Barbara Goicoechea 12/31/23BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Barbara Marie Goicoechea
BOARD/COMMITTEE: Production Industry Council
DATE OF APPOINTMENT: 12/20/2021
Appointed by: Comm. Alex Fernandez
FOR SCANNER
Scan o
Scan o
Scan o
Scan o
Scan o
RECEIVE D
JAN 4- 2022
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment [7/%913$/mamosos-ar so o cross»
o oard an~mfnittee Application (Completed on ,
• Resnercseuonvoe p2/30 /2 f
o Diversity Statistics Reporting (Completed on >v „
o Oath
veo.l2/31b3ro.l2/31/f
Liaison on
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
CIT OF MIAMI BEACH
OFFICE OF THE CITY CLERK o Citywide Permit Application (Parking Department Form)
Scan o
Scan o
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 RE PORT} G Keep COPY In fjle and ORIGINAL for Annual Report.
Ill vf ~ ;)_ s;g,ed s, , ~;-,
0
- ,"""' ~
Processed on:_:_1 ! y Employee:f •
--+/-+-/-'i,_(,_a:-~-µ_ __ By Employee:--~~_____:¡:;;._-=------
Received on:
Scanned on:
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
a .oM//B EA CH /i4/\/\/\/ 'fs f ! V ± Y li . "
City of Miami Beach, 1/00 Convention Coner Drive, Miami Bach, Ior ida 33139 yyyy_migr i boa chll.g ov
OFFICE OF THE CITY CLERK, Rafool E. Granado, Cly Clerk
Tol: 305.673.7411, Fax. 305.673.7254
Emal l: CityCl erk@mi amibeoch fl.gov
D e cemb er 20, 2021
M s. Ba rba ra G o ico e che a
20 Isla nd A ve #50 4
M IA M I BE A C H , F lo rid a 33 13 9
SUBJECT: Prod ucti on Industry Council
C o ng ra tu la tio ns! Y o u hav e bee n reap p o inte d by Commissioner Alex Fernandez to the ab ove
refere n ced , bo a rd or co m m ittee nam ed above, for a term end ing : 12/31/2023.
P u rsu a n t to C ity of M iam i B e a ch C o de S e ction 2-2 2 (5 ) a, "N o tw ithstand ing any other pro vision of the
C ity C o d e o r of any re so lutio n , com m encing w ith term s beginning on or after Jan uary 1, 2007, the term of
eve ry bo a rd m e m b e r w ho is directly ap po inted by a m em be r of the C ity Co m m ission shall autom atically
exp ire up on th e la tt e r of: Dece m ber 31 of the ye ar the ap pointing C ity C o m m issioner leaves offi ce or
upo n th e app oin tm en t/el e ction of the successo r C ity Co m m ission m e m be r."
If yo u are un ab le to acce p t th is ap pointm ent, or ha ve any qu e stio ns, ple a se call the O ffi ce of the C ity
C le rk at 30 5 .6 7 3 . 74 11. Pl e a se read the enclosed m aterials carefully.
C o ng ratula tio ns and go o d luck. RegR/
Ri,G,anado
C ity C le rk
cc: M o nica B e ltra n, P a rking D irector
V ero nica He n n ig , C ity Li aiso n
ATT ACHMENTS:
Le tter of A p po intm e n t
O ath
C ity C o de /O rdina n ce se ctio n ap p licable to agency, board or com m ittee
C ity C o de S e ct ion 2-22, 2-2 3, 2-24, 2-25, 2-26 , 2-45 8 and 2-4 59
O rdina n ce N o . 20 0 6 -3 54 3 - Amendment to C ity C o de S ection 2-22
M ia m i-D a d e C o u n ty C o d e S ection 2-11.1 - C on flict of Interest and Code of Ethics O rdinance
C ity W id e Pe rm it Ap plic ation - (P a rking Depa rtm e nt Fo rm )
Bo okl et - G ui d e to the S un shine A m e ndm ent and Co de of Ethics for Public O ffi cers and Em ployees
City of Miami Beach, 1/00 Cconvonlion Conter Drive, Mami looch, Tlorida 33 139 yw.miamjhgachl]goy
OFFICE OF THE CITY CL E RK , Rafaal E. Granado, Ciiy Clark
Tel : 305.6 73.7 4 11, Fax. 305.673.7254
Emai l: CityClerk@miamibcochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Barbara Goicoechea
RE: Production Industry Council
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.
icoechea
Sworn to and subscribed before me this 2a' day flee_, 2021
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@mlamibeachfl.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 20 Island Ave #504 Miami Beach, FL 33139
□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).
[]g r ¢ ([ [yg[ne8S_
Hg[ness (d]re8S
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 ACT Productions
Business Address 407 Lincoln Road #10J, Miami Beach, FL 33139
"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.
Un declare that I have read the foregoing document and that the facts stated in it
ar , 12/o/2021
-------------- Date
Barbara Marie Goicoech ea
Printed Name
NOTARY
Sworn to {or affirmed) and subscribed before me, by means of o physical presence or online notarization,
e, 3e,ab)e.by_zoty. fh2.. @i@cl¿a
(Gity of Miami Beach Board/Committee [ember)n.tttttttttf 22±$ • 37%..
± A 'S Commission # GG 908601 3$$,$ y comm. ires o 26. 1023
onded through National Notary Assn.
Produced ID
./ Form of identification
Personally Known is (NOTARY SEAL)
Name of Notary, Typed, Print' d, or Stamped
M IA M I BEA C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.goy
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSI TY STATI STICS REPORI
Goicoechea Barbara Marie
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:
LM Male
x] - Female
[Joher
Ll'1 prefer not to answer.
Race/Ethnic Categories:
What is your race?
EN African Am erican/Black
01 Asian or Pacific Islander
l Caucasian/Wh ite
[l Native Am erican/Am erican Indian
Ll other -- Print Race: ------------- Lk, prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
t .- lYes
Xl -- I No
) n.I prefer not to answer.
Do you consider yourself Physically Disabled?
t) -"Yes
8) - No
L !'¡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 IAM I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachhl.gov
OFFICE OF THE CITY CL ERK
Email: BC@miamibeachfl.gov
Telephone: 305. 67 3 .7 41 l
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)
Goicoechea Barbara Marie
Last Name First Name Middle Initial
I understand that no later than July 1, of each year all m em bers of Boards and Committees of the City of Miami
Beach, incl uding those of a purely advisory nature, are required to com ply w ith M iam i-Dade C ounty Financial
Di sclosure Requirem ents.
One of the fo llow ing fo rm s must be filed w ith the City C lerk of M iam i Beach, 1700 C onvention C enter D rive,
M iam i Beach, Florida, no later than 12:00 noon of Ju ly 1, of e ac h year:
1. A "S ource of Incom e S tate m ent;" or
2. A "S tatem ent of Financial Interests (Form 1)';" or
3. A C opy of your latest Federal Incom e Tax R eturn .
Fa ilu re to fil e one of these fo rm s, pursuant to the M iam i-Dade C ounty Code, m ay subject the person to a fine
or9m or e,yen 8 99,9 2"v "9 .orta u. ' 'aal 12/3 0/2 021
íatt e [R
1 M em bers of the Planning Board and Board of A djustm ent will be notified directly by the State of Florida,
pursuant to F.S . §112.3145(1 }(a), to file a Statem ent of Financial Interests (Form 1) with the M iam i-D ade C ounty
S uperv isor of E lections by 12:00 noon, July 1. P lanning Board and Board of A djustm ent m em bers who fil e their
Form 1 with the C ounty S uperv isor of E lections autom atically satisfy the County's financi al disclosure
require m ent as a M iam i Beach C ity Board/C om m ittee m em ber and need not fil e an additional fo rm with the O ffi ce
of the C ity C lerk. How ever, com pliance w ith the C ounty disclosure re quirem ent does not satisfy the S tate
requirement.
Page 5 of 6
F:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DAD E,
&III
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 Goicoechea Barbara Marie
Mailing Address - Street Number, Street Name, or P,O. Box
20 Island Ave #504
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 tiëi!e.
Filing as an Employee (check one)
D County O Public Health Trust O 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
Production Industry Council
Alternale address (if home address is exempt} I Work telephone I Term began on/ended on
305 538-3809 12/31/21 - 12/31/22
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
ACT Productions
407 Lincoln Road #10J,
Full Service Production Company Miami Beach, FL 33139
I hereby swear (or affirm) that the information above is a true and correct statem ent.
$/ A ' le 1 < d > sana6 arPerson i&closiné
,1✓
12/30/2021
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
O Hardcopy RECEIVED
O Electronic Copy
JAN 4- 2022
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFF ICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
l ±!A.I I ,,2 1± l
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". ln 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 Information
Date of Application: 12/30/2021
Applicant Name: Barbara Marie Goicoechea
Board/Committee Name: Production Industry Council
Address: 1701 Conventin Center Drive, Miami Beach, FL 33139
E-Mail Address: Barbara@actproductions.com
Work Phone: 305 538-3809 Home Phone
Cell Phone: 305 986 8177 Preferred Ca9gt Method:
Vehicle Information
Tog: LGZA25 Color: White
State: FL Year: 2019
Make: Land Rover Model: Discovery /
Applicant SR+nature: e
Please provide signed'form the Par} fng Department located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email : ParkingReception@miamibeachfl.gov
e-mail sub'ect: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
p, ·kd D ar 1na epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: e Signature:
Date Issued: Date Completed:
s
mng man ommtees pOtngt tm, toc orm up(ore