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Susan Hart 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 01-21-2014 Susan Hart 5121 North Bay Road Miami Beach, Florida 33140 SUBJECT Sustainability Committee Congratulations! You have been appointed by Mayor Philip Levine 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, Rafael E. Gr nado City Clerk cc: Saul Frances, Parking Director Elizabeth Wheaton 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. 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 Susan W. Hart 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. 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, a board or committee on w i I erve)on July 1, following the closing of the calendar year on whic I ave se.rved. usan W. Hart Sworn to and subscribed before me this day of, , 2014. d 7 Maria E. Martinez Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Comm Requirement for additional information regarding the Financial Disclosure Re q We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,historic community. ® CITY OF MIAMI BEACH NAIAMI BOARD AND COMMITTEE APPLICATION FORM NAME: Hart Susan W Last Name First Name Middle Initial HOME ADDRESS: 5121 North Bay Road Miami Beach FL 33140 Apt No. Home No./Street City State Zip Code PHONE: 3058659231 wendy.hart@me.com Home Work Fax Email Address Business Name: Position: Address: Miami Beach FL 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: No •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: Worked in development in Miami Beach 1991-2003.Taking coursework in Climate Change/Sustainable Development. •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: Sustainability Committee Choice 2: Choice 3: 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: 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 Miami 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? ..........................................................................................._..._...._.._................................_......_.........., Name "Title ITemple Beth Sholom ,Member • List all properties owned or have an interest in,which are located within the City of Miami Beach: Property :5121 North Bay Road, Miami Beach, FL 33140 • I am now employed by the city of Miami Beach: No Which department? 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: 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: • 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 board/committee you have served on for period of one year after leaving office(Miami Beach Code section 2-26). • 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 Susan Hart agreed to the following terms on 1/19/2014 4:58:15 Received in the City Clerk's Office by: l r Name of Deputy Clerk Control No. Date Wendy Hart 5121 North Bay Road Miami Beach, FL 33140 Employment History: American Friends of Jamaica Board Director/Florida Gala Chair—Charity that raises Present money for education, healthcare and economic development in Jamaica. Gelber for Senate Campaign Service Projects/Field Director 2009-2010 OFA Data Specialist—Field Office for Obama Campaign 2006-2008 Backup Consultant in the field of hospitality, real estate and small 2003 —2006 business consulting. Island Outpost Ltd Vice President of Development and Business Affairs for Miami Beach, FL this pioneering boutique hotel company. 1991- 2003: Worked in various positions in finance, marketing and development as the company added properties in South Beach, the Bahamas and Jamaica. Becton Dickinson Product Manager—Latin America and the Caribbean Franklin Lakes,NJ Product Manager for Fortune 500 medical 1989-1990: products company. Bank of Nova Scotia Analyst NY,NY 1988 - 1989 BATCO Associate Kingston, Jamaica Contract administration and negotiation for government's 1983-1986 commercial arm for the bauxite and alumina sector. Academic Background: Columbia University Masters in Business Administration NY,NY Major in Finance 1986-1988 Christ's College Bachelor.of Arts Law Cambridge University Cambridge, England 1980-1983 ` IAMI- E SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/initial Mailing Address—Street Number,Street Name,or P.O.Box City,State,Zip ID Number A W1 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 Count Board Member )(M unici al Board Member Name of Munici ality.❑ y p � p 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 v I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: i ❑ Hardcopy �' ❑Electronic Copy i' Signature of person disclosing Print name D t sig ed OFFICE USE ONLY Accepted: Y/ N De iciency: Processed Date/Initials: Scanned Date/Initials; 138 SP-1 2/13 v � ' � K -""H to E v City of Micmi Secch, 1700 CcnvenIHcn Cen er Drive, NVani Beach,Flcrida 33 139, .•r�.v.n ian i^,eccn 7.ccV CI IY CLERK Office CiyClerC`r ricmibeacn'l.gcv Tel:305.673.7"1 i ,Fax:305.673.723 Acknowledgement of fines/suspension for Board Members for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-11 .1(i) (2) Board-Member name: - -- -S - - -.. - understand tnat no later than JULY 1 OF EACH YEAR cil 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 Ciy Advisory Boards, whose sole or primary responsibility is to recommend legislation or give advice to the City Commission,mus rile,even though you may have been recently appointed. �. 1 700 �(OU C�i'iUSt i[�e On° of the follc�,ving �.vrn the Ci ,� Cler'•: of N!iaml Beach, i r I�; r ti r r C�nven�on Center Crive, "'liami Bea�h: Florida, b i J.�ly i, 201 0. "Source of Income Statement(a«ached) or %. A FF inancial Staterment(aL ache-d( orj 3. Copy of the person's current Federal Income Tax Return Failure to file, according to the rViami-Dade County Cod: Chapter 1, General Provision, Section 1-5 may subject the person or firm to a fine not to exceed X500.00 or by imprisonment in the county jail for a period not to exceed sixty days, or both. 1 i Z 7 Jla rf<ore: Dct