Jared Rogoff 06/30/21September 23, 2020
Mr. Jared Rogoff
5223 north bay road
Miami Beach , Florida 33140
RE: Youth Commission
Dear Mr. Jared Rogoff:
Congratulations! You have been appointed by Mayor Dan Gelber to the above-referenced Board or
Committee, for a term ending: 06/08/2021.
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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards,
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.
Oath of Office Oath
of Civility and
Acknowledgements
TO: Mr. Jared Rogoff RE:
Youth Commission
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: 06/08/2021.
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. Jared Rogoff
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.
MIAM I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Emai l: BC@miamibeachfl_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF _
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as ( check ( ✓) all that apply):
.¡¡Í I am a resident of the City of Miami Beach for six months or longer.
D 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).
D 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 nd that th +
fai. I.l "
Signature \ ~-- Date 1La9of
Printed Nme
NOTARY J
Sworn to (or affirmed) and subscribed before me, by means of D physical presence o~ online
os-).,Allí ..o Joco
----,.------------- (City of Miami Beach Board/Committee Member).
X roauceat tese
Form of Identification
"%22.- ¿ _1 _,
Signature of Notary Public
Name of Notary, Typed, Printed, or Stamped
(NOT ARY SEAL)
A8Ya,, Charles J. DAgosti
3%} gNoTAR Y PuLIC
STATE OF FLORI DA
tli:/ comm# GG168171
Ferss 12/14/2021
MIAM I BEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach[l_gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 7411
~ 6=[-\ DIVERSITY sT_A_T]_,s_r,_~ s_k_EP-+-o---Fj_T
Last Name~ First Name
1
Middle Initial
The following infÔPM'fation is voluntary and has no bearing on your consideration for appointment. It is being
asked to comply with City diversity reporting requirements.
Gender:
íae
Dremale
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
rel'Caucasian/white
"[Native American/American Indian
O Other - Print Race: ------------ □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
/ Eves
Mo
O I prefer not to answer.
Do you consider yourself Physically Disabled?
lves
to
O I prefer not to answer this question.
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MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach[l.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 7411
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-
t..7 "res
Last Name ½ First Name -M-id----c~--
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.
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;" or
2. A "Statement of Financial Interests (Form 1)1;" or
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. [ D / :&:;k
Ja alt iIS
Signature Date
1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
pursuant to F.S. $112.3145(1)a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County
Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their
Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure
requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office
of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State
requirement.
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