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Sandy Rojas 12/31/23MI A MI BE A CH FOR SCANNER Scan o Scan o Scan o Scan o Scan o , oA AND9, cow rr eE e cow -s)2/,/ 2/ aron»rea._l)y4loh: "e»S _re orareoynwvr.y -, so»orco»wwree LAS o s» Q- R5,6o z»le Z ree.. ...Jlh3...•••72[j/3 o Letter of eappoz·nt ent o to tenter !'y%/tm7en4Reappointment e-malled to committee Liaison on o d im ,tt.te'Ap'/l(~lompleted,7 l o Résumé/Curriculum Vitae ¡_ î ~ 7 .''"'\ _.,.....,,, Y-:)_ o Diversity stat istics Reporting (Completed or g_! D hl o Oath tr 7 IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK t 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 O Citywide Pert Application (Parking Department Form) O Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees O Source of Income Statement O Acknowlec of Financial Disclosure Requirement enes recreo- ..me .u.- ..o»ns» Reca o l( d /=, son a r s{'4$Sii dh,a4d' Processed on._Llf. ' 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 FICLER BO ARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\B& C Checkl ist 2015 MASTER.docx Wo ore committed to prodding excellent public service and solety to al who le, wok, onod p'ay in oar vwbvant, topical, historic com munity. Scanned with Cam Scanner M IAM I BEACH City of Miami Beach, 1/OO Convention Conter Drive, Miami Boach, Hlorida 33 139 wNyyw.miaIibachll.goy OFFICE OF THE CITY CIERK, Rafool E. Granado, City Clerk Tel: 305.673.7411, Fax. 305.673.7254 Email: CityClerk@mi amibeach ll.gov December 06, 2021 Ms. Sandy Rojas 1370 Marseille Dr Miami Beach , FL 33141 SUBJECT: Disability Access Committee Congratulations! You have been reappointed by Commissioner Kristen Rosen Gonzalezto the above referenced, board or committee named above, 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. Congratulations and good luck. Regards, Rafael Granado City Clerk cc: Monica Beltran, Parking Director Valeria Mejia, City Liaison ATT ACHMENTS: Letter of Appointment Oath City Code/Ordinance section applicable to agency, board or committee City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 Ordinance No. 2006-3543 - Am en dmen t to City Code Section 2-22 Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance City Wi de Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees M IAM I BEACH City of Miami Beach, I/OO Convention Canter Drivo, Miami Boach, Florida 33 139 yaw._miamibeach[l.go OFFICE OF IHE CITY CIERK, Rafaol E. Granado, City Clerk Tol: 305.673.7411, Fax. 305.673.7254 Emai l: City Clerk@miamibeachll.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Sandy Rojas RE: Disability Access 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 requirem ents 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. Sandy Rojas Sworn to and subscribed before me thi,.~-1---~~ dayJ~ 2 ty Clerk Pl ease visit the City of Miam i Beach web site at www.m iamibeach fl.gov under City Clerk/B oard and Committees for additional information regarding the Financial Disclosure Requirements. M IA M I BEACH Ci ty of Miami Beach 1700 Covontion Cantor Drivo Miomi Beach, Florido 33139 OFFICE OF THE CITY ClERK Em ait: BC@miamibeach.gov Tolo,phono: 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): / tam a resident of the City of Mi a mi Beach for six months or longer. ore n» 13 7o Maaeile- Da ME Hl 3)9/ (\/"'Ï 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). o- seos Fxci«. es )l0 cille D,- lf 54/ ts lama full-time employee of a business (for a minimum of six months) and l am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months). vars or socs._ lin ch áçop 1.A.7 suness Aas/ D ,/{or b "O w ners hip Interest' m eans the owners hip or ten perce nt (10%) or m ore (in dm g the ow n~;;f, , 10% or m ore of th e outst a nding capital stock) in a busin ess. B usin ess" m eans any sole pro prieto rsh ip , spon sors hip , co rp ora tion, lim ited lia bility com pany, or other entity or business ass ocia tion. ecl are that I have read the foregoing docum t and that th facts stated in it / 20 20 22- Date NOTARY s10~ (or affir~) and subscribed before me, b ~ion, aa)@a, > Y, Pro. d Sign (NOTARY SEAL) Scanned with Cam S cann er gji#;z., cRiEs i. Gosrw {•{:&·~~ MY COMMISSION# HH 165705 :%., ¿si EXPI RE S:D 72 A,g i: )ecomber 14, 2025 jiij?" Bond ed Tu Notary Pubic Underwriters MIA M EI1 SOURCE OF INCOME STATEMENT Sect'on 2-11.1/0) ot tho County Eth'cs Codo requlres that certain employoes and publc otfclals file a financial disclosuro Statement on a yearty bas/s by July 1st of every year. Dlsclasuro fr Ter Yeor En MIddlo Nome/inltll CIty, Stata, Z/p My ' lt your hom e addre ss ls yo ur m alling addre ss, and yo ur hom e addre ss Is ex em pt from public re co rds purs uan t to Fla. Stat. $119.07, road In stru ction s on tho followi ng page an d ch eck here.El FIlng as an Empl oyeo (check ono) E] county [] Public Health Trust E] Munlclpal: (Mtunlclpalty) Department Pus/tlon or Tltle Employee ID Number Work address ¡work telephone Employment began on/ended on Fling as a Board Member (chock one) :z/=z%e3:.:327,5% property dealings, interest, rents, didends, pensions, IRA distributions, and socla) security payments. Also, Include any source of Income received by another person tor your benefit However, the come of your spouse or any business partner need not be disclosed. It continued on a separate sheet, check here.L_] Mamo ot Source of Income Address Description ot the Princlpal Business Activity yeier e ud. 1na li G /'ámoins+lie, € 0! DEP} IEIT L] Hardcopy "t oo REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE crrY ci{bi Ekit on +AnDcoPY. Scanned with CamScanner M IA M I BEA C H City of Miami Beach 1700 Convention Center Drive Miami Beach, Florid 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATIS TICS REPORI Middle Initial The following information is voluntary and has no bearing on you asked to comply with City diversity reporting requirements. onsideration for appointment. It is being Gender: Dtae !A remale Cl oner O I prefer not to answer. Race/Ethnic Categories: What is your race? O African American/Black O Asian or Pacific Islander LX 6aucasianwite O Native American/American Indian O Other- Print Race: _ O I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? , ho O I prefer not to answer. Do you consider yourself Physically Disabled? Lyes N o O I prefer not to answer this question. Page 6 of6 F:CLER$ALLURE GBOARD ANDO COMMIT TEE APPLICATIONS FINAL DRAFTSBOARD ANDO COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 Scanned with Cam Scanner MIAMI BEACH City of Miami Beach 1700 Convenlion Center Drive Miami Beach, Florida 33139 www.miomibeachfl,goy OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 BOARD & COMM IIIEE 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) íl. ílt> Middle Initial l 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 fomms 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)';" or 3. A Copy of your latest Federal Income Tax Return. Failure to file one of these forms, pursuant to the Miami-Dade County Cod4, may subj¡ the person to a fine of no more th n $500, a ìn{ail, or both. ) .. "'> / 0 20 ,,l/hl/ [gtg '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 (Fonn 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 fonn with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 5 of6 FCLERSALL REGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSBOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 Scanned with CamScanner £ e I I 4