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Adam Kravitz 12/31/22BOARD AND COMMITTEE CHECKLIST APPOINTEE: ____________________________________ DATE OF APPOINTMENT: ______________ BOARD/COMMITTEE: ____________________________ Appointed by: ___________________________ FOR SCANNER FOR CLERK STAFF Scan ○ ○ Letter of Appointment TERM END: _______________ TERM LIMIT: _____________ Scan ○ ○ Letter of Reappointment ○Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on _____________ Scan ○ ○ Board and Committee Application (Completed on ) Scan ○ ○ Résumé/Curriculum Vitae ○Diversity Statistics Reporting (Completed on ) Scan ○ ○ Oath IMPORTANT INFORMATION FOR BOARD AND COMMITTEE 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 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 ○Citywide Permit Application (Parking Department Form) ○Booklet – Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees Scan ○ ○ Source of Income Statement Scan ○ ○ Acknowledgment of Financial Disclosure Requirement ○DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report. Received on: _______________________ Signed by X________________________________________________ Date Board or Committee Member Processed on: ______________________ By Employee: ________________________________________________ Date City Clerk’s Office Staff Initials Scanned on: ______________________ By Employee: ________________________________________________ Date City Clerk’s Office Staff Initials CONCLUDED & RESIGNATION LETTERS Term Expired Letter Date Processed Initials Scan ○ Resignation Letter Date Processed Initials Scan ○ Removal Letter due to absences Date processed Initials Scan ○ F:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx Adam Kravitz 6 October 2020 (for 1 January 2021) Police Citizens' Relations Committee Ricky Arriola 12/31/2022 12/31/2022 10/8/2020 10/8/2020 10/8/2020 10/8/2020 10/8/2020 10/9/2020 City of Miami Beach, 1700 Convention Center Drive, Miami 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: CityClerk@miamibeachfl.gov October 06, 2020 Mr. Adam Kravitz 2982 Alton Road Miami Beach, FL 33140 SUBJECT: Police/Citizens Relations Committee Congratulations! You have been reappointed by Commissioner Ricky Arriola to the above referenced, board or committee named above, for a term ending: 12/31/2022. 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, Rafael Granado City Clerk cc: Saul Frances, Parking Director Chief Rick Clements, 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 providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. Oath of Office Oath of Civility and Acknowledgements TO: Mr. Adam Kravitz RE: Police/Citizens Relations 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: 12/31/2022. 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. Adam Kravitz Sworn to and subscribed before me this day of , 2020 ________________________________ Charles D'Agostin Deputy Clerk *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. 8 October M IA M I BEACH City of Miami Beach l 700 Convention Center Drive M iam i Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: BC@miamibeachfl_goy Telephone: 305.673.7 411 AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH STATE OF FLORIDA COUNTY OF Miami-Dade I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check(✓) all that apply): ~ I am a resident of the City of Miami Beach for six months or longer. O I have an ownership interest (for a minimum of six months) in a business established in the City of Miami Beach (for a minimum of six months). O I am a full-time employee of a business (for a minimum of six months) and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months). "Ownership Interest" means the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" means any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true. a._. soao-zozo -------------- Signature Adam Kravitz Date Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of [] physical presence or [ online notarization, this _8_ day of October , 2020_b y Adam Kravitz _______________ (City of Miami Beach Board/Committee Member). RECEIVED 001 6 2020 ., char#q« pg8gE2LEACH &@ Nork'Y'I ' y CLERK j bsrArorroRIA %#±dig corm+ cc1es171 "ces° poires 12/14/2021 Produced ID Form of Identification x Personally Known Cuc.bl.2 D'atzi Signature,af Notary Pjbii . Ch ar les D'Agostin Name of Notary, Typed, Printed, or Stamped  