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Mario Coryell 09/30/2014 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 02-28-2014 Mario Coryell 901 7th Street#2 Miami Beach, Florida 33139 � SUBJECT v� Fine Arts Board Congratulations! You have been appointed by Commissioner Jonah M. Wolfson to the agency, board or committee named above for a term ending: 9/30/2014. 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, Ra ael E. Granado 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, 2-458 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. "' 111111 SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/initial t1_21 �, -3 4�f f / ���� rLL_ � � l] Mailing Address—Street Number,Street Name,o0.0.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 A e�.vc-P Ts "fUC. Ri4i gc :5cr1 es v� TV 3 3 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 Print name Date signed OFFICE USE ONLY Accepted: Y / N Deficiency: °rocessed Date!Initia!s: Scanned Date/Initials: 138 SP-1" 2/13 y MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139, www.rniarnibeachfl.aov CITY CLERK Office CityClerk @rniamibeachfl.gov Tel:305.673.741 1 ,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 2-1 1.1(i) (2) Board Member name:. understand than no later than JULY i 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 complywith Miami-Dade County Disclosure Requirements. This means thatthe 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, 2010. 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 pet-son 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: