Tierney Danehy 12/31/19BOARD AND COMMITTEE CHECKLIST
APPOINTEE: J (er�'/% ��/✓� v� % DATE OF APPOINTMENT:
BOARD/COMMITTEE: co"',�^�
(.! S � � r ,Appointed by: � OM'A
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o Letter of Appointment TERM END: TERM LIMIT:
o Letter of Reappointment
0 o y� of L er of Appointment/Reappointment e-mailed to
Committee Liaison on
Scan o o Board and ommittee Application (Completed on �J )
Scan o o Resume/Curriculum Vitae
o Diversity Statistics Reporting (Completed on )
Scan o o Oath
CD IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓ City Code Ordinance Section applicable to the agency, board or committee
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✓ 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
f'a'jCom` amended through December 2010)
' ✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓ Highlights of the Miami -Dade County Ethics Code
U:''- ✓ Sunshine Law and Public Records — Frequently Asked Questions
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gX .".� : ,, ✓ Memorandum - Solicitation by City Board and Committee Members
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cC°'.+ o Citywide Permit Application (Parking Department Form)
o Booklet — 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 REPORTING Kee Kee„p COPY n file and IGINAL for Annual Report.
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Y p YDate 's Office Staff Initials
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter I Date Processed r
Initials Scan o
Resignation Letter Date Processed
Initials Scan o
Removal Letter due to absences Date processed
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F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
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MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 vvvvw.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk
Tel: 305.673.741 1, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
January 11, 2018
Ms. Tierney Danehy
900 Bay Dr Apt 726
Miami Beach, FL 33141
RE: Miami Beach Commission For Women.
Dear Ms. Tierney Danehy:
Congratulations! You have been appointed by Commissioner Michael Gbngora to the above -referenced
Board or Committee, for a term ending: 12/31/2018.
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 enclosed materials carefully as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards
Raae4Grado
City Clerk
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.
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: Ms. Tierney Danehy
RE: Miami Beach Commission For Women
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) on July 1 st, followin the closing
of the calendar year on which I have served.
j 144 j
Ms. Tierndy Danehy
Sworn to and subscribed before me this day of l_, 2018
Cha s D'Agostin
//Oeputy 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 live, work and play in our vibrant, tropical, historic community.
MIAMIDASOURCE OF INCOME STATEMENT
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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 Last Name First Name Middle Name/Initial
mw- 90/? %A-Ajt-,-/4U -T
Mailing Address — Street Number, Street Name, or P.O. Box /
City, State, Zip
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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)
Count 1 Public Health Trust F� Municipal
_ \ (Municipality)
Department
Position or Title Employee ID Number
Work address Work telep Employment began on/ended on
Filing as a Board Member (check one)
0 County nicipal: (/1
(Municipality)
Board where serving
IV
Alternate address (if home address is exempt) Work telephony Term began qn/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. -Race 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. Hoviever, 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
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I hereb ar (or affirm)�,t the in�rmati n bove is a true and- ect statement. RECEIVED BY ELECTIONS DEPARTMENT,
❑ Hardcopy
-Electronic Copy
Signa�{ire o Person Disclo� g
Date sig -led
rG=;fie USE ONLY Accepted: V ! ry na;iei?ney Processed Date/initials: Scanned Date/initials:
138 SP -14 COE 2016
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.aov
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(1) (2)
Board Member's Name: T I fi�0 & —PA7J
I understand that no later than Julv 1, of eaJh 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
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.
r
Signatdre
Updated: Thursday, December 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
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Date'
D'Agostin, Charles
From:
D'Agostin, Charles
Sent:
Tuesday, January 30, 2018 12:21 PM
To:
'tdanehy@gmail.com'
Cc:
Hatfield, Liliam; Wong, Claudia; Stewart, Bonnie; Burger, Michele
Subject:
Miami Beach Commission for Women
Attachments:
Tierney Danehy Appt.pdf
Dear Ms. Danehy,
Congratulations! You have been appointed to the above board by Commissioner Michael Gongora.
Please stop by the Office of the City Clerk to be sworn in, sign your board paperwork and pick up your package.
I am copying Michele Burger committee liaison, for the schedule of the Committee meetings.
If you need additional information, do not hesitate to contact me at anytime.
Regards,
Charles D'Agostin, Office Associate III
OFFICE OF THE CITY CLERK
1700 Convention Center Drive, Miami Beach, FL 33139
Tel: 305-673-7411 Fax: 305-673-7254 / Ext. 6465 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
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M, !Ak...,
DIVERSITY STATISTICS REPORTING
Name: L�IZ%ll G. j �i 0-4 1/ 41/
i
Board/ Committee: 1 1 fO W VV__4 t4
Appointment Date: l
Pp �
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 El Female CI
Race/Ethnic Categories
What is your race?
African-American/Black
CaucasianAVhite
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, Latinola,
No
121 Yes
Do you consider yourself Physically Disabled?
o
Yes
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Up,d .a_d: Monday, Janua., 2'. 2015