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Meryl Wolfson 12/31/2018 (2)MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov December 27, 2017 Ms. Meryl Wolfson 5055 N. Bay Rd Miami Beach, Florida 33140 RE: Miami Beach Commission For Women Dear Ms. Meryl Wolfson: Congratulations! You have been appointed by Commissioner Mark Samuelianto the above-referenced Board or Committee, for a term ending: 12/31/2018. Pm suar rt to City of Miar r Ii Beacl 1 Code Sectior 1 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 appointmenUelection 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 as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations again and good luck. cc: Saul Frances, Parking Director Michele Burger, 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 2-22 Miami-Dade County Code Section 2-11.1 -Conflict of Interest and Code of Ethics 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. Appointments To Be Made COMMISSIO~ER MARK SAMUELIAN Name Term End I Term Limit Date If Not Reap~ointed, Please List the Name of the New Appointee. Note: The New Appointee Will Take Office on January 1, 2018 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov TO: Ms. Meryl Wolfson 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 ot'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. 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 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. Sworn to and subscribed before me this _2j}_ day of~· 2017 ~rles-6'A-gosttn~ 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 Jive, work and play in our vibrant, tropical, historic community. /\/\11 A/\\/\I RFAa 1 .~ , . , .. , . , u~JI i 1'l .. City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www. m iarrllbeachfl .gov CITY CLERK'S OFFICE Telephone: 305.673.7 411 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.i(i) (2) soa~Membe~sName:~-~~~~~1~~~~~~/r~S~~6~~~~~~~ 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. Updated: Monday, April 20, 2015 Page 4 of 4 F:ICLERISALL\aFORMS\BOARD AND COMrvllTIEESIBC APPLICATION REVISED 06022014.docx I DatJ MIAMI· mrl 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 I Last Nam,11 / 1 /')..,, J:..' J --~ ;JH5r7 vv0 fr0 uvv Mailing Address -Street Number, Street Name, or P.O. Box Middle Name/Initial Firsttf; /111 ~l/L City, State, 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. D Filing as an Employee (check one) --·-· LI County D Public Health Trust [J Municipal: - (Municipality) Department Position or Title Employee ID Number Work address I Work telephone Employment began on/ended on Filing as a Board Member (check one) ·-----------·---~ D County D Municipal: (Municipality) Board where serving Alternate address (if home address is exempt) 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 seryices, 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.D Name of Source of Income Address Description of the Principal Business Activity M(MA( (3.evteA.-t rec.... t/ IO I fJvvJL;tr.ee. 11\11 ~ PL ~a.VL.. ~)A.. ( V\. s:.fv u c fa V" - - .. I hereby swear (or affirm) that the information above Is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: D Hardcopy D Electronic Copy OFFICE USE ONLY Accepted: Y I N Deficiency:_ 138_8P-14 COE 2016 Processed Date/Initials: ·----Scan11ed Date/Initials: ___ _ /\/\ I A!V\ I BEA DIVERSITY STATISTICS REPORTING Name: Board I Committee: vJ <!IP S__? v_----~-~ _/J!lfi ... __ ~(b_;wvr ... /2Qr IA/ 6~ ~- ARpointment Date: _ _J_LLJy ___ ~-·---.... ~- 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,. Race/Ethnic Categories What ls your race? 0 African*American/Black 0 Caucasian/White 0 Asian or Pacific Islander 0 Native~Arnerican/American Indian 0 Other -Print Race: -----------···-·-·--·-··----··"-·- Do you consider yourself to be Spanishi Hispanic or Latino/a? Mark the "No'1 box if not Spanish Hispanic) Latino/a.. ~o ·aves Do you consldet· yourself Phys1cat!y Disabled? -e::r;;o Oves C:\UsHrs\CE~~rTFraN\AppD~Etta\L.oc~1,1'.J11icrosoft\V\./indr;.ws\Tr.;moorarv !nt0r'nf~t Fik?s\Ccnt;;:;r)t.Outk1ut(\f\JP1.1 • .JSJGN~<\8C rn::1cti1v Information form 05·20·1 :i FINAL.doc · Updated: Monde.v, Januar\"' 26. 2015