Jeff Feldman 12/31/21. , , . " . 'BF····;-. r"'" ¡ A4 A¡i A(_i ¡±fii4/44 É. i 1%l5 \3/ !1 k=f i s f
BO A R D A N D C O M M ITTEE C H E C KLIST
APPOINTEE: _.Ty FAA DATE OF APPOINTMENT: '/2/202
7
BOARD/COMMITTEE: hag ±lousy, bu. /Ap poi nte d by. D_A2 D e
oseAweR ro as«sor ' ]2/3//o7 2/3// c an o o Letter of Ap poi ntm ent TERM END: _ -4Z TERM LIMIT: _y 97
S c a n o o Letter of Reappointment T 7
o 7°/';):1/ L~AppointmenUReappointm eï'. e-7 ed to Committee Liaison on
scan e oar@an~committee Application (completed on /_, _l_ 97}O
seno ·gesseretumvse [/))/
- Diversity statistics Reporting (completed on dry)o)O
Scan o oOath 7 7
E CE I VE D
JAN 21 2020
CI TY OF MIAM I B E A CH
FEICF ar 1CLERK
IM P O RT AN T INFO R M A TI O N FO R BO ARD AND CO M M ITT EE M EM B ER S B O O K
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 - Confict of Interest and Code of Ethi cs 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
S c a n O
c an 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
o D IV E R S ITY S TA TIS TIC S R E P O R TIN G
1/t.z/U> u:, Signed by X. _ _..,,'-,++'1-_,·,~r,c.,,;.,h..,,_,...,,.7 11 -!,f....:.--·--'--~-----
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)_ate
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1 Date
R IG IN A L for An nual R eport.
Received on:
Processed on:
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CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed Initials Scan o
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
Ve are committed to providing excellent public service and sceiy to cll who live, work, and lay in our vibrant, trooicci historic communiy.
MIAM I BEACH
City o f M ia m i B e ach, 1700 Convention Center Drive, Miomi Beach, Florido 33139 www.miomibeachfl.gov
OF FIC E O F TH E CI TY CL ERK , Rafael E. G ra nado, City Clerk
Tel: 30 5 .6 7 3 .7411, Fax: 305 .6 73.7 25 4
Em a il: C ity C lerk@ m ia m ibeachfl.gov
January 02, 2020
Mr. Jeffrey Feldman
20 Island Ave. #1006
Miami Beach, Florida 33139
SUBJECT: Affordable Housing Advisory Committee
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, "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.
Rafael
City Clerk
cc: Saul Frances, Parking Director
Alba Tarre, 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 - Am endment 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.
MIAM I BEACH
City of Miami Beach, 1700 Convention Center Dive, Mi ami Beach, Florida 33139 wwy_miamibeachfl_gov
OFFICE OF TH E 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. Jeffrey Feldman
RE: Affordable Housing 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: 12/31/2021.
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.
Sworn to and subscribed before me this_A day of _)- , 2020
*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.
MIAMIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www._miamibegchf]_gov
CITY CLERK'S OFFICE
Telephone: 305.673.7411 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)
• Board Member's Name:. /H t 9_A.¿
>
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 form s must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miam i 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 latest Federal 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.
Signature
l
Updated: Thursday, Decem ber 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
4 9 EIII SOURCE OF INCOME STATEMENT
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 fo r Tax Year Ending I Last Nam e First Nam e Middle Nam e/Initial
2019 [5-p 0et d,
M ailing Address - Street Number, Street Nam e, or P.O. Box
2 1= LAD? p é #4U
City, State, Zip
tb p 3372 7 ~
If your ho m e addre ss is your' m ailing address, and your hom e addre ss is exem pt fro m public records pursuant to Fla. Stat. $119.07, read
instructions on the follow ing page and check here. D
[] county
Departm ent
Position or Title
Work address Work telephone
Filing as a Board Wember (check one)
[] county ~unicipal: -"'=''-----'---+-------''--------'--____.:_---;=-~-~
Board where serving c
Alternate address (if home address is exempt) Work telephone
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.O
Name of Source of Income Address Description of the Principal Business Activity
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I hereby sw ear (or affi true and correct statement.
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e rs #REER 7B "" J Hardcopy
O Electronic Copy
JAN 2 1 2020
CITY O F MIAM I BEACH
OFFICE J CITY CLERK
O FFIC E US E ON LY Accepted: Y / N Deficien cy. Processed Date/Initials: Scanned Date/initials:
138_SP-14 CO 2016
A]A,MA/REC} //a.[V li),\4 l
DIVERSITY STATISTICS REPORTING
Name: J y_ _-
Board/committee: 1PP)0 Hu us¿
Appointment Date: l/2/222
7 7
Pursuant to City of Miami each 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~e O
Race/Ethnic Categories
What is your race?
ù Aftcan-American/lack
doacesanwwhite
D Asian or Pacific Islander
[¿Native-American/American Indian
[lther-Print Face. -
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not
Spanish, Hispanic, Latino/a.
am v es
Do you consider yourself Physically Disabled?
ne
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Updated: Monday, January 23.2015