Magui Benitez 12/31/19BOARD AND COMMITTEE CHECKLIST
APPOINTEE: \qc
BOARD/COMMITTEE:
FOR SCANNER
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41,41,
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DATE OF APPOINTMENT:
Appointed by:
FOR CLERK STAFF o Letter of Appointment TERM END: P
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on
40,1-01 CIV1
TERM LIMIT:
o Board and Committee Application (Completed on
o Resume/Curriculum Vitae
o Diversity Statistics Reporting (Completed on
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)
• 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 and Employees
O Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
o DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report.
Received on: 761/ T Signed by X
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Processed on: By Employee:
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Scanned on: 41( / By Employee:
Date
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed
Resignation Letter Date Processed
Removal Letter due to absences Date processed
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FACLER1$ALLABOARD AND COMMITTIES DATABASE\CHECKL(ST MASTERT&C Checklist 2015 MASTER.docx
Ole ore coinmitte-ci to providing excellent public service and safety to all who tie. work. and p/o in our vibrant tropicalhisbric community
I\AIA/VU BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachf .aov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.741 1, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
March 16, 2018
Ms. Magui Benitez
757 West Ave. #412
Miami Beach, Florida 33139
SUBJECT: Sister Cities Program
Congratulations! You have been reappointed by Mayor Dan Gelberto 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.
Regard
R
City Clerk
d
cc: Saul Frances, Parking Director
q64‘, Michele Burger, 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.
MIAM BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov
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: Ms. Magui Benitez
RE: Sister Cities Program
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United
Staters,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 1st, following the closing
of the calendar year on which I have served.
Benitez
Sworn to and subscribed before me this ,,,4,'7day of /L,/`iee'fl2018c;p4)
t
�Ira1'I�s D�gostri
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 (1) 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
/{(4aiyi
Mailing Address Street Number, Street Name, or 13,0. Box
City, State, Zip
/,Z 9
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. El
Filing as an Employee (check one)
] County El Public Health Trust }: Municipal:
(Municipality)
Department
Position or Title
Work address Work telephone
Employee ID Number
Employment began on/ended an
Filing as a Board Member (check one)
D County
Board where serving
Z..er7:475
Alternate address (if home address is exempt)
Municipal:
L--,i-eas C.- A
(Municipality)
-Vint
telephone
Term began onlended on
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. E
Name of Source of Income Address Description of the Principal Business Activity
1 hereby swear (or affirm) that the information above is a true and correct statement.
- -
Signature of Person 0" closing
Date signed
rIFFICP USE ONLY Accepted: Y 1 NI neficienry:
138SP-14 COC 2016
RECEIVED BY ELEGTIONS DEPARTMENT:
LIJ Hardcopy
Electronic Copy
Processed Datetinitiars:
Scanned Dateilnitials:
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
vvww.miamibeachfl.goy
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(1) (2)
Board Member's Name:
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)"
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 $500, 60 days in jail or both.
Signature
Updated: Thursday, December 28, 2017
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FACLER1$ALL\aFORMS\BOARD AND COMMITTEESTC APPLICATION REVISED 06022014,clocx
ate
DIVERSITY STATISTICS REPORTING
Board Committee:
Appointment Date:
• . „, • •'•
. • , ,
• •
' • •
Pursuant to City of Miami Beach Ordinance 2009-3602, the City is required to annually
prepare and present a report to the City Commission identifying the City's diversty
sta.tistics, This form allows board and committee applicants and members to voluntarily
self -id ntify their race, ethnicity, disabled status and gender.
Please check the appropriate box for each category:
Gender: Male
Fe
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Race/Ethnic Categories
is your race?
Pfrican-Arneri ack
aucasian/White
sian or r)c,cific ista, uer
ative-AmericanleP\merican indian
ther — Print Race:
Do you consider yoursetf to
anish, Hispanic,,Latino/a,
No
Yeb,
Do you consider yot
No
Yes
e
"•' "'" • • '• .• . • " " • •
f Phy I Disabled?
Latino/ Mark the No box if not
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Updated: NI 0 nd y, January 26, 2015