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Gayle Durham 12.31.2017 MIAMI BEACH City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.Qov OFFICE OF THE CITY CLERK,Rafael Granado,City Clerk Tel:(305)673-7411,Fax:(305)673-7254 January 05, 2016 Ms. Gayle Durham 1455 West Ave. #804 Miami Beach, FL 33139 SUBJECT: LGBT Advisory Committee Dear Ms. Gayle Durham: Congratulations!You have been reappointed by Commissioner Michael Grieco to the above referenced, board or committee named above, for a term ending: 12/31/2017. 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 and good luck. Regards, . Rafael Granado City Clerk cc: Saul Frances, Parking Director Daphne Saba, 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 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. 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 TO: Ms. Gayle Durham RE: LGBT 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: 12/31/2017. 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. 676 Ms. Gayle Durham a� Sworn to and subscribed before me this )day of , 201p. 1•€ 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 are committed to providing excellent public service and safety to all who live, work and play in our vibrant,tropical,historic community. MIAMI•DADE COUNiY SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial 2014 � f)r /a 6Q y/� . Mailing Address—Street Number,Street Name,or P.D.Box / �LE5 c (A)es-f 4 ,e / -44 $ y City,State,Zip ID Number • (/'I r (e c-(„ / 3 1 3 4 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 a�an Frnployee 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 Work address Work telephone ITerm began on List below every source of income you received,aloha 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 d e( (+7 u- S e� '(c' s -c- - - �a l ��+,, �"i fis S is e,,,.pltye re -/1 Cv�►-. r affirm)that the information above is c' I RECEIVED BY ELECTIONS DEPARTMENT: I hereby swear(or aflrm�that the info.oration a�o��Is a true and correct statement. ❑ Hardcopy ./D • / ❑ Electronic Copy Signature of pe son disclosing Ie. �� w, �� aoib y I yr Print name Date signed OFFICE USE ONLY Accepted: Y i N Deficiency: Processed Date/Initials: Scanned Date/Initiais: 138_SP-14 2/13 Gayle Durham C(305) 812-5331 1455 West Avenuegayle@gayledurham.com Apt # 804 Miami Beach, FL 33139 Objective– I seek appointment to the City of Miami Beach Gay Lesbian Bisexual Transgender (GLBT)Committee Residence- I am a Miami Beach home owner since 2004 Employment History- I am employed in the computer wholesale distribution industry for twenty-four years Governmental and Civic Activities in Miami Beach Graduate of Citizen Police Academy, March 2014 Self Defense for Women class taught by Miami Beach Police Department, April 2014 City of Miami Beach Tennis Advisory Committee, 2013 Graduate of the City of Miami Beach Neighborhood Leadership Academy, 2009 Co-founder West Avenue Corridor Neighborhood Association,2012 to Present Co-Founder,Miami Beach Tennis Players Association, 2009 Created website documenting history of tennis in Miami Beach, www.mbtpa.net Field Worker for the United States Census Bureau, 2010 Volunteer at Sony Ericsson Tennis Tournament, Key Biscayne, 2010 As a resident appointed by the Miami Beach City Manager to serve on Evaluation Committee for Building Department enterprise software, 2010 As a resident appointed by the Miami Beach City Manager to serve on Evaluation Committee for construction of Flamingo Park Tennis Center, 2011 As a resident, appointed by the Miami Beach City Manager to serve on an Evaluation Committee for Local Area Network service, 2011 1 Gayle Durham C (305) 812-5331 1455 West Avenuegayle@gayledurham.com Apt # 804 Miami Beach, FL 33139 Memberships City of Miami Beach Tennis Center, 2006 to present Flamingo Tennis Center Round Robin Tennis Group, 2008 to present Miami Beach Tennis Players Association, Co-Founder , 2008 to present Miam Beach Women’sTennis League, 2010to present United States Tennis Association (USTA) Education M.A. International Studies, Fairleigh Dickinson University, NJ1988 B.A. Geography, State University of New York, Oneonta1985 High School Diploma, Ramapo High School, New Jersey1981 Date and Place of Birth –April 26, 1963, Jersey City, NJ 2 fir, r' r ' .� Is . IAi r 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) 6, ildW9 Board Member's Name: 7e 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: htto://www.miamidade.•ov/elections/Libra /source of income statement..df 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. )34 /016/.4 Signature Date Updated:Wednesday,April 09,2014 Page 4 of 4 F:\CLER\SALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx PMIAMIBEACH DIVERSITY STATISTICS REPORTING V Name: 6 a o A 71'7 Board / Committee: - dU/5ôf/ Z ,,,/i/e/ie c Appointment Date: //6/0, 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 IZJI Female' Race/Ethnic Categories What is your race? African-American/Black Caucasian/White Asian or Pacific Islander Ul 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,arNo La Yes Do you consider yourself Physically Disabled? !1 No 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