Ronald Issenberg 12/31/21+ 1 +m, r= A A1[A NA'pÉ J f i 4 3j\/4i # } \/ 1/; /3fly4 J $ {j, k .s k' #ter CH
APPOINTEE:
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BOARD AND COMMITTEE CHECKLIST
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S c a n o o Letter of Reappointment
° 99É)Sf"74° A om m eR e=om m en_e-m anes to committee Lason on
o B~ard a_nd C~mmittee_Application (Completedln 1§~7p~/J)
o Résumé/Curriculum Vitae / •
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o Diversity Statistics Repor ting (Com pleted on 'd
o Oath ff Scan o
RECEIVE D
JAN 1 4 2020
CITY OF MIAMI BEACH
OFFICE OF TH E CITY CLERK
IM P O R T AN T IN F O R M A TI O N FOR BO AR D A ND CO M MI TT EE M EM BE RS B O O K
✓City Code Ordinance Section applicable to the agency, board or committee
Y 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
am en ded through December 201 O)
✓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
✓Mem orand um - Solicitation by City Board and Committee Members
S c a n o
S c a n o
O Citywi de Perm it Application (Parking Depar tm ent Form)
o Booklet - Guide to Sunshine Am endment & Code of Ethics for Public Officers and Employees
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
O DIVERSITY S TA TIS TI C S REPORTING Keep çQPy in file an d ORIGINAL for Annual Report.
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C O N C LU D ED & RE S IGN A TI O N LETTERS
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Resignation Letter Date Processed Initials Scan o
Removal Letter due to absences Date processed Initials Scan o
cc
F:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.dccx
We are committed to providing excellent public service and safety to all who live, work, and lay in our vibrant, tropical, hisioric community.
M IA M I 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: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Ronald lssenberg
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 calendar year on which I have served. -£..=
e2o20
mv ,29t9 Sworn to and subscribed before me this ,,., 1
~
*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.
M IA M I BEACH
City of Miami Beach, 1700 Convention Center Drive, Miomi ßeoch, Florido 33139 www miomibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
Decem ber 10, 2019
Mr. Ronald lssenberg
1567 Daytonia Road
Miami Beach, Florida 33141
SUBJECT: Marine and Waterfr ont Prote cti on Authority
Congratulations! You have been reappointed by Commissioner David Richardson 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, "Notw ithstanding any other provision of the
City Code or of any resolution, commencing with terms beginning on or after Jan uary 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 appointm ent/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. 7 411. Please read the enclosed materials carefully.
Congratulations and good luck.
7 Razranado
à CityClerk
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 Wi de 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.
MI A MI BEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 331 39
www._migmibeach[]gov
CITY CLERK'S OFFICE
Telephone: 305.673.7 411 Fax: 305.673.7254
CilyClerk@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)
es.... _Ko9¿/I__sccelo
I understand that no later than July ,of gach 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.
2 l-lt-2ooo
Signature Date
Updated: Th ursday, Dece mber 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMIT TEES\BC APPLICATION REVISED 06022014.docx
MIAMID
Em SOURCE OF INCOME STATEMENT
Section 2-11.1(@) 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
2019
First Name Middle Name/Initial
~
15 a d
City, State, Zip
a l., 3 - 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. D
D County [] Municipal:
Department
Position or Title Employee ID Number
Work address Work telephone
r-con ca Maxi Teal [] Municipal: i uri ci a iy
Board where serving
A
Alternate address (if home address is exempt) Work telephone
I
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 I Address I Description of the Principal Business Activity
2
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I hereby swear (or affirm) that the information above is a true and correct statement.
<p2- e
Signature of Person Disclosing
L-Lt -do 2 o
Date signed
EcEe Y HRS PEPE+ENE
Hardcopy
E ectromic g9y 1 4 2020
CITY OF MIAMI BEACH
O FFIC E O F TH E C ITY C LER K
O FFIC E US E O N LY A ccepted: Y / N D eficiency: Pro cessed Date/Initials:S can ned Date/Initials: _
138_SP-14 COE 2016
MIA. J\ ¡,IF\ rÂ. r, s
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Name:
DIVERSITY STATISTICS REPORTING
ko. Isoehe;
Appointment Date:
cara rcommmtee: //tu/A
7
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Pursuant to City of Miam i Beach Ordinance 2009-3632, the City is required to annually
pre pare and present a report to the City Commission identifying the City's diversity
st at is ti cs. This form allows board an d committee applicants an d members to voluntarily
se lf-id e n tify th e ir ra c e , eth n ic ity , d is a b le d sta tu s a n d ge n d er.
Please ch eck the appr opriate box for each category:
ceder wee[KI
Race/Ethnic Categories
W hat is your race?
_African-American/3lack
(£$ caucasian/white
O Asian or Pacific Isla nd e r
[? Native-American/American Indian
(l ther- Print Face.
Do you consider yourself to be Spanish, Hispanic or Latino/la? Mark the "No" box if not
Spanish, Hispanic, Latino/a.
fG
lves
Do you consider yourself Physically Disabled?
2
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iformation form 05-20-13 FINAL.dóc'
Updated: Mon d ay, January 26, 2015