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Daniel Smith 12/31/19All� B EAC I BOARD AND COMMITTEE CHECKLIST APPOINTEE: bA#jr'_'e' / SA4 l T� DATE OF APPOINTMENT: BOARD/COMMITTEE: Ve)(_fi Cry' 66ur i' Appointed by: Comm FOR SCANNER FOR CLERK STAFF !n Scan o o Letter of Appointment TERM END: tj/-)? /C TERM LIMIT: r Scan o o Letter of Reap ointment o p f try of Appointment/Reappointment e-mailed to Committee Liaison on PJ-�Scan o o Boar and Committee Application (Completed on ) Scan o o Resume/Curriculum Vitae & 3 o Diversity Statistics Reporting (Completed on Scan o o Oath IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK 77 t ✓ 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) Ln ✓ 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 Scan o Scan o Received on: Processed on Scanned on: 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 i o DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report. l11.2 Signed by 16 eel g- By Employee: Em to ee: Date / Sr By Employee: Date CONCLUDED & RE ED Term Expired Letter Date Processed Initials Scan O Resignation Letter Date Processed Initials Scan o Removal Letter due to absences Date processed Initials Scan U FACLERISALL\BOARD AND COMMITTIES DATABASEICHECKLIST MASTERT&C Checklist 2015 MASTER.docx - 7? i..n . •'0 ..j " i ! ui, (' �.. , c , ?Il f , (, <. , .,'y .;�, f ':U- , , h._'J` l i�fr, Ill,i!ti P✓ it MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov September 28, 2018 Daniel Smith 90 Alton Road, Apt 2202 Miami Beach, Florida 33139 RE: Next Generation Council Dear Daniel Smith: Congratulations! You have been appointed by Commissioner Micky Steinberg 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. i Congratulations again and good luck. Regards, Ra ael Granado Ci' Clerk C. Saul Frances, Parking Director Erick Chiroles, 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 331 39 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Daniel Smith RE: Next Generation Council 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. 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, following the closing of the calendar year on which I have served. MM ���EOOM Daniel Smith Sworn to and subscribed before me this :5 day of P f2018 harl 'Agostin e uty Clerk *Please visit the City of Miami Beach website at www.miamibeachfi.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. M I A MI B F A 1�1 DIVERSITY STATISTICS REPORTING Name: Board / Committee: 1 - c r C`�e�e�~,`~^ ��✓ncI Appointment Date: ------F—= p 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 I-V Female 0 Race/Ethnic Categories What is your race? [�_] Ar an-American/Black Gaucasian/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, Latinole. No es Do you ider yourself Physically Disabled? �No ID Yes C:\Users\CFVTFra,N'AppData\Local,'Mi,:rosoftivUindc.ws\Temoorar. Internet Fi!es\Content.out!ook\NIP�'j9CN;C\BC mino;iiy information form 05-20-13 FINIL.doc updated: Nionday, January 2E. 2015