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David Doebler 12/31/2015 ` City of Miami Beach,. 1700 Convention Center omm'Miami eeoc6' Florida 33139, OFFICE Op THE CITY CLERK, Rafael Gmnodo,City Clerk Tel: (305) 673-7411, Fox: (3O5) 673-7254 1/2/2014 David [)o2bler 33O\/eDiti@M Way #66 Miami Beach, Florida 33139 Sustainability Committee Congratulations! You have been reappointed bv Commissioner Micky Steinberg to the above referenced agency, board or committee for a term ending: 12/31C2015. If you are unable to accept this oppointrnent, please notify the City Clerk's Office at (3O5) 873-7411. Please read the enclosed material carefully. Again, congratulations and good luck. S)DO8nel L~~^ R ael E. Gr@D@dO City Clerk cc: Saul Frances, Parking Director Elizabeth Wheaton ATTACHMENTS: Letter ofAppointment Oath City Coda Ordinance aeotion, applicable to ogenoy, board or committee City Code Section 2'22. 2-23. 2_24. 2-25. 2-20. 2-2458. 2-45B Ordinance 2OO8'3543-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 '(Perking Department Form) Booklet-Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We are committed to pmw6me excellent public service and safety to o8 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.miamibeachfi.gov OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk Tel:(305)673-7411,Fax:(305)673-7254 TO David J. Doebler RE: Sustainability 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: 12/31/2015. 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 is -.I-have s avid J. Doebler Sworn to and subscribed before me this `7 day of N VM-1014. Silvia Prieto Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfi.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. A 1 A f /"ol"V k� bh L rl / V ,, A( City of Miami Beech, 1700 Ccnvamion Cent-er Drive, Wcmi 6eccn,Ficridc 3 313 9, `N`MN.miC�'t l�`cCCn7.CG`/ CiIY CLERK OFiC� CiyClerl<`micmibeccn7.go� -e!:30q.673.7A i 1 ,rcx:305.673.725 ' Acknowledgement of fine=/suspension for Board Members for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-1 1 .1(i) (2) Board Member name: undertand that no later than .DULY 1 OF EACH YEAR ail rn rnbers of Boards and Committees of the City; of Miami Beach, including those of a purely advisory nature, a;c r-equire=d to complyviith Miami-Dade County Disclosure Requir:.ments. ►his means thatth e rn.mb�rs Of Clt;!r.dvisory Boards, vi hose- sole- or primary responsibility is to recommend le.gis[ation o r give advice to the Ci�y Commission; must illy,even though you may'r�ave begin rc�ntly appointed. YOU Must file onl of the folloviing with the City Clerk\ of Miami B:,ach, 1700 0cnye_ntla h Centee r jDrlve. I`'v`�lami Beach. FIar ida1 Dy�:'ly 1,. 2010. 1. A`'Source of Income Statement(ai-Cached) or %. inancial Statement(EU_=shed(orl 3. ;"Copy of the parson's current F:.deral income ►ax Return Failure to file, according to the Nflarni-Dade County Code Chapter 1, General Provision, Section 1-5 may subject the per son or firm to a fine not to Exceed 5500.00 or, by imprisonment in the county jail for a period not to exceed sixty days, or both. �'gnature: Dot;,: "'I®°� SE SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Na a First Name Middle Name/Initial �rA '0z Mailing Address—Street Number,Street Name,or P.O.Box 33 G Vey-/c,In City,State,Zip ID Number yV l ` ; 63 L G!—i! (� 3 3 134 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 ❑ County Board Member Municipal Board Member, Name of Municipality: Board where serving 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 RtWiption of the Principal Business Activity (,S C tr1CA J YS�rn� t3y� t14 5-T sArn('LC 2D 330Lc4 5�5CU(L/PA P-)tr& I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy Sign of person cl 0 0 Print name Date signed OFFICE USE ONLY Accept;d: Y / N Oeficiency: Processed Date/lnitials: Scanned Darr/Initials: 13g-SP-14 2/13