Greg Branch 12/31/22BOARD AND COMMITT EE CH ECKLIST
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Scan o o Letter ot Appointm ent TERM END: /ly1 TER M LIMIT: -
Scan o o Letter of Reappointmen t
° f@99))3//%}' of Appoi ntmen t/r eapp ointmen t
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Scan o
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e-ma7·1 d to Committee
(~ 2» z_, 2-
o Board and Committee Application (Completed on1«)
o Résumé /curriculum Vitae/ l2o22 o Diversity Statistics Repor ting (Completed on_'y : )
o Oath
Liaison on
IMPORTANT INFORMATION FOR BOARD AND COMMIT TEE MEMBERS BOOK
, ✓City Code Ordinance Section applicable to the agency, board or committee
Received January 5, 2022 ciy code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Office of the City Cler] County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinan ce (as
amended through December 2010)
Amendments to the Code of Ethics Ordinan ce (September 2009 through July 2012)
t Highlights of the Miami-Da de County Ethics Code
/ Sunshine Law and Public Records -- Frequently Asked Question s
Memorandum - Solicitation by City Board and Committee Members
Scan O
Scan o
9 Citywide Permit Application (Parking Department Form)
ookdet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
6 source of Income Statement
9 Acknowledgment of Finan cial Disclosure Requj
0 A, DIV;RSffY STATISTICS REPORTING lo/o2 X F'@Ce]ye O,fi ' l1e(d [)/ "Gr---
Date B oard or Committee Member
1/5/2022 Chaea Z'A »at,
Processed on: B y Employee: Y7?
ate ciy cieñks orce safniu ais
1/7/2022 O / ) 72,q y,L
y Em ployee: @td, LA KY/°-
City Clerk's Office Sf initials
file and ORIGINAL for Annual Report.
Scanned on:
Date
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
EACLER\BOARD AND COMMIT TE-S DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.dOcx
City of Miami Beach, 1/OO Convention Cenler Driva, Miami Boach, Eorida 33 139 y¿wy_migmibgachfl_go
OFFI CE OF THE CI TY CLERK, Rofal E. Gran ado, Cly Clerk
Tel: 305.673.7411, Fax 305.673.7254
Email: Ci/Clerk@miamiboachfl.gov
December 21, 2021
Mr. Gregory Branch
3200 Collins Ave
Miami Beach, Florida 33140
RE: Budget Advisory Committee
Dear Mr. Gregory Branch:
Congratulations! You have been appointed by Commissioner Alex Fern andez to the above-referenced
Board or Committee, for a term ending: 12/31/2022.
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. 7 411.
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.
7 Rafael 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 - Am endment 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 - (P arking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
City of Miami Beach , \/0) Corvontion Cons Drio, Miami Boch, Hord0 33139 w4 _miaIilea_hi go
OFFCE OF THE CITY CIERK., Ratol L. Granado, Cy Clark:
Tel. 305.673./A1i, fax 305.673.7254
Email:. Cit/Clerk@miambeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgem ents
TO: Mr. Gregory Branch
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 wh ich I have been appointed for a
term ending: 12/31/2022.
To my colleagues and to all of those l 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,1 st, following the closing
of the calendar year on which I have served. ¿, /' f e . ·,-- .. /t •e ,.,:;.=:LE:::. __ ·-----·-
- iGr egory Bran ch
Swor to and subscribed before me th oh aay or /an %9}
Charles D'Agostin
Deputy Clerk
Please visit the City of Miami Beach website at www.miamibeachft.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
' A AI I\/V\i
City of Miami Beach
7 0 Convention Center Drive
Miami Beach, Florido 33139
OFFICE OF THE CITY CIERK
Email: BQ@myamineach\.go y
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WI TH TH E CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
am in com plian ce with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check
(/) all th at apply):
t_ lam a resident of the City of Miami Beach for six months or longer.
32 l A 4l] 4 p,, u f 339y0 Home Address ° oo_le' Neuoe 1 j / M au lía z >
I have an own ership interest (for a minimum of six months) in a business established in the City ot
Miam i Beach (for a mi nimum of six month s).
[]qm9 { P{//eS.....-
(IS,I[esS (]Hf%S3.....
a lam a full-time empl oyee 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).
[]q[Te ] [[JS/fl@S}.
[1/fes, fa,S.--o.--
"O w ne rs h ip In terest" means tho own ers hip of ten percen t (10%) or m o re (including th e owner s hip of
10 % or m o re o f th e o u tsta n din g capita l st ock) in a busin ess.
"B u sin e ss" means any sole proprietorship, sponsorship, corp oratio n, lim ited liabi lity company, or other
en tity or business association.
Under penal¿i /4~e£i,~2f.-'.! declare that I have read the foregoing document and t at the facts stated in it
are true. .l> '2y( 2, >
e t-O
Signatture
Go.,T ha,
Printed Na7
Date
NOTARY
Sworn to (or affirmed) and subscribe d before me, by means of )physical presence or o online notarization,
u 5th aay or Jan uary ao22y Gregory T.Branch
(City of Mi ami Beach Board/Co mmittee Memb er).
F L D river's Li ce n se X Produced ID
Form of Identification
Personally Kn own
Citato 0'peto
Sign ature of Notary Public
Ch ar l e s J. D'gostin
Name of Notary, Typed, Printed, or Stam ped
(NOTARY SEAL)
A/ \
City of M iam i Beach
1700 Con vention Center Drive
Miami Beach, Florida 33139
www_miamIbeachfl.goy
OFFICE OF THE CITY CLERK
Email: BQ@miamibyeachl.goy
Telephone: 305.673.7411
BOAB D & COMM I TTEE FINAN CIAL ACK N OW LEDGE ME NT STATEM ENT
Acknow ledgement of fines/suspension for Board/Com mi ttee Mem bers for failure to compl y wi th Miami -
Dade County Financial Di sclosure Code Provision Code Secti on 2-11.1(i) (2)
7
Last Name first Nam 7 Middle Initial
I understand that no later than dull of each ear all member s of Boards and Committees of the City of Miami
Beach, including those of a purely advisory nature, are require d to comply with Miami-Dade County Finan cial
Disclosure Requirem ents.
One of the fol lo wi ng torms mu st be filed wi th 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 "S ource of Incom e St atemen t;" or
2. A"Statement of Finan cial Interests (Form 1)1," or
3. A Copy of your latest Federal Income Tax Return.
Failure to file on e otfhese forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no mor e tharí $590, 60 days in jail, or both .
·y= los /2o2o
Signattíre Date
' Members of the Planning Board and Board of Adjustment will be notifi ed directly by the State of Florida,
pursuant to F.S . $112.3145(1)(a), to file a Stat em ent of Fin an cial Int ere sts (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 thei r
Form 1 wi th the County Supervisor of Elections automatically satisfy the C ounty's finan cial disclosure
requirem ent as a Miami Beach City Board/Comm ittee member and need not file an additional form with the Office
of the C ity Cl er k . However, compliance with th e County disclosure requirem en t does not satisf y th e State
requirement.
Page 5 0f 6
F.CLEFS ALLAIRE GOARD AND COMMIT TEE APPLICATIONS FINAL DFAFT SB O AH O AND COMMIT TEE APPLICATION HEG FINAL.d0OK
Updated: June 2020
S e ct i on 2 -1 1 .1(@ ) of th e C o un t y E thic s C o d e re q ui re s that certain employees and public officials file a financial disclosure Statem ent on a yearly basis by July 1st
of every year .
Disclosure for Tax Year En ding Last Name
2020 ql
Mailing Address -- Street Numb er, Street Nam e, or P.O. Box
3200 col/is Av e»&
First Name >veo,
Middle Name/initial
City, State, Zip /a, Beach 2/
If your hom e address is your mailing address, and your home address is exempt from public records pursuan t to Fla. Stat. §11 9.07. read
instructions on the following page and che ck Hel e.
Filing as an Employee (check one)
[] county I Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began onlended on
Filing as a Board Member (check one)
[J county ~M unicipal:
Board where s Ig
d
Alternate add ress (if h e a Work telephone Term be ;zn o /ended on
397-728-2067 2 22 27 # .> / o.
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 tor your benefit. However, the income ot your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here. L I
Name of Source of Income Address Description of the Principal Business Activity
/8) f7acca[ /2y /hwwb haz¡ y, "cs /uac/ /1vs
Coval 6aes, H 3734 Loara Ln, Mac4e re
I '
,e3
'./
thereby swear (or fmátion above is a true and correct statement.
signa«t 6tP
20 2 2 O o <
D at e signed
RE CEWED BY ELEC TION S DEPARTMENT;
[J H ardcopy
X Electronic Copy
Received January 5, 2022
Office of the City Clerk
REMEMBER T O PRINT, S IG N , AND SUBMIT TO THE OFFICE OF THE CI T Y CLERK VIA EMAI L OR HARDCOPY.
City of M iami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachf\.gov
OFFICE OF THE CITY CLERK
Email. BC@miamibgachf]_gov
Telephone: 305.673.7411
Last Naki 6
DIVE RSITY STATISTICS REPORT
ive]
First fame 7 M iddle Initial
The following inform ation is voluntary and has no bearing on your consideration fo r appointment It is being
asked to com ply with City diversity reporting requirem ents.
Gender:
c2fa
r em ate
lohet
O I prefer not to answer.
RacelEthnic Categories:
W hat is your race?
[± A tican American/lack
Lk Asian or Pacifi c Islan der
El Caucasian /wh ite
Lk Native Am erican/Am erican Indian
[_]} O ther -- Print Race.
O I prefer not to answer.
Do you con sider yourself to be Spanish, Hispani c, or Lat inola?
lves g o
[ltpreter not to an swer.
Do you co nsider yourself Physically Disabled?
Jes
'5A»
D I prefer not to answer this question.
Page 6of6 ,
F:ICLERI$AL LIRE GBOARD AND COMMIT T EE AP PL ICATION S FINA L DRAF T S\BOARD AND COM MI TT EE AP PLICATION REG FINAL .docx
U pdat ed:. June 2020
//\//\//\/ ,_, 1,IwDE {CW) BOARD & COMMITTEES
ca# • io.i .á vaie ore #on PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph:. (305) 6737505 or (305) 673.7000 ca. 6200
A city wi de (CW} parki ng permit is honored al m eter e d parking spaces and restricted residential zon es
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 veh icl e licen se pl ate serves as your "parking permit". In or d er to avoid
any unnecessar y en forcem ent action s, it is im portant th at our recor d s reflect the most curren t and
accurale information regarding your vehicl e license plate. Inaccurale and/or outdated vehicle
information may lead to the issuance of parking citation(s] and/or the towing of your vehicle.
Pl ease note that this new access card CANNOT be hole punched or perforated in any man n er . 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. Ple ase 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.
Bo ard M em ber Inform ation
Date of Application:
Applicant Name »to
Board/Committee Name: " ) u/6.&
Work Phone:,
3°
Cell Phone: 2) -)38 28 j P el er red Conto+ Method: o//
Veh icle Inform ation
Ta: D y px2 Color: lac
State: t:::l Year: 2 3 o]
Make: CAU ](ta Model: C ele e
Applicant Sianature: 5
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2° [loor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@mniamibeagchfl,gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
Parkip9,P2gpgrtment section
PERMIT SY GARAGE A CCE SS
Expi ra tion D ate : ID Cord Serial #t:
lssued B y Print Name: Print Name:
Signature: ó Signature: ES
Dote Issued: Date Completed