Margueritte Ramos 11/30/18BOARD AND COMMITTEE CHECKLIST
APPOINTEE: G16-t-Olf A40 -S DATE OF APPOINTMENT:
BOARD/COMMITTEE: �C�h u5 O &A,'4' Appointed by:41M`1��
FOR SCANNER FOR CLERK STAFF 101+Ah'' L 1`3
`J /Scan c o Letter of Arrointment TERM END: lJl )`,/ ` TERM LIMIT: 3� !Y
Scan o o Letter of Reappointment
o py J_t of Appointment/Reappo
intment
d to Committee Liaison on
r//")Scan o o Board and Committee Application (Complete�Scan o 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
Cn
✓ City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Cot ✓ County Code Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance (as
k_ = C_, amended through December 2010)
• .- ✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
Z3 ✓ Highlights of the Miami -Dade County Ethics Code
CO a ✓ Sunshine Law and Public Records - Frequently Asked Questions
C\j 140-
✓ Memorandum - Solicitation by City Board and Committee Members
•ac �- k_
o Citywide Permit Application (Parking Department Form)
V-40 Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officend Employees
Scan o O Source of Income Statement /
Scan o o Acknowledgment of Financial Disclosure Requirem'ent
Z
aRSITY STATISTICS REPORTING Kee PYA.#' ' INAL for Annual Report.
Received on: 7 Signed by X
Date bard or eommittee Mem er
Processed on: 0 d1- Iqj By Employee:
Date v Clerk's Office Staff Initials
Scanned on:
By Employee:
Date
Office Staff ti
suanned
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter
Date Processed
Initials Scan 0
Resignation Letter
Date Processed
Initials Scan o
Removal Letter due to absences
Date processed
Initials Scan o
F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
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CO'pri�!�!n�
MIAMIBEACH
City mfMiami Beach, }700Convention Center Drive, Miami Beach, Florida 33lJg
OFFICE OFTHE CITY CLERK, Rafael EGravvJo City Clerk
Tel: 305.673.7411' Fax: 385.673.7254
Email: CityCIerk@miamibeochfI,9ov
June O1.2U18
Mu. MorgueritteFamoo
153OBay Drive
Miami Beach, FL33141
RE: Mayor's General Obligation Bo d Advisory Panel
Dear Ms. &arguerittoRamos:
Congratulations! You have been appointed by Mayor Dan Gelberto the above -referenced Board or
Committee, for a term ending: 11C30/ 018.
Pursuant VnCity ofMiami Beach Code Section 2-22(5)a�
Notw8hstondingmnyoMherpmviaioncdtheCih/CudeorofonyRean|uUnn.00mmencingwKh
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 ofthe successor City Commission member.
If you are unable to accept this appointmont, or have any queodons, please call the Office of the City
Clerk at3O5.873.7411.
Please read the enclosed materials carefully asthey concern your duties, responuibi!ih*a, and
requirements oaoboard orcommittee member.
Congratulations again and good luck.
Regard
l
R��*|Granadn
City Clerk
cc: Saul Fnannes, Parking Director
John Woodruff, City Liaison
ENCLOSURES:
Oath ofOffice/Oath ofCivility/Acknowledgements
City Code/Ordinance section applicable hoagency, board orcommittee
City Code Sections 2'22. 2-23, 2-24, 2-25, 2'28. 2458 and 2-459
Ordinance No. 2OO8-3548'Amendment VuCity Code Section 2-22
Miami -Dade County Code Section 2-11.1 - Conflict ofInterest and Code of Ethics
ChyVNdePermitAppUoodon-(PmddnDDepadmantForm)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
We are committed mproviding excellent public service and safety mall who five, work and play mour vibrant tropical, histonc community.
MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov
OFFICE OF THE CITY CLERK, Rafael Granado, City Clerk
Tel: (305) 673-7411, Fax: (305) 673-7254
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Margueritte Ramos
RE: Mayor's General Obligation Bond Advisory Panel
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: 11/30/2018.
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 Miamj-Dade County o he -
State of Florida (depending on the board or committee on which I serve) on Judy sf, following-tl% closing
of the calendar year on which I have served. Gam' /�_"?
/ Ms. Margueritte Ram6s
Sworn to and subscribed before me this day of��2018
Deputy Clerk SA.#_V r0e_v
*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 B EAC H
DIVERSITY STATISTICS REPORTING
Name:
Board / Committee:
Appointment Date:
Sys �..P�/ ���A�
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 ID Female
Race/Ethnic Categories
What is your race?
ncan-American/Black
L. Caucasl'WNhite
Asian or Pacific Islander
Native-Arnerican/American indian
0 Other — Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box i not j
Spanish, Hispanic; Latincla.
ED No
Yes
LD you onsider yourself Physically Disabled?
� 10 �
N
Yes
Ca`,Sssrs+C���l"i=r2"J`�n�u0atalL ocaP,h,4ir��,so`:�^;.nric;,si7".=rr:por� ;ni_ __=i!�clCent�^r.0�.:1400'c\f�P^-.J�,^,;d;C.�� mirc,ci+l;
information form 05-20-13 F1NAL.d« c
U dated: PAonday, January 25. 2rJ 5
MIAIv11 BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
CITY CLERK'S OFFICE
Telephone: 305.673.7411 Fax: 305.673.7254
CityClerk@miamibeachfi.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:
G
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-Incor e -ax Return
Failure to file one of these forms, pursuant to the Miami -Dade County Code, may subject the person to a fine
of n;more than $55509.,-60 days ' aii or both.
Si ture C" ate
Updated: Thursday, December 28, 2017
Page 4 of 4
FACLER\SALL1aFORiMS13OARD AND COMMITTEESIBC APPLICATION REVISED 06022014.docx