Beth Edwards 06/30/23FOR SCANNER
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BOARD AND COMMITTEE CHECKLIST
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o Letter, of Reappointment
o fl:¡ ?;" '-¡t, ;)_ Appointment/Reappointment -~mailed to Committee Liaison on
o Bo rd and c.lminittee Application (Completed on : I
o Resumercuricoum vie / jy./
o Diversity statistics Report@no (completed on Ó//o, i)OO)
o Oath
RECEIVED
AUG 1 6 2022
CITY OF M IAM I BEA CH
O FF IC E O F T H E C ITY C L E R K
IMPORT ANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓City Code Ordinance Section applicable to the agency, board or committee
✓City Code Sections 2-21, 2 -2 2, 2-23, 2 -24, 2-25, 2 -2 6, 2 -458 and 2-459
✓County Code Section 2-11.1 -- Conflict of Interest and Code of Ethics Ordinance (as
amended through December 20 1 O)
✓Amendments to the Code of Ethics Ordinance (September 2009 through July 20 12 )
✓Highlights of the Miami-Dade County Ethics Code
✓Sunshine Law and Public Records -- Frequently Asked Questions
✓Memorandum - Solicitation by City Board and Committee Members
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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
Y STATISTICS REPORTI G ep C PY . fil and ORIGINAL for Annual Report.
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CO N C LU D E D & RE S IG N A TIO N L E TTE R S
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
FACLER\BOARD AND COMMIT TIES DATABASEICHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are committed to providing excellent public service and salety to all who live, work, and ploy in our vibrant, hropoical, historic community.
MIAMIBEACH
City of Miami Beach, 700 Convention Canter Dive, Miami Bsach, Florida 33139 yyyyy_miaIihcachll_go
OF FICE OF THE CITY CL E RK, Rofaol E. Gr an ado, Ciy Clerk
Tel: 305.673.741, Fax. 305.673.7254
Email: CilyClerk@miamibeachfl.gov
August 15, 2022
Ms. Beth Edwards
5900 Collins Ave. #1806
Miami Beach, Florida 33140
SUBJECT: Committee for Quality Education in Miami Beach
Congratulations! You have been reappointed by Miami Beach Feinberg Fisher K-8 PTA to the above
referenced committee named above, 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 ap pointm ent/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.
Congratulations and good luck.
3 Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Dr. Leslie Rosenfeld, 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 endm en t to City Code Section 2-22
Miami-Dade County Code Section 2-11.1-Conflict of Interest and Code of Ethics Ordinance
City W ide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
City of Miami Beach, 1ZOO Convonlion Cantor Divo, Miami Eoa ch, Fonda 33139 www.truiauiboachll.goy
OFFKCE OF THE CITY CIERK, Rolaol E. Granado, Ciy Clerk
1ol: 305.673.741, Fax: 305.673.7254
Emoll: Ciiylerk @miamtbeochll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Beth Edwards
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.
Ms. Beth Edwards
Sworn to and subscribed before me this •
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.
MIA\MIBEACH
City of M iam i Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
AUG 16 2022
CITY O F M IA M I BEACH
OFFICE OF TH E 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): X I am a resident of the City of Miami Beach for six months or longer.
o »e » Qoo lo ye ,/7 F 3so
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).
[q rn % (f [/I /m e S i
[[][}S S J([fe 3
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).
[[3 rf 9 (9f /1 [f @ S b}
Hp41fess J(](Hrs,S-
"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.
Unde< penatti"ï,o\i'jurY, I ciare that h9p read the foregoing docu~t and that the facts stated in it
o w e /1, ouelo 8//$/027
"eye Éc woes Date
Printed Name
NOTARY
Sworn to ( or affirmed) and subscribed before me, by means of ~y~al presence or o online notarization, .Éh»,+ Asa +t.2». Belt Llnep s
coy or war e ach oararcommtee M emi en . m pep ,EI,a,as14„„a„,,A
X oasea [ [vctes te se 4£$j"%; wcoi@ir@ssioivi is» /l [j;pl9,á$ ExPRs: Doom »or 14, 2025
Form_ Identification ;jj?" Bonded Thu Notary Public Underwriters
(NOTARY SEAL)
Name of Notary, Typed, Printed, or Stamped
I/A\MIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Em ail: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
ar.
Last Name
3e1u
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:
OMate
dermale
O Other
Ll prefer not to answer.
Race/Ethnic Categories:
What is your race?
O African American/Black
Ll Asian or Pacific Islander
~ caucasiawwte
O Native American/American Indian
O Other -- Print Race: e □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latinola?
s
No
O I prefer not to answer.
Do you consider yourself Physically Disabled?
Jes Ao
O I prefer not to answer this question.
Page 6 of6
F:\CLER\$ALLIREG\BOARD AND COMMITT EE APPLICATIONS FINAL DRAF TS\BOARD AN D COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
MIA M/BE A CH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl,gov
OFFICE OF THE CITY CLERK
Email: BC@m i am i b eachfl.gov
Tel ep h on e: 305.673.7411
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATE ME NT
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)
L Name ' delta A
First Name Middle Initial
I understand that no later than Jul 1,Of each Vear 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 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)1;" or
3. A Copy of your latest Federal Income Tax Return.
Failure to file on of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
otnoj 90)99 day/8 in fa)y or both.
&lo //o z z
Signature Date 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.
P age 5 of6
FCL E RIS ALLR EG B OARD AN D CO MM ITT EE APPLICATI O NS FINAL DRAFTSIBO ARD AND CO MM ITT EE APPLICATIO N REG FINAL.dccx
Updated: June 2020
M IA M l·OAD E-
&Em 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 I Last Name First Name Middle Name/Initial
2021 Edwards Beth Ann
Mailing Address -- Street Number, Street Name, or P.0. Box
5900 Collins Ave unit 1806
City, State, Zip
Miami Beach, Fl 33140
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)
[] county D Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board iember (check one)
[] county [] Municipal: City of Miami Beach
(Municipality)
Board where serving
Miami Beach Quality of Education Committee
Alternate address (if home address is exempt) Work telephone
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, IHA distributions, and social security payments. Also, include any source of income received by a"{
person tor 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
Self Employed 5900 Collins Ave Unit 1806 MB, Direct Import-Global Sourcing
Fl33140
I hereby swear (or affirm) that the information above is a true and correct statement. 4/4/.sel
ore sap3E"EID
[ ] Hardcopy
L] Electronic Copy
AUG 1 6 2022
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed ate/initials: Scanned Date/initials:
138 SP-14 COE 2016
1 \I A MI BE A CH CT w (cw oAso & cones lg
rorro-+s. o«ovo sen«o PAR KING AP PLIC ATION [AJ##IS
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 e4. 6200 PARKIN
A city w id e (C W ) pa rking pe rm it is honored at m etered par king sp a ces and restricted residential zones
p a rking sp a ce s. A C W parking pe rm it IS NOT ho nored in pro hibited areas. A n A ccess C ard w ill be
p ro vid e d to yo u fo r C ity H a ll G a ra g e (G 7 ) access.
IMPORTANT NOTE: Yo ur vehicl e lice nse pla te serves as yo ur parking per m it". In ord er to avoid
a ny unne ce ssar y enfo rcem e nt actions, it is im porta nt that our records reflect the m ost current and
accura te in fo rm a tio n regarding yo ur vehicl e lice nse plate. Inaccurate and/o r outda ted vehicl e
in fo rm a tio n m a y le a d to the issuance o f parking citation(s) and/or the tow ing of yo ur vehicl e .
Ple a se no te that this new access card CANNOT be hole-p unched or perfo ra ted in any m a nner. To use
the ne w car d p le ase hold the car d at cl ose pro xim ity to the rea d er until the gate o pe ns. You m ay need
to try the o the r sid e of the car d. Please ensure yo u hold the entire surfa ce of the car d ag ainst the reader
until the g a te o p e ns.
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 e m b e r ln fo r ·
Date of Application:
Applicant Name:
Board/Com mittee Name:
Address:
Mont Address: r?
W ork Phone: Home Phone
Cell Phone:
V e h icl e ln fo r ·
Tag:
State:
Preferred Contact Method: cl,
Make:
L3 r
Color:
Year:
Model:
Ap plicant Si@nature: es
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: P a rki n g R e ce p tio n@ m ia m ib e achf l.g ov
e -m a il su b 'e ct : B O A R D & CO M M ITT EE P A R K IN G A PPLI CA TIO N - A PP LI CA N T N A M E
Pa r in g )epartment Secti on
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: e6 Signature: 86
Date lssued: Dote Completed:
ki D
N D : N o n o
C L.A S S : E -Ary non-commercial vah wh a GVWR « 26.0 6s.0 01 lbs. or any fv
The state at FL retains all property rights herein.
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