Nicole Bostick 12/31/21A A A»'BEA J\/i{\£\/4 Hf( ti
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APPOINTEE:
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BO A R D A N D C O M M ITTE E C H EC K LIST
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o Letter cot Appointment TRMEND. /= (5//2[_ rRM urr. /2j 3/
o Letter of Reappointment
· Pl"/j51 8, sommenvrR=somment e-mantes te comme> Lusson
Bord and Committee Application (Completed on )
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o Diversity Statistics Reporting (Completed on O ; ~
o Oath , , Scan o
REC E IV E D
JAN 08 2020
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
Y County Code Section 2-11.1 -- Conflict oi 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
CITY OF MIAM I BEA CH
OFFICE OF TH E CITY CLERK O Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
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Received on:
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
O DIVERSITY STATISTICS REP-O RT~p COPY in file and ORIGINAL for Annual Report.
_________ Signed by X J ~ ~ .,,-- _
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CONCLU D ED & RESIGN A TION LETTERS
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Resignation Letter Date Processed Initials Scan o
Removal Letter due to absences Date processed Initials Scan O
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FICLERBOARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are committed to providing excellent public service and scíey to all who live, work and lay in our vibran t, tropicai historic community.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov
OF FICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CiyCl erk@ miamibeach fl.gov
January 02, 2020
Ms. Nicole Bostick
2333 North Bay Road
Miami Beach, Florida 33140
SUBJECT: Miami Beach Commission For Women
Congratulations! You have been reappointed by Mayor Dan Gelberto the above referenced, board or
committee named above, for a term ending: 12/31/2021.
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 appointmenUelection 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.
Congratulations and good luck. Re71
Rat-Granado
City Clerk
cc: Saul Frances, Parking Director
Tathiane Trotino, 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.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miomi Beach, Florido 33139 www.miomibeochfl.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7 411, Fox: 305.673.7254
Email: CityClerk@miomibeochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Nicole Bostick
RE: Miami Beach Commission For Women
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: 12/31/2021.
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.
----. ·- - Ms. Nícole BN
Sworn to and subscribed before me this ;f /, day of Jlf!_ , 2020
u2?a;
*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.
_;, ."
MI A MIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibegchh],go
CITY CLERK'S OFFICE
Telephone: 305.673.7 411 Fax: 305.673.7254
Cit/Clerk@miamibeachfl.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)
sawer-rs«n». hole Éo//l
I understand that no later than July 1 of each year all members of Boards and Committees of the City of
M iam i B each, incl uding those of a purely advisory nature, are required to com ply w ith M iam i-D ade County
Financial Discl osure R equirem ents. This m eans that the m em bers of C ity A dvisory Boards, w hose sole or
prim ary responsibility is to recom m end legislation or give advice to the City C om m ission, m ust file, even
though they m ay have been recently appointed.
One of the fo llow ing fo rm s must be filed wi th the C ity Clerk of M iam i B each , 1700 Conv enti on C enter Drive,
Mi am i B each , Florida, no lat er than 12:00 noon of July 1, of each year.
1. A "Source of Incom e S tatem ent"
2. A "S tatem ent of Fin an ci al Intere sts (F orm 1)"
3. A C opy of your latest Federal Incom e T ax R eturn
Failure to file one of these fo rm s, pursuant to the M iam i-D ade C ounty C ode, m ay subject the person to a fine
of no m ore than $500, 60 days in jail or both.
,- %.E
S ignature ls
U p d a ted : T hu rsda y , D e ce m b e r 28 , 20 17
P a g e 4 of 4
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DIVERSITY STATISTICS REPORTING
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Pursuant to City of Miam i Beach O rdinan ce 2009-3632, the City is require d to annu ally
pre pare and pre sent a report to the City Com m ission identifying the City's diversity
statistics. This form allow s board an d com m i ttee ap plican ts and mem bers to voluntarily
self-identify their ra ce, ethnicity, disabled status and gender.
Please check the appropriate box¡or each category:
Gender: Male[l em al
Race/Ethnic Categories
4„ur race?
retes
ü c aucasta white
O Asian or Pacific Islander
[ZNative-American/American Indian
L} t her-Print Face.
D o you con sider yourself to be Sp an i sh, H ispani c or Latino/a? Mark the "No" box if not
Spanish, Hi s panic, Latino/a.
sid er yourself Physically Disabled?
C:\Use:sCNTFaN'AppData\loca!'MicrosoitßWindowsTemooray interne! ilesCcntent.utiooANP4JSCNXC icrity
information form O5-20-13 FINAL.dc
Updated: Monday, January 23,2015