Magui Benitez 12/31/23MIAMI BEACH
BOARD AND COMMITTEE CH ECKLIST .
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Scan o o Bo=arabaa Committee Application (Completed on._ _)
scan o Resume/curriculum vtae )/)/ j
o Diversity Statistics Reporting (Completed on,>_ _y )>
Scan o oOath r
RECEIVED
FEB 1 7 2022
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
CIT Y O F M IA M I B EA C H
OF FI CE O F TH E CITY CL E H { Citywide Permit Application (Parking Department Form)
Scan o
Scan o
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
o Source of Income Statement
Scanned on:
o Acknowledgment of Financial Disclosure Requirement
O DIVERSITY STATISTICS REPORTING Keep CO PY in fil e and O RIGINAL for Annual Report
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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:IC LERIBO A RD A ND CO M M ITT IE S DA TA BA SEIC HEC K LI ST M A STERIB&C Checklist 2015 M A STE R.docx
We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
City of Miami Beach, 1ZOO Convention Coner Drive, Miami Beach, Florida 33 139 yyw_IiaIibeachll gov
OFF ICE OF THE CITY CLERK, Rafa.l E. Gran ado, City Clerk
Tl: 305.6 73.7 11, Fa. 305.673.7254
Email: CityCl erk @ml amiboachf l.go v
Feb r u ar y 10, 2022
Ms. Magui Benitez
757 West Ave. #412
Miami Beach, Florida 33139
SUBJECT: Senior Affairs Committee
Dear Ms. Magui Benitez:
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.
Respe~
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Luis Callejas, 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 - Am endment 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 Am endment and Code of Ethics for Public Officers and Employees
1B
City of Miami Beach, 1ZOO Convention Conler Drive, Miami Boach, Florida 33 139 ywy_miaIibeachfl_gov
OFFICE OF THE CITY CLERK, Rafa»l E. Granado, Cly Clerk
Tl: 305.673.7411, Fax. 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M s. Magui Benitez
R E : S e nio r A ff airs C o m m itt ee
I do so le m n ly sw ea r o r affirm to b e a r true faith , loyalty and allegiance to the Government of the United
S tates, the S ta te of F lo rida , a nd the C ity of M ia m i B e ach, a nd to p erf orm all the d utie s o f a m e m b e r o f the
a b o ve-m e ntio ne d b o a rd o r com m itt e e o f the C ity o f M ia m i B e a ch to w hich I h a ve b e e n ap p o inte d fo r a
term ending: 12/31/2023.
T o m y colle a gu e s and to a ll o f tho se I rep resent a nd se rve , I p le dge fa irn e ss, integrity a nd civility, in a ll
a ctio ns taken a nd all co m m unicatio ns m a de by m e a s a public se rv ant.
I h a ve b e e n issu e d a co py o f se ction 2 -1 1 .1 of the M ia m i-D a d e C o u n ty C o d e (C o nflict of In te rest a nd
C o de of E thics O rdina n ce), a s w ell as F lo rid a C o m m issio n on E thics G uide to the S u nshine A m e nd m e nt
a nd C o de o f E thics for P ub lic O fficers and und e rstand tha t a s a m e m b e r o f a C ity of M ia m i B e ach B o ard
a nd/or C o m m itt ee , I m ust co m p ly w ith the fina ncia l discl o sure* requirem e n ts of M ia m i-D a de C o unty o r the
S tate of F lo rida (de pe nd ing on the b oard or com m itt ee o n w hich I serve) o n July 1st, fo llow ing the cl o sing
o f the cale nda r yea r on w h ich I have served.
i.. ni eeniez
S w orn to and subscrib ed b efo re m e this ........, __ d ay off~2022
4.
*P le a se visit the C ity o f M ia m i B e a ch w e b site a t w w w .m ia m ib e a c hfl.g o v un d e r C ity C le rk/B o a rd and
C om m ittee s fo r additio na l info rm atio n regarding the F ina ncia l D iscl osure R e quirem e n ts.
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 1 7 2022
CITY OF MIAMI BEACH
OFFICE OF THE CI TY 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):
y I am a resident of the City of Miami Beach for six months or longer.
Hom e Address. Z5? lest Ahl? l. n/ L33t3
□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 - H3[S]Pe J(]]f@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 , 4, 2A zgtd,,, g, y2z
Signatae Date "- •
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by mean s o?ph ysical presence or on line notarization, s/alla uaepe.22, ai [este
esa. /7j,""772,%$""7 "".a aa aa % h [l Ué / ' .2@if., CHARLES J. DAGOSTN êj %; wcownssiow 1sos
j,9,ii xPREs: December 14, 2025
8;$° ponded Tru Notary Pub/le Underwriters
i
~orm of Iden~
(NOTARY SEAL)
Signature
MIAMl·DADE-
EEI SOURCE OF INCOME STATEMENT
Section 2-11.1(i) 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 Last Name
2021
First Name
/(nuer
Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
City, State, Zip
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. O
Filing as an Employee (check one)
[] Municipal:
Department
Position or Title
Work address Work telephone
□County [] Municipal:
(Municipality)
Board where serving
Alternate address (if home address is exempt) Work telephone 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.[]
Name of Source of Income Address Description of the Principal Business Activity
531 /íerAe»
I hereby swear (or affirm) that the information above is a true and correct statement.
-~ /• egue
Signaure~'°n Disclosing
2/A lez
Date sign6d?
RECEIVED BY ELECTIONS DEPARTMENT:
□Hardcopy RECEIVED
[] Electronic Copy
FEB 1 72022
CITY OF MIAMI BEACH
OF FICE OE TE IT CLERK
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
1 700 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
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:
M ale
Cí rem ale
O Other
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
l caucasian/white
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?
d ves
No
O I prefer not to answer.
Do you consider yourself Physically Disabled?
aves
dk
O I prefer not to answer this question.
Page 6 of6
F:IC L E R \$A L L\R E G IB O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A FT S IBO A R D AN D C O M M ITT EE AP PLI C A TIO N R EG FIN A L.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 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.
ass.Pr«, 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:ICLER\$ALLIREG\BOARD AND COMMITT EE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION REG FINAL.dccx
Updated: June 2020
±l g£4 .2 + „2212% 1l
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 6200 PARKHIIG
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 pp licatio n:
Ap plic ant Name: Mpou [éU172
Bo a rd/C om mi tte e N a m e : ,, 2/I0(<5
A dd ress 297
E-M a il A dd ress:
W ork Pho ne :
C el l Ph on e: ,,
Home Phone,
Preferred C o ntact M ethod :
le- 1Vt
Vehicle Information
Tag : .-" > C o lo r: lerce 7/3p6
State: Hloaro Y ear : 2ar7
M a ke :
Hl/ttr
M odel: £Ltd
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Ap pl ican t Siana ture: es
Pl ea se provi de si g ned for m to th e Par king D epa rtm en t locate d at 17 55 M eridia n A ven ue, 2" floor . W orking
ho urs are 8:3 0 to 5:0 0 p.m . or em a il to : ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P ·ki D a r un a e p a rt m e n e c'Io n
PERM IT SYSTEM G A RA G E A CCESS
Expiration Date: ID C ard Serial #:
Issued By Print Nam e: Print Nam e:
Si gn at u re: Si gn a ture : 5
Date Issued: Date Com pleted:
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