Gabriella Kalmanowicz 12/31/22MIAMI BEACH
BOARD AND COMMITTEE CHECKLIST
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Scan o o Lette of Reappointment
o oyy f .et Appointment/Reappointment on
Scan o
Scan o
Scan o
RECEIVED
APR 14 2022
o and'Cor " e Application (Completed of-. I »'l
o Résumé/Curriculum Vitae o Diversity statistics Reporting (Completed on7//l là _
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
✓Memorandum - Solicitation by City Board and Committee Members
ITY OF MIAMI BEACH
FFICE OF THE CITY CLERK o Citywide Permit Application (Parking Department Form)
o Booklet -- Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o
Scan o
o Source of Income Statement
o Acknowled ment of Financial Disclosure Requirement
A l1S11CS REPOR G p £QfY. in file and ORIGINAL for Annual Report.
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Processed on:/I ', < TC ByEmployee: f, 5„a„, as,,,a
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CONCLUDED & RESIG ATION LETTERS
Tenn 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:\CLERIBOARD AND COMMITTIES DATABASE\CHECKUST MASTERIB&C Checklist 2015 MASTER.docx
We are commuted to prodng excellent public service and salety to all who le, wok, and play in out vbrant topcal, bstouc community
M IA M I BEACH
City of Miami Beach, I/OO Convention Con er Drivo, Miami Boach, Florida 33 139 yyw.miaribcachll.gov
OFFICE OF THE CITY CLERK, Raf0ol E. Gran ado, City Clerk
Tol: 305.673.7411, Fax. 305.673.7254
Email: CiNyClerk@miamibeachfl.gov
April 07, 2022
Ms. Gabriella Kalmanowicz
330 W47TH ST
MIAMI BEACH, FL 33140
RE: Next Generation Council
Dear Ms. Gabriella Kalmanowicz:
Congratulations! You have been appointed by the City Commission to the agency, board or committee
named above for a term ending: 12/31/2022.
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.
Regard~,
7 I .
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Erick Chiroles, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
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 - 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
MIAMI BEACH
City of Miami Beach, 1/0O Convonlion Conlor Divo, Miami Boach, Ilorido 33 139 yw.mnlaribaachll goy
OFFICE OF THE CITY CLERK, Ralool É. Granado, Ciy Clork
Tel: 305 673.7411, Fax. 305.673.7254
Email. CIN/Clerk @miamtboochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Gabriella Kalmanowicz
RE: Next Generation 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. Gabriella Kalmanowicz
Sworn to and subscribed before me thisL
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 Conventíon Center Drive
Miomi Beach, Florido 33139
OFFICE OF THE CITY CLERK
Email: BC@mIamIbeachf] gov
Telephone: 305.673.7411
RECEIVED
APR 14 2022
CITY O F M IAM I 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 Mi am i Beach City Code Sections 2-22 (4), as (check
() all that apply):
1am a resident of the City of Miami Beach for six months or longer.
Home Address. 2o ) dliui , Hiai {el, FL_ 33l[C
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).
[9mpP9 Pf y5pm]es-
1gS,1mes,SS, (](fes5»
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 Mi am i Beach (for a minimum of six months).
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by,]ne,, (d (]fes.
"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
% .tg__ lad.... hile
Signature Date
Cab-cll a kAl a uo
Printed Name
NOTARY
Swom to (or affirmed) and subscribed before me, by means of physical presence or ,ponline notarization,
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Form of Identification
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3!¿sé ExPREs: pocember 14, 2025
jjj±%$ Bonded mu Notary Pobc Udenwitens
Sig
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miomi Beach, Florido 33139
www.miamibeachfl,goy
OFFICE OF THE CITY CLERK
Email:. BC@miamibeachfl.qov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORI
L
Last Name First Name Middle Initial
The following infonnation is voluntary and has no bearing on your consideration for appointment It is being
asked to comply with City diversity reporting requirements.
Gender:
I Mate
LA remale
loner
O I prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
O Asian or Pacific Islander
EN Caucasian/white
O Native American/American Indian O Other- Print Race: _
D] l prefer not to ans w er .
Do you consider yourself to be Spanish, Hispanic, or Latinola?
ves
E
D I prefer not to answer.
Do you consider yourself Physically Disabled?
ves
a no
D I prefer not to answer this question.
Page 6of6
F:ACLER$ALLUREGBOARD AND COMMITTEE APPLICATIONS ANAL DRAFTS\BOAROANO COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
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M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miomi Beach, Florido 33139
www.miami beachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
BOARD & COMMITTEE FINANCIAL ACKN OWLEDGEME NT 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 Jyfy 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.
0ne of the following forms must be fifed 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)';" 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.
lLl_ l.Lo. //
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 5of6
F:CLERISALL RE GBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS'BOARD AND COMMITTEE APPLICATION REG FINAL.dock
Updated: June 2020
"7"T T 7 mm
m " "" "7099791
ab» EIE SOURCE OF INCOME STATEMENT
Secti on 2-11.1(0) 0t tho County Ethics Cod e requires that certain employees and public officlals file a financial disclosure Statem ent on a yearly basis by July 1st
of ever y year.
Dlsclosure for Tu Year 8dlg lust Name Flrst Name Middle Mame/initial
2021 [-lw«ori 2 Caorell leves
Malling Address - Street Number, Street Name, or P.O. Bax
330 O -414 sl #ts-cs er z. {<±53ls
City, State, Z0p -- e F 3340
lf your home address ls your malling address, and your home address ls exempt from public records pursuant to Fla. Stat. $119.07, read
Instructions on the following pago and check here.[l
Fuig as an Employee (check eno)
[] county I] Pub lic Health must I] Municipal:
(Municipality)
Department
Position or Tile Employee ID umber
Work address [oar telewone Employmen t began o/ended on
FIlay as a Board llenber (check eno)
Ercoun ty 0.a. Cow!/ [I unicipat: Mr-ti Bea
(Municipality)
Board where serving
Je+ Cnwh oq ow\
Altemte address (it home address ls exempt) [wort etenon _ [mm ton otended so
8yf$ qr-533 -z] [/1/2
List below ever y source of income you rece ived, along with the address and the principal activity of each source. Include your public salary. Place tho sources ot
Incom e in descending order, with the largest' source first. Examples of sour ces of incom e Include: compensation for services, Income fror busin ess, gains from
property dealings, Interest, rents, dividends, pensions, IRA distributions, and socla) sec urity payments. Also, Include any source of Incom e recei ved by another
person tor your benefit. However, the Income ot your spouse or any business partner need not be disclosed. t continued on a separate sheet, check here.Ll
Name ot Source ot tncome Address Description oft the Princlpal Business Acthvty
$\« oste )o o l7+« Mai ,F w· dr-, btr 'iv. +
Mio« e«w Cosweh \«Hi 30o Ako Gcey d lAw«9Fa
60t Cen\e $. 305 +ut, 34, F
I hereby swear (or affirm) that the Information above Is a true and correct statement.
Ai kL..
Signature oft Person Disclosing
4[/2
Date signed
RECEIVED BY ELECTIONS DEPARTMENT
rem RECEIVED
[] Electroni c Copy
APR 14 2022
CITY OF MIAMI BEACH
y
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
M\IAN\I BEACH CTwIE (CW 6OARD & COMM»TEES E3 City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 r (305) 673-7000 ox4. 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 em b e r In fo rm a ti o n
Date of A ppl ication : -{[u ]z
Ap plic an t N am e: (o e l\ \(\6o osZ
Boord/C om m ittee N am e: Nexk U ralo oov\
A dd ress: 330 o [7+« \ ar , FL. 33140
E-Mail A ddress: ), loes_z @ \vo l. ovo
W ork Phone: Hom e Phone
Cell Phone: q11- 533-202_ Preferred Contaci M ethod: 'eW peve
V eh icl e In fo rm a ti o n
To g : CFxT47 Color: ]Y
State: (lo l o Year: 2020
M ake: l \Y09660v M od el: T40ovo
Ap plican t Sianature:
Ple ase pro vi de signed form to th e Parkin g Departm ent located at 17 55 M eridi an A ven ue, 2d floor. W orki ng
hours ore 8:30 lo 5:0 0 p.m . or em ail to: Pa rk in g R ece p tio n @ m ia m ib e a ch fl .g o v
e-m ai l sub i e ct: B OARD & COMMI TTE E PARK ING APPLICATION -- APPLICANT NAME
Parkina Department Section
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Nome: Print Nome:
Signature: i Signature: AS
Dote Issued: Dote Completed:
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