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Sabrina Cohen 12.31.2016 s ■ ® e ® 1915•2015 City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk @miamibeochfl.gov January 15, 2015 Sabrina Cohen 1800 Purdy Ave Miami Beach, Florida 33139 SUBJECT: Disability Access Committee Dear Sabrina, 'Congratulations! You have been reappointed by Commissioner Ed Tobin to the above referenced agency, board or committee for a term ending: 1213112016. 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. Regards, Rafael E. Granado City Clerk cc: Saul Frances, Parking Director Valeria Mejia 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 F:\CLER\BOARD AND COMMITTIES DATABASE\CLARA LA ROSA DOCS\Sabrina Cohen Reappointment Letter.Docx — ION.. INN. 0 a■11.■■IIIIIIIIII MI■IIIIIIM=IN■11■1111■1 1915•2015 MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk©miamibeachfl.gov TO: Sabrina Cohen RE: DISABILITY ACCESS 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 12.31.2016. I have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Code of Ethics Ordinance), as well as the Florida Commission on Ethics Guide to the Sunshine Amendment 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 the State'of Florida (depending on the board or committee on which I serve) on July 1, following the closing\of the calendar year on whch I have served. �., `' ''' () \ri C 0\itz A 1/%------- j 4,-----,,.. Sabrina Cohen Sworn to and subscribed before me this 4 5 day of : N V Olt( 2015. 2L ,a,_. ofac________ ! 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 Requirement. F:\CLER\BOARD AND COMMITTIES DATABASE\CLARA LA ROSA DOCS\SABRINA COHEN OATH.Docx MIAMIC SOURCE OF INCOME STATEMENT COUNTY Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 201 r.rkty v P :./(,I 1 Mailing Address—Street Number,StreetName,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 0 Municipal Board Member, Name of Municipality: Board where servi g AJ 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 AV Description of the Principal Business Activity . if �, , i ' /���� P� l -k. Ac-D7 Iyolo _ I he by swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: 111 Hardcopy ❑ Electronic Copy Signature of person disclosing l - 5. -elk ( iAI giL C 115 / Print name Da e signed OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138 SP-14 2/13 MIAMI BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.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) • ' � \ t , Board Member's Name: � Q.`'�\r I y `���1,� 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" 2. A "Statement of Financial Interests (Form 1)" 3. A Copy of your latest Federal Income Tax Return Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject th/e person to a fine of n \rnore than $500, 60 days in jail or both. / 5-7 / \\\4 it r Signatu�� Daie Updated:Tuesday,January 06,2015 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx