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Pam Rogers 12/31/2017MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk Tel: 305.673.741 1, Fort 305.673.7254 Email: CityClerk@miamib,sachfl.gov June 7, 2017 Ms. Pam Rogers 5415 Collins Ave. #505 Miami Beach, FL 3314.0 RE: Miami Beach Commission For Women Dear Ms. Pam Rogers. Congratulations! You have been appointed by Commissioner John Aleman to the above -referenced Board or Committee, 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 encllosed materials carefully as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations and good luck. Regards Rafael Gr ado City Clerk cc: Saul Frances, Parking Director Bonnie Stewart, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements City Code/Ordinance section applicable to agency, board or committee City Code Sections 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 Ordinance No. 2006-3543 - Amendment to City Code Section 222 Miami -Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance Citywide 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 331 39 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements RE: Miami Beach Commission For Women 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. To my colleagues and to all of those I represent and serve, I pledge fairness, integrity and civility, in all actions taken and all communications made by me as a public servant. I hereby acknowledge that 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 that I understand that as a member of the above -referenced City of Miami Beach Board 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. Ms. Pam Rogers Sworn to and subscribed before me thi ! day of J— �y�-2017 Phairles D'Agostin Deputy Clerk We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. M MIAMI BEACH CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM NAME: Rogers Pam E Last Name First Name Middle Initial HOME ADDRESS: 5415 Collins Avenue, #505 Miami Beach Florida 33140 Apt No. Home No./Street City State Zip Code PHONE: Home (866) 491-6737 Work pamrogersl@gmaii.com Business Name: St. Thomas Univ. Human Rights Institute Position: Attorney Address: 2650 S.W. 27th Avenue, Suite 304 Miami Street City Email Address Florida 33133 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: Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I am a female attorney who has worked in the non-profit sector for approximately 12 years, while living on Miami Beach for over • Are you presently a registered lobbyist with the City of Miami Beach? No riease iist your preterences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that onlythree (31 choices will be observed by the City Clerk's Office (Regular Boards of City) Choice 1: Miami Beach Commission For Women Choice 2: 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 Issuance Date License Number 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: Child Name Age Program • 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 • Are you currently serving on any City Boards or Committees: No • What organizations in the City of Miami Beach do you currently hold membership in? If yes, please explain in detail: If yes, which board? • 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: Property 5415 Collins Avenue, #505 Gender: Female 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. 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 Pam Rogers agreed to the following terms on 6/1/2017 9:27:50 PM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date PAM ENGLAND ROGERS, ESQ. 5415 Collins Avenue, Miami Beach, FL 33140 (305) 297-5762 pamrogersl@gmail.com WORK EXPERIENCE: St. Thomas University Human Rights Institute, May 2005 -present Staff Attorney, Miami, FL Represent clients in immigration court litigating a variety of applications for relief, including asylum, CAT, and withholding of removal; Prepare and file motions, trial and appellate briefs, waivers and adjustment of status applications in immigration court and with USCIS; Represent clients at USCIS hearings; Provide clients with legal advice and assistance in numerous aspects of immigration related matters including criminal issues. Miami -Dade County State Attorney's Office, February 1995 -June 2003 Assistant State Attorney, Miami -Dade County, FL 1997-2003: Extraditions Unit - handled international and domestic fugitive cases 1996-1997: Felony Division - litigated over 20 felony jury trials 1995-1996: County Court Division - litigated over 50 complex DUI and misdemeanor cases 1995: Juvenile Division — litigated over 50 bench trials for all levels of Juvenile cases University of Miami School of Law, January 1994 -December 1994 Assistant Director, Career Planning, Miami, FL University of Florida College of Law, November 1992 -December 1993 Public Sector Coordinator, Career Services Office, Gainesville, FL EDUCATION: University of Florida College of Law, Gainesville, FL Juris Doctorate, July 1992 Legal Honors & Activities: Trial Team - Final Four at ABA Regional Competition, 1990 Rotary Foundation Scholarship, 1990-1991 High Honors, Summer 1992; Honors Fall 1991, Fall 1988 Florida State University, Tallahassee, FL Bachelor of Arts, Communications for Business, 1986 Graduated Cum Laude MEMBER: Florida Bar; American Immigration Law Association (AILA); Vice Chairman and Member of the Board, Brickell Avenue Literary Society PERSONAL: Speak Spanish; Enjoy spinning, reading and foreign films '! 1. H tI ! L� 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.aov 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: Pa vyi /Zo 7 & r'S, 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. 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. Signature Updated: Monday, April 20, 2015 Page 4 of 4 F.\CLERISALL\aFORMS\EOARD AND COMMiT` EES\6C APPLICATION REVISED 06022014.docx "'®' 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 Last Name First Name Middle Name/Initial 2016 �RO e r S Mailing Address — Street Number, Street Name, or P.O, Box 514t'j- City, State, Zip V\ . , 1 ,e,- . 'R 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 as an Emnlovee (check one) County F Public Health Trust ❑ 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) 6 County Municipal: �t � �- (Municipality) Board where serving IO KAA ✓}Jz^a11 Qv sl vr> (Zy l �v» 0--'D ,r vi o »► P-r) Alternate address (if home address is exempt) I Work telephone I 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 nerson for vour benefit. However. the income of vour spouse or anv 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 S1. or\ I hereby swear (or affirm) that the information above is a true and correct statement. TL -- Signature of Person Disclosing (olt1�711-� Date signed RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138 SP -14 COE 2016 B I Y %IAM1F A�� Name: DIVERSITY STATISTICS REPORTING ko Board / Committee: ►-1 t a -y? Appointment Date: CI Z 7 /7 6e-A0__A &mPy1 f 551 Dr, Apr- VUc)w, eve 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 rXII Race/Ethnic Categories What is your race? r— I African-American/Blau Caucasian./White Asian or Pacific Islander Native-American/American indian Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the `'No" box if not Spanish, Hispanic, Latina/a. No Yes Do you consider yourself Physically Disabled? No Yes C:��.ise.siuEUTFr2"1v, �Q�Ca` .00c�`,ty'SIC!'OSOtt`ibrindGb';S�r2Cri,C7�f2tV lntarnet riles"Conten I.Out look\NP".i9CN)h�\Bc fiirVity information form 05-20.13 FIN,AL.doc Updated: Monday, January 25. 2015