Anthony Broad 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
Email CityClerk @miamibeach.gov
12/20/2012
Anthony Broad
1750 West 24th Street
Miami Beach, Florida 33140
SQpnCT�A Debarment Committee
Congratulations! You have been reappointed by Commissioner Ed Tobin
to the above referenced agency, board or committee for a term ending: 12131/2014.
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,
1
R ael E. Granado
City Clerk
cc: Saul Frances, Parking Director
Alex Denis
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.miamibeachfi.gov
OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk
Tel: (305)673-7411, Fax: (305)673-7254
Email CityClerk @miomibeach.gov
TO Anthony Broad
RE: Debarment 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.
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 t; board or committe n which I serve)on
July 1, following the closing of the calendar year on whic av _se d.
A hony Broad
Sworn to and subscribed before me thisg day of 1, 201
L4_.C_
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 ore committed to providing excellent public service and safety to oil who live, work and play in our vibrant, tropical, historic community.
"'®°ADE SOURCE OF INCOME STATEMENT
0
Disclosure for Tax Year Ending Last Name First N me Middle Name/Initial
Mailing Address—Street Number,Street game,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
�6 ti
Work address Work telephone Term began
AJ IA- / ! /5
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
pro At//f
I hereby swear(or affirm)that the infor tion above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
Signature of person disclosing
a I
Print name D to sig d
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138 SP-14 2/13
A1\A i BEACH
city of Miami Beach,
1700 Convention Center Drive,
Miami Beach,Florida 33139,
www miamibeochfLAOV ,
CfTY CLERK Office CityClerkCmiarnibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
Acknowledgement of fines/suspension for Board Mem hers 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 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 or give advice to-the City Commission,-m ust-fiie,:even-though you may have.been
recently appointed.
You must file One ofthe following with the City Clerk of Miami Beach, 17.00 Convention
Center.Drive, Miami:Beach, Florida,.by.July 1 each:year..
-1. A"Source.of.Income.Statement" (attached)or
2. A"Financial Statements (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
Prevision, Section 'I-5 may subject the person or firm to a f ne not-to exceed
$500.00 or by imprisonment'in the county.jail for-a period not to exceed sixty
days, or.both.
Signature: Dat