Loading...
Allison Stone 12/31/2015 MIAMIBEACH 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 01-22-2014 Allison Stone 4775 Colins Avenue #1905 Miami Beach, Florida 33140 SUBJECT: Safety Committee Congratulations! You have been appointed by Commissioner Michael Grieco to the agency, board or committee named above for a term ending: 12/31/2015. Pursuant to Ordinance No. 2006-3543, commencing with terms beginning on or after January 1, 2007, the term of board members who are directly appointed by a member of the City Commission shall automatically expire on December 31 of the year the appointing elected official leaves office. If you are unable to accept this appointment or have any questions, please call the City Clerk's Office at 305-673-7411. Please read the enclosed materials carefully. Congratulations again and good luck. Sincerely, 1 i t Rafael E. Granado 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, 2-458 and 2-459 Ordinance No. 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 Employee We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,historic community. MIA/01BEACH 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 TO: Allison L. Stone RE: Safety Committee 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 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 Florida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public Officers andunderstand 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 st, following the closing of the calendar year on which have served. Allison L. Stone Sworn to and subscribed before me this c�g day of �yi , 2014 %. AT_� 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 Requirements. We are cor i� t?f'} �'�@jft fli�fl� eE'Gi ` `� W14H6t4e,,W&k,& Ay ifs&r,4"nf;IWIC�1,5ttri�t6FE '6WiV77unity. R MIA/V\1 MIAMI�y rwi �yqy BEACH CITY OF MIAMI BEF'iCi� IOARD AND L.sO1MITTEE APPLICATION FORM NAME: Stone Allison L Last Name First Name Middle Initial HOME ADDRESS: 4775 Collins Avenue#1905 Miami Beach FL 33140 Apt No. Home No./Street City State Zip Code PHONE: 305-725-5283 N/A N/A loristar22 @me.com Home Work Fax Email Address Business Name: Allison Stone,Esq. Position: Attorney Address: 4775 Collins Avenue#1905 Miami Beach FL 33140 Street City State Zip Code 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 minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six(6)months Yes • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six(6)months: Yes •Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Attorney for over ten years. I have been a business owner in Miami Beach for several decades and have lived in Miami Beach f •Are you presently a registered lobbyist with the City of Miami Beach? 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.(Regular Boards of City) Choice 1: Safety Committee Choice 2: Bicycle-Pedestrian Facilities Advisory Committee Choice 3: Debarment Committee Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: No Years of Service: N/A 2. Present participation in Youth Center activities by your children No if yes, please list the names of your children,their ages,and which programs. List below: • Have you ever been convicted of a felony: No If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach codes: No If yes, please explain in detail: • Do you currently owe the City of Money Beach any money: No If yes, please explain in detail: •Are you currently serving on any City Boards or Committees: No If yes,which board? •What organizations in the City of Miami Beach do you currently hold membership in? • List all properties owned or have an interest in,which are located within the City of Miami Beach: _....................... ........ ..................................................................................... Property G _....:. .._.M.:k...:.... r.,:...::.:.......:.M :.:..w.w N:.:.w _..M...:.:.. .., ..H H G :615 5th Street Corp. LLC f . I zfm now employed by the city of Miami Beach: No Which department? N/A 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: Female Race/Ethnic Categories What is your race?Mark one or more races to indicate what you consider yourself to be. White Other Description: N/A Are you Spanish/Hispanic/Latino? Mark the "No" box if not Spanish/Hispanic/Latino. No Physically Challenged: No 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: o Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459). o Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1). o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office(Miami Beach Code section 2-26). o 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." I Allison Stone agreed to the following terms on 12/26/2013 9: :23 PM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date MIAWUM40E SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial t)o'Ve 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.§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 Description of the Principal Business Activity accA co L s+o,.,e, z#I75 Co 111,17s v S0s d I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT. ❑ Hardcopy ❑ Electronic Copy Signature of person disclosing zfy/ O'-7 '5k nom. Print name Date igned OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138 SP-14 2/13 AA I ANA I BE AC H City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139, HrN,v.miamibecch9.cov CFY CLERK Office CityCierlc�micmibeechfl.gov i el:3 05.673.7411 ,Fax:305.673.7251 Acknowledgement of fines/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. 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 orgive advice to the City Commission,mustfile,even though you mayhave been recently appointed. You must file one of the follaArIng with the City Cleric of Miami Beach, 1700 Convention Center Drive; Miami Beach, Florida, by July 1. Q1 1. A`Source of Income Statement(attached) or 2. A"Financial Statement(a�Lached( or] 3. A Copy of the person's current Federal Income Tax Return Failure to file, according to the Nfiami-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 sixty days, or both. Signature: Date: