Brian Keane 12/31/23MIA
B8OARD AND COMMITTEE CHECKLIST
01/03/2022 PP[N[TEE;_DTE OF PPOINTMENT:
Brian Keane
eoorco»retee """ """""""A»e.mo«es r_Commi»r"md
FOR SCANNER
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FOR CLERK STAFF
o Letter of Ap pointment
Letter of Reappointment $ß/$5/95j° of Appointment/Reappointment e-mailed to
- 6oar@ ana Cori tee Application (Compietea on 01/03/2022
F,sumé'Currcum Vitae 01/11/2022
renoso. " rerum. "
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Com mittee Liaison on
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s versiy Satistiss Reporting (Completed on'
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Received January 11, 2022
Office of the City Clerk
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓City Code Ordinance Section applicable to the agency, board or committee
t 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
Memor an dum - Solicitation by City Board and Committee Members
O Citywide Permit ppoiication (Parking Department Form)
Sooklst-- Gide to Sunshine Amendment &8 Code of Ethics for Public Officers and Employees
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0 Source of cos Statement
O Acknowledgm ent of Financial Disclosure Requirem ent
..tg% g se
Received on:
TIS'TIS REPORTING Keen çQPY in file and ORIGINAL for Annual Report. ·e.o_é- -
ard or Committee Member
«on. "" so err City Clerk's Orfc Staff initials Le.e
01/11/2022
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ate
CON
Term Expired Letter
SIGNA TAON LET TERS
Initials Scan O
Resignation Letter Date Prcessed
Removal Letiar u€ 0 3secs
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iritiels Scan
We are comm;med to providing excellent public service and safety to ol who ive, work, and piay mn our vibrant, tropical, historic community
Ml
City of Miami Beach, /00 Convontion Conter Drive, Mimi Beach, Hlorida 33139 ¿¿y._miamihcachll go
OFHCE OF THE CITY CLERK, Rafaol E. Granado, City Clark
1al. 305.673.7411, fax. 305.673.7254
[mall:. Ci/Clerk@miamibeachtl.gov
January 07, 2022
Mr. Brian Keane
1000 West Ave #PH 1 O
Miami Beach , FL 33139
R E : Bl a ck Affairs Advisory Committee
Dear Mr. Brian Keane:
Con gratulation s! You have been appointed by Commissioner Mark Samuelian to the above-referenced
Board or Comm ittee, fo r a term ending: 12/31/2023.
Pursuant to City of Miam i Beach Code Section 2-22 (5)a.
Notwithstanding any other pro vision of the City Code or of any Resolution, commencing with
term s beginning on or after Jan uary 1, 2007, the term of every board member wh o is directly
appointed by a member of the City Comm ission shall autom atically expire upon the latter of:
December 31 of th e year the appo inting City Com mission er leaves office or upon the
appoi ntm ent/election of the successor City Com m ission member.
If you are unable to accept this appointment, or have any questions, please call the Office of th e City
CIerk at 305.673.7411.
Please read the enclosed materials carefully as they concern your duties, responsibilities, and
requirem en ts as a board or comm ittee member.
Congratulations again and good luck.
I /8
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Lissette Arrogan te, City Liaison
E N C L O S U R E S :
Oath of Office/Oath of Civi lity/Ackno wl edgem ents
City Code/Ordinance section applicable to agency, board or committee
City Code Section s 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2-459
Ordi nan ce No. 2006-3543 - Amen d men t to City Code Section 2-22
Miam i-Dade County Code Section 2-11.1 - Confli ct of Interest an d Code of Ethics
City Wi de Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics fo r Public Officers and Em ployees
H
City of Miami Beach, 7OO Convcontion Cantor Dro, Mia mi Baach, Forida 33139 y22y._miamrtbgachfl.goy
OFFICE OF THE CITY CLERK, Ralaol E. Granado, Ciy Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Emal: Ci»yClerk@riamibeachtl.gov
O a th o f O ffi ce
Oath of Civility
a n d
A ckn owl e d g e m e n ts
TO:Mr. Brian Kean e
RE: Black Affairs Advisory Committee
! do solemnly swe ar or aff irm 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 memb er of the
above-mentioned board or comm ittee of the City of Miami Beach to which I have been appointed for a
ts ending: 12/3112023.
To my colleagues and to all of those ! represent and serve, I pledge fairness, integrity and civility, in all
actions aken and ai communications mae y me as a public servant
ave en issued a copy of section 2-11.,of the Miami-Dade County Code (Conflict of interest and
ode of tis Gr&in.ace), as well as Florida Commission on Ethics Guide to the Sunshine Am endm ent
and Code of Ethics for Public Officers and understand that as a member of a City of Miami Beach Board
ancior Comrittee, must comp?y win the financial disclosure requirements of Miami-Dade County or the
Sta of torioa idepending on is toard or committee on which i serve) on July 1st, followi ng the closing
0 the calendar year on which } have served.
I 7
7 Mr. Brian Kean e
Sw9r to and subscribed before me this /¡}.-
"please vsit the City of Miami Ba ch website at www.miamibeachf!.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
MIAMIBE H ,
City of Miami Beach
I700 Convention Center Drive
Miami Beach, Flor ida 33139
OFFICE OF THE CITY CLERK
Emal: BC@miamibeachfl_gov
Telephone: 305.673.7411
AFFIDAVIT OF AFILIATION WITH THE CITY OF MIAMI BEACH
ST8. CF FLORIDA
OJNTY OF MIAMI-DADE
l ar in compliance with tho affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check
() all that
/1ara resile/i ofthe City oí Miami Beach for six months or longer.
'have an cwne rship interest ¡or a mirimum of six months) in a business established in the City of
Miam i Beach (for a minimum of six months).
¿{{{ {F ¿,jlzg-o.
usin1ss Ader ess
• ara a ai-tmns cmployse fa a minimum of six months) and l am based in an office or
oner iocation of the business tnat is physically located in Miami Beach (for a minimum of six month s).
gl4 ff ?¿¿?¿}boo«--
business dares
2i ten percent (10%) or more {including the ownership of
10% or mo re of the outstanding cap ital stock} in a busine ss.
usiness means any sole proprietor ship, sponsorship corporation, limited liability company, or other
Ut.sr&ss association
NOTARY
ani susci before me by means of{ ohysical presen ce or online notarization,
t . ow
TG!Cà L
#Re.. LUIS GONZAL EZ
3% 2RY 6@ii4is$Io # 66 964 02
±±¿, :; EXPIRES: June 29, 2024
jg" onad Thro Notary Public Underwriters
NCOME STATEMENT
Section 2-1 , f te y Etis de recures thar caran empiyeas and oublie 3ìfciais fie a financial disclosure Statement on a yearly basis by July 1st
or every ye
First Namco
Rn
wilddle Name/initial
Cly. State. Zip
Eve, [a n 33/37
lf ycd ere zcdrss is cu mail&g a&dress, &rd
instructions on the foi!swing page and check
hate address is exempt a public records pursuant to Fla. Stat. $119.07, read
Fifing s Emotoyse check one)
·-·~~--~·-··•"''" ·•··•····•···· ·•····. ··-·•·•·
ablie Health Ttust
(Municipality)
Employee ID Number
iork telephone Employment began on/ended on
a é oard Member (check ones)
(Municipality)
Barz her sang al , llar
¡work telephone /Term began on/ended on
01/2022
List sow av sours o income ycu rsovs, t,the address anc mne principai activity of an source. Include your public salary. Place the sources of
ec0ns sr; witp the !agest suce vampes of sources of inom a inchude: compensation for services, income from business, gains frcm ±mm"me"ers±rats
Address Description of the Principal Business Activity
co0
, RECEIVED BY ELECTIONS DEPARTMENT:
Hardcopy
Xlectronic Copy
Received January 11, 2022
Office of the City Clerk
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
ii
MIAM /BE H
City of Miami Beach
1700 Convention Center Drive
Mi am i Be a ch , Florida 33139
www .mi am ibe g ch !l_go y
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl._gov
Telephone: 305.673.7411
DIER,SIT Y STATISTICS REPORT
Ba
Last Name First Name Middle Initial
Th e following information is voluntary and has no bearing on your con sideration for app ointment. It is being
asked to with City require m ents.
Gender:
C~ai,?
leale
lomee
lt refer not to an swer.
What ls your race?
£can A er a /lack
DMAsian or Pactc islander
lj Native Amer ican/American Indiar
y j ¡:, ..Tg±T }3 . ..or«os«oou-oooooooo.or
Hispanic, or Latinola?
not to answer.
Disabled?
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a ce 6of6
FACAS?A.LIS£CAE N X MAN TE APLICA"IS FINAL DORA SS OARD AND COMMITTEE APPLICATION REG FINAL.d0cx
Upissec: ..e 0 2G
City of Miami Beach
1700 Convention Center Drive
Miami Beach , Florida 33139
www.miamibeachfl.gov
O FFIC E O F TH E C ITY CL ERK
Em ail: BC @m i a mi be achf .gov
Telephone: 305.673.7411
o for Board/Committee Members for failure to comply with Miami-
D a d e C o u n ty Financial DÜisclosure C o d e P rovision C o de S ectio n 2-11.1(i ) (2)
Last Name First Name Middle Initial
l understand that n later than gills- all members of Boards and Committees of the City of Miami
Be ach , ac s or y natare, are require d to comply with Miami-Dade County Fin anci al
Disclosure nm1s.
One of the following ors luii-ii irzs with tie City Clerk of Miami Beach, 1700 C on v en ti on Center Drive,
Miami each no later then 20 00n cf July 1, of each year:
Failure ts file one of these
of no mre than
Gig0fur
to Miami-Dade C ount y C ode, m ay sub j ect th e person to a fine
Date
'Members of the card a s oard of Adjustment will be notified dire ctly by th e State of Florida,
pursuant t S. 112.3145(1,fa "Statement of Financial interests (Form 1) with th e Miami-Dade County
12.00 no0 n. .larnig Board and Eoard of Adjustment members who file their
Form 1 w ith the is of Election s automa tically satisfy the County's fin anci al disclosure
reouirerentzs g {iami aaoh Esomrittee member and need not file an additional form with the Office
of the with the County cisclosure requiremen t does not satisfy the State
FY.±RSA. SC».AN
Update ±er 2?
age5os
5IN«. .5T SEC AR ANE CMMI TE ± APL.CATION REG .AAa..cocx
//\l, [BE, '}CITYWIDE (CW) OARD & CO M MI TTEES
ciy of tent e a+, PAR «N o DEPARtNr PAR KING PP[[CATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200
A citywi de [C W} parking perm it is hon or ed at metered parking spa ces and restricted residential zon es
parking spaces. A CW parking permit LS NOT honored in prohibited areas. An Access Card will be
provided to you for City Hall Garage (G7) access.
IMP ORTANT NOTE: Your vehicle license plate serves as your "parking permit". In order lo avoid
any unnecessary enforcement actions, it is important that our records reflect the most curren t and
accurate information regarding your vehicle license plale. Inaccura te and/or outd aled 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 CA N N O T be hole-p unch ed or perforated in any man ner. To use
the new card please hold the card a 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 oh the card against the reader
until the gate opens.
ACKNOWLEDGEMENT: i acknowledge that should my access card be lost, stolen or
d am age, I wi ll b e respon sibl e to pay a $10.00 replacement fee.
Boar! Member information
Date of Application: 1 / '1/fl/J1.,-2.- --------·----------------<
Preferred Contact Method: A/
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Vehicle lnformotion
Ta g : 0p212 z T I Color:
Stare: Har a Year:
Make: - : 'fo( /{ut111.0 I 1:~ud/.fl.v_-e1r _ _,_¡ ,_V·,_ºª_1e1_: ---'------~,___ ---;
AppíÏCO''ll sr ndture: ,?:!_ ---- ~---~·
Please provide signed for to the Parking Department located at 1755 Meridian Aven ue, 2 floor. Working
hours are 8:30 to 5:00 p.m. or email to: Parkin gR ecep tion@m iam ibeach fl .gov
e-mail subject: BOARD 8 COMMITTEE PARKING APPLICATION - APPLICANT NAME
GARAGE ACCESS -.------------------; ID Card Serial #:
P¡t Name. ------ ----- ---------------------1