Michael DeFelippi 12/31/2014 ,1`0 1 A NA� I B E A C H
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
05-15-2014
Michael DeFilippi
1111 Lincoln Rd. Ste., 400
Miami Beach, Florida 33139
SUBJECT i`# Sustainability Committee
Congratulations! You have been appointed by Commissioner Ed Tobin
to the agency, board or committee named above for a term ending: 12/3112014.
- -----Pursu'ant-to- rdinarnce-No.--2006=3543,—commencing with terms beginning on or a ter---- ---------
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. Granado
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 Michael Defilippi
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: 12/31/2014.
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 the board or committee on which I serve) on
July 1, following the closing of the calendar year on which I have served.
�2ea a U44i
Mic hael filippi
Sworn to and subscribed before me this/ gq �
� day of /''`�1 , 201
' a
Silvia Prieto
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.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.
MIAMI BEACH, BOARD AND COMMITTEE APPLICATION FORM
/ �J / .
C q
Last Name First Name, Middle Initial
Home Address City State Zip Code
Ads &lael
P rwJ,-e,,A
Home Telephone Work Telephone Cellular Telephone Email address
ee-t
Business Name Occupation
Business Address City State Zip Code
Professional License(describe): Expires:
Please attach a copy of currently effective professional license.
Pursuant to City Code section 2-22(4)a&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 for a minimum of six months.
• Resident of Miami Beach for a minimum of six(6) months: Yes or No
• Demonstrates ownership/interest in a business ins Mia pi Beach for a minimum of six months: Yes�D or No�
• Are you a registered voter in Miami Beach: Yes or No I.-D .
• I am now a resident of: North Beach IZI South Beach Middle Beach ID
• I am applying fora ap ointment because I have special abilities, knowledge and experience. Please list below:
��Upon�►,��-� ct f e h v
• Are you presently a registered lobbyist with the City of Miami Beach?Yes or 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.
❑Ad Hoc Charter Review and Revision Board ❑Disability Access Committee ❑Miami Beach Human Rights Committee
❑Ad Hoc Committee Centennial Celebration ❑Gay, Lesbian, Bisexual and Transgender ❑Miami Beach Sister Cities Program
Enhancement Committee(GLBT)
❑Affordable Housing Advisory Committee ❑Health Advisory Committee ❑Normandy Shores Local Government
Neighborhood improvement
❑Art in Public Places Committee ❑Health Facilities Authority Board ❑Parks and Recreation Facilities Board
❑Board of Ad'ustment* ❑Hispanic Affairs Committee ❑Personnel Board
❑Budget Advisory Committee ❑Historic Preservation Board ❑Planning Board
❑Committee on the Homeless ❑Housing Authority ❑Police Citizens Relations Committee
❑Committee for Quality Education in MB ❑Marine&Waterfront Protection Authority ❑ProdUafion Industry Council
❑Convention Center Advisory Board ❑Miami Beach Commission for Women 9-600-stainability Committee
❑Design Review Board* ❑Miami Beach Cultural Arts Council ❑Transportation,Parking,&Bicycle-Pedestrian
Facilities Committee
❑Visitor and Convention Authority
* Board members are required to file Form 1 —"Statement of Financial Interest"with the State.
{If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review
Board, Historic Preservation Board or Planning Board, attach a copy of your currently-effectively license, and furnish the
following information:
Type of Professional License License Number
License Issuance Date License Expiration Date
Page 1 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx i
°O Note: If applying for Youth Center Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: Yes No Dates of Service:
2. Present participation in Youth Center activities by your children:Yes Z3 No
If yes, please list below the names of your children,their ages and the programs in which they participate:
Child's name: Age: Program:
Child's name: Age: Program:
• Have you ever been convicted of a felony?Yes or No If yes, please explain in detail:
• Do you currently have a violation(s)of City of Miami Beach Code?Yes Q or No If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money?Yes Z!or No Ur"If yes, explain in detail:.
•Are you currently serving on any City Board or Committee?Yes Q or No If yes,which board/committee?
• In what organization(s) in the City of Miami Beach do you currently hold membership?
Name Position
Name Position
• List all properties owned or in which you have an interest within the City of Miami Beach:
•Are you now employed by the City of Miami Beach?Yes 1-:3 or No
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have a parent �, spouse �, child brother or sister . I who is
employed by the City of Miami Beach?Check all that apply.
If"Yes,"identify person(s)and department(s):
The following informationjis information ' voluntary and is neither part of your application nor has any bearing on your consideration for
appointment. It is bein sked to comply with City diversity reporting requirements.
Gender: Male Female
Race/Ethnic Categories
What is your race?
ZI 9 fr* n-American/Black
Caucasian/White
Asian or Pacific Islander
Native-American/American Indian
Other—Print Race:
Page 2 of 4
F:\CLER\$ALL\aFORMS\BOARD.AND COMMITTEES\BC APPLICATION REVISED.docx
Do you consider yourself to be Spanish, Hispanic or Latino/a?Mark the "No"box if not Spanish, Hispanic, Latino/a.
No
Yes
Z Do;No ou con ourself Physically Disabled?
Yes
NOTE: IF APPOINTED, YOU WILL.BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE
MEMBERS.THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO:
• 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 the board/committee you have served on for period of one year after leaving office (Miami Beach
City Code section 2-26).
• Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
• 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).
• Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open
government can be found in Chaoter 286 of the Florida Statutes. These statutes establish a basic right of access to most
meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities.
• Voting conflict—Form 8B is for use by any person serving at the county, city or other local-level of government on an appointed or
elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies
who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes.
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 I HAVE RECEIVED, READ AND.
WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR
CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND
STATUTES ACCORDINGLY."
�4 �6 ?�;
s
Applicant's Signature ate ame of plicant(PLEASE PRINT)
Received in the City Clerk's Office by:
Name of Deputy Clerk Control No. Vate
PLEASE REMEMBER TO ATTACH A CURRENT RESUME, PHOTOGRAPH AND A
COPY OF ANY APPLICABLE PROFESSIONAL LICENSE.
ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED
INFORMATION.
Page 3 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx
4:00:07 PM 5/15/2014
Liaenseel.Details -
Licensee Information
Name: DEFILIPPI, MICHAEL (Primary Name)
'(DBA Name) -
M_ ain-Address: 410 EUCLID AVE _ 1
#6
MIAMI BEACH Florida 33139
County: DADE
License Mailing:-11:. _
UcenseLocation 1111 LINCOLN RD: --
_ - SUITE 400
MIAMI BEACH FL-!'33139 `
County: DADE ..
License Information
License Type: Real Estate.Broker or Sales
Rank: es" As'socibte
Ass
_...License Number:_ SL3228773 _
Status: Current Active
Licensure Date: 12/0912009
Expires: 09/3012015
Special Qualifications Qualification-Effective
. r
View Related License Information
View License Complaint '
- .. - _ _ - .__, no+<eosooa ..,a•oe. o - -;c. .. _ . „o uc,. . _5: �e�'.._ r _ -
1940 North Monroe Street,Tallahassee FL 32399 :: Email Customer Contact Center:: Customer.Contact Center:850.487.1395
The State. .of Florida.is an AA/EEO employer.Copyright 2007-2010 State of Florida.Privacv Statement
Under Florida law;email addresses are'public records.If you do not want your email-address released in response to a public-records
request,do.not°send electronic mail to this entity.Instead,contact.the office,by,'phone or by traditional mail.If-you have any
questions,please con ta'cto,85 0.487:1395.*Pursuant to Section 455.275(1);Florida.Statutes,effective October,'1,-2012,licensees
licensed under Chapter 455,KS.must provide the Department with an email address if they have'one:The erriails provided may be
used for official communication with the licensee.'However email addresses are public record.If.you do not wish to supply,a personal
address,please provide the Department with an email'address which'can be made'available'to the public..;Please see our-Chapter
455 page to determine if you are affected by-this change.
h .xc Y
°'gem� a
' # G
Tint J ..
i
' IAM11-DE SOURCE OF INCOME STATEMENT
,
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
Mailing Address—Street Number,St eet 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.F]
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 k"z/
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 Descri ion of the Principal Business Activity
F -7--4 A�
Lfe,e
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
4) e
h/
4
J
Print name Oate signed
OFFICE USE ON!Y Accepi._d: Y / !! J !c�-r:.cy_ Pr D e,'Ir.i ia!s: SCc� Ca ; ,s:
13& SP 2/1_
r
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfi.gov
CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
_Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
Board Member's Name: Do /A-
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
Financial 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, must file, even
though they may have been recently appointed.
One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida, no later than-12:00 noon of July 1,-of each year.-
1. A "Source of Income Statement"
For your convenience, the form is attached. The form can also be downloaded at:
http://www.miamidade.gov/elections/Library/source of income statement.pd
2. A "Statement of Financial Interests (Form 1)"
For your convenience, the form is attached. The form can also be downloaded at:
http://www.ethics.state.fl.us/ethics/forms.htmI
3. A Copy of your 2013 Federal Income Tax Return
Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, 60 days in jail or both.
Signature Date
i
Updated:Thursday,March 13,2014
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEESW APPLICATION REVISED.docx