Steve Haas 12/31/23M IA M I BEACH
BOARD AND COMMITTEE CHECKLIST _ /
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BOARD/COMMITTEE:
FOR SCANNER
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RECEIVED
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o . o y of Lett r of Appointment/Reappointment e-mailed
• Boata í«ca ## eaton comotee+ o_/ h]
o Résumé/Curriculum Vitae
o Diversity Statistics Reporting (Completed o! l =
º Oath
to Committee 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)
CITY OF MIAMI BEACH ✓Highlights of the Miami-Dade County Ethics Code
OFFICE OF THE CITY CLERK ✓Sunshine Law and Public Records - Frequently Asked Questions
✓Memorandum - Solicitation by City Board and Committee Members
FEB 1 2022
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Received on:
Processed on:
Scanned on:
o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
o Source of Income Statement
o Acknowledgment of Financial Disclosure R uirement ! ;º DIVERSITY STATISTICS REPORTING Jg COPY n file and ORIGINAL for Annual Report.
?/122 soneaoX ' I 'i,! J _..,._.,.B_o C_o_m_m_i_tt_e_e _
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'.)_/ rt)--,)_ By Employee -~----.----~--------- baie
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 MASTERdocx
We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical historic community
M IAM I BEACH
City of Miami Beach, 1/O0 Convention Conter Drive, Miami Boach, Horida 33139 wyy.miamibgachll.goy
OFFICE OF THE CITY CLERK, Rafool E. Granado, Cy Clerk
Tol: 305.673.7411, Fax. 305.673.7254
Email: CilyClerk@miamiboachfl.gov
January 20, 2022
Mr. Steven Haas
10000 W. Bay Harbor Drive
Miami Beach, Florida 33154
SUBJECT: Visitor and Convention Authority
Dear Mr. Steven Haas:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/2023.
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.
Respectfully,
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Grisette Roque, City Liaison
ATTACHMENTS:
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 - Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
M IA M I BEACH
City of Miami Beach, 7OO Co nven tio n Cantor Drive, Miami Boa ch, Horida 33 139 wywy_miamibga chfl.goy
OFFICE OF THE CITY CIERK, Rafool E. Gran ado, City Clerk
Tol: 305.6 73.7411, Fax. 305.673.7254
Email: CiNyClerk@miamibeachll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M r. Steve n H aas
R E : V isitor and C o nvention A uthority
I do so le m n ly sw ea r or affi rm to bear true faith, loyalty and allegiance to the Govern m ent of the U nited
States, the State of Florida, and the C ity of M iam i Beach, and to perf orm all the duties of a m em ber of the
ab ove-m entione d board or com m ittee of the C ity of M iam i Beach to w hich I have been appointed fo r a
term ending: 12/31/2023.
T o m y colle agues and to all of those I represent and serve, I pledge fairn ess, integrity and civility, in all
actio ns taken and all com m unications m ade by m e as a public serv ant.
I ha ve be en issu e d a copy of section 2-11.1 of the M iam i-Dade C ounty C ode (C onflict of Interest and
C o de of Ethics O rdinance), as w ell as Florida C om m ission on Ethics Guide to the Sunshine Am endm ent
and C o de of Ethics fo r Public O ff icers and understand that as a m em ber of a C ity of M iam i Beach Board
and/or C o m m itt ee , I m ust com ply w ith the finan ci al di scl osure requiremen ts of M iam i-Dade County or the
State of F lo rid a (de pending on the board or com m ittee on w hich I serve) o July 1st, fo llow ing the closing
of the cale nda r yea r on w hich I have serv ed. - . ,,,,.,,,.-·
Sw orn to and subscribed befo re m e this _l_ day of F~022
1
pl ea se vi sit the C ity of M ia m i Be ach w ebsite at w w w .m iam ibeachfl.gov under City Clerk/Board and
C o m m itt ees fo r additional info rm ation regarding the Financial Disclosure R equirem ents.
M IA M I BEACH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
FEB 1 2022
CITY OF MIAMI BEACH
OFFICE OF TH E CITY CLERK
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):
o I am a resident of the City of Miami Beach for six months or longer.
Home Address _
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 _
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. y]DC
q0, „Ja 4, _A ß,F 33739 Business Address. l]. 1@dou bud (olu pc _lP,
"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 b iness association.
of perjury, I declare that I have read the foregoing docume t nd that the facts stated in it
Si9nay4r g /lu» [/aor
Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of a physical presence or a online notarization,
)a lemon 2a Slee H]
Produced ID
(City of Miafr,. Beach Board/Committeezmb.er). Fl '„et. 2 9 > l U/s /Ch
Signat
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
BOARD & COMMIT TEE EINANCIAL 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)
Last Nâme 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 th $500, 61 " jail, or both. 1. I 2] >
Date r 7
1 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:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DAD E- EII 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
2021
First Name Middle Name/Initial
Mailing Address - Street Number, Str« 1e, or P.O. Box
a/enaleo 0ol
a 'a 393°
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 here. D
Filing as an Employee (check one)
□County □Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title
Work address Work telephone
Employee ID Number
Employment began on/ended on
Filing as a Board Member (check one)
[] county [] Municipal: /a V
(Municipality)
Board where serving
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
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.O
Name of Source of Income Address Description of the Principal Business Activity
(or affirm) that the information above is a true and correct statement.
Sign ure of Person Disclosing ...r
RECEIVED BY ELECTIONS DEPARTMENT:
O Hardcopy VED
tro no .R3ECEl
FEB 1 2022
CITY OF MIAMI BEACH
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/initials:
138_SP-14 COE 2016
M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach],gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
S/eue
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:
3
tirerete
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
(fj Caucasian/white
Ll 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?
v es
EfNo
C!J I prefer not to answer.
Do you consider yourself Physically Disabled?
ves po
[!} 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.dccx
Updated: June 2020
±£4.41+$%£32 Il
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 PAR ING
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". In 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:
Applicant Name:
_j
Board/Committee Name: J)
Address: [qot CoA/ E,3,
I 'ti0o C .,,../e, Dr
E-Mail Address_9
Work Phone: orne one
Cell Phone a 33 «s Preferred Contact Method:
Vehicle Information
Tag: 1-0 9070 Color: tock
State: rL Year: 20&
Make: lo2 Model: o 4
Applicant Sianature: e I "#
Please provide signed ffm fo the Parking Department located at 1755 Meridian Avenue, 2d floor. Working
hours are 8:30 to 5:0 p.m. or email to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P ·¢ D ar mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature:
Date Issued: Date Completed:
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