Al Feola 12/31/22M IA M I BEACH
BOARD AND COMMITTEE CHECKLIST
AP P o Nr E f ref D A T E O F A PP O IN T M E N T : _
B O A RD /C O MM I T TE E : /r__ _2_v -7Appointed by:
FOR SCANNER
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FOR CLERK STAFF
o Letter of Appointment TERM END: TERM LIMIT: _
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on
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o Board and Committee Application (Completed on _,
o Résumé/Curriculum Vitae
o Diversity Statistics Reporting (Completed on
o 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 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:
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 Financial Disclosure Requirement
O DIVERSITY STATISTICS REPORTING çr ORIGINAL for Annual Report. 21s21 .sones oy fe
Date Board or Committee Member
EreSSed Qn. [/ [mp[0/e€.
Date City Clerk's Office Staff Initials
Scanned on: P \y l[[/gg,
Date City Clerk's Office Staff Initials
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
F :IC L E R IB O A R D A N D C O M M ITT IE S D A T A B A SE \C H E C K LI S T M A S T E R IB &C C hecklist 20 15 M A STE R .docx
WVe are committed to providing excellent public service and safety to all wh o live, work, and play in our vibrant, tropical, historic community.
1/13/2021
City Commission
12/31/22 12/31/23
1/20/2021 1/20/2021
1/25/2021
1/25/2021
1/25/2021
MIAMI BEACH
C ity of Miami Beach, 1/00 Con vention Cen ter Drive, Miami Beach, Florida 33 139 yw _miamibca chll_go
OFFKCE OF THE CITY CLERK, Rofoal E. Granado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: CiNyClerk@miamibeachfl.gov
January 14, 2021
Mr. Al Feola
220 W. Rivo Alto Dr.
Miami Beach, Florida 33139
SUBJECT: Transportation, Parking and Bicycle-Pedestrian Facilities Committee
Dear Mr. Al Feola:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/2022.
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.
7
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Monica Beltran, 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 en dm ent to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance
City Wi de Permit Application - (Pa rking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
M IA M I BEAC H
City of Miami Beach, 170O Convention Conlor Drive, Miami Boa ch, Florida 33139 yyw_miamibeach!l.gov
OFFICE OF TH E CITY CLERK, Rafael E. Gran ado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Emai l: CityCl erk @mi am ibeach fl.gov
O ath of Office
O ath of Civility
and
Acknow ledgem ents
TO: Mr. Al Feola
RE: Transportation, Parking and Bicycle-Pedestrian Facilities 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.
7
Sworn to and subscribed before me this day of/ , 2021
29 0
foz_' Charles D'A gostin
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.
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachf_gov
Telephone: 305 .673 .7 41 l
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF nu»-Md£
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check(✓) all that apply):
i a resident of the City of Miami Beach for six months or longer.
if, 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). ¿, 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.
Signature Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of D physical presence or D online
notarization, this 2 day of Jßt\\A"' ú-j
________________ (City of Miami Beach Board/Committee Member).
Produced ID
Form of Identification
Y
re of Notary
llKvA N wo n. BB 0 UL cHl
Name of Notary, Typed, Printed, or Stamped
#% äiitjii corms.or r cs nu44s» ?%5$° wy com m . Expires Dec 6, 2023
Bonded th rough Nation al Notary Assn .
M IA M I-DAD E. EIE 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 tor Tax Year Ending Last Name
2020
First Name Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
2 2 o • fo f 2e .
City, State, Zip . .
n m) 5:eh,
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/he/following[page and check here. []
Filing as an Employee (check one)
D County D Public Health Tru st [] Municipal:
(M unicipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[] county Iínunicipat:
(Municipality)
Board where serving
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.O
Name of Source of Income Address Description of the Principal Business Activity
ti ff o4 . 76o ocu4. f €ú7i& J±ry «
/
I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Person Disclosing
Date signed
RECEIVED BY ELECTIONS SEPARTMENT:
[ Hard cop y
[] El ectron ic Copy
O F F IC E U S E O N LY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: _
138_SP-14 COE 2016
M IA M I BEACH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
www._miamibeach[]_gov
OFFICE OF THE CITY CLERK
Em ail: BC@ m iam ibeachfl.gov
Telephone: 305 .673 7411
DIVERSITY STATISTICS REPORT
Last Nam e First Nam e Middle Initial
The fo llow ing info rm ation is voluntary and has no bearing on your consideration fo r appointm ent. It is being
asked to com ply w ith City diversity reporting requirem ents.
Gender:
sí
remate
O O ther
D I prefer not to answ er.
Race/Ethnic Categories:
What is your race?
O A frican A m erican/Black
Astan or Pacific Islander
Ed caucasian/wh ite
O Native A m erican/Am erican Indian
O O ther- Print Race: _
D I prefer not to answ er.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Des
u1 No
D I prefer not to answ er.
Do you consider yourself Physically Disabled?
Eres
EI No
D I prefer not to answ er this question.
Page 6 of 6
F:ICLER\$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.dccx
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MIAMI BE A C H
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibeacht_gov
OFFICE OF THE CITY CLERK
Email: BC@ míamibeachfl.gov
Tele phone: 305. 673 .7 4 1 1
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT
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)
A('L
Last Name First Name Middle Initial
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.
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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