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Pedro Fuentas Outside Employment Statement 2016 MIAMFDAOE OUTSIDE EMPLOYMENT STATEMENT For Full-time County and Municipal Employees Full-time County and municipal employees engaging in outside employment must file an annual disclosure report by July 1st of Disclosure for each year, in accordance with Section 2-11.1(k)(2) of the Miami- Tax Year Ending: 2016 Dade County Code. Last Name: Fuentes First Name: Middle Name: Pedro Employee ID#: 20489 Filing as(check one) n Miami-Dade Co. Employee ❑■ Municipal Employee of: City of Miami Beach Position Title: Civil Engineer II County/Municipal Department: County/Municipal Division: Public Works Engineering If your home address is exempt from public records Work Telephone: pursuant to Florida Statutes§ 119.07, please see the note on the following page and check here: 305-673-7080 Mailing Address (Street Name and Number) Apt. # 162 NE 25th Street 912 City State Zip Code Miami Florida 33137 Please list the sources of outside employment, the nature of the work, and the amounts of money or other -compensation you received. If continued on a separate sheet, please check here: Name and Address of the Source of Nature of the Work Amount of Money or Outside Income Performed Compensation Received Self-employed Sculpting and Painting $0.00 I hereby swear(or affirm)that the aforesaid information is a true and correct statement. Signature of Person Disclosing Date Si ned / 5// 7 COE 2014 Outside Employment Statement Page 2 OUTSIDE EMPLOYMENT INFORMATION Required by the Miami-Dade County Code, Section 2-11.1(k)(2) OUTSIDE EMPLOYMENT means providing personal services, other than to Miami-Dade County, or to the respective municipality, that are compensated or traditionally compensated, including but not limited to, being an employee, an independent contractor, an agent, or by self-employment. FILING INSTRUCTIONS This form must be filed by July 1st of each year. The form should only be filed by employees who have outside employment to disclose. Miami-Dade County personnel shall file completed forms with Miami-Dade Elections Department or P.O Box 521550 2700 NW 87th Ave. Miami, FL 33152-1550 Doral, FL 33172 Or through email: financial.disclosuresCa miamidade.gov Municipal personnel shall file completed forms with their Respective Municipal Clerk. For further information, contact the Miami-Dade Elections Department Financial Disclosure Section at (305) 499-8413 or your respective Municipal Clerk's Office. Note re: Florida Statutes § 119.07: The role of our office is to receive and maintain forms filed as public records. If your home address is exempt from disclosure and you do not wish your home address to be made public, please use your office or other address for your mailing address. The following persons are exempt from disclosing their home addresses: active or former law enforcement personnel, including correctional and correctional probation officers, personnel of the Department of Children and Family Services whose duties include the investigation of abuse, neglect, exploitation, fraud, theft, or other criminal activities, personnel of the Department of Health whose duties are to support the investigation of child abuse or neglect, and personnel of the Department of Revenue or local governments whose responsibilities include revenue collection and enforcement or child support enforcement; firefighters; justices and judges; current or former state attorneys, assistant state attorneys, statewide prosecutors, or assistant statewide prosecutors; county and municipal code inspectors and code enforcement officers. COE 2014