Dale Gratz 12/31/2014 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael Granado,City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
1/2/20114
Dale Gratz
215 E. San Marino Dr
Miami Beach, Florida 33139
SUBJECT• Committee on the Homeless
Congratulations! You have been reappointed by Commissioner Joy Malakoff
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.
Sincerely,
Rafael . Granado
City Clerk
cc: Saul Frances, Parking Director
Maria Ruiz
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.
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
TO Dale Gratz
RE: Committee on the Homeless
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.
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 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 on which I have served.
ec,4�D j2��
Dale G atz
Sworn to and subscribed before me this P-day of , 2013.
e °
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.
V\
N At\A 1 B EAC H 88 AIR D AN D G0,Vs.f,l T T EE A P P L C A T 10 N, FOR.,1
Last Name First Name Middle Initial
E/ 3,31,30Y
215-* Sat ma-llno fD,-. M-8/
Home Address City State Zip Code
S� 1e7 C, P,04-.�O cZ�fa
Home Telephone Work Telephone Cellular Telephone Email address
Business Name Occupation
Business Address City State Zip Code
Professional License (describe): Expires:
Please attach a copy of currently effective professional license.
Pursuant to City Code section 2-22(4)a & 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 minimum 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 0 or No ED
• Demonstrates ownership/interest in a business in Mi mi Beach for a minimum of six months: Yes ED or No,
• Are you a registered voter in Miami Beach: Yesr No.EZI
• I am now a resident of: North Beach South Beach 1-D-A Middle Beach 54' 0EP7"e Y'IQ,7 4�4 UVOq
• 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 or 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 by the City Clerk's Office.
❑Ad Hoc Charter Review and Revision Board ❑Debarment Committee ❑Miami Beach Human Rights Committee
❑Ad Hoc Committee Centennial Celebration ❑Design Review Board* ❑Miami Beach Sister Cities Program
❑Ad Hoc Committee Flooding Task Force ❑Disability Access Committee ❑Normandy Shores Local Government
Neighborhood Improvement
❑Affordable Housing Advisory Committee ❑Fine Arts Board ❑Parks and Recreation Facilities Board
❑Art in Public Places Committee ❑Gay, Lesbian,Bisexual and Transgender ❑Personnel Board
Enhancement Committee(GLBT
❑Beautification Committee ❑Golf Advisory Committee ❑Planning Board
❑Bicycle-Pedestrian Adviso Committee ❑Health Advisory Committee ❑Police Citizens Relations Committee
❑Board of Adjustment* ❑Health Facilities Authority Board ❑Production Industry Council
❑Budget Advisory Committee ❑Hispanic Affairs Committee ❑Safety Committee
❑Capital Improvements Projects Oversight ❑Historic Preservation Board ❑Single Family Residential Review Panel
Committee ,
Vtommittee on the Homeless ❑Housing Authority ❑Sustainabilit Committee
❑Committee for Quality Education in MB ❑Loan Review Committee ❑Tennis Advisory Committee
❑Community Development Advisory Committee ❑Marine Authority ❑Transportation and Parking Committee
❑Community Relations Board ❑Miami Beach Commission for Women ❑Visitor and Convention Authority
❑Convention Center Advisory Board ❑Miami Beach Cultural Arts Council ❑Youth Center Advisory Board
❑Waterfront Protection Committee
* Board members are required to file Form 1 —"Statement of Financial Interest"with the State.
If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) 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:
Type of Professional License License Number
License Issuance Date License Expiration Date
Page 1 of 4
F-.\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc
°O Note: If applying for Youth Center Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board:Yes No Dates of Service:
2. Present participation in Youth Center activities by your children:Yes EZI oEZI
If yes, please list below the names of your children,their ages and the programs in which they participate:
Child's name: Age: Program:
Child's name: Age: Program:
• Have you ever been convicted of a felony?Yes[ZI or No 00 If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach Code?Yes[ZI or Nooif yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money?Yes Ea or No 2-2 If yes,explain in detail:
• Are you currently serving on any City Board or Committee? es VorNoZllf yes,which board com ittee?
• In what organization(s)in the City of Miami Beach do you currently hold membership?
lu a -1 Q C�U n r i o -P S� i Ly® rr► le?
Name T Position
Name � i � �C 6Zen S .�P?
• List all properties owned or in which you have an interest within the City of Miami Beach:
• Are you now employed by the City of Miami Beach?Yes 0 or No
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have a parent ED, spouse 1—D- 1, child fD brother or sister who is
employed by the City of Miami Beach?Check all that apply.
If"Yes,"identify person(s)and 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 City diversity reporting requirements.
Gender: Male Female
Race/Ethnic Categories
What is your race?
Zt African-American/Black
aucasiaNWhite
ID Asian or Pacific Islander
El Native-American/American Indian
ED Other—Print Race:
Page 2 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No"box if not Spanish, Hispanic, Latino/a.
k No
Yes
Do you consider yourself Physically Disabled?
W No
El Yes
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:
• 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 the 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).
• Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open
government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most
meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities.
• Voting conflict—Form 8B is for use by any person serving at the county,city or other local level of government on an appointed or
elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies
who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes.
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 CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATUTES ACCORDINGLY."
Applicant's Signature Date Name of Applicant(PLEASE PRINT)
Received in the City Clerk's Office by
Name of Deputy Clerk Control No. Date
PLEASE REMEMBER TO ATTACH A CURRENT RESUME, PHOTOGRAPH AND A
COPY OF ANY APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
Page 3 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc
r a.
MIAMI
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/Committee Members for failure to comply with Miami-
Dade County Financial Disclosure Code Provision_Code Section 2-11.1(i) (2)
Board Member's Name: �� �'� z---�
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
Financial 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 they may have been recently appointed.
One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, no later than 12:00 noon of July 1, of each year.
1. A "Source of Income Statement"
For your convenience, the form is attached. The form can also be downloaded at:
http://www.miamidade..qov/elections/Library/source of income statement.pdf
2. A "Statement of Financial Interests (Form 1)"
For your convenience, the form is'attached. The form can also be downloaded at:
http://www.ethics.state.fl.us/ethics/forms.html
3. A Copy of your 2013 Federal Income Tax Return
Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, 60 days in jail or both.
Signature date
Updated: Monday,December 16,2013
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION 46 BOARDS 12-16-2013.doc
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MIAMF F_ SOURCE-OF INCOME STATEMENT �
i
Disclosure for Tax Year Ending Last game First Name Middle Name/Initial
L)rp)Ap
I
Mailing Address—Street Number,Street Name,or P.O.Box
City,State,Zip ID Number
If your home-address is-your-mailing-address,-and your home-address is-exempt-from public records-pursuant to-Fla.Stat.oiq.w,read
Instructions on the following page and check here,❑
I°ollnnn ne an 19mninume
❑County Employee ❑Municipal Employee,Marne of Municipality:
o-�a�iziae�«ei�ar�tiu�i[t
Department where employed
Work address work telephone Term began on
Filing as a Boawd rAe"aber
i
i
.❑County_Board-Member ❑_Municipal_hoard-Member,-Aaron Pf-Municipality:
Board where serving
'1710 —) le �S�
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 Source of Income Address Description of the Principal Business Activity
I hereby swear(or affirm)that the inforalatioii above is a ti'tae and correct stateniient, UcBaVEu BY ELEG-1 joiijS DLPATjTjv�ciR
❑Hardeopy
❑Electronic Copy
Signature of person disclosing
i L001
Print name Date signed
� l I
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Inifials;�_____ Scanned Date/initials: j
138_SP-14 2/13 -- 1
Dale Gratz /
-•- 215 E.San Marino Dr
Miami Beach Florida 33139
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, v^~.miamibeachf1.9ov
City Clerk's Office
Telephone: 305.673.7411 FAX: 305.673.7254
CityClerk @miamibeachfl.gov
Date: May 1, 2012
To: Members of City of Miami Beach Advisory Boards
Subject: Financial Disclosure - Section 2-11.1(i) (2) Code of Miami-Dade County
All Boards and Committees of the City of Miami Beach, including those of a purely advisory
nature, are required to comply the 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 2, 2012.
1. A"Source of Income Statement" (form attached), or
2. A "Statement of Financial Interests (Form1) (form attached), or
3. A Copy of the 2011 Federal Income Tax Returns
Failure to file, pursuant to the Miami-Dade County Code, may subject the person to a fine of no
more than $500, or 60 days in jail, or both.
Should there be any questions, please direct them to Ms. Silvia Prieto at (305) 673-7000 ext.
6269.
Rafael E. Granado
City Clerk
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About the Honorees
1 4A AMU
Jo Asmundsson Jane Gross _
Jo Asmundsson has been making a difference in Miami Beach Dedication to our community and long hours of volunteer
since she first arrived here 25 years ago. After leaving her native service are the reasons we are honoring Jane Dee Gross as a
England (where she was a CEO of 5 companies!), Jo has served Miami Beach "Woman worth Knowing". Jane relocated to
as board member and treasurer of the Miami Dade Gay & Lesbian Miami Beach in the early - 80's after a successful Corporate
Chamber of Commerce and remains an active member. She is Marketing Career in Connecticut to work on many historic
also a member of the board of Friends of the Miami Public Library preservation projects from the first Hotel Restoration on Ocean
System and actively helps them with their book sales each year. A Drive, the Carlyle Hotel, to the first nightclub project, Club Z
constant presence at Miami Beach's city hall, Jo was in her 5th (now Mansion) to the first commercial restoration and the
year serving as president of the Miami Beach Taxpayers 1939 H & S Kress Building at 12th street and Washington
Association and as co-chair of the governmental committee of the Avenue; met and married not yet Commissioner Saul Gross in
Miami Beach Chamber of Commerce when she resigned to run for the late 80's and gave birth to Jonathan in 1990. Anonymous
Miami Beach City commission. Among her proudest achievements benefit projects have always been Jane's favorites however,
is getting 3000 votes and coming in 3rd in the race where she was she regularly volunteers for a wide variety of civic
1 woman against 6 men. She has served on the board of WLRN organizations; Temple Beth Shalom, Daily Bread Food Bank,
(our local National Public Radio affiliate) for 3 years and hers is Community Partnership for the Homeless, New Life Family
one of the voices you hear in their on-air fundraising drives. Jo Shelter, American Cancer Society, WLRN Radio Reading
has also been a reader with WLRN's Radio Reading Service for 16 Services for the Blind, Miami Dade School System. She is a
years. Jo takes great pride in having worked on the gubernatorial Board member of People Acting for Community Together
campaigns of both Janet Reno and Bill McBride. Now, Jo serves (PACT), Miami Design Preservation League and the Miami
on the Miami Beach Community Development Corp. where she Beach Community Health Center. A favorite quote of Jane's
devotes her time and talent to supplying affordable housing in the is "Life is what happens to you when you're busy making other
City of Miami Beach. Jo sums up her philosophy by saying "I plans"John Lennon 1980.
usually go for people who've been given the wrong end of the
stick." We are proud to introduce you to Jo Assmundson, a kind, Merle Weiss
passionate, very funny woman - quite worth knowing. Merle Weiss might be the most photographed woman on
Miami Beach. She is a South Beach institution, original,
®ale Grata interesting and involved. She moved to Miami Beach in 1985
Ms. Gratz has lived in Miami Beach for over 40 years. She and her and has served on the boards of prominent organizations
husband have three children and five grandchildren. Ms. Gratz including the Miami Beach Cultural Arts Council, DASH,
received her degree from Sophie Newcomb College (today part of Miami Beach Fine Arts Board,Art Center South Florida, Miami
Tulane University) and spent several years as a social worker in Film Festival, Miami Gay and Lesbian Film Festival, Dade
New Orleans and Chicago. Throughout her 40 years on Miami Human Rights Foundation, and Miami Beach Art in Public
Beach, Ms. Gratz has never hesitated to give of herself to her Places. With her tough love attitude she gets things done. With
community. She began her volunteer efforts with the National glitz, glitter and glamour, she not only knows how to make
Council of Jewish Women and today is a lifetime member of that money for the groups she loves but she knows how to have
organization. She served as a Guardian Ad Litem for 11 years, fun. She has been on the events and/or planning committee
advocating on behalf of abused and neglected children. Dale has for several groups including Wolfsonian FIU Museum, Miami
volunteered in area public schools and served as a mentor for at- Light Project, Winter Party, Museum of Contemporary Art and
risk students. She has served on the Board of Trustees and the Dance for Life. In addition to her community involvement,
School Board for Temple Beth Sholom, in addition to volunteering Merle was a pioneer in the Miami Beach retail industry. She
in the synagogue's monthly "Feeding the Hungry" program for the opened Merle's Closet on Lincoln Road in 1990, when the
past 15 years. Eight years ago, Dale signed on as poll worker Road was deserted and people were afraid to venture there
earning minimum wage "to help make voting a more pleasant after dark. She was one of the catalysts that helped bring the
experience" for the citizens of Miami Beach. Also, Ms. Gratz is a Road back to life. She has also worked for Av-Med Health
long-time member of the Commission on the Status of Women Plan and Miami Dade county government. Married to Danny,
until she was recently "termed out". We were sorry to see her go - Merle is a proud mother of three sons and a grandmother of
but happy to honor her tonight. For Ms. Gratz is one of those five. Merle has always had an interest in others and believes
quiet, tireless worker bees. When told she would receive this in the power of individuals to change the world. You will see
award, she was shocked, overwhelmingly honored and most of all, Merle at all the best and most important events and
humble. "I've never done anything big or spectacular." However happenings. If you want to go places you need to know
her outlook on life sums it all up: "I've always felt fortunate in my Merle. With sparkle and dazzle and the moxie to get things
life and felt I had to give back in some way or I would not be able done Merle Weiss is not only a Woman Worth Knowing she is
to live with myself." a woman everyone wants to know.