Alberto Ravelo 12/31/211
MIAMIBEACH )
BOARD AND COMMITTEE CHECKLIST
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FOR SCANNER
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RECEIVED
FE 26 2021
FOR CLERK STAFF
Letter of Appointment TERM END. 12/31/2021 TERM LIMIT. 12/31/2026
- Letter of Reappoint ment - 5f7}„8$, eter ot AppointmenvReappointment e-nailed to Committee Lason on
Board and Comm ittee Application (Completed on 2/19/2021
- Resume/Cu rriculum Vitae
Diversity Statistics Reporting (Completed on 2/19/2021
Oath
IMPO RTANT INFORMA TION FOR BO ARD AN D COMMITTE E MEMB ERS BOOK
City Code Ordinance Section applicable to the agency board or committee
« City Cod e Sections 2-21.2-22 2-23. 2-24, 2-25. 2-26 245 8 and 2459
County Code Secto n 2-11.1 - Confct of Interest an d Cod e of Ethics Ordnance (as
amended through December 2010)
Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
t Highlights of the Miami-Dade County Ethics Code
Sunshine Law and Public Records - Frequenty Asked Questons
t Memorandum - Solicitaton by City Bard and Committee Members
CITY OF MIAMI BEACH
OFF ICE OF THE CITY CLE RK O Citywide Permit Application (Parki ng Department Form)
Booklet - Guide to Suns hine Amen dment & Code o! Ethics tor Public Officers and Employees
Scan
Scan
So urce of income Statemen t
C Acknowledg men t of Financial Disclosure Requy
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sees o 2/1/221 .swear G.
Processed on. 2/19/2021 -------- Date City Clerk's Office Saft Initials
2/19/2021 .aymworece. Caoba ?'ge
Date City Cerk's Orce Saff inrtais
mber
D'aeat
Scanned on
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter ] Date Processed Imitals Scan O I
Resignation Letter / Date Processed Initials Scan O I
Removal Letter due to absences [ Date processed Initials Scan O I
F WCLERBOARD AND COMM IT TI ES DATABASE CHE CKLIS T MASTER B8&C Cnexus 2213 MAS TER 0c
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MIAMI BEA CH
./
City of Mia mi Beach, I/0O Coventon Corter Dre, Miami Boah, Florida 33139 www._muaiAeac_hilg
OFF ICE OF TH CITY CLERK., Rial E Granado. Cy Clad
1el 305.673.7411, Fax 305.673.72 54
[mal: Caylerl@mlambeachll.go
Februar y 11. 2021
Mr. Alberto Ravelo
5838 Collins Ave Apt 9G
Miami Beach, Florida 33140
RE: Human Rights Committee
Dear Mr. Alberto Ravelo:
Congratulations! You have been ap po inted by the City Commission to the agency. board or committee
named above for a term endi ng: 12/31/2021.
lf you are unable to accept this appoi ntme nt, or have any question s, please ca ll the Offi ce of the City
Cerk at 305.673.7411.
Please read the enclosed materials ca refully as they con ce rn your duties, responsibilities. and
requirements as a board or committee member.
Congratulations again and good luck.
Regards.
Rafael Gran ad o
City Clerk
cc: Monica Beltran. Parking Director
Lana Hernandez. City Liaison
EN CLOS URES :
Oath of Office/Oath of Civility/Acknowledgem ents
City Code/Ordinance section applicable to agency. board or committee
City Cod e Secti on 2-22, 2-23. 2-24, 2-25. 2-26. 2-458 and 2-459
Ordinance No. 2006-3543 - Amendment to City Code Sect ion 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics
City Wde Permit Application - (Parkin g Department Form)
Booklet - Guid e to the Sun shine Amendment and Code of Ethi cs for Pubic Officers and Employees
- /
MIAM/BEACH
City of Miami Beach, 17OO Convention Canter Drive, Mami Beoch, Horida 33139 www.mm_amIogchl go
OFFICE OF THE CITY CLERK, Ralosl É. Granado, Cay Cdad
Il 305.673 711, Fr 305.673.7254
Email CyCGard@mimibeochll.gov
Oath of Office
Oath of Civility
and
Acknowle dgem ents
TO: Mr Alberto Ravelo
RE: Human Rights Committee
l do solemnly swear or affirm to bear true faith. loyalty and allegi ance 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 boa rd or committee of the City of Miami Beach to which I have been appointed for a
term ending: 12/31/2021.
To my co lleag ues 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 co py of se ctio n 2-11.1 of the Mi ami -Dade County Code (Co nflict of Interest an d
Code of Ethics Ord inance ). 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 ot a City of Miami Beach Board
and/or Com mittee . I must comply with the financial discl osur e" req uireme nts of Miami-Dade County or the
State of Florida (depending on the board or committee on which 1 serve) on July 1st. following the closi ng
orne siena«r vesi swin te s«rea p)-,
" 77 r. Aero Raveio Ly-
e
Sworn to and subscribed before me this lh day t TSP 2021
Ciao, D'pet
Charles D'Agostin
Deputy Clerk
"Please visit the City of Miami Be ach website at www .miami beachfl.gov unde r City Clerk/Bo ard and
Committees for additional information regarding the Financial Disclosure Requirements.
/ - e
BEA C H
City of Mi am i Beac h
1703 Co ve io Center Dive
Msari Bech. Flrdc 33139
OFFICE OF THE CTY CLERK
Email: BC@ m ambeacn aov
Teleph on e . 305.673741'
AF FIDAVI T QF AFFILIATION_ WI TH THE CIT Y OF MIAML BEACH
STATE OF FLORIDA
COUNTY OF Miami-Dade
I am in co m pl ian ce with th e affiliation requirement of Miami Beach Cty Code Se ctions 2-22 (4).
as {ch eck (/) al l that apply)
[] tam a resident of the Ci ty of Miam i Beach for six months or longer
[] yhavean ownership interest (for a minimum of six months} in a busines s established in the
City of Miami Beach (for a minimum of six months}
[] lama full-time employee of a business (for a minimum of six months) and l am based in an
office or other location of th e busin ess that is ph ysically loca ted in Miami Beach (for a
m inim um of six m on t hs).
Ownership Interest" means th e ownership of ten percent (10%) or more (including th e
ownership of 10% or more of the outsta nding capital stock) in a busi n ess
"Business' means any sole pronetorship. sponsorship, corporation, limit ed liab ility com pa ny.
or other entity or business association
"."
so9fr,' ° elb2 one ' ' lhh.V Ly e
Pr in te d N am e
NOTARY
S w om to (or a ffir m e d) and subscrib ed before me. by means of physical pr e sence or 2ontine
notarzaton. this '&Uayr February 20 y
Alberto Ravelo
City of Miami Beach B oard/C om m ittee llember}
X
Produced ID FL Drivers License
Form of Ide ntifi ca tio n
Personally Known
Cta.'ge
Si gn atur e of Notary P úblic
Charles J. D'Agostin
Name of N ota ry , Typed, Printed, or Stamped
(NOTARY SEAL)
&ro,, Charles J. DAgostin
t!)NOTARY PUBLIC
& STATE OF FLORIDA
Comm# GG168171
5}. <{ @ íS" Expires 12/14/2021
/
SO UR CE O F IN CO ME STATEM ENT
Section 2-11.1i) af the Cunty Ethcs Code requres ttat ce rta n enpoyees ard public co!fcals file a fnancal discicsure Statement an a yearly tass y ly 157
i every yea
Disclosure for Tax Year Endin g
2020
La st Name
[Z«ve\
Mi ddle Name /in itial
V
M ai lin g Ad dress - Stre et Numb er, Street Na me , or P.0. So x
583? C„Ins Duo ": if your home adress is yur mailing address. and your hmne address is eem t trom pubc records oursuant to Fa. Stat. S179.07, read
nstructu ors on the taiowing page and ch eck here. []
Filing as an Employee (check one)
[County [ Public Health Trust [ Municipal:
{Mum icipaity)
Department
/Position or Title Employee ID Number
works address
I 1 Work telephone Em ployment began on/ended on
l
Filing as a Boa rd Member (check one)
[ county í once»e ah4 0 [_u [A-ci
(M uni cipaity
Alterna te address (it home addressjs exempt
5 ¥°
Work tel eph on e Term began o/ended on
7001 02/202
Ls" be»aw ver y sourc e ot income yu receved, ain g with the cress and th e pr ncipa actnwty o! each source. in clud e yur pubic saary. Pace te sources o'
incomne in descend ing crcer, wt the largest source first Examples of sources at ncum nclude com pensation for serv ices . income fromr psness, gains ircmn
prooerty deaiings. nt erest , rents. dvcencs, persons. IRA distbutons. and soca! securty payments. Also, incude any scurce ot income recesvec by an9tegg
person 'r ycur benefit. However. te income ci yur spouse or any busness partner need not be cscses ht continued on a separate sheet, check here[]
Na me of So urc e of inc ome Ad dre ss Description of the Principal Business Activity
M as D o all -00 M &A0e AA&ju«cl Fl es o Maa ,T 3313 I
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I herety swear tor a5jirte@nat thg informnaton above is a true and correct sta temn ent l]„- IN
- - - t
RCEIVED BY ELECTIONS DEPARTMENT.
. Hardc opy
XElect ronic Copy
Rece ived on Febru ary 19, 2021
O ffi ce of the City Clerk
OFFICE USE ONLY Ad pe tceny Processed Cate/mta#s Sann es Dlate inai.
± ¥-·4 CE?'é
r ~
'-' ~
, ... , ' BEACH
City of Miami Beach
1700 Convention Cente: Drive
Miam Beach. Fonda 33139
www._miam _beg chfl gov
OFFICE OF THE CITY CLERK
Emal. 3C@mnamnpegch!Iggy
Telephone 305.673 7411
BOARD & COMMIIIE FINANCIAL_ACKNOWLEDGEMENT _SIA1MENI
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)
awl0
La st Nam e
Al/e, lo
First Name
v
Middle initial
I underst and that no later than July 1,of each_year all memb ers of Boards and Com mittee s of the Cty of Miami
each, including those of a purely advisory nature, are required to comply with Miam i-Dade County Financi al
DOsclosure Requirements.
One of the following forms must be filed with the City Clerk of Miam i Beach, 1700 Convention Center Drve
Miami Beach. Florida, no later than 1200 noon of July 1, of each year
1 A'Source of Income Statement:" or
2 A'Statement of Financial Interests (Form 1)'." or
3 A Copy of your latest Federal Income Tax Return
Failure to
of no m
i/(,.
Sign
ese forns, pursuant to the Miami-Dade County Code, may subject the person to a fine
porta y/ 2,IS 202/
Date / /
' Members of the Planning Board and Board of Adjustment will be notifed directly by the State of Fonda.
pursuant to F.S $112.3145(1)(a), to file a Statement of Financial Interests {Form 1) with the Miami-Dade County
Supervisor of Elections by 12.00 noon. July 1 Planning Board and Board of Adjustment members who file their
Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure
requirement as a Miami Beach City Board/Committee memer and need not file an additional form with the Office
of the City Clerk However, com pliance with the County disclosure requirement does not satisfy the State
requirement
Page5cf6
F CLER SALL.REGARD ANO COMMTTE AL UCATIN S FINAL DRAFTS BOARD AN COMMITTEE APLICATION REG FNA, 33¢
Up3ated June 202
e -)
MA/BEACH
City of Miami Beach
1700 Conventon Center Drive
Mi a m i each, Fl orida 33 13 9
wwwmiamibeachtl. gov
OFFICE OF THE CITY CLERK
Email C@r uamteacnf_gov
Teletone: 305.573.7411
DIVERSITY STATISTICS REPORT
2vele
Last Name
All,lo U
First Name Middle Initial
The following information is voluntary and has no be aning on your consideration for appointment It is being
asked to comply wth City diversity reporting requirements
Gender:
zí
remale oner
Llorefer not to answer.
Race/Ethnic Categories:
What is your race?
L} African Amencan/Black
l _A sian or Pacific Islander
Ld Caucasian/white
[lNative American/American Indian
lother - Print Race o
Ll trefer not to answer
Do you consider yourself to be Spanish, Hispanic, or Latinola?
iv.
o
lyrefer not to answer
Do you consider yourself Physically Disabled?
as
[l prefer not to answer this question
age 6 of
F CLER'SALL'RGBOARD ANO CCAMITTEE APICA TIONS FINA! DRAFTS BARD AND COMMIT TEE APP.CATION REG INAI J0¢
up3ted une 2C2
5a e
e d
City of Miami Bea ch, PARKING DEPARTMENT
CITY WI DE (CW) BOARD & COMMI TTEES
PAR KI N G APPLICATION
175$ Merdia n Aven ue. Sue 200/Miami 3e, FL 33 139/PE (305} 673-7505 {305 673-7000 ea 6200
a
PARKI NG
A citywide (CW} parking permit is honored at metered parking spaces and restricted residential zones
parking spaces. A CW parking permit IS NOT honored in prohibited areas. An Access Card will be
provided to you for City Hall Ga rage [G7] access.
IMPORTANT NOTE: You r vehicl e license pl a te serves as your "parking per mi t". hn ord er to avoid
any unnece ssary entorcement actions, it is important that our records reflect the most curr ent and
accurate information regarding your vehicle license plate. Inaccurate and/or outdated vehicle
informa tion may lea d to the issuance ot parking citation/[s] and/or the towing of your vehicle.
Please note that this new access card CANNOT be hole-punched or perforated in any manner. To use
the new card please hold the card at close pro xi m ity 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.
ACKNOWLEDGEMENT: I acknowledge that should my access card be lost, stolen or
damage, I will be responsible to pay a $10.00 replacement fee.
Board Member information
Date of A ppl ic ati on :
Applicant Name:
Address. +3rd
E-Mcil Address: /
Work Phone:
cot Pone(7 a)? 210 Preferred Contact Method; 2_-
Vehicle Information
Tag. L_YD0% 'Color. I HIT I
I
Stare ' /Year 204q +
Make: I Cl@a> Model xT S I
I
A p plic an t Sig nat u re: s
Please provide signed form to the Parking Department located at l755 Meridian Avenue, 2 fcor. Working
hours ore 8:30 to 5.00 p.m. or email to: Par k ing Recepti on@miamib eachfl .gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
l Parkina Depa rtme nt Sec t
PERMIT SYSTEM GARAGE ACCESS
Expiration Da te: ID Card Seral #
issue d By Print Name. Print N am e .
' Sgnature. e si gn ature.
Dat e Issued . Date Completed.
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