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Courtney Reeve 063023M IA M I BEACH BOARD AND COMMITTEE CHECKLIST rreo»ree (o-h we) keevc o»re oro»eownve. 6/23/2a BOARD/COMMITTEE: C[)Mt'1 1/fe-e 1'h r Appointed by: A.Jor/-1-i ße,¡d, E/-e,,,œ,, ~ on sctR ro cs ne,-«hj El«at/,,y, [y_7? scan o oLeter ot Appointment rRM END: _(o, 39/25rrM LuMrr:. o, .2/2 Scan o o Letter of Reappointment ·% $ /"9$ eon-resent /cgpe uoso on scan o sf{ad c6nice Apcation (competed on tu (_e Scan o o Résumé/Curriculum Vitae o Diversity Statistics Reporting (Completed on _ ' t h 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 Section s 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 CITY O F M IA M I BEACH ✓Memorandum - Solicitation by City Board and Committee Members OFFICE E THE CITY CLERK RECEIVED JUN 29 2022 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 Board and Committees Liaison Responsibilities o DIVERSITY STATISTICS REPORTIN file and ORIGINAL for Annual Report. Received on: 629r2oz2 X _ __,,_'-+-'~,,.,,,,.-=------------- Scanned on: 755/"53 Processed on : _Q/gly By Employee: I I /#/22.. 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\BOARD AND COMMITT IES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx We are comm itted to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community M A MAI BEA CH City of M iam i Beach, 1/OO Co non !ion Con ter Drive, Miami Bea ch, Forida 33 139 ywyyy_miamibagch[lac OFFKCE OF THE CITY CIERK, Rafool E. Granado, Ciiy Clerk Tel: 305.673.7411, Fox. 305.673.7254 Email: CilyClerk@miamiboochfl.gov May 23, 2022 Ms. Courtney Reeve 5701 COLLINS AVE APT 1415 MIAMI BEACH, FL 33140-2384 RE: Committee for Quality Education in Miami Beach Dear Ms. Courtney Reeve: Congratulations! You have been appointed by North Beach Elementary School PTA to the above- referenced Committee, for a term ending: 06/30/2023. 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 305.673.7411. 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. 7 Rafael Granado City Clerk cc: Monica Beltran, Parking Director Dr. Leslie Rosenfeld, 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, 1/00 Convention Conter Drive, Miami Beach, Eorida 33 139 yyyw_miamibgachl]_goy OFFICE OF THE CITY CLERK, Rafaol E. Gran ad o, Ciy Clerk Tel: 305.673.7411, Fox. 305.673.7254 Email: CilyClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Courtney Reeve RE: Committee for Quality Education in Miami Beach 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: 06/30/2023. 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. is. cocaey Reeve som to o4 sosos« -oren-1 „Jo 4a 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. MIAM 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 g$jg¿., CHARLES J. DAGOSTN ?j"Z, wv coussioN H 16s705 ,9d,sé ExRts: pecamter 14, 2025 "Czá ponded Thru Notary Public Underwriters l'sis=ween\/ED AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH JUN 29 2022 STATE OF FLORIDA COUNTY OF MIAMI-DADE O/TY OF MIAMI BEACH OFFICE OF THE CITY CLERK I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check (✓)all that apply): }( I am a resident of the City of Miami Beach for six months or longer. Home Address 4756 Alton Rd/ Miami Beach, FL 33140 o I have an ownership interest (for a minimum of six months} in a business established in the City of Miami Beach (for a minimum of six months). [[are [ [ys[[esS [[yS//ess (](f@SS o I am a full-time employee of a business (for a minimum of six months} and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months). [pare [ [yS[fess [S[n%SS (]]reSS "Ownership Interest" means the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" means any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are trjl'e~. ) S. _62sr2022 si@atare" ,= bate Courtney C. Reeve Printed Name NOTARY Sworn to (or affirmed} and subscribed before me, by means o~sical presene or o online notarization, o0rOe .2 orty. eeUc ci y orami Beach sorarcommttee Mente9ggegr ,,,a44g4,„4„,,„ #t ')ves h¡aj 5€ [$"jê; wrcouvssir vi nos ] T lt(2 lii,J%i,±i Exs: Decomer 14,2025 •;¿$ Bonded Tru Notar y Public Underwrit ers i' Produced ID (NOTARY SEAL) Signa Name of Notary, Typed, Printed, or Stamped 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: 305.673.7 411 DIVERSITY STATISTICS REPORT Reeve Courtney c 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: LlMate W 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 [} Caucasian/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? lyes No O I prefer not to answer. Do you consider yourself Physically Disabled? ves A o O I prefer not to answer this question. Page 6 of 6 F:ICLE R \$A LL\RE G \BO A RD A ND C O M M ITT E E A P P LI CA TIO N S FIN A L DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 MIAM I BEACH City of Miami Beach 1 700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 BOARD & COMMIT IEE 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) Reeve Courtney c 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 Qèmore thcp~500, 6.~ days in jail, or both. $- 6/29/2022 Signature Dan ' 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 COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.dccx Updated: June 2020 4 1 I ; 1 \ ,i i ! I ·l j l I /IA/\[BE ACH CIWDE (Cw) OARD & coMw rTE Es g .- or ·iii-i w+is. wi re iriviwoi PARKING APPLICATION EM.II 1755 Meridian Avenue, Sutt» 200/Mioml Beach, FL 33139/Ph: (305) 673.7505 or (305) 673.7000 o4. 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 Date of Application: Applicant Name: Board/Committee Name: Address: $2190 E-Mail Address: Work Phone: Cell Phone: Vehicle Information Tag: State: Make: Preferred Contact Method: Color: Year: Model: Z»1z- Applicant Sianature: S Please provide signed form fo fHewkíng Department located at 1755 Meridian Avenue, 2d floor. Working hours are 8:30 to 5:00 p.m. or emai to: ParkingReception@miamibeachfl.gov e-mail subiect: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME P, ·kid De ari una partment ection PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Cord Serial #: Issued By Print Name: Print Name: Signature: 6 Sign ature: Date lssued: Date Com pleted: 5 .