Melissa Beattie 12/31/231B
APPOINTEE:
BOARD AND COMMITTEE CHECKLIST
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MB Commission for Women BOARD/COMMITTEE: committee Appointed by: Commissioner Samuelian
FOR SCANNER
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FOR CLERK STAFF
o Letter of Appointment
o Lettey of Reappointment
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o 30rd an Comnmittee Application (Completed on.L / l t ±)d)
o Résumé/Curriculum Vitae _)
o Diversity Statistics Reporting (Completed ong HQ).
o Oath
RECEIVED
1 2022 FEB
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 201 O)
✓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
✓
CITY OF MIAMI BEACH ,
OFFI CE OF THE CITY CLERK
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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
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o Acknowledgment of Financial Disclosure Requirement
L/75%322:Y· ::i;· Da7t , •· , B a1)d o C~~e Member -···
Processed on:_ _/, JO)d npoyee: 4 1
0f500.3 C, • • By Employee:.
Received 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
F:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.dccx
WVe are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, topical, historic community.
City of Miami Beach, 1/00 Convention Center Drive, Miami Beach, Florida 33 139 y.miamIhaachf]_gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, Ciy Cdork
Tel: 305.673.7411, Fax. 305.673.7254
Email: Cit/Cl erk@mlamibeachf l.gov
January 31, 2022
Ms. Melissa Beattie
230 East Rivo Alto drive
Miami Beach, FL 33139
RE: Miami Beach Commission For Women
Dear Ms. Melissa Beattie:
Congratulations! You have been appointed by Commissioner Mark Samu e li an to the above-referenced
Board or Committee, for a term ending: 12/31/2023.
P ursuant to C ity of Miami Beach Code Section 2-22 (5)a:
Notw ithstanding any other pro vision of the City C ode or of any Resolution, commencing with
term s beginning on or after January 1, 2007, the term of every board member who is directly
appointed by a m em ber of the C ity Com m ission shall autom atically expire upon the latter of:
D ecem ber 31 of the year the appointing C ity Com m issioner leaves office or upon the
appointm ent/election of the successor C ity C om m ission m em ber.
If you are unable to accept this appointm ent, or have any questions, please call the O ffi ce of the C ity
C lerk at 305.673.7411.
P lease read the enclosed m aterials carefully as they concern your duties, responsibilities, and
requirem ents as a board or com m ittee m em ber.
C ongratulations again and good luck.
R~~
/<)
Rafael G ran ado
C ity C lerk
cc: M onica B eltran, Parking D irector
M onica M atteo-S alinas, C ity Li aison
ENCLOSURES:
O ath of O ffice/O ath of C ivility/A cknow ledgem ents
C ity C ode/O rdinance section applicable to agency, board or com m ittee
C ity C ode S ection s 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2-459
O rdinance No. 2006-3543 - Am en dm en t to C ity C ode S ection 2-22
M iam i-D ade C ounty C ode S ection 2-11.1 - C onflict of Interest and C ode of Ethics
C ity Wi de P erm it Applic ation - (P arkin g D epartm ent Form )
Booklet - G ui de to the Sunshine A m endm ent and C ode of Ethics fo r P ublic O fficers and E m ployees
City of Miami Beach, 1/OO Convention Conter Drive, Miami Beach, forida 33 139 yw _miamibgachl_goy
OFFICE OF THE CITY CIERK, Rolaol E. Granado, Cy Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Emai l: Cit Cl erk @miam ibeac hfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M s. M e lissa B e a tt ie
R E : M ia m i B each C o m m issio n F or W om e n
I d o so le m n ly sw ear o r affi rm to b e a r true faith, lo yalty a nd a lle g ia nce to the G overn m e nt o f the U nited
S tate s, the S tate o f F lo rida , and the C ity of M ia m i B e ach, a nd to perf orm a ll th e d utie s o f a m e m b er of the
a b ove-m e ntio n e d bo a rd or com m itt ee of the C ity o f M ia m i B e a ch to w hich I h a ve b e e n a p po inted fo r a
term ending: 12/31/2023.
To m y co lle a gu e s a nd to a ll o f tho se I represent a nd se rve , I p le dg e fa irn e ss, inte grity a nd ci vility, in all
a ctio ns taken a nd a ll com m u nica tio ns m a de by m e a s a pub lic servan t.
I ha ve b e e n issue d a co py of se cti o n 2-1 1 .1 of the M ia m i-D a d e C o u nty C o d e (C o n fl ict o f In terest and
C o de o f E thics O rdina nce), a s w ell as Flo rid a C o m m issio n o n E thics G u ide to the S u nshin e A m e nd m e nt
a nd C o de o f E thics fo r P ub lic O ffi cers and u nde rsta nd tha t a s a m e m b er of a C ity o f M ia m i B e ach B o ard
and/or C o m m itt ee , I m u st com p ly w ith the financi al d iscl osure* requirem e n ts o f M ia m i-D a de C o unty o r th e
S tate o f Flo rid a (de pending o n the b oa rd o r com m itt ee on w hich I se rve) o n Ju ly 1s t, fo llow in g the cl osing
of the cale nda r yea r o n w hich I have served .
M s. M e lissa B e att ie
S w orn to an d sub scribe d b ef or e m e this. '°',. d ay of. Feb -_, 2 02 2
/-27
*P le a se visit the C ity o f M ia m i B e a c h w eb site at w w w .m ia m ib e a chfl.g o v u n d e r C ity C le rk/B o a rd a n d
C om m ittee s fo r a dditional info rm atio n rega rd ing the Fina nci a l Di scl o sure R equirem e n ts.
MIAM I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 7411
RECEIVED
FEB 12022
CITY OF MIAMI BEACH
OFFICE OF THE 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):
I I am a resident of the City of Miami Beach for six months or longer.
Home Address 2@OE Bivo to Dr. Miami Beach33139
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 ------------------------
[[IS[[@SS J\(]]f@SS
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).
[]qr9 (9f [[,]PeS3
Business Address ------------------------
"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.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it
are tru~ " I rea»1.ave»
Signature T Date
Melissa Beattie
Printed Name
NOTARY
Sworn to (or affir~ed) ;nd subscribed.before me, by mean_s ~f,□physi:al pres.en.ce ~r')(6nline notarization,
oe L a le-122 Oe[SSA Jen1tie
x
_(City of (ami Beach Board/Committee Member).
rocca o / Ddefs Li&o sd
Form of Identification
Sign
gii%., CHwRiEs i. iGosnw ? p$"?$? wv counssro rn iosros %/2tasi Exentes: Don»r 14, 202s5
ji;ji"°' Bonded Thu Notary Publico Underwritero
(NOTARY SEAL)
Name of Notary, Typed, Printed, or Stamped
M IA M IB E H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
ww w.miamibeachfl,go v
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
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)
Beattie Melissa Text
Last Name 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 than $500, 60 days in jail, or both.
~ Feb.1,2022
Signature T [n
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.
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F:ICLER\$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M IAM I
City of Miami Beach
1700 Convention Center Drive
Mi am i Beach, Florida 33139
www.miamibeachll, goy
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
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:
OMate
LN eemiate
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
LO caueastanwnte
O Native American/American Indian
O Other - Print Race: ------------- □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Oves
Ll o □I prefer not to answer.
Do you consider yourself Physically Disabled?
ves
L o
D 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 .docx
Updated: June 2020
±e l.-."".", Il 1755 Meridian Avenue, Suite 200/M iami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 6200 %A R II IG
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
D a te of A p plication: Feb. 1,2022
A p p lica nt N a m e : Melissa Beattie
B o a rd/C om m itt ee N a m e : MB Commission for women committee
A ddre ss: 230 e rivo alto dr, miami beach, 33139
E-M ail A d dr e ss: melgbeattie@gmail.com
W o rk Pho ne : 305-799-5783 H o m e Phone
C e ll Pho ne : 305-799-5783 Pre ferred C ontact M e thod : 305-799-5783
Vehicle Information
Tag: DJN K94 C o lo r: Silver
State : Florida Y e ar : 2020
M ake: Lexus Model: GX460
Applicant sanature: es )d0
Please provide signed form to the Parking Department located at l755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or ema il to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION -- APPLICANT NAME
p ·i D ar una epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Dote: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signat ure: e
Date Issued: Date Completed:
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