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Josephine Manning 12/31/23MIAMI BEACH FOR SCANNER Scan o Scan o Scan o Scan o ..,.-. BOARD AND COMMITTEE CHECKLIST / reo»ree laspe A,]art3»re oraeeone.2i7/2o>o BOARD/COM MITTEE://_s S/ow _pointed y. 1. }-x0A-{e Z 6e" pEb p/. / FroR CLERK srArr {3//)2 2//9 o Letter of Appointment TERM END: , /A TERM LIMIT:a" > / o Letter of Rea pointment ;;f___ Y. of er O~~ointment/Reappointment e7aileïd _to Com,ee Liaison on 6 or@ an@ Cormittée plication (completed o,,7 )0 Resum/curriculum vtae /7/ ,99 o Diversity Statistics Reporting (Completed on_} Nd'> º Oath Scan o RECEIVED FEB -7 2022 CITY OF MIAMI BEACH OFFICE CF THE CITY CLERK 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) ✓Highlights of the Miami-Dade County Ethics Code ✓Sunshine Law and Public Records - Frequently Asked Questions ✓Memorandum - Solicitation by City Board and Committee Members Scan o Scan o 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 Requirement O DIVERSITY STATISTICS REPORTING Keep, CORY in file and QRI GI N AL for An n u al R epor t. Received on. blgned by · ~ vvL- Q __ · '-_\;$,_...,... __ /37 · Processed on:_oV' ,___-+--+----~--_By Employee: -----,h,,£.--,H'---!::----"-==-------- j 7 _d-- d_~_~ __ By Employee: ------,,=------,H'-----~~--"""'------- Date Scanned on: 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:ICLER\BOARD AND COMMITT IES DATABASEICHECKLIST MASTER\B&C Checklist 2015 MASTER.docx WVe are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical historic community M IA M I BEACH City of Miami Beach, 1/OO Convention Conter Drive, Miami Beach, Hlorida 33 139 yywy_miamibachl].go OFFICE OF THE CITY CLERK, Rafool E. Granado, City Clerk Tel: 305.673.7411, Fax. 305.673.7254 Email: CityClerk@miamibeachfl.gov February 07, 2022 Ms. Josephine Manning 1460 Ocean Drive #408 Miami Beach, Florida 33139 RE: Miami Beach Commission For Women Dear Ms. Josephine Manning: Congratulations! You have been appointed by Commissioner Alex Fernandez to the above-referenced Board or Committee, 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 305.673.7 411. 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. es",,/ / Rafael Granado City Clerk cc: Monica Beltran, Parking Director Monica Matteo-Salinas, 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 - Amendment 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 - (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, I/OO Convention Coner Drive, Miami Boach, Florida 33 139 yyN_Iiamibcachll.gov OFFICE OF THE CITY CLERK, Rafool E. Gran ado, City Clerk Tol: 305.673.7411, Fax. 305.673.7254 Email: CiyClerk@miamibeachll.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Josephine Manning RE: Miami Beach Commission For Women 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. t £ab4e Sworn to and subscribed before me this _ day of 2022 J Charles D'Agostin 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. M IA M I BEACH 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 -7 2022 CITY OF M IAM I BEA CH 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 (60,aif @hat apply): V I am a resident of the City of Miami Beach for six months or longer. o so». I+ O eo,_Di"-,B3313? 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 ~onths). Name of Business () Business Address ...___-- _ 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). - [ame of businesS 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 we . '_c @.'@- zl / ignatu , Date Sae,l-'e +. 4r"3 Printed Nan NOTARY Sworn to (or affirmed) and subscribed before me, by means of 4physical presence or online notarization, this laay or_E gon_,2d_oy _He ed..a tr1 .·g 4 (City of Miami Beach Board/Committee MemDO'' geeseeeseeseeemeteegg ; giii¿, RAFAEL E. GRANADO $"?? cosso n H 14o21o %?h,9Skis; ExPREs: septomber 16, 2025 f jji% ponde d Thru Notary Public Underwriters Produced ID Form of Identification L Personally Known s;gnature of N~ (NOTARY SEAL) Name of Notary, Typed, Printed, or Stamped MIAMl·DAD E- EI 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 Last Name M RN N [d G First Name so Mailing Address - Street Number, Street Name, or P.O. Box ..J.t!_ I4,0 cf Middle Name/Initial City, State, Zip t t 1 O , l Qt @O If your hom e address is your m ailin g addre ss, an d your hom e addre ss is exemp t from public record s pursuant to Fl a . Stat. $119.07, read instructions on the follow ing page and check here. D Filing as an E [] coun t y [] M un i cipal : Department Position or Title Work address Work telephone Filing as a Board Member (check one) [] coun t y Kí Monica: Ch of /l /AT ea! (Municipality) Board where serving 0 o,SS,oou - bo o c/ Alternate address (if home address is exempt) I Work telephone f"7"5 .. 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.[] Name of Source of Income Address Description of the Principal Business Activity 8x .Q B8ea. 1 1A U s ln,s e..a> I here by sw ear (or affi rm ) that the info rm ation above is a tru e and corre ct statem ent. , e A.la ignat e of Person Disclosing z/? h2- Date signed RECEIVED BY ELECTIONS DEPARTMENT: war-IE-CEIVED [] Electronic Copy FEB -7 2022 C ITY OF MI AM I BE A CH CITY CLERK OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: _ 138_SP-14 COE 2016 \9£4.2 1 ±±.a Ia 1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139 /Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 PARKING 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 \ fl' ~ Date of Application: \ '\ ( ) Applicant Name: \ "- / - Board/Committee Name: \ /I A /~ Address: \ ( - H '------, 1 E-Mail Address: \ -" ~ " Work Phone: \ Home Phone Cell Phone: \ Preferred Contact Method: \ Vehicle Information \ Tag: - colte State: Year:\ Make: Model: " ." '-- Applicant Sianature: ef Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2d floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME P, ·i D ar ma epartment ection PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: e Signature: e Date Issued: Date Completed: s : pig man rartorms cw oar is committees par' mgtorm.doc MIAM I 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 Last Name DIVERSITY STATISTICS REPORI \' Jseple 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: tate J2A-Female O Other O I prefer not to answer. j Race/Ethnic Categories: What is your race? O African American/Black LJ-Asian or Pacific Islander [rcaucastan/white 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? Jves g±No O I prefer not to answer. Do you consider yourself Physically Disabled? lves 23 O I prefer not to answer this question. Page 6 of 6 F:\CLER \$ALL\REG\BOARD AND COMMITT EE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION REG FINAL.dccx Updated: June 2020 MIAM I 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 & 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) Last Name First Na 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 r "?±:... /a l.. Date 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 COMMITT EE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION REG FINAL.docx Updated: June 2020