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Israel Sands 12/31/19BOARD AND COMMITTEE CHECKLIST APPOINTEE:?�S1P--cl@( t/ CI • DATE OF APPOINTMENT: BOARD/COMMITTEE: QO 1 Iured C('r QaOG'Appointed by: FOR SCANNER FOR CLERK STAFF Scan o c Letter of Appointment Scan o o Letter of Reappointment c 0 C pryOr of Appointment/Reappointment e-mailed to Committee Liaison on Scall o Scan c Scan 0 S Can C Scan Received on: Qa tr 's 5 /;r►. o Board and Committee Application (Completed on o Resume/Curriculum Vitae o Diversity Statistics Reposing (Completed on 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-)3, 2-24, 2-25, 2-26, 2-458 and 2-459 ✓ County Code Section 2-11.1 - Confiict 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 Lai and Public Records - Frequently Asked Questions ✓ Memorandum Solid aUon by City Board and Committee Members O Citywide Permit Application (Parkina Department Form) O Booklet- Ci :de to Sltnsnine men rn nt._r D. :n E; nom. c _ —. es te.id lie C.+o•^.�. of Citi ^toy O Source of income S . kn iwie ,ent of Financial Disclosure Requirement • D ERSITY STATISTICS RFF0F i I ; 1Ke ,. Signe by r `'rocessecl on: ry f ` i /7 Dat Scanned on: (gilt -a/7 at_ 'D T =rrr., Expired-L-e-tt r t esionation Letter Rernova! Letter d• By Employee: fl', and OFdG!NALfcrAnnual ^eport. imftteersiilember Lea,/ I Office Staff Initials ,ity Cid{ Office Sian Initials A ttP ItI I IIN ' E I $ ERS 1 -Date Processed Initials Scan o Date Processed Initial_ Scan 0 'kink :10 301i,Se Processed 13V381W"I,4 d0 A11.0 initials Scan 0 - ;O.1 _R\:BC-R.D AND Still/it 'f1.-1AL I-�Fl� .._. _ !1 GQc: u3h1333 i MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov February 16, 2017 Mr. Israel Sands 3520 East Fairview Street Miami, FL 33133 SUBJECT: Cultural Arts Council Dear Mr. Israel Sands: Congratulations! You have been reappointed by the committee, for a term ending: 12/31/2019. If you are unable to accept this appointment or have at 305.673.7411. City Commission to the above referenced board or any questions, please call the Office of the City Clerk Please read the enclosed materials carefully. Congratulations and good luck. Respectf Ily, Ra ael Granado City Clerk cc: Saul Frances, Parking Director Brandi Reddick, 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.aov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov TO: Mr. Israel Sands RE: Cultural Arts Council 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: 12/31/2019. 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. r. srael Sands Sworn to and subscribed before me this I/ day of `Z 2017 541 Deputy C *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. ea_ MAMIBEACH NAME: Sands Last Name HOME ADDRESS: 3520 East Fairview Street Apt No. Home No./Street PHONE: 305.951.3333 Home 305.951.3333 Work Israel First Name Miami City CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM FL isands@aol.com Middle Initial State Email Address 33133 Zip Code Business Name: Israel Sands Law, P.A. Position: Principal Address: 1130 Washington Avenue, Third Floor Miami Beach FL 33139 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 No • 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: No • (Please circle one): I am now a resident of: • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I have served on CAC before for 6 years. Board Member of Several Arts Organizations. • 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 (31 choices will be observed by the Citv Clerk's Office. (Regular Boards of City) Choice 1: Cultural Arts Council Choice 2: Sister Cities Program Choice 3: Hispanic Affairs Committee • 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 • Do you currently owe the City of Miami Beach any money: No • Are you currently serving on any City Boards or Committees: Yes CAC • What organizations in the City of Miami Beach do you currently hold membership in? If yes, please explain in detail: 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: Gender: Male 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. Yes 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 Israel Sands agreed to the following terms on Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Quezada, Ramon From: Quezada, Ramon Sent: Wednesday, February 22, 2017 9:17 AM To: 'isands@aol.com' Cc: Reddick, Brandi; Granado, Rafael; Hatfield, Liliam; Wong, Claudia Subject: Cultural Arts Council Dear Mr. Israel Sands, Congratulations! You have been reappointed to the above Board by City Commission. At your convenience, please stop by the Office of the City Clerk to be sworn in and pick up your package. I am copying Brandi Reddick committee liaison, for the schedule of the Committee meetings. If you need additional information, do not hesitate to contact me at any time. Regards, MIAMI BEACH Ramon Quezada, Office Associate 111 OFFICE OF THE CITY CLERK 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411 x 6523 Fax: 305-673-7254 / www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. 1 /A nS JW ._ 1 City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www. m is m i beac h fl . aov CITY CLERK'S OFFICE CityClerk@miamibeachfl.gov Telephone: 305.673.7411 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(1) (2) Board Member's Name: s ra 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. /02/4/)- s••'i re D "eat Updated: Monday, April 20, 2015 Page 4 of 4 F:\CLER'k.SALL\aFORMS\BOARD AND COMMI l FEES\SC APPLICATION REVISED 066022014.dOC. MINVU BEA DIVERSITY STATISTICS REPORTING Name: 1:5 ra 103 3 Board / Committee: 0-01 iv rai act) L Appointment Date: / 5// / - 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: Mae1 Female Race/Ethnic Categories What is your race? an -America n/ Black Caucasian/White LJ 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. e Do you con r yourself Physically Disabled? ED Yes CAUsers\CENTFraN'AppData\Local\MicrosoftlWindows\Ternoorary interact Fi!es\Content.Outlook\Nr-vitJ9C,N)0,80, mcty information form 05-20-13 ANALdoc Updated: Monday, Januani 26, 2015