Heidi Tandy 12/31/231B
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: "" DATE oF APPOINTMENT: "an 2022
BOARD/COMMITTEE: __ H_um_an_Ri_g_ht_s_c_o_m_m_itt_e_e Appointed by: C1tiJ Cí;_,,vw1-¡ :rs 10V
reo« eso.b/3//3 reru«. y/3y _/3 FOR SCANNER
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REC E IV ED
FEB -7 2022
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o f L, ter
I
~j'ppointment/Reappointment e-mailed to Committee
o 5sr a' u don#í€cato corretea o_/
• esumercuneon vtae 2/_] 9 )
o Di v ersi ty Statistics Reporting (Completed on._, _] hd
o Oath 7
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 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 O F M IAM I BEA CH
OFFICE O F THE CITY CLERK o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
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Scanned on:
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
J. _ o :VERSITY STATISTICS REPORTING Ke~p- COPY in file and ORIGINAL for Annual Report.
2, 7 ]à soea» "ci d--/- _7Date¡ ') Ì Boa f,l' C mittee Me_m_b_e_r-J--~
Processed on: ·._._Cg_By Employee: It
2J3/12
' r_77_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\BO A R D A ND CO M M ITT IE S DATA BA SE\CHE C KLI S T M A STER\B&C Checklist 2015 M A STER.dccx
Wfe are commuted to providing excellent public se vice and safety to ail who five, wok, and play in our vibrant, topical, historic community.
City of Miami Beach, I/OO Convention Center Diva, Miami Boch, Florida 33 139 ywy_IiaIIihgachfl_go
OF FICE OF TH E CI TY CIERK, Rafaal E. Gr an ado, City Clerk
Tel: 3 05.6 73.7 4 11, Fox 305.673.7254
Em ai l: CilyClerk@miamibeachfl.gov
January 20, 2022
M s. Heidi Tandy
4825 Lakeview D rive
M iam i B each, Fl orida 33140
SUBJECT: Human Rights Committee
D ear M s. Heidi Tandy:
Congra tulations! Y ou have been reappointed by the City Commission to the above referenced board or
com m ittee, for a term ending: 12/31/2023.
If you are unable to accept this appointm ent or have any questions, please call the Office of the City Clerk
at 305.673. 7411.
Please read the enclosed m aterials carefully. C ongratulations and good luck.
'7AA
R¿I Granado
C ity C lerk
cc: M onica B eltran, Parking D irector
Lana H ern andez, C ity Li aison
ATTACHMENTS:
Letter of A ppointm ent
O ath
City C ode/O rdinance section applicable to agency, board or com m ittee
C ity C ode S ection 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 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 Code Section 2-11.1 - C onfl ict of Interest and C ode of Ethics O rdinance
City Wi de P erm it A pplication - (Par kin g D epartm ent Form )
Booklet - G uid e to the S unshine A m endm ent and Code of Ethics fo r Public O fficers and E m ployees
City of Miami Beach, 1/O0 Convention Conter Divo, Miami Booch, Horida 33139 yywy_miamiLagchl_go
OFFICE OF TH E CITY CLERK, Rofaal E. Granado, City Clerk
Tel 305.673.7411, Fax. 305.673.7254
Email: CilyClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Heidi Tandy
RE: Human Rights 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* requirements 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. Heidi Tandy
Sw orn to and subscribed before me this-j-¡_ day of ;:i-Jfo2022
££ Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
MI A#l H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
FEB -7 2022
OFFICE OF THE CITY CLERK
Emai l: BC@miamibe achtl.gov CITY OF MIAMI BEACH
Telephone: 305.673.7411 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 am a resident of the City of Miami Beach for six months or longer.
Home Address 5 5 0 0 Collins Ave., 18 0 1 Miami Beach FL 3 3 14 0
□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).
[[9me ([ [[S[@SS
[[IS[[@SS, J\(]]fe5
□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).
[are [ [I[[eSS-
[[IS[Pes,S J\((]r@SS
"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 true. ad taly 02/07/20 22
Signature
Heidi Tandy
Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or _Mn line notarization,
.7 _a[el .23 he(i IA)]
Produced ID
(City of Miami Beach Board/Committee Member).
FL. DoVKs le>o
Form of Identification
.#'%5 . /f-I' ,'·-:if\ CHARL ES J. DAGOS TIN ii. ¿¿ MY'COMMIssIoN # HH 16s7s
$%53%3%' EXP IRE S: Decomber 14, 202s
{'°' Bon ded Thu Notary Public Underwriarg
(NOTARY SEAL)
Signat
Name of Notary, Typed, Printed, or Stamped
14l/AM/
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 & 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)
Tandy Heidi
H
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.
lar tas4 02/07/2022
Signature Date
' 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:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M IAM I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibeach[l, gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY ST A TISTICS REPORT
Tandy Heidi H
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:
L.late
[X remale
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
XO Caucasian/white
DI 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?
Jves
6h No
O I prefer not to answer.
Do you consider yourself Physically Disabled?
□!y es
(so
D I prefer not to answer this question.
Page 6 of 6
F:\CLER \$A LL\R E G\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DADE. EII SOURCE OF INCOME STATEMENT
Section 2-11.1(i) of the County Ethics Code requires that certain em ployees and public officials file a financial disclosure Statement on a yearly basis by July 1st
of every year.
Disclosure for Tax Year Ending I Last Name First Name Middle Name/Initial
2021 Tandy Heidi I
M ailing Add ress - S tr eet Num ber, S tre et Nam e, or P.O . Box
5500 Collins A ve
City, State, Zip
M iam i Beach, FL 33140
If your hom e address is your mailing address, and your hom e address is exem pt from public records pursuant to Fla. Stat. §119.07, read
instructions on the follow ing page and check here. O
Filing as an Employee (check one)
[] county D Public Health Trust [] Municipal:
(M un ici palit y)
Departm ent
Position or Title Em ployee ID Num ber
W ork addre ss I W ork telephone Em ploym ent began on/ended on
Filing as a Board Member (ch eck on e)
[] county [] Municipal: M iam i Beach
(M un icip alit y)
Board w here serving
Hum an Rights Com m ittee
Altern ate address (if hom e addre ss is exem pt) I W ork telephone I Term began on/ended on
1691 M ichigan A ve STE 250, M iam i Beach, FL 33139 3059262227 Jan 2022
List below every source of incom e you received, along with the addre ss and the principal activity of each source. Include your public salary. Place the sources of
incom e in descending order, with the largest source first. Exam ples of sources of incom e include: com pensation fo r services, incom e fro m business, gains from
pro perty dealings, interest, rents, dividends, pensions, IRA distributions, and social security paym ents. Also, include any source of incom e received by an other
person for your benefit. However, the incom e of your spouse or any business partner need not be disclosed. If continued on a separa te sheet, check here.[i..l
Nam e of S ource of Incom e Address Description of the Principal Business Activity
Salary 1450 Brickell A ve, 1900 Law practice
M iam i, FL 33131
I hereby sw ear (or affi rm ) that the info rm ation above is a true and correct statem ent.
Hlad; 1an
S ignature of Person Disclosing
0 2/07/20 2 2
Date signed
RECE IVED BY ELECTIO NS DE PARTM E NT:
□Hardcopy RECEIVED
O Electronic Copy
FEB -7 2022
CITY O F M IA M I BEACH
OFFICE OF THE CITY CLERK
O FFICE USE ONLY A ccepted: Y / N D eficiency: Processed Date/initials: Scanned Date/Initials: _
138_SP-14 COE 2016
/\/\IAN\! CITYWIDE {CW ) BOARD & COMMITTEES
C ity of M ia m i B each , P A R K IN G D E P A R T M E N T PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Bech, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 6200
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.
B o a rd M e m b e r In fo rm a tio n
Date of Application: 0210712022
Applicant Name:
Heidi Tandv
Board/Committee Name: Human Rights Commtitee
Address: 5500 Collins Ave, 1801, MB FL 33140
E-Mail Address: heidi8@gmail.com
Work Phone: Home Phone
Cell Phone: 3059262227 Preferred Contact Method:
V e h icl e In fo rm a tio n
Ta g : 989DND Color: red
State: Florida Year: 2022
Make: Honda Model: passport
Applicant Sianature: e Hali 1ansl4
Please provide signed form to the Parking Department located at 17 5 5 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email to: PgrkingReception@miamibeachfl.gov
e -m ai l su b je ct: B O A R D & C O M M ITT E E PA R KI N G A P P LI C A TI O N - A P P LIC A N T N A M E
p, ·k D rt a r Ina ep a m e n e c'Io n
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID C a rd Serial #:
Issued By Print Name: Print Name:
Signature: e Signature: e
Date Issued: Date Completed:
tS ·ti
: „p mg ·m a n rar form s cw oat s comm»tees p a r» g tor m , to