Pedro Cofino 12/31/19�\IBEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: ecQ /20 &(:)-7ea, AA:) DATE OF APPOINTMENT: 3 -C /7
BOARD/COMMITTEE: P° `` / C! �1 -.)S Appointed by: C O44/1/I - 6-0^-/-1 v,�
FOR SCANNER FOR CLERK STAFF / /
Scan o o Letter of Appointment TERM END: �/ 3/ 49 TERM LIMIT: ( /'2/.J ? /
/ 425
Scan o o Letter of Reappointment
o CApy 7� r of Appointment/Reappointment e-maiailled to Committee Liaison on
Scan o o Board and Committee Application (Completed on /�O //, )
Scan o o Resume/Curriculum Vitae 3 l �� // (Y
o Diversity Statistics Reporting (Completed on / / 0
Scan o o Oath
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Received on:
Processed on:
Scanned on:
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)
✓ Highlights of the Miami -Dade County Ethics Code
✓ Sunshine Law and Public Records — Frequently Asked Questions
✓ Memorandum - Solicitation by City Board and Committee Members
o Citywide Permit Application (Parking Department Form)
o Booklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers -, d Employees
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement /
o D ERSI ► STATISTICS REPORY1 • = ��`=7re�iar for Annual Report.
•
e Signed by X -44111111
ate
3 //( rBy Employee:
Dat
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Date
By Employee:
ity C r s Office Staff Initials
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed
Resignation Letter Date Processed
Removal Letter due to absences Date processed
Initials Scan 0
Initials Scan 0
Initials Scan 0
F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
;? comm'tf,: , to providl q e<ce nt public_ service and sa eN to all who - e work. and play in our vibrant tropic rn>t historic coet ;n! y
MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
March 05, 2018
Mr. Pedro Cofino
407 Lincoln Rd Suite 10A
Miami Beach, 33139
RE: Police/Citizens Relations Committee
Dear Mr. Pedro Cofino:
Congratulations! You have been appointed by Commissioner Michael G6ngora to the above -referenced
Board or Committee, 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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards,
Rafael Granado
City Clerk
cc: Saul Frances, Parking Director
Chief Daniel Oates, 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. Granado, 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. Pedro Cofino
RE: Police/Citizens Relations Committee
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 Inter t and
Code of Ethics Ordinance), as well as Florida Commission on Ethics Guide to the Sunshine endment
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 iami-Da• - County or the
State of Florida (depending on the board or committee on whic
of the calendar year on which I have served.
ofino
Sworn to and subscribed before me this ` day of l lil/g2018
Ch . s D'Agostin
eputy 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 BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.aov
CITY CLERK'S OFFICE CityClerk@miamibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
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: —Q4) /Ltn
rn
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 come Tax Return
Failure to file one of these form-, pursuant to the Miami -Dade County Code, may subject the person to a fine
of no more
1
ur buil i.
Signature
Updated: Thursday, December 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
Date
MIAMI-DADE
COUNTY
SOURCE OF INCOME STATEMENT
Section 2-11.1(i) of the County Ethics Code requires that certain employees and pubic officials file a financial disclosure Statement on a yearly basis by July 1st
of every year.
Disclosure for Tax Year Ending
Last Name
6/7 C 19Al (D
Mailing Address — Street Number Street Name, orP.O.Bar
1/00
City, State, Zip
First Name
Middle N�e(Initia!
/
M f I , _ 3 3 r s I
If your home address is your mailing add ess, 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)
Gun 0 Public Health Trust D Municipal:
Department
Position or Title
Work address
Filing as a Board Member (check one)
0 County Municipal:
Board where serving
d t�i�
Alternate address (if home address is exempt)
(Municipality)
Employee ID Number
Employment began on/ended on
(Municipality)
/ (4/zsF71-7—no's
Work telephone Term begann/ended on
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List below every source of Income you received, along with the address and the principal activity of each source. Include your public salary.'Place 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. However, 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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that the infor :tion ab've is a true and correct statement.
Signature of Person Dish
3 i.
Date signed
nc_!CE USE ONLY Accepted: Y / N n_nrj_ icy
135 SP -14 CCE 2015
RECEIVED BY ELECTIONS DEPARTMENT.
❑ Hardcopy
Electronic Copy
Processed Date/Initiafs: Scanned Date/Initials:
Li 2\�
Name:
Board / Committee:
Appointment Date:
ERSI TY STATISTICS REPORTING
r/
Pursuant to City of Miami Beach rdinar e 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 Femaled
Race/Ethnic Categories
What is your race?
!fin=american!3iac�:
Caucasian/White
ED Asian or Pacific Islander
Li Native-American/American Indian
_ Other — Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" bov if not
Spanish, Hispanic; Latinola.
Yes
Do you consider yourself Physically Disabled?
No
L i Yes
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information form 05-20-13 FiNIA _.doc
Updated: PAondav, January 23 015