Stephen Fox 12/31/21À
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APPOINTEE:
BOARD AND COMMITTEE CHECKLIST /:2 /e o.eoreo»pe. ///7/25o
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reos se. // ·ruto. /2/31/2 FOR SCANNER
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FOR CLERK STAFF
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o Letter of Appointment
o Letter of Reappointment
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o BÓard and Committee Application (Completed on / }J Î / ~
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o Diversity Statistics Reporting (Completed on: ~ , O
o Oath
Liaison on
RECEIVED
MAR -3 2020
CITY OF MIAM I BEA CH
OFFICE OE TE CITY CLERK
IMPORTAN T INFORMATION 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
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
Scan O
Scan O
Received on:
Processed on:
Scanned on:
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 Require
O DIVERSITY STATISTICS REPORTING
3{.?J2cx? O Signed by X ß,,, ~> omm,Ho:~,
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3 3 W-0 By Employee: , , • =// , ,
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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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F:ICLERBOARD AND COMMIT TIES DATABASE\CHECKLIST MASTERB&C Checklist 2015 MASTER.dox
WVe are committed to providing excellent public serics and safely to cl who lie. work and pay in our vibrant tropical historic community.
M IA M I BEACH
C ity o f M ia m i B e a ch , 1700 Convention Center Drive, Miami Beach, Florido 33139 yww _miamibe achf gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Em ail: CityCl erk@ miam ibeachfl.gov
January 17, 2020
Mr. Stephen Fox, Jr.
1350 Pennsylvania Ave, Apt 102
Miami Beach, FL 33139
SUBJECT: Human Rights Committee
Dear Mr. Stephen Fox, Jr.:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/2021.
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.
Respectfully,
cc: Saul Frances, Parking Director
Lana Hernandez, 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 com m itt ed to pro viding excellent public serv ice and safety to all who live, work and play in our vibrant, tro pical, historic com m unity.
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miomi Beach, Florido 33139 www .miomibeachfl.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7 411, Fox: 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Stephen Fox, Jr.
RE: Human Rights 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. ~
Mr. Stephen Fox, Jr.
swor to and subscribed before me this _> aayr Keo2o
*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 Beac:h
l 700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibeachf]_gov
CITY CLERK'S OFFICE
Telephone: 305.673.7411 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(1) (2)
Board Member's Name: ol }. [>g
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.
Qne 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 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
, 60/days in jail or both.
3
Signature
Updated: Thursday, December 28, 2017
Page 4 of 4
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx
S O U R C E O F IN C O M E S TAT E M E N T
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
2019 Foo M
First Name
t ole
Middle Name/Initial
M
Mailing Address - Street Number, Street Name, or P.O. Box
\358 \R B- Ao+ (oe
City, State, Zip
D; Bee' L,- 31
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
[] Municipal:
Department
Position or Title Employee ID Number
Work address Work telephone
Filing as a Board Wember (check one)
[] county O Municipal:
(Municipality)
Board where serving
Alternate address (if hom e 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 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 Address Description of the Principal Business Activity
> co ls e. Nies, PL A+yon 9
hat the information above is a true and correct statement.
Signature of Person Disclosing
3/,3/2
Date signed '
RECEIVED BY ELECTIONS DEPARTMENT: HEEv_L-
[ Hardcop y
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CITY OF MIAMI BEACH
OFFICE OF TH E CITY CLER K
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/initiais. Scanned Date/initials:
138_SP-14 COE 2016
MAIA,AM/REACH //a. lL?-.\i i
Name:
DIVERSITY STAT1STICS REPORTING
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Board I Committee: Cd1.
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:
ceder Mae(e l
Race/Ethnic Categories
What is your race? E}Af rican-American/Black
Caucasian/White
CC! Asian or Pacific Islander
[!Native-American/American Indi an
Lither- Print Race.
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not
Spanish, Hispanic, Latino/a.
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Do you consider yourself Physically Disabled?
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information form 05-20-13 FINAL.dc
Updated; Mon day, January 26.2015