Chris Rollins 12/31/22MIAMI BEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: OuramJ�-b, fout� DATE OF APPOINTMENT: / 1,2.f
Appointed by)f BOARD/COMMITTEE: _\�....._Cf)--....,__ _____ _
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
o Board and Committee Application (Completed on ______ _
o Resume/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 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
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
Received on:
O DIVERSITY STATISTICS REPORT
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Keep COPY in file and PRIGINAL for Annual Report.
_____ Signed by X (!,� 9,1 �
Date Board or Committee Member
Pro cessed on: __________ By Employee:------,-------:---.,----,-----------Date City Clerk's Office Staff Initials
Scanned on: __________ By Employee :------,-------=---:----,-----------City Clerk's Office Staff InitialsDate
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:ICLERIBOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We ore committed to providing excellent public service and safety to all who live, work , and ploy in our vibrant, tropical, histor i c community .
City Commission/MBVCA
12/31/22 12/31/23
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Received January 21, 2021Office of the City Clerk