Mark Rabinowitz 12/31/20 MIAMI BEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: AA aC a\D4Y\ ("L .\ 7 DATE OF APPOINTMENT: 1/17// 1
BOARD/COMMITTEE: OA C Appointed by: l( (o,", 1 55 ' b'~
FOR SCANNER FOR CLERK STAFF / ?/S/ 3
Scan o 0 Letter of Appointment TERM END: / //XTERM LIMIT:
Scan o o Letter of Rea pointment
o o yl _a/ tt r of Appointment/Reappointment e-mailed to Committee Liaison on
Scan o 0 o rd and mlttee Application (Completed on
)
Scan o o Resume/Curriculum Vitae � 7/0- --Ilq o Diversity Statistics Reporting (Completed on
Scan o o Oath
co c_ IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
'= v ✓ City Code Ordinance Section applicable to the agency, board or committee
C. N `,,c.- V City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
U- = ""_ ✓ County Code Section 2-11.1 — Conflict of Interest and Code of Ethics Ordinance (as
. ,1 amended through December 2010)
t N ,}=- ✓ Amendments to the Code of Ethics Ordinance(September 2009 through July 2012)
C ✓ Highlights of the Miami-Dade County Ethics Code
✓ Sunshine Law and Public Records—Frequently Asked Questions
, _ ✓ Memorandum -Solicitation by City Board and Committee Members
c
o Citywide Permit Application (Parking Department Form)
o Booklet—Guide to Sunshine Amendment& Code of Ethics for Public Officers and Employees
Scan 0 0 Source of Income Statement
Scan 0 0 Acknowledgment of Financial Disclosure Requirement
o ,DIVERSITY STATISTICS REPORTING
' -Keep COP in file and ORIGINAL for Annual Report.
Received on: 21 I Zr 4 Signed by X /�[,r�
ateBoar. •r Committee Me •-
�i 9Processed on: /dqi By Employee:
Dateyerello 'ce - - I ' '.
Scanned on: 4 / 9 By Employee: /
Date City CIer Office Staff Initial r
-.
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed
Initials Scan 0
Resignation Letter Date Processed
Initials Scan 0
Removal Letter due to absences Date processed Initials Scan 0
ci.,7-,--
F:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We ore committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
MIAMI B
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
CITY CLERK'S OFFICE CityClerk@miamibeachfl.gov
Telephone: 305.673.7411 Fax: 305.673.7254
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: Ai Q V A u 0IA) '
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 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.
x/17 //9
Signature Date
Updated:Thursday, December 28,2017
Page 4 of 4
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MIAMI 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
January 17, 2019
Mr. Mark Rabinowitz
1550 N.E. Quayside Terrace
Miami , FL 33138
SUBJECT: Health Advisory Committee
Dear Mr. Mark Rabinowitz:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/2020.
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.
Respectfully,
Rafa Granado
11X� City lerk
cc: Saul Frances, Parking Director
Sonia Bridges, 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.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: Mr. Mark Rabinowitz
RE: Health Advisory Committee
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: 12/31/2020.
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 1st, following the closing
of the calendar year on which I have served.
Mr. Mark Rabinowitz
Sworn to and subscribed before me this 12-- day of , 2019
Chart I'Agostin
I ; .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.
miAMi•DADE SOURCE OF INCOME STATEMENT
COUNTY
Section 2-11.1(i)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
2018 RAbiNG'Cr ( PE AA Ati1, 1L.,
Mailing Address-Street Number,Street Name,or P.D.Box
i t (��. I Scc,1764- v-6 g f.- 0--c: 2-0'3--
City,State,Zip
A4W/k 4 I) 1:L., 3/81
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)
0 County 0 Public Health Trust 0 Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address Work telephone Employment began on/ended on
Filing as a Board .member(check one)
County I Municipal: 41 1'444% 3 eA c4
(Municipality)
\(. Board where serving
Alternate address(if home address is exempt) Work telephone Term began on/ended 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.❑
Name of Source of Income Address Description of the Principal Business Activity
µt I &ilk r i4 eco(-Lt (ti, 9!' g (S -0-7 to c se/cm 0
r (0.10...14k • (4-4014 0•.)1 3 t vb
I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
/( Lc- ❑ Hardcopy
❑ Electronic Copy
• Signature of Person Disclosing f
p. .As 10110 "Oir
. 9 I 'z(1ri
Date signed ,
OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials:
136 SP-14 COE 2016
MIAiV'd BEACH
DIVERSITY STATISTICS REPORTING
Name:
Aro aA4tt taut
Board / Committee: (4 AC—
Appointment ointment Date: l/l .?-/i
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: Mal Female�I
Race/Ethnic Categories
What is your race?
African-American/Black
baucasian/White
Asian or Pacific Islander
Native-American/American Indian
0 Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No"box if not
Spanish,SpniHispanic, Latino/a.
e9 No
Yes •
Do youyoconsider yourself Physically Disabled?
e� No
Yes
C:1Users\CENTFraN\AppData\Local\Microsoft\WindoWs\Temoorary Internet Files\Content.Out!ook\NP4J9CNX16C minority
information form 05-20-13 FINAL.doc
Updated: Monday,January 26,2015