Keren Bajaroff 12.31.2016 MIAMI BEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.aov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
01-16-2015
Keren Bajaroff
5500 Collins Ave. #1802
Miami Beach, Florida 33140
' UBJEtTII Affordable Housing Advisory Committee
Congratulations! You have been appointed by Commissioner Ed Tobin
to the agency, board or committee named above for a term ending: 12/31/2016.
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
Richard Bowman
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.miamibeachfl.aov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Keren Bajaroff
RE: Affordable Housing Advisory 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 Interest
• and 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 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 1st, following the closing of the calendar year on which I
have served. l
1
0 / ! CO r frf
Keren Bajaroff
Sworn to and subscribed before me this \ day of Gt . , 2015
•
/ e
Silvia Prieto
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 Requirements.
We arecommitted to p,rovidinaaexcellentRublIc service an�safety to all wl�o live, work anti play in our vibrant,trppicfal historic Community.
e are committc to prov rnp exce e t pu ic:service an sae o alfwho eve, wor, an p o y in our vi rant, tro Ica, us oric commune
fMIAMMaADE SOURCE OF INCOME STATEMENT
COUNTY
Disclosure for Tax Year Ending Last Na First Name Middle Name/Initial
201 4 J4 _f) • ik2�
Mailing Address— treet Number,Street Name,or P.O.Box
)C dr-
City,State,Zip ID Number
ICI 01A/11 Ems. 3 3 )
9l
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
/917a-Pgi 4C//11/7 19 '/ ?/ .
Work address Work telephone Ter began on
j-3co S��s�+ r ou � Jr a--3 QsL-i-Ga6--O t i l 1 16 115- .
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
fc 'c
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
Signat re.person disclosing /
kere A -g 4-3-Pi- ( (lb l l5
Print name Date 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)
Board Member's Name: kii c i
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 the person to a fine
of no more than $500, 60 days in jail or both.
Signature / Date
Updated:Tuesday,January 06,2015
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