Beverly Heller 12/31/21à ji j $ ± + /\/ii/\ jp 1 i à1 3 j '
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APPOINTEE:
FOR SCANNER
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B O A R D A N D C O M M IT T E E C H E C K L IS T
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Letter of Appointment TERM ND: 2 3 ] y TERMLuMr. /),3//2
o Letter of Reappointment
° 9h %/ $"575f AssoimtmenReaomment, e-meajed to commtee tuason on
o Board and Committee Application (Completed on~ Id / ;)<)-3-<J
• Resumergureusm ve 3/ ?/ o9-n
o Di v ersi ty Statistics Reporting (Completed on . ' O
o Oath Scan o
RECEIVED /
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MAR -3 2020
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CITY O F MIA M I BEA CH /
OFFICE O "+ CITY CLERK ✓
✓
IMPORT ANT INFORMATI ON FOR BOARD AND COMMITTE E 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 oi Et hi cs Ordinance (as
amended 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
Memorandum - Solicitation by City Board and Committee Members
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Received on:
Processed on:
Scanned on:
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 Financial Disclosure Requirement
O DIVERSITY STATISTICS RE PORTI NG Keep çQPy in file an d ORIGINAL for Annual Report.
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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 Scan O
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FICLERBOARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We re committed to providing excellent public serics ad scíeiy to cl who live, work, and pa y in our vibrant, trooicai historic community.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miomi Beach, Florida 33139 www.miamibeachfl gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: Ci#yClerk@miamibeachfl.gov
March 02, 2020
Ms. Beverly Heller
5916 LaGorce Dr
Miami Beach, Florida 33140
RE: Committee for Quality Education in Miami Beach
Dear Ms. Beverly Heller:
Congratulations! You have been appointed by Commissioner Steven Meinerto the above-referenced
Board or Committee, 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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regj¿1
Rafael Granado
City Clerk
cc: Saul Frances, Parking Director
Dr. Leslie Rosenfeld, 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.
M IA M I 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: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Beverly Heller
RE: Committee for Quality Education in Miami Beach
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.
Hsd, lle
Ms ,,.Beverly~
3 Sworn to and subscribed before me this 3
*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 AMIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www._miamibeachf].go
CITY CLERK'S OFFICE
Telephone: 305.673.7411 Fax: 305.673.7254
Cit/Clerk@miamibeachl.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)
soar a M em b er s Nam. •£Ly_ l'LL
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 "Statement of Financial Interests (Form 1)"
3. A Copy of your latest Federai 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.
sod Hlta- 3-3- 2020
Signature À Date
U p d a ted : Th ursd a y , D e cem b er 28, 20 17
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F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEESIBC APPLICATION REVISED 06022014.docx
MIAMI-DADI
EI 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 for Tax Year Ending I Last Name First Name Middle Name/Initial
2019 el\efe
Mailing Address - Street Number, Street Name, or P.O. Box
Sq1 La-Goce_D,
City, State, Zip
( at >al 33¢"
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. O
Filing as an Employee (check one) ..
[] Municipal:
Department
Position or Title
Work address
[] county o /lpa«i
(Municipality)
Board where serving
Alternate address (if home address is exempt) Work telephone Term began on/ended on
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 ln 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
(etceD
I hereby swear (or affirm) that the information above is a true and correct statement.
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\uzt " isclosing
3-3- 220
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
araeECEIVED
D Electronic Copy
MAR -3 2020
c AMI BEACH
IT CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: _
138_SP-14 CO 2016
MAI A,AA4[REACH /Va.[/ IL?-.\4 i
DIVERSITY STATISTICS REPORTING
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Board/ Committee: Ektu+ov
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! Female ù
Race/Ethnic Categories
What is your race?
ü African-American/lac
¿ caucasa white
CC!Asian o: Pacific Islander
[¿Native-American/American Indian
Lither- Print Race.
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not
Spanish, Hispanic, Latino/a.
5go
lee
Do you consider yourself Physically Disabled?
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information farm 05-20-13 FINAL.doc
Updated: Monday, January 23, 2015