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Carolyn Baumel 12/31/19APPOINTEE: //� /l ,/""" ,,,moi BOARD/COMMITTEE: 5l *54-e C G lie Appointed by: /f/ io,e lc -elk -43k FOR CLERK STAFF Prosvi ��J ?f '/p`i� o Letter of Appointment TERM END: /C9)301 l / TERM LIMIT: i o Letter of Reappointment o Cpptof Appointment/Reappointment e-mailed to Committee Liaison on (BEACH BOARD AND COMMITTEE CHECKLIST C/M20 ` iA1 Aq-Lit /� e ( DATE OF APPOINTMENT: 3 �/f'- FOR SCANNER Scan 0 Scan 0 Scan o Scan o Scan 0 Scan 0 Scan 0 o Board and Gdmmittee 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 / %0 DIV RSSITY STATISTICS REPORTING Keep COPY in ' and ORIGINAL fo nnual Report. b Y XReceived on: Signed te Processed on: q(,(ao( G/ ( By Employee: Pate � // By Employee: Scanned on: Initials nate - y v - s Office Staff Initials,kitaD CONCLUDED & RESIGNATION LETTERS Term Expired Letter Resignation Letter Date Processed Date Processed Removal Letter due to absences Date processed Initials Scan 0 Initials Initials F:\CLER\BALL\BOARD AND COMMFTTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx 2.1t pub cel.v,ce ant, t_ .,_!y, to of L L. 11, Scan 0 Scan 0 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 Tek 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov April 03, 2018 Ms. Carolyn Baumel 1700 W. 25th Street Miami Beach, Florida 33140 SUBJECT: Sister Cities Proararm Congratulations! You have been reappointed by Mayor Dan Gelber to 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. Regards, fael Granado ity Clerk cc: Saul Frances, Parking Director 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. 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 Oath of Office Oath of Civility and Acknowledgements TO: Ms. Carolyn Baumel RE: Sister Cities Program 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 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. Sworn to and subscribed before me this Ms: arol,rn Baumel day of 2018 arl ''Agostin uty 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. M1AiVi BEACH Name: DIVERSITY STATISTICS REPORTING ( "4 2 L -/ d' u rpt s r -;-- Board / Committee: � 2 `� 1 � � �� C 1 Appointment Date: 4( 3 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 1 - g Female 1/41 Race/Ethnic Categories What is your race? African-American/Black L.,. J Caucasian/White 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, Latino/a. E3 No Yes Do you consider yourself Physically Disabled? , No Yes CAusers\CEiNT rai\l'AppDatalLocal\MiCrosnii ,Hindi:', \Temporary in.-.�. FII e ?C` . s`�G:�nt . t.0�tloo<INP-J� ^�J;t�SC information form 05-20-13 FINAL.doc Updated: Monday, January 26. 2015 MIAMI= 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 2017 Last Name fu Mt Mailing Address — Street Number, Street Name, or P.O. Box First Name 92301 Co N9 L SbU City, State, Zip arv,'t L 33 Middle Name/Initial 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. 0 Filing as an Employee (check one) El County © Public Health Trust 0 Municipal: Department Position or Title Employee ID Number Work address Work telephone (Municipality) Filing as a Board Member (check one) County Board where serving HIRM t 13eacti Alternate address (if home address is exempt) 0 Municipal: �htAM+ DE (Municipality) Work telephone (30€)4a < U�3 Employment began on/ended on Term began on/ended on c9o(� 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 1 I hereby swear (or affirm) that the information above is a true and correct statement. ec„,c,G0 Signature of Pers Disclosing ' lt? • I ?7 Date signed OFFICE USE ONLY Accepted: Y / N Deficiency: 1311_6P•14 COE2016 RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy LI Electronic Copy Processed Date/Initials: Scanned Date/Initial