Robert Gonzalez 12.31.2016 M z EAC
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
January 11, 2016
Robert Gonzalez
2121 Lake Avenue
Miami Beach, FL 33140
SUBJECT: Parks and Recreational Facilities Board
Dear Robert Gonzalez:
Congratulations!You have been appointed by Commissioner Ricky Arriola to the agency, board or
committee named above for a term ending: 12/31/2016.
Pursuant to City of Miami Beach Code Section 2-22 (5)a,"Notwithstanding any other provision of the City
Code or of any resolution, commencing with terms beginning on or after January 1, 2007, the term of
every board member who is directly appointed by a member of the City Commission shall automatically
expire upon the latter of: December 31 of the year the appointing City Commissioner leaves office or
upon the appointment/election of the successor City Commission member."
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.
Regards,
•
afael Granado
City Clerk
cc: Saul Frances, Parking Director
Elizabeth Valera, 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
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
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.
MIAMIBEACH
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.dov
OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk
Tel:(305)673-7411,Fax:(305)673-7254
TO: Robert Gonzalez
RE: Parks and Recreational Facilities Board
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 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.
Al .1
Robert Gonzalez
Sworn to and subscribed before me this day of -3 , 201 j
Dep ty Clerk
uvrr ( r th4.
*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 are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical,historic community.
MlAM1•DADE SOURCE OF INCOME STATEMENT
7l hrtt
Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial
2014 CO Pv 1( 6.
Mailing Address—Street Number,Street Name,or P.O.Box
v-€ Nr) v-Q •
City,State,Zip ID Number
PrIeN(1 L-1,
If your home address is your mailing address, and your home address is exempt from public records pursuant to Ha.Stat.§119.07,read
instructions on the following page and check here.—
Filing a� an Er:Tpliiyee
n County Employee n 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 n Municipal Board Member, Name of Municipality: ffrtt eao- .
i Board where serving
rt<S 0'4 )2_,Q Cre_al/ipee( l /( . 6 r. /�
9 5 `aC
Work address Work telephone Term beoan on
List below every source of income you received,alono 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
¢1-m-k G Ste, e S /. r c 9 U0 a Os-k, ,Lta C t ose.�•� �e.�c e n�-E-`I
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
Hardcopy
I! ❑ Electronic Copy
_I
Sig dri7f person dish ng
W 0 Gan , 3
Print name Dat signed
OFFICE USE ONLY Accented: 'f i N Deficiency: Processed Datelln ials: Scanned D a-e/r i'i ais:
+3a S?-14 2/13
it i %'• i Y
! % 6 I I \1 `'\ r PAL C
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.m iamibeachfl.gov
CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov
Telephone: 305.673.741 1 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: gD 6 r Con zQ/ea
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, 1 700 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:
htto://unvw.miamidade.gov/elections/Library/source of income statement.odf
2. A "Statement of Financial Interests (Form 1)"
For your convenience, the form is attached. The form can also be downloaded at:
htto://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.
.11h■: 'VAL, - -3 t
Sig atur lirger Date
Updated:Wednesday,April 09,2014
Pace 4 of 4
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•
DIVERSITY STATISTICS REPORTING
Name: PviDariCCr..)Y) le z_
Board / Committee: Pa KV-4, 64 Le C,reitoni
Appointment Date: Id
7/ 1 / ‘12
•
Pursuant to City of Miami Beach Ordinance 2009-3632, the City is required to annually
prepare and present a report to the City Commission identifying the City's diversity
statistics. This form allows board and committee applicants and members to voluntarily
self-identify their race, ethnicity, disabled status and gender.
Please check the appropriate box for each category:
Gender: Male k4,- Female ll
Race/Ethnic Categories
•
What is your race?
Lji African-American/Black
•l Asian or Pacific Islander
1Z3 Native-American/American Indian
La Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No"box if not
Spanish, Hispanic, Latino/a.
0 No
JYes
Do you consider yourself Physically Disabled?
�t
!-mot No
0 Yes
C:\Users\CENTFraN\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\NP4J9CNX\BC minority
information form 05-20-13 FINAL.doc
Updated: Monday,January 26,2015