Allison Stone 12/31/2018 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
March 06, 2017
Ms.Allison Stone
4775 Collins Avenue#1905
Miami Beach, Florida 33140
SUBJECT: Affordable Housing Advisory Committee
Dear Ms.Allison Stone:
Congratulations!You have been appointed by the City Commission to the agency, board or committee
named above for a term ending: 12/31/2018.
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
Richard Bowman, 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.
/v\ iAMBEACH
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: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
TO: Ms.Allison Stone
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: 12/31/2018.
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.
...A1251v.‘e
Ms.Allison Stone
f4
Sworn to and subscribed before me this T day of Ar , 2017
Ramon Quezada
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.
f\A I Atv\I B EAS, CITY OF MIAMI BEACH
r -- BOARD AND COMMITTEE APPLICATION FORM
NAME: Stone Allison L
Last Name First Name Middle Initial
HOME ADDRESS: 4775 Collins Avenue#1905 Miami Beach Florida 33140
Apt No. Home No./Street City State Zip Code
PHONE: (305)725-5283 none loristar22@me.com
Home Work Email Address
Business Name: none Position: attorney
Address: 4775 Collins Avenue#1905 Miami Beach FL 33140
Street City State Zip Code
Pursuant to City Code section 2-22(4)a and b: Members of agencies,boards,and committees shall be affiliated with the city;this
requirement shall be fulfilled in the following ways:a)an individual shall have been a resident of the city for a minimum of six
months;or b)an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city.
• Resident of Miami Beach for a minimum of six(6)months Yes
• Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six(6)months: Yes
•Are you a registered voter in Miami Beach: Yes
• (Please circle one): I am now a resident of: Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
Attorney
•Are you presently a registered lobbyist with the City of Miami Beach? No
Please list your preferences in order of ranking[1]first choice[2]second choice,and[3]third choice. Please note that only three(3)
choices will be observed by the City Clerk's Office. (Regular Boards of City)
Choice 1: Affordable Housing Advisory Committee
Choice 2: Police/Citizens Relations Committee
Choice 3: Health Facilities Authority Board
Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center:
1. Past service on the Youth Center Advisory Board: No Years of Service:
2. Present participation in Youth Center activities by your children No if yes, please list the names of your children,their
ages,and which programs. List below:
Child Name Age Program
• Have you ever been convicted of a felony: 4444 If yes,please explain in detail:
Nitor
•
• Do you currently have a violation(s)of City of Miami Beach codes: No If yes, please explain in detail:
• Do you currently owe the City of Miami Beach any money: No If yes,please explain in detail:
•Are you currently serving on any City Boards or Committees: Yes If yes,which board?
Affordable Housing Advisory Committee
•What organizations in the City of Miami Beach do you currently hold membership in?
• List all properties owned or have an interest in,which are located within the City of Miami Beach:
Property
615 5th StreetMiami Beach, FL 33139615 5th Street Corp.LLC
4775 Collins Avenue#1905Miami Beach, FL 33140
• I am now employed by the city of Miami Beach: No Which department?
The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is
being asked to comply with federal equal opportunity reporting requirements.
Gender: Female
Race/Ethnic Categories
What is your race?Mark one or more races to indicate what you consider yourself to be. White
Other Description:
Are you Spanish/Hispanic/Latino? Mark the"No"box if not Spanish/Hispanic/Latino. No
Physically Challenged: No
NOTE: If appointed,you will be required to follow certain laws which apply to city board/committee members.
These laws include,but are not limited to,the following:
o Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459).
o Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1).
o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office(Miami
Beach Code section 2-26).
o Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1).
(re:CMB Community Development Advisory Committee): prohibition,during tenure and for one year after leaving office,
from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself,
or those with whom you have business or immediate family ties(CFR 570.611).
Upon request,copies of these laws may be obtained from the City Clerk.
"I hereby attest to the accuracy and truthfulness of the application and have received,read and will abide by Chapter 2,Article
VII—of the City Code"Standards of Conduct for City Officers,Employees and Agency Members."
I Allison Stone agreed to the following terms on 11/2/2016 1:45:33 PM
Received in the City Clerk's Office by: 4,1 /A //
Name of Deputy Clerk Control No. Date
ALLISON LORI STONE,ESQ.
4775 COLLINS AVENUE APARTMENT 1905 MIAMI BEACH, FL 33140
Phone: (305)725-5283 E-mail: loristar22@me.com
LEGAL EXPERIENCE:
ALLISON STONE,ESQ.,Miami,Florida
April 2010-Present
MILLENNIUM MANAGEMENT,LLC,Miami,Florida
General Counsel,July 2008—April 2010
Responsible for all legal and risk management affairs for more than 22 skilled nursing facilities in Florida, South
Carolina and North Carolina.
Liaison between Federal and State governmental entities including CMS, AHCA, and various licensure boards and
investigative agencies.
Engage,supervise and assist outside counsel with respect to various litigation and corporate matters.
Arbitration of labor claims and client representation at union grievance sessions.
LESER,HUNTER,TAUBMAN&TAUBMAN,Miami Beach,Florida
Associate,January 2008—July 2008
Draft and negotiate various corporate documents, including real estate agreements, contracts for the sale of
intellectual property,and corporate governance agreements.
Audit websites and draft privacy policies to ensure compliance with Federal and State laws,rules and regulations.
TRI-STATE HEALTH INVESTORS,LLC,Miami Beach,Florida
General Counsel,March 2004—August 2007
Responsible for all legal and risk management affairs for 11 skilled nursing facilities in six states. Liaison between
Federal and State governmental entities including CMS, AHCA, and various licensure boards and investigative
agencies.
Engage, supervise and assist outside counsel with respect to various litigation and corporate matters. Represented
client on a variety of real estate matters including purchase acquisitions and leases, eviction proceedings, code
enforcement hearings and zoning matters.
KUBICKI DRAPER,Miami,Florida
Associate,Appellate Division February 2003—January 2004
Research and draft appellate briefs.
Provide insurance coverage analysis to insurers for specific incidents.
Research and draft memorandums of law and motions for litigation attorneys within the firm.
THIRD DISTRICT COURT OF APPEALS,Miami,Florida
Law Clerk, The Honorable David M Gersten,July 2002—January 2003
EDUCATION:
UNIVERSITY OF MIAMI SCHOOL OF LAW,Coral Gables,Florida
Juris Doctor,December 2001
Honors: Dean's List, Phi Delta Phi Legal Fraternity, Alpha Epsilon Lambda Graduate Honor
Society, Dean's Certificate of Achievement for Outstanding Academic Performance (Contracts,
Professor R.Hausler).
UNIVERSITY OF MIAMI,Coral Gables,Florida
Bachelor of Arts,May 1998
Honors: Recipient of numerous scholarships and academic and civic awards.
BAR ADMISSIONS: Florida,2002
VOLUNTEER WORK AND AWARDS: Volunteer, Mt. Sinai Medical Center (2006-2007); Volunteer, Miami
Heart Institute(2006—2007);Volunteer,Jewish Community Services Meal Center(2006-2007);Attorney Position,
City of Miami Beach Health Facilities Authority Board (2006-2013); Member, Young Leadership Division and
Volunteer, Volunteer Chai Lifeline (2004 — Present); Member, Young Professionals Committee, Greater Miami
Jewish Federation(2003-2004).Recipient,Chai Lifeline Young Leadership Initiative Award(2010).
Page 1 of 1
Allison Lori Star Stone
Member in Good Standing
Bar Number: 558001
Mail Address: 4775 Collins Ave Apt 1905
Miami Beach,FL 33140-3265
United States
Office:305-373-2010
Email: loristar22@me com
Personal Bar URL: www.floridabanorg/mybarprofile/558001
vCard: kO
County: Miami-Dade
Circuit: 11
Admitted: 05/07/2002
10-Year Discipline History: None
Law School: University of Miami School of Law,2001
Services: Civil Law Notary
.„,
http://employee/BACAdmin/Home/GetFile/24/842 11/3/2016
COUNTYSOURCE OF INCOME STATEMENT
Section 2-11.1(i)of the County Ethics Code requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July 1st
of every year.
Disclosure for Tax Year Ending Last Name First Nae, Middle Name/Initial
2016 /U i1 Vigo1,-) Loe ;
Mailing Address—Street Number,Street Name,or P.O.Box
Coul,`4s Ave -4i9O5
City,State,Zip
M (A,w!� t1 ) �L 33 if Li
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.0
Filing as an Employee(check one)
D County 0 Public Health Trust 0 Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address Work telephone Employment began on/ended on
Filing as a Board Member(check one)
0 County 'n Municipal: tQ Win' c,ta7 •
(Municipality)
Boardgwhere serving
744 co r (14 act V i c, 0Y �;� kyr rn r /e.
Alternate address(if home address is exempt) Wo&telephone Term began on/ended 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.Examples of sources of income include:compensation for services,income from business,gains from
property dealings,interest,rents,dividends,pensions,IRA distributions,and social security payments.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
(S
CD r/3 • 1 zpo I�r l<<i' PJ 8- r
I-114m. I. 33133
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, P, 4.7-75 Coll iSave f_eLAA) .
a, c, / Ob 3 L.i C.0!t1 Road ry ' FL 33 . �uJ�, •
I hereby swear(or affirm)that the information above is a true and correct s atement. RECEIVED BY ELECTIONS DEPARTMENT:
Hardcopy• ElElectronic Copy
Signature of Person DisclosingaAr. -.)•\•..)1.--nN-e
in44705// 7-
Date igned
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138_SP-14 COE 2016
EZ
. i .i, \i i 1 l L.
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
wN w.miamibeachfl.aov
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: All, c;o n 651, r1 t'
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.
•
OL-1/05 / 17
Signature ! Date
Updated Monday,April 20, 2015
Pace 4 of 4
F:\CLER\SALL\aFORMS',BOARD AND COMMITTEES\SC.',APPLICATION REVISED 06022014.dccx
J IAMfBEACH
DIVERSITY STATISTICS REPORTING
Name: A-//i c UriA on
Board / Committee: / � r6 L b �42 � 1 UU (vt
Appointment Date: fYr
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 0 Female L1
Race/Ethnic Categories
What is your race?
Li African-American/Black
Caucasian/White
0 Asian or Pacific Islander
Native-American/America-n !nd'an
Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? ,; tn._: "No _._
Spanish, Hispanic, Latino/a.
ZLi No
Yes
Do you consider yourself Physically Disabled?
1.ki No
! Yes
i3formariof form 05-20-13 FMletece
Updated: M;lond0.0