Barbara Gillman 12/31/2014 1.A 1\A 1 B E AC H
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) 673-741 1, Fax: (305) 673-7254
Email CityClerk @miamibeach.gov
1/3/2013
Barbara Gillman
16 Island Avenue #613
Miami Beach, Florida 33139
/SUBJECT: Safety Committee
Congratulations! You have been reappointed by Commissioner Jonah M. Wolfson
to the above referenced agency, board or committee for a term ending: 12/31/2014.
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,
Rafa E. Grana
City Clerk
cc: Saul Frances, Parking Director
Sonia Bridges
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.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachA.gov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
Email CityClerk @miamibeach.gov
TO Barbara Gillman
RE: Safety 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: 12/31/2014.
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 (depe t g on the board or c mittee on which I serve)on
July 1, following the closing of the calendar year o hich I have serve
1
Barbara Gillman
Sworn to and subscribed be re me this day of 1 2013.
Silvia Prieto
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 of Miami Beach,
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www miamibeochfl.pov
CITY CLERK Office CityClerk @miarnibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
Acknowledgement of fines/suspension for Board Mere bers for.failure
to comply with Miami-Dade County Financial .Disclosure Code Provision
Code Section 2-11 .1(i) .(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,mustfile,: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.
I. 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, according to the Miami-Dade.County Code Chapter 1, General
Provision, Section 1-5 may subject the person or firm to a f ne not to exceed
.$500.00 or by imprisonment"in the county jail for s period not to exceed sixty
days, both.
S gnature: Date:
MIMI®— SOURCE OF INCOME STATEMENT
Disclos a for Tax Year Ending Last Nam First Middy/Initial
Mailing Address—Str t NM Name P. B�xs
City, t Z. 2 1 r"ber
If your home address is your mailing address,and your home address is exempt from public records pursuant to Fla.Stat.§119.07, read
instructions on the following page and check here.
Filing as an[Employee
County Employee Municipal Employee, Name of Municipality:
Position held or sought
Department where employed
Work address Work telephone Term began on
Filing as a Board Member yy�
D-County Board Member Municipal Board Member, Name of Municipality: ��d/� ��ilrl
Board where servingI�
Work address Work telephone Term began on
List below every source of income you received,along with the address and the principal activity of each source. Include your public salary.Place
the sources of income in descending order,with the largest source first.Also, include any source of income received by another person for your
benefit. However,the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet,check here.
Name of Sou ce of Income Address Descri tion of the Principal Business Activity
F
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑Electronic Copy
Signa f person dis losing
Print me Date signed
Zj'
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 SP-14 2/13