Amy Litos 12/31/23MIAIBEA CH
BOARD AND COMMITTEE CHECKLIST
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FOR SCANNER
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FOR CLERK STAFF
res e/2/31/23roo/2/3//27
Liaison on
Scan o
Scan o
Scan o
o Letter of Appointment
o Letter of Reappointment
o of Appointment/Reappointm
o ¾-"'"------a---1----'C...,....,,,.__-, tee £pplication (Completed o -:;r,---,..,.,__~---1-r /
o Résumé/Curriculum Vitae l
o Diversity Statistics Reporting (Completed on_/e '<
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
CITY OF MIAMI BEACH ✓Memorandum - Solicitation by City Board and Committee Members
OFFICE OF THE CITY CLERK
RECEIVED
JAN 42022
o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o o Source of Income Statement
Scan o o Acknowledgment of Financial Disclosure Requirement
O DIVERSITY STATISTICS REPORTING Keep çoPY,' file and ORIGINAL for Annual Report.
Received o,. 01/02/22 Sioned X
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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:\CLERIBOARD AND COMMITTIES DATABASE\CHECKLIST MASTERIB&C Checklist 2015 MASTER.docx
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IA,AA/BFACH / \i IV Eh
City of Miami Beach, 1ZOO Convention Canter Drive, Miami Boach, Hlorida 33139 y¿y._miaIIib_achi]_go
OFFICE OF THE CITY CLERK, Rofal E. Granado, City Clerk
Tel: 305.673.7411, Fox. 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
December 21, 2021
Ms. Amy Litos
650 West Ave., #1802
Miami Beach, FL 33139
RE: Marine and Waterfront Protection Authority
Dear Ms. Amy Litas:
Congratulations! You have been appointed by Commissioner Alex Fernandez to the above-referenced
Board or Committee, for a term ending: 12/31/2023.
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
appointm ent/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,
Raz;£o
City Clerk
cc: Monica Beltran, Parking Director
Kenneth Varela, 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
C i t y o f M ia m i B e a c h , I/OO Convenlion Center Drive, Mvomi Eooch, Ilorda 33139 yyaw._miamrib_gchf]_go
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fox. 305.673.7254
Email: CityClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Amy Litos
RE: Marine and Waterfront Protection Authority
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: 12/31/2023.
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.
Ms. Amy Litos
swom to and sots«sanes store me wig_aa4/„,, ??
*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.
M A MIBEA CH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Em ai l: BC@miamibeachfl_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check
( ✓) all that apply):
I am a resident of the City of Miami Beach for six months or longer.
Home Address 650 West Ave. #1802 Miami Beach, Florida, 33139
o 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).
Name of Business _
Business Address _
o 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).
Name of Business -------------------------
Business Address _
"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 decl r that I have read the foregoing document and that the facts stated in it are"ab 01/02r22
--------------- Sign ature Date
Amalia Litos
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by m ans of o physical presence or o online notarization,
o 2a,a)299a 22, ·/o
'K
Ci y o MD. i Beach Board/Committee Member).
coa«eso / )icuL_y_ea
Form of Identification
ers nally Known
Sign %:.. CHRLÈS ü. DAGOSTIN ê" j wcouussIoN # H 165705
j,ft&$ xens: Decenter 14,2025
8;ks Bonded Thu Notary Public Underwriters
ii»
MIAMI BEACH
City of Miami Beach
1 700 Convention Center Drive
Mi am i Beach , Florida 33139
ww w miamibe achhl g o y
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305. 673.741 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)
Litos Amalia H.
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, days in jail, or both.
01/02/22
Signature Date
1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
pursuant toF.S. S112.3145(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.
Page 5 of 6
F:\C LE R\$A LL\R E G \B O A RD A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D RA FT S \BO A RD A ND C O M M ITT E E A P P LI C A TIO N RE G FINAL.docx
Updated: June 2020
MIA\MIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_migmibeach!l g ov
O FFIC E OF THE CITY CL ERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Litas Amalia H.
Last Name First Name Middle Initial
The following information is voluntary and has no bearing on your consideration for appointment. It is being
asked to comply with City diversity reporting requirements.
Gender:
JMate
X remale
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
L)Asian or Pacific Islander
X! Caucasian wh ite
O Native American/American Indian
O Other - Print Race: ------------- □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Yes
1o
O I prefer not to answer.
Do you consider yourself Physically Disabled?
t)
l Yes
f+
O I prefer not to answer this question.
Page 6 of 6
F:ICL E R\$A LL\R E G \B O A RD A ND CO M M ITT E E A P P LI C A T IO NS FINA L D R A FT S\BO A RD A N D C O M M ITT E E A P P LI C A TIO N R E G FINA L.docx
Updated: June 2020
M IA M I-DA D E. Em
Clear From Print Form
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 for Tax Year Ending I Last Name First Name Middle Name/Initial
2020 Litos Amalia H.
Mailing Address - Street Number, Street Name, or P.O. Box
650 West Ave. #1802
City, State, Zip
Miami Beach, FL 33139
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 the following page and check Hele.
Filing as an Employee (check one)
O 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)
O County D Municipal:
(Municipality)
Board where serving
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
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. D
Name of Source of Income Address Description of the Principal Business Activity
Custom Touch Interiors 8004 NW 154 St. #331 Interior Design
Miami Lakes, FL 33016
Rental property income 3211 Sabal Palm Manor #207 D vie, FL 33024
I hereby swear (or affirm) that t information above is a true and correct statement.
Signature of Person Disclosing
01 /02/22
Date signed
c vto sr e+PP 4/E
]Hardcopy
J Electronic cop)N 4 2022
CITY OF MIAMI BEACH
OFF ICE OF THE CITY CLERK
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
i2\9..4..1.21±E, La
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 NOT honored in prohibited areas. An Access Card will be
provided to you for City Hall Garage (G7) access.
IMPORTANT NOTE: 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 CANNOT 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.
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 Info rmation
Date of Application: 01/01/22
Applicant Name: Amalia Litos
Board/Committee Name: Marine and Waterfront Protection Authority
Address: 650 West Ave. #1802 Miami Beach, FL 33139
E-Mail Address: A_litos@icloud.com
Work Phone: 305-206-1215 Home Phone 305-206-1215
Cell Phone: 305-206-1215 Preferred Contact Method: E-mail
Vehicle Info rmation
Tag: JFWM96 Color: Black
State: FL Year: 2005
Make: Chrysler Model: Chrysler 300 r-.
Applicant stao. Q-al I » e -
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2d floor. Working
hours are 8:30 to 5:00 p.m. or email to: Park ingR ecept ion@m iamibeach fl.gov
e-mail subject: BOARD & COMMITT EE PARKING APPLICATION - APPLICANT NAM E
p, ·kd D rt ar Ina epa men ecr1on
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature:
Date Issued: Date Completed:
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