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Beth Edwards 06/30/19F ' � ��£� 1 � �f�, � �� `� ; . ' ?� p u� , � ., _ '�. -:a � v BOARD AND GO�ViMITTEE CHECKLIST APPOINTEEo ��1 �(� ��J,�J DATE OF APPOINTMENTo � l�/! � BOARDICOMMITTEE: (..o�'�'� - ��' ��`fi'��j qppointed by:`��`"l``� �� FOR SCAtVNER 1��t�� d� �C �t �/ ✓�� Scan o Scan o Scan o Scan o Scan o Scan o Scan � Received on: Processed on Scanned on� FOR CLERK STAFF � o Letter of Appointment TERM END: ��`� �� TERIVI LIMIT:� � c� �� o Letter of Reappointment � 0 opy l� I et$� of Appointment/Reappointment e-m� to Committee Liaison on � o Board and Committee Application (Completed on ) o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on � o Oath IMPORTANT INFORMATlOfV FOR BOARD AND COMMITTEE MEMBERS �OOK ✓ City Code Ordir�ance Section applicable to the agency, board or committee ✓ City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 ana 2-459 ✓ County Code Section 2-11.1 — Canflict of Interest and Code of Ethics Ordinance (as amended through December 2C10) ✓ Amendmerts to the Code of Ethics Ordinance (September 2009 through July 2012) ✓ Highlights of the Miami-Dade County Ethics Code ✓ Sunshine Law and Public Records — Frequently Asked Questions ✓ Memorandum - Solicitation by City Board and Committee Members o Citywide Permit Application (Parking Department Form) a Baoklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees o Source of Income Statement o Acknowledgment of Financial Disclosure Requirement `\ G DiU R�I i Y STATiSTiCS REPORTI G O n file d R GI Ann ` Report. �//� /�/� x ` � � Signed by � � �e B�d o C mittee M e� � l �� By Employee: Dat �CI ff� ni Is � ! � / � �� B Em lo ee: � � � Y p Y Date City k's Office Staff Inifials CONCLUDED & RESIGNATION LETTERS Term Expired Letter Date Processed � Initials Scan o Resignation Letter Date Processed � Initials Scan o Removal L.etter due to absences Date processed Initials Scan o F\CLER1$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx , . 7;a. �. , �: f;,. � �..;,r, ,� t��;'. ' .�i.(,.`:� c2;�: � .: r�� ; � - ',i :. �, ..�'u7 _ ,_!�. �� , - �i _�. , u;�^`i' � �un., h=_�J�i' i��rm:,�7ipf , r' . MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami 8each, Florida 331 39 www.miamibeachfl.aov OFFICE OF THE CITY CLERK, Rafael E. Granado, Ci1y Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Beth Edwards RE: Committee for Quality Education in Miami Beach 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: 06/30/2019. 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 1 st, follo ing the closin of the calendar year on which I have served. � � � Ms. Beth Edwards / Sworn to and subscribed before me this � day of� , 2018 Charl 'Agostin utv 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 331 39 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 June 12, 2018 Ms. Beth Edwards 5900 Collins Ave. #1806 Miami Beach, Florida 33140 RE: Committee for Qualitv Education in Miami Beach Dear Ms. Beth Edwards: Congratulations! You have been appointed as a representative to the above-referenced Board by Nautilus Middle School PTA for a term ending on 06/30/2019. Pursuant to City of Miami Beach Code Section 2-22 (5) a: Nofinrithstanding 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. Rega , Ra el anado �City Clerk � cc. Saul Frances, Parking Director Dr. Leslie Rosenfeld, 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. �� : City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.�ov CITY CLERK'S OFFICE Telephone:305.673.7411 Fax:30S.673.7254 CityClerk@miamibeachfl.gov Acknowledgement of finsslsuspension for Board/Committee Members for failure to comply with Miami- Dacie County Financial Disclasure Code Provision Code Section 2-11.1(i) (2) , � �'' �--�t�' � �'� 1 � � �oard Member s N�me: � � � / C understand that no later than Julv 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 followirg forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami �each, Florida, r�a later than 12:00 noon of July 1, of each year. 1, A°Source of Incame Statement" 2. A"Staterr�ent 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 af n� more than $500, 60 days in jail or both. � � ,` � ,�1 , _ Signature Updated: Thursda�, Decemberr28, 2017 Page 4 of 4 F\CLER\$ALL1aFOR��1S\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx 7��/ �� [�ate � - n,�, � ��'� � � � ��-0 � e Narne: DIVERSIiY STAT15T1C5 REPORTING �' , � �G�� r'�_..SS ,r., . . . Board / Comrnitiee: Appointment Date .___ J�� %a, ��/� � Pursuant to City of Miami Beach Ordinance 20Q9-3632, the City is reGuired to annuaily prepare and present a repor� to the City Cammissian identifying the City's diversity statistics. This form alfows 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 � Female� Race/Ethnic Categories tiVhat is your race? � African-American/�lack �Ca��casianM/hite � Asi�n or Pacific lsland�r � Na�ivc-�merican!;�merican indian � Oth�r — Print Race: Do you consicier yourself to be Spanish, Hispanic or Latino!a? M�r�: tne ";Vo" box r` nct Spanish, Hrspanic, LGtir�oia. No � Yes Do }�ou consider yourself Physically Disabfed? � o �, Yes � , �-- _..� r'':1S0:S;!.,�I�llrra��Ji�t��c(3�iL't,'==.i�-,��i �i� �� CI . , - .. �..., ,.., ,�., ._ . ,. „ ,._ ,.. .,...,,. . _ .��., ...:�� . ,,.,.� _.. �:. . , information farm 05•20-i3 f�iN,^-,L.doc I �r,:-+atad: P;lonc>4', Janur��+,� ?w.:'Oi;