Magui Benitez 12/31/21A BEACH //%l. -
BOARD AND COMMITTEE CHECKLIST ,/
APPONTEE:._A6r 2ZTéZ DATE OF APPorMwenn, h? 121220
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BOARDICOMMITTEE: 2€7Pk° /rt touAppointed by.. CG'j o1 Go v
ree D/I/1 reo«so. 2/sy/2 FOR SCANNER
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RECEIVED
001 29 2020
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o ,Copy _ofLétter _of Appointment/Reappointment e-mailed to Committee
• Boatd and Committee Application (Completed on (//4 9_/ )
e Résumé/Curriculum Vitae fó /4 î ç/ /
Diversity Statistics Reporting (Completed on ff O /) ¿7 (.__I
Oath
CITY OF MIAM I BE ACH
EEO Ore -Ty CLERK
Liaison on
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
City Code Ordinance Section applicable to the agency, board or committee
Y 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
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
(as
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Received on:
Processed on:
Citywide Permit Application (Parking Department Form)
O Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
• Source of Income Statement
ó Acknowledgment of Financial Disclosure Requirement
,- 7PlVEBSI TY STATISTICS REPORTING Keen COPY in file and ORIGINAL for Annual Report.
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¡o R.,: fi; l2.• Employee I_/ - ,,,, - .• /L' .. . . ... Scanned on:
CO N C LU D E D & R E SIG N A TIO N LE TTE R S
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
F:ICLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTERIB&C Checklist 2015 MASTER.docx
i s are committed to prosidng excellent pu b ic service and salty to oli whe live. work, and play in cur vibrant, tropical, histric cm +uni,y.
M IA M I BEACH
City of Miami Beach, 1ZOO Covention Center Drive, Mi am i Beach, Flor ida 33 139 ywwwy_mambeach' gov
OFFICE OF THE CITY CLERK, Rafael E. Granada, City Clerk
Tel: 305.673.7411, Fox. 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
October 29, 2020
Ms. Magui Benitez
757 West Ave. #4 12
Miami Beach, Florida 33139
RE: Senior Affairs Committee
Dear Ms. Magui Benitez:
Congratulations! You have been appointed by Federation Towers and approved by City Commission to
the agency, board or committee named above 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. 7 411.
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
Diana Fontani, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
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 - Amendm en t 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
O ath of O ff ice O ath
of C ivili ty and
A ckno w led gem ents
T O : M s. M a g u i Benitez
R E : Senior A ff airs C o m m itt ee
I do solem n ly sw e a r or affirm to bear true faith, loyalty and allegiance to the G overn m ent of the U nited States, the
State of Flo rid a, and the C ity of M iam i Beach, and to perf orm all the duties of a m em ber of the above-m entioned
bo a rd or co m m itt ee of the C ity of M iam i B each to w hich I have been appointed fo r a term ending: 12/31/2021.
T o m y co lle a g u e s and to all of those I represent and serv e, I pledge fa irn ess, integrity and civility, in all actions
take n and all co m m u nications m ade by m e as a public serv ant.
I ha ve be en issue d a copy of section 2-11.1 of the M iam i-Dade C ounty C ode (C onflict of Interest and Code of
Ethics O rdin a n ce), as w ell as Florida C om m ission on Ethics G uide to the S unshine Am endm ent and Code of
Ethics fo r P ublic O ffi cers and unde rstand that as a m em ber of a City of M iam i Beach Board and/or Com m ittee, I
m ust co m ply w ith the financial disclosure* requirem ents of M iam i-D ade C ounty or the State of Florida (depending
on the bo a rd or co m m ittee on w hich I serv e) on July 1st, fo llow ing the cl osing of the calendar year on w hich I
ha ve se rv ed.
Sw orn to and subs cribed before m e this 29 day of O ct , 2020
Ciato '9et
Charles D'A gostin
D eputy Clerk
*P le a se visit the C ity of M iam i B each w ebsite at www .m iam ibeachfl.gov under City Clerk/Board and Com m ittees
fo r ad d itiona l info rm a tion regarding the Financi al D iscl osure R equirem ents.
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community.
A s//BEACH ]\/\}/if\/\} H- , -
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C ity o f M ia m i B ea ch
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
O FFIC E O F TH E C ITY C LERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF DAD
I, the undersigned, do hereby state under oath, and under penalty of perjury, that the following
facts are true:
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as ( check ( ✓) all that apply):
~ Resident of the City of Miami Beach for six months or longer.
[] Demonstrates an ownership interest (for a minimum of six months) in a business established
in the City (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.
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Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or□online
oorzasen . ve.2]_ca»u/abo@ _2o, AA Bu,he
/
(City of Miami Beach Board/Committee Member).
X eone »o [)ere Leo se
Form of Identification
Name of Notary, Typed, Printed, or Stamped
(NOTARY SEAL)
Charles J. DAgostin
NOTARY PUBLIC
ST ATE OF FLORIDA
Comm# GG168171
Expires 12/14/2021
M IA M I-DAD E-
ETEI 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
2o19 herez
First Name
/Gat
M iddle Nam e/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
\7r leo1 Atue 942
City, State, Zip
/ 73/3
lf 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.Dl
Filing as an Employee (check one)
[] county [ Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[3 County [] Municipal: ALPI l>
(Municipality)
Board where serving
mm277E
Alternate address (if home address is exempt) Work telephone Term began on/ended on
List below every source of incom e you received, along with the addre ss and the principal activity of each source. Include your public salary. Place the sources of
incom e in descending order, with the largest source first. Examples of sources of income include: compensation for services, income from business, gains from
pro perty 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
$51 Ke tree
I hereby swear (or affirm) that the information above is a true and correct statement.
AG Signature of Pers0 .,
la1/203o -
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
x Hardcopy ECEIVED
[] Electronic Copy
001 29 2020
CIT»
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3EACH
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OFFIC E USE ON LY Accepted: Y / N Deficiency. Processed Date/initials: Scan ned Date/initials:.
138_SP -14 COE 2016
/1 A,}N/ BEACHCITWIDE (CW) BOARD & COM»rEEs •
City of Miami Beach, PARKING DEPARTMENT PA RK IN G A PPLIC A TIO N --
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph [305) 673-7505 or [305) 673-7000 ext. 6200 PARKING
A citywide (CW) parking permit is honored at metered parking spaces and restricted residential zones
parking spaces. A CW parking permit IS N O T honored in prohibited areas. An Access Card will be
provided to you for City Hall Garage (G7) access.
IM PO RTA N T N O TE: Your vehicle license plate serves as your "parking permit". In order to avoid
any unnecessary enforcement actions, it is important that our records reflect the most current and
accurate information regarding your vehicle license plate. Inaccurate and/or outdated vehicle
information may lead to the issuance of parking citation(s) and/or the towing of your vehicle.
Please note that this new access card CA N N O T be hole-punched or perforated in any manner. To use
the new card please hold the card at close proximity to the reader until the gate opens. You may need
to try the other side of the card. Please ensure you hold the entire surface of the card against the reader
until the gate opens.
A CK N O W LED G EM EN T: I ackno w led ge that should m y access card be lo st, stolen or
dam age, I w ill be resp o nsible to pay a $10.00 repl aceme nt fee.
Board Member Information
Date of Application: 09/18/2020
Applicant Name: Magui Benitez
Board/Committee Name: Seniors Affairs Committe
Address: 757 West Avenue #412 Miami Beach Fl 33139
E-Mail Address: Mbenitez045@gmail.com
Work Phone: Nia Home Phone
Cell Phone: 786-368-4449 Preferred Contact Method: Either one
Vehicle Information
Tag: JFS D67 Color: Beige
State: Florida Year: 2017
Make: Hyundai Model: Elantra
Applicant Signature: es 232,
Please provide signed form to the P&king Department located at 17 55 Meridian Avenue, 2" floor. Working
hours are 8:3 0 to 5:0 0 p.m. or email to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
Parkina D - .
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: es Signature: es
Date Issued: Date Completed:
s
f;\ping \$m an\rar\forms\cw boards&comm ittees parkingform.doc form updated 9/26/2017