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BOARD AND COMMITTEE CHECKLIST
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o Letter of Appointment TERM END/l/_2[_ TERM LIMIT: /=/ _/
o Letter of Reappointment · j71'/$355os v sr s«re
o Baíd ad Committee Application (Completed on _LL 4,L )
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o Diversity Statistics Reporting (Completed on, e=
o Oath T 7
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IM P O R T AN T IN F O R M A TI O N FO R B O A R D A N D C O M M ITTE E M E M B ER S B O O K
City Code Ordinance Section applicable to the agency, board or committee
RECEIVED ✓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 oí Interest and Code of Ethics Ordinance (as
amended through December 2010)
JAN 14 2020 Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓Highlights of the Miami-Dade County Ethics Code
C ITY O F M IA M I B EA CH Sunshine Law and Public Records - Frequently Asked Questions
OFFICE OF THE CITY CLERK / Memorandum - Solicitation by City Board and Committee Members
S c a n O
S c a n O
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 Financia! Disclosure Requirement
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I O DIVE~SlTY STATISTICS R~û
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CONCLUDED & RESIGNATION LETTERS
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Resignation Letter Date Processed Initials Scan O
Removal Letter due to absences Date processed Initials Sca n O
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FICLERBOARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We cre committed to providing excellent public service and scfeiy to cl who live. work and play in our vibrant tropical historic community.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miomi Beach, Florido 331 39 www miomibeochfl.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 30 5 .6 7 3 .7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
January 07, 2020
Ms. Caitlin Pomerance
5 Island Ave., Apt. 8E
Miami Beach, Florida 33139
SUBJECT: Marine and Waterfront Protection Authority
Congratulations! You have been reappointed by Commissioner Ricky Arriola to 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 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.
Congratulations and good luck.
Regards,
R ~ado Jc
cc: Saul Frances, Parking Director
Tasha Byars, 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 pro viding 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
O FFIC E O F TH E CI TY C LE RK , Ra fa el E. G ra na d o , C ity C le rk
Tel: 305.673.7411, Fax: 305.673.7254
Em a il: C ityC le rk@ m ia m ib eachfl.g o v
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Caitlin Pomerance
RE: Marine and Waterfront Protection Authority
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 ca lendar year on w hich I have serv ed. G,J ~l& ~ #
•• Emiai, r6merance
14~ "Ç,° I/"\ 2020 • day of L
*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 pro viding excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
MIAMIBEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www _miamibegchf]_goy
CITY CLERK'S OFFICE
Telephone: 305.673.7411 Fax: 305.673.7254
Cit/Cl erk@m iamibeachfl.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)
esrroo.. L'A h/i! Lo'AK
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 "Statem ent of Financial Interests (Form 1)"
3. A Copy of your iatest Federai income Tax Return
Failure to file one of these form s, 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.
oh.
Updated: Thursday, December 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
MIAMI-DAD.
E7I SOURCE OF INCOME STATEMENT
Section 2-11.1(i) of the County Ethics Code requires that certain em ployees and public officials file a financial disclosure Statement on a yearly basis by July 1st
of every year.
Disclosu re for Tax Year Ending
2019
Last Nam e vol First Nam e
arti
M iddle Nam e/Initial
M aili ng Ad dress - Street Num ber, Street Nam e, or P.O. Box
223/ S u 3 0t A #l
City, State, Zip Ft 331 2 3
If your hom e 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. D
Fi ling as an Em ployee (check one)
[] M uni cip al:
Departm ent
Position or Title Employee ID Number
W ork address
Filñ g as a Board W em ber (check one)
W ork telephone
D County ~unicipal: t~ NA. [ac
(Municipality)
Board where serving 1d 'A
Altern ate addre ss (if hom e addre ss is exem pt) ,---- W ork teleph on e
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
incom e in descending order, with the largest source first. Examples of sources of income include: compensation for services, income from business, gains from
pro perty 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 incom e of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here.O
Nam e of Source of Income Address
He e + w,/ivover =r pl+>
Description of the Principal Business Activity
pl 0 ta ro o]
I hereby swgar @r affirm ) that th e information ab ove js a true an d correct statem en t.
ate signed
RECEIVED BY
D Hardcopy
E ectronte lé#y 1 4 2020
NT:
C ITY O F M IA M I BE AC H
OFFICE OF THE CITY CLERK
OFFI C E US E ON LY Accepted: Y / N Deficiency. Processed Date/initials: Scanned Date/initials:
138_SP-14 COE 2016
MA[A,MA[REA[ /r.[V IL?ni\4 l
DIVERSITY STATISTICS REPORTING
L'A±NU LAAS
Board /Committee: L I
20,)0
Appointment Date: [_ l
Pursuant to City of Miami Beach Ordinan ce 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 !lows board and committee applicants and members to voluntarily
self-identify their race ethnicity, disabled status and gender.
Please ch eck the appropriate box for each category:
cender: Mete Fae7l
Race/Ethnic Categoties
What is your race?
l African-Am erican/lack
@caucasawwte
[CC¿Asian or Pacific Islander
['Native-American/#Am erican Indian
d oter-Pt ac
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not
Spanish, Hispanic, Latino/a.
~No
lv>
Do you consider yourself Physically Disabled?
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information form 05-20-13 FINAL.doc
Updated: Monday, January 23. 2015