David Grieser 12/31/23MI AI BE A CH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: David C Grieser DATE OF APPOINTMENT: 1/1/2022
BOARD/COMMITTEE: Budget Advisory Committee
FOR SCANNER
Scan o
Scan o
FOR CLERK STAFF
Appointed by. M Samuelan
os/2/23b$.. .2/3// o Letter of Appointment
o Letter of Reappointment
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o Board'an@ 'orimíttee Application (Completed on_/e i-z-/
o Résumé/Curriculum Vitae
o Diversity Statistics Reporting (Completed on_y I'I
o Oath
Liaison on
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Scan o
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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 ✓Memorandum - Solicitation by City Board and Committee Members
OF MIAMI BEACH
OFFICE OF THE CITY CLERl) Citywide Permit Application (Parking Department Form)
RECEIVED
JAN 4 2022
Scan o
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
o Source of Income Statement
Scan o o Acknowledgment of Financial Disclosure Requirement
O DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report.
Received o. 12/27/2021 Sionea X Daoud ---------------------- e
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Date
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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:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
City of Miami Beach, 1/OO Convention Conter Drive, Miami Booch, Horida 33139 y¿y_yy_miamib_ach[i_go
OFFKCE OF THE CITY CLERK, Rofoal E. Granado, City Clerk
Tel. 305.673.7411, Fax. 305.673.7254
Email: CityClerk@miamibeachfl.gov
December 17, 2021
Mr. David Grieser
1754 Meridian Ave, Apt. 201
MIAMI BEACH, FL 33139
RE: Budget Advisory Committee
Dear Mr. David Grieser:
Congratulations! You have been appointed by Commissioner Mark Samuelian 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
appointment/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. %2
¿I Granado
City Clerk
cc: Monica Beltran, Parking Director
Tameka Otto Stewart, 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
MAIAMIBEACH
City of Miami Beach, ZOO Convention Cenlr Drive, Miami Bach, Horida 33 139 yyew._miaIrib_ach[]_go
OFFICE OF THE CITY CLERK, R0fol E. Granado, City Clerk
Tel: 305.6 73.7411, Fax. 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. David Grieser
RE: Budget Advisory 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: 12/31/2023.
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.
Mr. David Grieser
Sworn to and subscribed before me this '-/ day orJ ~02;::2__
*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 IA N\I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 741 l
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):
IX I am a resident of the City of Miami Beach for six months or longer.
Home Address 1754 Meridian Avenue, #201 Miami Beach, FL, 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 declare that I have read the foregoing document and that the facts stated in it
are vue pou go 12/27/2021
Signature 1/- Date
David Grieser
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, b means of o physical presence or o online notarization,
th is 9Î day of D f'.~~~20 .)_f by -~-+-1-~t=-------+,,_,__-'----'""'----==---,-__;:::;=-------
Produced ID
(Cit¥.-.of Mia2) Beach Board/Committee Member).
Ft_ vet Leo_Se
Form of Identification
(NOTARY SEAL)
Name of Notary, Typed, Printed, or Stamped
MIAMI BEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl_gov
Telephone: 305.673.7411
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)
Grieser David e
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.
axa fac. 12/27/2021
Signature Date
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.
Page 5 of 6
F:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibegcht]_ gov
OFFICE OF THE CITY CL ERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Grieser David e
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:
qO Mae
O Female
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
[XO Caucasian/white
O Native American/American Indian O Other- Print Race: _
O I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
ves
2No
O I prefer not to answer.
Do you consider yourself Physically Disabled?
aves
O R
O I prefer not to answer this question.
Page 6 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M IA M l·DAD E-
EIII
Clear From Print Form
SOURCE OF INCOME STATEMENT
Section 2-11.1() 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 Grieser David e
Mailing Address - Street Number, Street Name, or P.O. Box
1754 Meridian Avenue Apt. 201
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 ch ec k Hele.
Filing as an Employee (check one)
D County D 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 {J Municipal: Miami Beach
(Municipality)
Board where serving
Budget Advisory Committee
Alternate address (if home address is exempt) I Work telephone IT erm began on/ended on
(786)563-5988 1/1/2022 - 12/31/2023
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
NCLH 7665 Corporate Center Drive Employment in Internal Audit Dept.
Investment Income and Gains 1754 Meridian Ave, Miami Beach Stock s an d other equities appreciation and dividends
Interest Income 1754 Meridian Ave, Miami Beach Bank account and certificate of deposit interest
I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Person Disclosing
12/28/2021
Date signed
RECEIVED BY EL
l ]Hardcopy
J Electronic c9pN 4 202
CITY OF MIAMI BEACH
OF FI CE OF TH E CI TY CL ERK
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
hl.L.4."+±2% L%
1755 Meridian Avenue, Suite 200/Miomi 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 Gar age (G7) access.
IMPORTANT NOTE: Your vehicle lice nse plate serves as your "par king permit". In order to avoid
any unnecessar y enfo rcement actions, it is important that our records reflect the most current and
accurate info rmation regarding your vehicle license plate. Inaccurate and/or outdated vehicle
info rmation may lead to the issuance of parking citation(s) and/or the towing of your vehicle.
Please note that this new access car d 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 w ill be responsible to pay a $10.00 replacement fee.
Bo a rd M e m b e r In fo rm a tio n
Date of Application: 12/28/2021
Applicant Name: David Grieser
Board/Committee Name: Budget Advisory Committee
Address: 1754 Meridian Ave #201, Mi am i Beach, FL, 33139
E-Mail Address: dcgrieser@gmail.com
Work Phone: Home Phone
Cell Phone: (786)563-5988 Preferred Contaci Method: Cell
V e h icl e In fo rm a tio n
Tag: BRLD45 Color: White
State: FL Year: 2009
Make: Nissan Model: Versa
. Daoud Ocao Applicant Sianature: ei 'f
Please provide signed form to thé Parking Department located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email to: Pa rk in g R ecep tio n@ m iam ib eachfl .g o v
e -m a il su b je ct : B O A R D & CO M M ITT EE PA R K IN G A PPLI C A TIO N - A PPLI CA N T N A M E
Parkina Department Section
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature: e
Date Issued: Date Completed:
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