Isabelle Ivette Borello 12/31/19_` ff
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BOARD AND COMMITTEE CHECKLIST
APPOINTEE: �5A"X, , ( Uerr& DATE OF APPOINTMENT:
BOARD/COMMITTEE: �L�{LSaNN� i>r)A-R.D Appointed by: (SC�M.,41f5t0-'%
FOR SCANNER FOR CLERK STAFF??
Scan o o Letter of Appointment TERM END: r,-)-131 TERM LIMIT: �Jf 1
Scan o o Letter of Reappointment
0 o f Mer of Appointment/Reappointment e-mailed to Committee Liaison on
M f
Scan o o Boar and Committee Application (Completed on
Scan c 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
✓ 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
amended through December 2010)
✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
'� n ✓ Highlights of the Miami -Dade County Ethics Code
fz '� ✓ Sunshine Law and Public Records - Frequently Asked Questions
y ✓ Memorandum - Solicitation by City Board and Committee Members
Wo Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Lts m cam
Scigo tw >_W o Source of Income Statement
Cb f!-- G �
Scan o cst o Acknowledgment of Financial Disclosure Requirement
cr o DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report.
Received on: l CP Signed by X me
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DateBard o-ommittee Men-ier
Processed on: ��- if b U By Employee:
_Da%te/ Cit Clerk's Office S aff Initials
Scanned on: �" [ l �lJ / / 0 B Employee:
Y
Date Ci Clerk's Office Staff Initials
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter
Resignation Letter
Removal Letter due to absences
Date Processed
Date Processed
Date processed
Initials Scan o
Initials Scan o
Initials Scan o
F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
^:`e ore comneir � to provid; q exce 2nt public seivic? on�-i so ety to cl? vvho !i e Kort. and ploy in our vibront troprcoi historic community
MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miomibeachfl.aov
OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
January 19, 2018
Ms. Isabel Ivette Borrello
2045 North Bay Rd.
Miami Beach, Florida 33140
RE: Personnel Board
Dear Ms. Isabel Ivette Borrello:
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,
7afae anado
City Clerk
cc: Saul Frances, Parking Director
Michael Smith, 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 vwvw.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
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Isabel Ivette Borrello
RE: Personnel 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 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.
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.
d . Isab4ivette Borrello
Sworn to and subscribed before me this & day ofd, 2018
Garles uvtgesth:�_
Deputy 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.
MIAMI- DADE SOURCE OF INCOME STATEMENT
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
,2 ti l `7 O L t� E CT(/
Mailing Address- Street Number, Street Name, or P.D. Box
City, State, Zip t
")-IiAL--T, �! I(_ 331 (�
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 Etnplayee (check ane)
F County ] Public Health Trust 0 Municipal:
Department
Position or Title
Work address
Filing as a Board Member (check ane)
QArrty Municipal
Board gar serving y�
Alternate address (if home address is exempt)
(Municipality)
Employee ID Number
Work telephone Employment began on/ended on
C/T, oP /�thy, r /3&"tc1�i
(Municipality)
I
Nark telephone Term began on/ended on
List below every source of income you received, along with the address and the principal actiiity of each source. include your public salary.`Piace the sources cf
income in descending order, with the largest source first. Examples of sources of income include: compensation far 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 far your benefit. However, the income of your sponse or any business partner need not be disclosed. If continued on a separate sheet, check here.❑
Name of Source of Income Address I Description of the Principal Business Activity
to, Voss S 6 A v{ D Avg le
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I hereby swear (or of firm) that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
❑ Hardcopy
- - -- - -- — - -Electronic Copy -
Sign re of Persa r isclosing y
a �l to
Date signed
OFFlC_ U S-= ONLY , ; _, r__, rd n 'i;;ie :y Pr-cessed Da'e/lnitals: Scanned Date; lnitl�-!5:
139 SP -1C COE 2315
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City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.micimibeachfi.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: IV677_6 6
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 both.
S' nature
Updated: Thursday, December 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
Oa -)6-16
Date
M I AMI C H
DIVERSITY STATISTICS REPORTING
Board / Committee: A4_,a CANC1, �0&fi_7-p
Appointment Date: 0 /- /0/'
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 ED Female
Race/Ethnic Categories
What is your race?
African-American/Black
Caucasian/White
Asian or Pacific Islander
Native-American/Amen an indiar�
laOther — Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Marr: the "No" box i,`not
Spanish, Hispanic, Latina/a.
N
� Yes
D�yo consider yourself Physically Disabled?
N
Yes
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