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Stevan Pardo 12/31/1919LAVINSTWA�WWR BOARD ARD COMMITTEE CHECKLIST APPOINTEE: Sfi, PtQb (J DATE OF APPOIN MENT: BOARD/COMMITTEE: MPS Appointed by: l 'f `, i FOR SCANNER Scan o Scan o Scan o Scan o Scan o FOR CLERK STAFF J� o Letter of Appointment TERM END: TERM LIMIT: o Letter of Reappointment o py� f L er of Appointment/Reappointme nt e-mailed" o Board and Committee Application (Completed on o Resume/Curriculum Vitae / r/ o Diversity Statistics Reporting (Completed on o Oath to Committee Liaison on O DIVERSITY STATISTICS REPORTI Gr K e P 11 a ORIGINAL for Annual Report. 1 r� �/ `e Received on: 1),1Z 175 Signed by X 'Dat /'*rrittProcessed on:cP_1 �� r B Em toee: Y P YD ece Staff InitialsScanned on: G ( B Em to ee:Y P Ybate e Staff Initials ' '11111110LAW;D 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\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx We o2= colnMWE'd to providing excellent public service and solely to all who live, work, and play in our vibrant, tropical, historic community. 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, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 r— '4 ✓ County Code Section 2-11.1 — Conflict of Interest and Code of Ethics Ordinance (as --3' xW amended through December 2010) C. d ci ✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012) U MM ._>- ✓ Highlights of the Miami -Dade County Ethics Code >✓ Sunshine Law and Public Records — Frequently Asked Questions I C'4 "" ✓ Memorandum - Solicitation by City Board and Committee Members LU O Citywide Permit Application (Parking Department Form) O Booklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees Scan o "'0 Scan o Source of Income Statement o Acknowledgment of Financial Disclosure equireme O DIVERSITY STATISTICS REPORTI Gr K e P 11 a ORIGINAL for Annual Report. 1 r� �/ `e Received on: 1),1Z 175 Signed by X 'Dat /'*rrittProcessed on:cP_1 �� r B Em toee: Y P YD ece Staff InitialsScanned on: G ( B Em to ee:Y P Ybate e Staff Initials ' '11111110LAW;D 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\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx We o2= colnMWE'd to providing excellent public service and solely 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 January 17, 2018 Mr. Stevan Pardo 6300 Allison Road Miami Beach, Florida 33141 RE: Historic Preservation Board Dear Mr. Stevan Pardo: Congratulations! You have been reappointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2019. 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, afael Granado City Clerk cc: Saul Frances, Parking Director Deborah Tackett, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements 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 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.Miiornibeachfl.aov_ OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Stevan Pardo RE: Historic Preservation Board 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 o'f 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, integrityand 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 Miam'each Board and/or Committee, I must comply with the financial disclosure` requirements of Miami -p ounty or the State of Florida (depending on the board or committee on which I serve) on Jgly 1st, fo the closing of the calendar year on which I have served. /l , Sworn to and subscribed before me thi /C day of&6 arles D'Ag4Stin Deputy Check 12018 "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, h1a4Urlc community. City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfi.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:�f (\_J PIWbo 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 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 th. Signature Dade � Updated: Thursday, December 28, 2017 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx M !A MI B F Al("� DIVERSITY STATISTICS REPORTING Name: Board / Committee: 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 Female X11 Race/Ethnic Categories What is your race? African-American/Black GaucasianhVhite 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 Yes Do you consider yourself Physically Disabled? No Yes C'\t s;s Cc r- � � r r�. • ��,� "C r_• ,� fr';t�;rrta�. ori„�, � ;.�, r information form 05.20-13 FIN=,L.doc UPdat?d: 0.Aond;_V', Jat,uary _. "015