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Randi Freedman 12/31/22BO ARD AND CO MM ITTEE CHECKL IST Aeon»re./al free]AU _Are orAeown»we. _3/0/22 oAcowwrree/al±iovEL.stereo»eao». /foe _/SC Egg"?" "%2%%2... roe»./2//2 /2///2 9 Scan o o Letter of Reappointment o Cppy of Le e of Appointment/Reappointment. ~:ailed tr¡ Committee Liaison on Scan o o B rd a a Committee Application (Completed on ~ _ ,2 ~ ~ Scan o o Résumé/Curriculum Vitae 3 /i > ) o Diversity Statistics Reporting (Completed on/ / y. Oz l Scan o o Oath ' 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 CH ✓Memorandum - Solicitation by City Board and Committee Members cr Or MIAM1BE OFFICE OF THE CITY Gld' Citywide Permit Application (Parking Department Form) RECEIVED 4 R8 15 2022 Scan o o Booklet -- Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees o Source of Income Statement Scan o o Acknowledgment of Financial Disclosure Requirement f O_DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report. ecovea._$//S /2 sores,X o ran«r -----".,,_ _ 3/5j 33 Processa o . //S5 hl y rotoree I Da7 ~~~~-- sanreaa. 3.'/5, _Ml eyrtoes A 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:\C LER\BO A R D AND CO M M ITT IES DATABASE\CH EC KLI ST M ASTER\B&C Checklist 2015 M ASTER.docx M IA M I BEACH City of Miami Beach, 1/0O Convention Con ter Drive, Miami Boach, Horida 33 139 yyw_miamibachfl_go OFFICE OF THE CITY CLERK, Rafool E. Gr an ado, City Clerk Tel: 305.673.7411, Fax 305.673.7254 Email: CiNyClerk@miomibeachfl.gov March 10, 2022 Ms. Randi Freedman 860 E Coco Plum Cir PLA NTATION, FL 33324 RE: Production Industry Council Dear Ms. Randi Freedman: Congratulations! You have been appointed by Mayor Dan Gelber to the above-referenced Board or Committee, for a term ending: 12/31/2022. Pursuant to City of Miami Beach Code Section 2-22 (5)a: Notw ithstanding 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 305.673.7411. 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. Regards'ìj Rafael.nado City Clerk cc: Monica Beltran, Parking Director Veronica Hennig, 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 - Am endm ent to City Code Section 2-22 Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics City Wi de Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees M IAMI BEACH City of Miami Beach, 1ZOO Convention Conter Drive, Miami Boach, Horida 33 139 yyw _miamiboachllgo OFFICE OF THE CITY CLERK, Rafaol E. Granado, City Clerk Tel: 305.673.7411, Fac 305.673.7254 Email: CiClek@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Randi Freedman RE: Production Industry Council 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: 12/31/2022. 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. Randi Freedman swom to and sotssored setore n / _a.(@fr.-, 7- I *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 1 700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305 .673 7411 RECEIVED MAR 15 2022 CITY OF M IAMI 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 am a resident of the City of Miami Beach for six months or longer. Home Address _ □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 _ ò< 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 Logistics Management Group Business Address 1900 Purdy Ave, #715, Mi am i Beach, FL 33139 second 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 true. Raud, Fveedwav 3-15-22 Signature Date Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of ~sica! presence or o online notarization, -.S shut 23 RA4: Fecl X Produce ID (Cly of Miami Beach Board/commjttee Member). / biueres leo $ Name of Notary, Typed, Printed, or Stamped „G È., CHARLES J. DAGOSTIN f~Â,. J.-~\ MY COMMISSION# HH 165705 z«: •• )5 ¿i; sS EXPIRES: Decem ber 14, 202 }¿7;¿$$ ponded Thu Notary Public Underwrit ers i ii » MIAMI-DAD E. EEI SOURCE OF INCOME STATEMENT Section 2-11.1(@) of the County Ethics Code re quires that certain em ployees and public officials file a financial disclosure Statem ent on a yearly basis by July 1st of every year. Di sclosure fo r Tax Year Ending I Last Nam e First Nam e Middle Nam e/Initial 2021 Freedman Randi E M ailing Addre ss - Street Num ber, Street Nam e, or P.O. Box City, State, Zip Plantation, FL 33324 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. 0 Filing as an Employee (check one) [] county D Public Health Trust [ Municipal: (M unicipality) Departm ent Position or Titl e Em ployee ID Num ber W ork address I W ork telephone Em ployment began on/ended on Filing as a Board Member (check one) [] county E] Municipal: Miami Beach (M unicipality) Board w here serving Miami Beachl Altern ate address (if hom e address is exem pt) I W ork telephone I Term began on/ended on List below every source of incom e you received, along with the address and the principal activity of each source. Include your public salary. Place the sources of incom e in descending order, w ith the largest source fir st. Exam ples of sources of incom e include: com pensation for services, incom e from business, gains fro m pro pert y dealings, interest, rents, dividends, pensions, IRA distributions, and social security paym ents. Also, include any source of incom e received by another person for your benefit. How ever, the incom e of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here.0 Nam e of Source of Incom e Address Description of the Principal Business Activity Logistics Management Group, Inc 860 E. Coco Plum Circle, Plantation, FL 33324 Special Events Producer & 1900 Purdy Ave. #715 Miami Beach, FL 33139 I hereby swear (or affirm) that the information above is a true and correct statement. Signature of Person Disclosing 3-15-22 Date signed RECEIVED BY ELECTI ONS DEPARTMENT: O Hardcopy RECEIVED O Electro nic Copy MAR 15 2022 CITY OF MIAMI BEACH OFFICE OF T OFFICE USE ONLY Accepted: Y / N Deficiency: Pro cessed Date/Initials: Scann ed Date/initials: 138_SP-14 COE 2016 MIAMI B E A C H 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 BOARD & COMMILIEE 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) Freedman Randi E Last Name First Name Middle Initial I understand that no later than July.1of each year all members of Boards and Committees of the Ci ty 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 (For m 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. Rad, Feeda» 3-15-22 Signature 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 wi th 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:IC LE R\$ALL\REG \BO ARD AN D CO M M ITT EE APPLI CATIO NS FINAL DRAFT S\BO ARD AND CO M M ITT EE APPLI CATIO N REG FINAL.dccx Updated: June 2020 M IA M I BEACH City of Miami Beach 1 700 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 STATISTICS REP ORI Freedman Randi E 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: DMale [0O 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 O Caucasian/White O Native American/American Indian O Other - Print Race: ------------ EU I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? ves No E! 1 prefer not to answer. Do you consider yourself Physically Disabled? aves No Œl I prefer not to answer this question. Page 6 of 6 F:\C LER\$ALLIREG \BO ARD AND CO M M ITT EE APPLI CATIO NS FINAL DRAFT S\BOARD AND CO M MITT EE APPLI CATIO N REG FINAL.dccx Updated: June 2020 M IA M I BEACH CITYW ID E {CW) BO A RD & COM M ITTEES La City of Miami Beach, PARKING DEPARTMENT PARKIN G APPLICATION 1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 PARKING A cityw ide (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: 3-15-22 Applicant Name: Randi Freedman Board/Committee Name: Production Industry Council Address: 1900 Purdy Ave, #715, Miami Beach, FL 33139 E.Moil Address: Lmgrand@aol.com Work Phone: 305-790-3356 Home Phone Cell Phone: Preferred Contact Method: email Vehicle Information Tag: KNQ V18 Color: Gray State: FL Year: 2020 Make: Nissan Model: Altima Applicant Sianature: e Rouw, Feedawwa Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2" floor. Working hours are 8:30 to 5:00 p.m. or email to: PgrkingReception@miamibegchfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME Parkina Department Section PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: e Signature: e Date Issued: Date Completed .'\p wg \man rar \torms cw boards&committees parkingtorm.doc orm upa0red ti Vi u't us4 +egg2gZ2„ ss 08/21 r2u1 .... 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