Cheryl Jacobs 12/31/2018MIAMIBEACH
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) 673-741 1, Fax: (305) 673-7254
Email CityClerk@miamibeach.gov
January 20, 2017
Ms. Cheryl Jacobs
20 Island #707
Miami Beach, Florida 33139
SUBJECT: Sustainability Committee
Congratulations! You have been reappointed by Commissioner Joy Malakoffto the above referenced,
board or committee named above, for a term ending: 12/31/2018.
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,
Rafa- I Granado
City Clerk
cc: Saul Frances, Parking Director
Elizabeth Wheaton, 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.
MIAMIBEACH
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
Email CityClerk@miamibeach.gov
TO: Ms. Cheryl Jacobs
RE: Sustainability Committee
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.
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.
S -f
Sworn to and subscribed before me thissir day of Co‘
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.
MIAM FDADE
COUNTY
SOURCE OF INCOME STATEMENT
Section 2-11.1(1) 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
2016
Last Name
.J4.e®6�
Mailing Address — Street Number, Street Name, or P.O. Box
gr?o ��1 V
First Name
COI ).
Middle Name/Initial
City, State, Zip
N-1 b PA 33 13q
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)
Filing as a Board Member (check one)
0 County
Municipal: x•14 -c 6.9- J
(Municipality)
Board where serving /
h itbi, / /. /`tet ion e
Alternate address (if home address is empt)
71 Work 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
■ County • Public Health Trust i■ 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
Municipal: x•14 -c 6.9- J
(Municipality)
Board where serving /
h itbi, / /. /`tet ion e
Alternate address (if home address is empt)
71 Work 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
AIA 04 ;am, I
Ja0 A)67 std} iNiiij 33;32
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I hereby s ear (or affirm) that the information above is a true and correct statement.
Signature of Perso i Disclosin
2-'-!?
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials:
138 SP -14 COE 2016
Scanned Date/Initials:
A JPA
City of Miami Beach
1700 Convention Center Drive,
Miami Beach, Florida 33139,
www.miamibeachfl.gov
CITY CLERK'S OFFICE
Telephone: 305.673.7411 Fax: 305.673.7254
CityClerk@miamibeachfl.gov
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, 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.
SignaturejtA4A-----
Date
o? --/-/7
Updated: Monday, April 20, 2015
Page 4 of 4
F:\CLER\SALLI2FORMSIBOARD AND COMMITTEES\SC APPLICATION REVISED 06022014.docx
MIAMI BF
Name:
DIVERSITY STATISTICS REPORTING
TAGolas
Board / Committee:
Appointment Date:
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 CD Female
Race/Ethnic Categories
What is your race?
Ei African-American/Black
Caucasian/White
ED Asian or Pacific islander
D Native-American/American Indian
Li Other — Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box (f not
Spanish, Hispanic, Latina/a.
[8(No
Yes
ou consider yourself Physically Disabled?
Doiy
No
0 Yes
GAUsers\CENTFraN\AppDataiLocar.MicrosoftVivH-,ivs,:rerricotery interne', '•• H• • •
information form 05-20-13 FINAL.dr3c
Updated: Monday, January 25. 2015
al- MIAMIBEACH
NAME: Jacobs
CITY OF MIAMI BEACH
BOARD AND COMMITTEE APPLICATION FORM
Cheryl H
Last Name
First Name Middle Initial
HOME ADDRESS: 20 Island Ave #707 Miami Beach
FL 33139
Apt No. Home No./Street
PHONE: 305-804-7446 305-448-7488
City
noogie69@icloud.com
State Zip Code
Home
Work
Business Name: Miami Center for Architecture & Design Position: Executive Director
Address: 100 NE 1st Ave
Miami
Email Address
FL
33132
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: No
• Are you a registered voter in Miami Beach: Yes
• (Please circle one): I am now a resident of: South Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
Interest and expertise in issues related to sustainability and resiliency.
• 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: Sustainability Committee
Choice 2: Cultural Arts Council
Choice 3:
• Board members are required to file Form 1 — "Statement of Financial Interest" with the State.
If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review
Board, Historic Preservation Board or Planning Board, attach a copy of your currently -effectively license, and furnish the
following information:
Type of Professional License
License Number
License Issuance Date License Expiration Date
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:
• Have you ever been convicted of a felony: No If yes, please explain in detail:
• 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: No If yes, which board?
• What organizations in the City of Miami Beach do you currently hold membership in?
• I am now employed by the city of Miami Beach: No Which department?
• List all properties owned or have an interest in, which are located within the City of Miami Beach:
Gender: none
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.
Race/Ethnic Categories
What is your race? Mark one or more races to indicate what you consider yourself to be. none
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."
1 Cheryl Jacobs agreed to the following terms on 1/17/2017 2:53:37 PM
Received in the City Clerk's Office by:
Name of Deputy Clerk
Control No. Date
41114
AIA
Miami
Cheryl H. Jacobs, Executive Vice President
American Institute of Architects — AIA Miami
Miami Center for Architecture & Design, Inc. (MCAD)
•1
MIAMI CENTER FOR ARCHITECTURE & DESIGN
As Executive Vice President of both AIA Miami and MCAD, Cheryl Jacobs guides both
organizations, in the development and implementation of programming that promotes
architecture, design and the built environment. Cheryl works closely with both organizations'
outstanding volunteer boards to create forums, seminars and events that improve awareness of
the industry and that build strong community and member connectivity.
With 20+ years in association and non-profit leadership experience, Cheryl has developed an
exceptional network of high-level contacts in the architecture and real estate industry in south
Florida. She is a strong and inspirational leader with a talent for recruiting and motivating
volunteers, and a passion for the creative industries. In 2013, Cheryl was awarded the AIA
Florida Presidential Award. She currently is the Project Director for MCAD's "Active Design
Miami" effort, supported by a grant from the Florida Department of Health and the Centers for
Disease Control.
Cheryl has a Bachelor of Arts in Communications from Fairleigh Dickinson University in
Teaneck, New Jersey and is a graduate of Leadership Miami and Leadership Daytona Beach.
Current professional and community involvement includes:
• Miami -Dade County Art in Public Places Trustee
• City of Miami Beach Sustainability Committee
• Greater Miami & the Beaches Hotel Association Sustainability Council
• Commercial Real Estate Women -Miami (CREW)
• Greater Miami Convention & Visitors Bureau
• Council of Architectural Component Executives (CACE)
Previous:
• Urban Land Institute Southeast Florida/Caribbean District Council Advisory Committee
• Coral Gables Chamber of Commerce
• Greater Miami Chamber of Commerce (GMCC), Board of Directors
• GMCC Natural Resources Committee Chair, 201 1 — 2012
• GMCC Workforce Housing Committee Chair 2008 — 2010
• GMCC Workforce Housing Committee Vice Chair 2006 - 2008
• GMCC Go Green Task Force Founding Chair (2007-2008)
• ULI Terwilliger Center for Workforce Housing Education/Outreach Co -Chair
• Miami Beach Chamber of Commerce (MBCC) Board of Governors
• MBCC Pillar Trustees Chair 2008 - 2009
• MBCC Sustainable Living Council Founding Chair 2007