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BOARD AND COMMITTEE CHECKLIST
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APPOINTEE: G tj�_A4VA_ S�6l_�r7� DATE OF APPOINTMENT: 1 -7-
B RD/COMMITTEE: Appointed by: 7'Y co-m'tovlz,�'S(04.
FOR SCooNNER Scan o etter ofRAppointment TERM END: TERM LIMIT: _/�/31
Scan o o Letter of Reappointment
0 o o jer of Appointment/Reappointment e-ma'led to Committee Liaison on
Scan o o Board and Committee Application (Completed on ;7// 0
Scan o o Re'sume'/Curriculum Vitae �,� ^ /, �s
o Diversity Statistics Reporting (Completed on
Scan o o Oath
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
712 City Code Ordinance Section applicable to the agency, board or committee
City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-267 2-458 and 2-459
County Code Section 2-11.1 — Conflict of Interest and Code of Ethics Ordinance (as
amended through December 2010)
> Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
Highlights of the Miami -Dade County Ethics Code
V Sunshine Law and Public Records — Frequently Asked Questions
2.
Memorandum - Solicitation by City Board and Committee Members
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® Citywide Permit Applicati o*n (Parking Department Form)
0 Booklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan 0 ® Source of Income Statement
Scan 0 0 Acknowledgment of Financial Disclosure Requirement
0 DIVERSIT''STATISTICS REPORTINGKeep P in
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Received on: Signed by X
Date Board or Committee Member
Processed on: cBy Employee:�a.
Date Xh CleEk's Office >9tqff Initials
Scanned on: By Employee:
Date City rk's Office Staff Initials
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed Initials Scan 0
Resignation Letter Date Processed Initials Scan 0
Removal Letter due to absences Date processed Initials Scan 0
F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTEMB&C Checklist 2015 MASTER.docx
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MIAM.BEACri
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33 139 www.miamibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfi.gov
January 17, 2018
Ms. Chana Sheldon
4434 Post Avenue
Miami Beach, FL 33140
RE: Art in Public Places Committee
Dear Ms. Chana Sheldon:
Congr,a,tu.11-Ations.1- Yo.p.A'bave -been -reappointed by the City Commission to the agency, board or committee
named above for a term ending: 12/31/2019.
If yo - u I are- e- unab I . e . to -accept this appointment; or have any questions, please call the Office of the City
Clerk at 30,5,673:7411:
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
D e h " 61' s L e � yva-, City, Liaison
ENCLOSURES:
Oath of Office/08th of Civility/Ackn'owledgements
City Code/Ordineinbe '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.
pity CiA_ -
of Miami Beach® 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.aov
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OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.741 1, Fax: 305.673.7254
Email: CiiyClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Chana Sheldon
RE: Art in Public Places Committee
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United
States, the State te of Florida, and the City of Miami Beach, and to perform all the duties of a member of the
above-me'ntio'n'ed`b',o*a'rd or committee of the City of Mi . ami Beach to which I hav( .�' been appointed for a
term ending: 12/31/2,019.
To my colleagues and. 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.
Ms. d"lli'ana Sheldon
-Y
Sworn to and subscribed before me this day of 712018
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, histo, fic community.
MIIAMIBEACH
City of Miami Beach
1700 Convention Center Drive
I FloridaMiami Beach, ro33139
www..miamibeac_h_f_1.aov
CITY CLERKS OFFICE
Telephone: 305.673.7,411 Fax: 305.673.7254.
CityClerk@miomibeachfl.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: t r � C��
I understand that no later than July 1, of each near 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 ) 75
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.
Signature
Updated: Thursday, December 28, 2017
Page 4 of 4
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