Beth Edwards 06/30/2018MIAMIBEACH
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: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
June 9, 2017
Ms. Beth Edwards
5900 Collins Ave. #1806
Miami Beach, Florida 33140
RE: Committee For Quality Education in Miami Beach
Dear Ms. Beth Edwards:
Congratulations! You have been re -appointed as a representative of the Nautilus Middle School
PTA to the above referenced board or committee, for a term ending: 06/30/2018.
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 and good luck!
U
,
ado,
City Clerk
cc: Saul Frances, Parking Director
Dr. Leslie Rosenfeld, City Liaison
ATTACHMENTS:
Oath of Office/Oath of Civility/Acknowledgements
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 E. Granada, City Clerk
Tel: 305.673.741 1, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
RE: Committee for Quality Education in Miami Beach
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: 06/30/2018.
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 1 st, following the closing of the calendar y r on which
I have served. A , .4
Ms. Beth Edwards
Sworn to and subscribed before me this_&d q of , 2017
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.
MI®DARE SOURCE 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 LasVName ZrsName Middle Na itial
Mailing Addre��treet Numb tr�e�tyNa�me, or P.O.�!T
0
City, S t Zip
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 Employee (check one)
0 County E] Public Health Trust F7 Municipal:
(Municipality)
Department
Position or Title
Employee ID Number
Work address
Work telephone
Employment began on/ended on
ruing as a nuara iviemuer (cnecK one)
0 County
Municipal: /1 00/
Boardsepving _
Alternate address (if home address is exempt) Work telephone Term began an/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
I hereb swe r (ora firm) that the information above is a true and correct statement.
W7 862�/_�
Signature
of Person Disclosing
Z�7
Dah signQd
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
FIVAMYSE I WOAA I
DIVERSITY STATISTICS REPORTING
Name:
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 ZI Female
Race/Ethnic Categories
What is your race?
frican-American/Black
,,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, Latino/a.
fN o
Yes
Do you consider yourself Physically Disabled?
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
.MIAMI BEACH
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.
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.
A611i
Signature ata
Updated: Monday, April 20, 2015
Page 4 of 4
F:\CLER\BALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
xAlAMIBEACH
,V14, � -
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: QA,,= -DATE OF APPOINTMENT:
BOARD/COMMITTEE:
FOR SCANNER FOR CLERK STAFF
Scan o o Letter of Appointment
Scan o o Letter of Reappointment
o Copy of Letter of
Appointed by:
Appointment/Reappointment e-mailed to Committee Liaison on
Scan o c Board and Committee Application (Completed on
Scan o o Resume/Curriculum Vitae
c Diversity Statistics Reporting (Completed on
Scan o o Oath
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓ City Code Ordinance Section applicable to the agency, board or committee
✓ City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
✓ County Code Section 2-11.1 — Conflict of Interest and Code of Ethics Ordinance (as
amended through December 2010)
✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓ Highlights of the Miami -Dade County Ethics Code
✓ Sunshine Law and Public Records — Frequently Asked Questions
✓ Memorandum - Solicitation by City Board and Committee Members
O Citywide Permit Application (Parking Department Form)
O Book!et — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o o Source of Income Statement
Scan o O Acknowledgment of Financial Disclosure Requirement
O DIVERSITY STATISTICS REPO TI K OP npfiedORIGINAL fo nual Report.
Received on: ZC))LI Signed by X
Date Board or Committee Member
Processed on: By Employee:
Date City Clerk's Office Staff Initials
Scanned on: By Employee:
Date City Clerk's Office Staff Initials
!' _ IF
_ - -
m al
Expired Letter
Date Processed
Initials Scan O
L11,erm
signation Letter
Date Processed
I
Initials Scan o
Removal Letter due to absences
Date processed
Initials Scan o
F:\CLER\BOARD AND COMMITTIES DA I ABASE\CHECKLIST MASTER\S&C Checklist 2015 Ih.docx
I/Ve ore committed to providing excellent public service oral sofen, to oil 1.11hp live tivorz and olcy in our vibront tropical. histm
historic ccmun;'