Seth Feuer 12/31/18MIAMIBEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: S:�/A � DATE OF APPOINTMENT: lld-ll,�-
BOARD/COMMITTEE:
100 (141J^ A/rRp�biinted by:
FOR SCANNER FOR CLERK STAFF
Scan o o Letter of Appointment TERM END: ( TERM LIMIT:
Scan o o Letter of Reappointment
0 �ov
ytm of Appointment/Reappointment e-mailed to Committee Liaison on
Scan o o B86rd Ad dom-mittee Application (Completed on / )
Scan o o Resume/Curriculum Vitae
o Diversity Statistics Reporting (Completed on )
Scan o o Oath
Scan O
Scan o
Received on:
Processed on:
Scanned on:
O Citywide Permit Application (Parking Department Form)
o Booklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
O DIVERSITY STATISTICS REEPPORTI��N��jjG" Keep COPY -in file and ORIGINAL for Annual Report.
'U Signed by X 1✓
oar Committee Me ber
By Employee:
v t lerk's Office Staff PA4S
By Employee:
Pity S -Office Staff Initials '1
14%1 #A&1101 iAi
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed Initials Scan O
Resignation Letter Date Processed Initials Scan O
Removal Letter due to absences Date processed Initials Scan o
F:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
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MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
January 02, 2018
Mr. Seth Feuer
1330 West Ave. #804
Miami Beach, Florida 33139
RE: Police/Citizens Relations Committee
Dear Mr. Seth Feuer:
Congratulations! You have been appointed by Commissioner Mark Samuelian to the above -referenced
Board or Committee, for a term ending: 12/31/2018.
Pulrsl�ant t -22 (s)Q:
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 enclosed materials carefully as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards,
Rafael ranado
City Clerk
cc: Saul Frances, Parking Director
Chief Daniel Oates, 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 a// 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. Granada, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Seth Feuer
RE: Police/Citizens Relations Committee
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: 12/31/2018.
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.
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)An July 1 st, following the closing
of the calendar year on which I have served.
Mr. Seth Feuer
Sworn to and subscribed before me this day of.� ��, 2018
F/Q'o
C les D'Agostin
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfi.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.
MIIAAKIDADE 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 ayearly basis by July 1st
of every year.
Disclosure for Tax�E�g I Last Name first N Mid Name/Initial
/—C
Mailing Address m Street Number, Str6et Name, or P.D. Box
A�l 0 Cj
City,State Zip'
9 / C,- C,
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 ane)
E] County Public Health Trust] Municipal.
icipality)
Department \
Position or Title Employee ID Number
ur„rk eddrecc JI
Filing as a Boardtuber (check one) p
County-Plt�cipal; 1�'�'! 6Cq Chi
` nicipality)
Board w re erving
-01\ ce I Cf4� 4�:� At
Alternate address (if home address is exempt) Work telephone I I4 Term hegano /ended on r��
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
IP -1 A
r ,...,�
I hereby sw r (or affirm) that the information above is a true and correct statement.
S' (at e of Person Disclosing
Date signed
Description of the Principal Business Activity
/&C � <- Ac- /40
RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
❑ Electronic Copy
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned DatelInitials:
138_SP-14 COE 2018
1 AMI B FA"H
DIVERSITY STATISTICS REPORTING
Name:�� Fe L(ec
Board/ Committee: rn�
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 RFemale a"I
Race/Ethnic Categories
What is your race*?
eri-an/Bla,t,
3-Wcan-Am ic U K
la'CaucasianANhite
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.
Bio
1:2 Yes
Do you consider yourself Physically Disabled?
No
Yes
C�,Use,-Sll,'ENT't-rat4',A-IIE)Data\'-oca.!' 'int=rne' r-iii-VitY
information form 05-20-13 F1 NAI L.doc
updated: Monday, January 26,20115
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: 5eM�
I understand that no later than Julv 1, of each vear 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
P r qn
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.
S;'rgnat re `
Updated: Thursday, December 28, 2017
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