home address is exempt from public records pursuant to
Florida Statutes§119.07 please check here(read instructions): ® Work Telephone:
Home Address: � AO, 4-t (zc-
Street Address
City State Zip 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 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
separate sheet,check here:
Description of the Principal
Name of Source of Income Address Business Activity
BOO CC
I hereby swear(or affirm)that the aforesaid information is a true and correct statement.
®$- 2-0
Signature W person disclosing Date signed