Gregory Branch 10/31/19 /V\ I , .M I H
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: G tr4r,&" 1 DATE OF APPOINTMENT:
BOARD/COMMITTEE: r1/2 5 Pmv-e r Appointedby: `7 O,k' 6— J8
FOR SCANNER FOR CLERK STAFF
Scan o o Letter of Appointment TERM END: i°/4I TERM LIMIT: w/3l//57
Scan o o Letter of Reappointment
o "pyj_f etterof Appointment/Reappointment e-mailed to Committee Liaison on
Scan o o Board and Co/mmittee Application (Completed on ' / )
Scan o a Resume/Curriculum Vitae
o Diversity Statistics Reporting (Completed on II7 q
Scan o 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 Departme Form)
o Booklet–Guide to Sunshine Amendment& •ode .f Ethics for Public Officers and Employees
Scan 0 0 Source of Income Statement
Scan 0 0 Acknowledgment of Financial Disclosur- Re. .] -ment
DIVERSITY�� Signedby X "�STATISTICS REPORTIN. • - CO in file and ORIGINAL for Annual Report.
Received on:
Date Boardr Committee -.•.er
Processed on: gld_5--h
/G, By Employee: /�
Date / City C - ' ice Staff Initials
/ rbc'
Scanned on: )�C J // 7 By Employee: ( P.II —ow
Date Ci y Clerk's o i•- Staff Initials
707, 71ned
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
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 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
February 25, 2019
Mr. Gregory Branch
6365 Collins Avenue, Apt 3707
Miami Beach, FL 33141
RE: Mayors Panel on Ocean Drive
Dear Mr. Gregory Branch:
Congratulations!You have been appointed by Mayor Dan Gelberto the above-referenced Board or
Committee, for a term ending: 10/31/2019.
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.
Congratulations a ain and good luck.
Regar ,
Rafael Granado
City Clerk
cc: Saul Frances, Parking Director
Amy Mehu, 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.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 vwwv.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: Mr. Gregory Branch
RE: Mayor's Panel on Ocean Drive
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: 10/31/2019.
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 Guidkil the Sunshine Amendment
and Code of Ethics for Public Officers and understand that as a membe, of City of Miami Beach Board
and/or Committee, I must comply with the financial disclosure* requirer}xents46f Miami-Dade County or the
State of Florida (depending on the board or committee on which I serie) •r( - 1st, following the closing
of the calendar year on which I have served.
Mr. Gregory Branch
Sworn to and subscribed before me this / day of K 2019
1
/ '
C les D'Agostin
Deputy 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 33139
www.miamibeachfl.gov
CityClerk@miamibeachfl.gov
CITY CLERK'S OFFICE
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 C• • Pro 'sion Code Section 2-11.1(i) (2)
Member's Name: /
Board � !� r
kileA
I understand that no later than lv 1, of each atulre, are eequir dBoards
complyCommittees
with Miami-Dade County
Miami Beach, including those of a purely advisory
Financial Disclosure Requirements. This legislation
e islati ans n otrthe g give advice stoftheCity
City Commiss Coory mmission, mustwhose
file even
primary responsibility is to recommend g
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 • the-e forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than ',:00, •1 days in jail or both.
Date
Sign- re
Updated:Thursday,December 28,2017
Page 4of4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
MIAM BEACH
DIVERSITY STATISTICS REPORTING
Name:
6(5,1a G(1
Board / Committee: Key0v` S k)A1,tia Oe1 "Ce"-v\ 'bPs1 VIK__
Appointment Date: 2-CI I 1
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" —€emale 0
Race/Ethnic Categories
1N tis your race?
African-American/Black
Caucasian/White
0 Asian or Pacific Islander
0 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, Hispanic, Latino/a.
O Yes •
Do you consider yourself Physically Disabled?
0
Yes
C:\Users\CFNTFraN`App0ata\Local\Microsoft\Windaws\TemPOrary Internet Files\Content.0utlook\NP4J9CNX\SC minority
information form 05-20-13 FINAL.doc
Updated: Monday,January 26,2015