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Beth Edwards 06.30.2016 MIAMI BEACH 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 August 10, 2015 Beth Edwards 5900 Collins Ave. # 1806 Miami Beach, FL 33140 SUBJECT: Committee for Quality Education in MB Congratulations! You have been appointed as a Representative of the PTA for Nautilus Middle School to the agency, board or committee named above for a term ending: 06/30/2016. If you are unable to accept this appointment or have any questions, please call the Office of the City Clerk at 305-673-7411. Please read the enclosed materials carefully. Congratulations again and good luck Sincerely, fael Gra ado ity Clerk cc: Saul Frances, Parking Director Leslie Rosenfeld, City Liaison 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 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 Employees We are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical,historic community. ®® mot " AcH -7 WIMMILIMMS 91 MIAMI BEACH City of Mi mi Beach,TI/00 Convent on Chive,ter Drive, Miami beach, oridam33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk CTO:l P -Ntin a L(M CkPg;5. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Emoil: CityClerk©miamibeochfl.gov TO: Beth Edwards RE: Committee for Quality Education in Miami Beach 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 one-year term ending 6/X/201 • 30 o 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 which I have served. 4/9 / 67o, )7/, Beth Edwards Sworn to and subscribed before me this L12 day of 2015. 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. We are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical,historic community. MIAMI•DADE COUNTY SOURCE OF INCOME STATEMENT Disclosu a far Tax Year-Ending Last me First Name Middle Name/Initial 2014 1 OM CSZ--0S Mailing Ada ---Street Number,Street Name,or P.O.Box 900 Co//ow City State,Zip ID Number (Wriq714 -er1C-k. rc S3/ 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.❑ FiIiing — _- _._ _ asan 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 _ F gereckCount Board Member Y Mu nicipal Board Member, Nam of Municipality; Board where serve e Work address work telephone ITerm began on I/fl n % /� S 1�f e Oo i 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 I Address Description of the Principal Business Activity -�VLS/CY? ( i s 1111 Li hereby swear(or affirm)t "t the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: Hardcopy + ❑ Electronic Copy 27?' A :gnat e f person closi niik)/02- io/i .S _I'll = J� ' , t'._i /tin Print name Date signed CS e I cQ d 0 Of I q164.7 OFFICE USE ONLY Accepted: Y ; N Deficiency: a mCe sse d Da.e/lriliaiJ: Sr2i n,ed D2te/i!4diS: 138 SP-1 2/13 EAC�� t I City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK'S OFFICE CityClerkCmiamibeachfl.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: I understand that no later than July 1, of each year all members of Boards and Committees of the City of Miami Beach, includingthose 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.pdf 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.html 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 ate Updated:Wednesday,April 09,2014 Page 4 of 4 F:ICLERISALL1aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx