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Abdul Muhammad 12/31/193 i i iii L0'—sem` o BOARD AND COMMITTEE CHECKLIST APPOINTEE: .1 &J61t1I M L4i4MC� DATE OF APPOINTMENT: � BOARD/COMMITTEE: J�.. G Appointed by: FOR. SCANNER FOR CLERK STAFF ��M ��/ q Scan c o Letter of Appointment�� Scan e o Letter of Reappointment & M o )��J;JL#P.7ol Appointment/Reappointment e-mailed to Commttee Liaison Scan o 0 oard anddCoommidee Application (Completed on / Scan o o REsume/Curriculum Vitae o 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 CD c- ✓ 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 N" amended through December 2010) LJ :I>- ✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012) `' ✓ Highlights of the Miami -Dade County Ethics Code rn �= ✓ Sunshine Law and Public Records — Frequently Asked Questions C= ✓ Memorandum - Solicitation by City Board and Committee Members W M1 U-- i - LU a «U- 0 Citywide Permit Application (Parking Department Form) � C, 0 Booklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employee Scan 0 O Source of Income Statement Scan 0 0 Acknowledgment of Financial Disclosure Requirement 0 DNERSITY STATISTICS REPORT/INj^ K- .p C PY i ' e a I O" for Annual Report. Received on: 1 I Signed by �•�.J _ v v' 'Date` and r ommittee Membe Processed on: ` By Em loyee: By P , / �D� e � C" C ac's Office St a` Initials Scanned on: By Employee: Date City C 's Office Stail Initials � RAS 14 Term Expired Leer I Date Processed Initials Scan C Resignation Letter Initials Scan 0 I Date Processed Removal Letter due to absences I Date processed I Initials Scan 0 FICLERIBOARD AND CO MMITT IES DA I ABASE CHcCKLIST V1ASTc-R1ScC Checklist 2015 lh.doc< 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 December 21, 2017 Mr. Abdul Muhammad II 41 SE 5th Street #1501 Miami, Florida 33131 SUBJECT: Production Industry Council Congratulations! You have been reappointed by Commissioner Ricky Arriola to the above referenced, board or committee named above, for a term ending: 12/31/2019. 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. Congratulations and good luck. Regards, Vafael �Granado ity Clerk Yl cc: Saul Frances, Parking Director Silvia Royer, 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. 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. Abdul Muhammad II RE: Production Industry 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. 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, following the closing of the calendar year on which I have served. 9/(r. A uul?Muhamma Sworn to and subscribed before me this daVD'Agostin of�r/'�! 20 ?Cha *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. 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@miomibeachfl.cov Acknowledgement of fines/suspension for BoardfCommittee 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. 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:\CLER\SALL\aFORMS\BOARD AND COMMIT EES\SC APPLICATION REVISED 05022014.docx MIAMI-DADE SOURCE OF INCOME STATEMENT 6a;Cj1W Section 2-111.11(i) of the County Ethics Code requires that certain employees and public officials fi I e a financial disclosure Statement on a yearly basis by July list of every year. Disclosure for Tax Year Ending Last Name A, F' st7ame Middle Name/Initial -7 At j4W, , . goi � Mailing Address - Street Number, 5treet Nam P jBox G i t 1y't at e _,Zip > If your home address is your mailing address, and your holme address is exempt from public records pursuant to Fla, Stat. §119.07, read instructions on the following page and check here. 7 ""'y" (check one) El_�E] Public Health Trust Fj Municipal: (Municipality) Department Position or Title Employee I D Numb - Work address Employment began on/e firing as a Board Member (check one) [7 County unicipal: Pm (Municipality) Board where serving 0411 Alternate address (if home address is exempt) Work telephone Term began /ended an T-1 Cpo List below every source of income you received, along with the address and the principal activity of each source. Include your public salary. Place thesources 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.0 Name of Source of Income Address Description of the Principal Business Activity C2, VAj4U1KtC, - _ g,, KO_AAAFL -3_�) [ -44 - I hereby swear (�or al�rm)Vhat the infor ation above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: Hardcopy Electronic Copy eo erson Disclosing Signatu/( Date JAI OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned DatelInitials: 138SP-14 COE2016 1 �,�'�t H DIVERSITY STATISTICS REPORTING Name: A�jvl 14c,�A#mn4&& Board / Committee: Appointment Date: 1-7 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 4'r/Female Z) Race/Ethnic Categories African-American/Black ls your race? 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" ba- if not Spanish, Hispanic, Latino/a. No Yes Do you consider yourself Physically Disabled? No Yes information form 05-20-13 FIN A L.doc updatee d: Monday, January 26. 20;:5