Deborah Ruggiero 12/31/2014 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
Email CityClerk @miamibeach.gov
12/13/2012
Deborah Ruggiero
7356 Gary Ave
Miami Beach, Florida 33141
ESl9�JECT Fine Arts Board
Congratulations! You have been reappointed by Commissioner Jerry Libbin
to the above referenced agency, board or committee for a term ending: 1213112014.
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.
SincerZEG�aranadio
Rafael
City Clerk
cc: Saul Frances, Parking Director
Gary Farmer
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.
I
MIAMIBEACH
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
Email CityClerk @miamibeach.gov
TO Deboah Ruggiero
RE: Fine Arts Board
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: 12/31/2014.
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 the Florida Commission on Ethics Guide to the Sunshine Amend-
ment 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 ithe State of Florida (depending on the board or committee on which I serve)on
July 1, following the closing of the calendar year o w.ich I
eboa Rug' "490
Sworn to and subscribed before me this day of 2012.
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Comm
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.
MIAMI BEACH CITY MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
Zd V
L s N first a le Initi I
ome s / City State 4 i Zi C de
'Se Dzv
e Telepho
n_p,, ork Telephone Cellular Telephone n Email addre s
o�w ab \'b"g� Position:
usiness Nam
(p ( /M
Business Address City State Zip Code
Professional License(describe) Expires:
Attach a copy of the license
Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards and committees shall be affiliated with the city;
this requirement shall be fulfilled in the following ways: a. An individual shall have been a resident of the city for a minimum of six
months; or b. An individual shall demonstrate ownership/interest for a mini m of six months in a business established in the city
for a minimum of six months.
• Resident of Miami Beach for a minimum of six (6) months: Yes or No F
• Demonstrate an ownership/interest in a bu ineseo
iami Beach for a minimum of six months: Yes or No F
• Are you a registered voter in Miami Beac : Yes r No
• I am now a resident of: North Beach U4 South Beach Q Middle Beach U
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
• Are you presently a registered lobbyist with the City of Miami Beach?Yes LJor No
Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that
only three 3 choices will be observed the City Clerk's Office. Regular Boards of City)
❑Affordable Housing Advisory Committee ine Arts Board ❑Normandy Shores Local Government
Neighborhood Improvement
❑Art in Public Places Committee ❑Gay, Lesbian, Bisexual and Transgender ❑Parks and Recreation Facilities Board
Enhancement Committee GLBT
❑Beautification Committee ❑Golf Advisory Committee ❑Personnel Board
❑Board of Adjustment* * ❑Health Advisory Committee ❑Planning Board**
❑Budget Advisory Committee ❑Health Facilities Authority Board ❑Police Citizens Relations Committee
❑Capital Improvements Projects ❑Hispanic Affairs Committee ❑Production Industry Council
Oversight Committee
❑Committee on the Homeless ❑Historic Preservation Board yf ❑Safety Committee
❑Committee for Quality Education in MB ❑Housing Authority ❑Single Famil Residential Review Panel
❑Community Development Advisory ❑ Loan Review Committee ❑Sustainability Committee
❑Community Relations Board ❑Marine Authority ❑Tennis Advisory Committee
❑Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Transportation and Parking Committee
❑Debarment Committee ❑Miami Beach Cultural Arts Council ❑Visitor and Convention Authority
❑Design Review Board* ❑Miami Beach Human Rights Committee ❑Youth Center Advisory Board
❑ Disability Access Committee ❑Miami Beach Sister Cities Program ❑Waterfront Protection Committee
* Board Required to File State Disclosure Form
If you seek appointment to a professional seat(e.g., lawyer,architect)on the Board of Adjustment, Design Review Board,
Historic Preservation Board,or Planning Board,attach a copy of your currently-effectively license,and furnish the
following information: _ J
Type of Professional License License Number ,
License Issuance Date ,and License Expiration Date
C:\Users\Hp\AppData\Local\Temp\Temp1_SourceoflncomeStatement.zip\BCApplication.doc
Employment Status: Employed L.1a Retired Q Homemaker L1 Other
Please remember to attach a current resume and a py of an lap licable
professional license.
Attach additional sheets, if necessary, to provide required i ormation.
C:\Users\Hp\AppData\Local\Temp\Temp1_SourceoflncomeStatement.zip\BCApplication.doc
NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT 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).
• 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 I HAVE RECEIVED, READ AND
WILL ABIDE BY CHAPT ARTICLE VII — OF THE CITY CODE "STANDARDS OF CONDUCT FOR CITY OFFICERS,
EMPLOYEES AND AG CY MEM S."
Ap i nNt' i ure
d d
at Name of A cant P SE PRINT)
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No. Date
i
C:\Users\Hp\AppData\Local\Temp\Temp 1—So urceoflncomeStatement.zip\BCApplicatio n.doc
/\AIAMI BEA H
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov
Telephone: 305.673.7411 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(i) (2)
Board Member's Name:
6
I understand that no later than July 1, 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, 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 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 not to exceed s' ays, or both.
I
ig a Date
C:\Users\H \A Data\Local\Tem \Tem 1 SourceoflncomeStatement.zi \BCA lication.doc
P PP P P _ P PP
M I A M I•DADE
SOURCE OF INCOME STATEMENT
Please Print or Type First Name Middle Name/Initial Last Name
Disclosure
For Tax Year
Name: - Y (� t;i�-Q Endings
Mailing Address: �(v
City/State/Zip: '
Social Security Number: — -
Filing as a: ® County Employee:
® Municipal Employee of:
Position held or sought:
Board where serving: Term or Employment
r I PL, Akss, SEP Began on:
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:
Street Add r s
l
ity 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 9f Source of Income Addres§ Business Activity
I Veb;,Lr swe affirm) the aforesaid information is a true and correct statement.
a �
nature of person closi . to signed