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Elizabeth Latone 08.01.23MI A IM, AIBEAC,, BOARD AND COMMITTEE CHECKLIST Elizabeth Kimbell Latone 01/01/2023 APPOINTEE:0AJ�C|��k�POY���ENT� BOAR D/COM M ITTEE: Ad Hoc Advisory Charter Revle� Appointed bv: Commissioner Laura Domingu( FOR SCANNER FOR CLERK STAFF Scan oLetter ofAppointment TERM END: TERM LIMIT: �x Scan oLetter ofReappointment n Coof Appointment/Reappointment e-mailed to Committee Liaison on 16 Scan * c Board and C6mmiUeeApp|icmUon (Completed on ) Scan oRdoum6/Curr|ou|umVitae / o Diversity Statistics Reporting (Completed on ` Scan o c, Oath IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK / City Code Ordinance Section applicable hathe agency, board nrcommittee � City Code Sections 2-2i.2-22.2-23.2-24.2^25'2^2G.3-468and 2-450 / County Code Section 2-11.1 — Conflict of Interest and Cod* of Ethics Ordinance (as amended through December 2010) / Amendments to the Code of Ethics Ordinance (September 2009 through July 2012) / Highlights wfthe Miami -Dade County Ethics Code / Sunshine Law and Public Records — Frequently Asked Questions / Memorandum ` Solicitation byCity Board and Committee Members 0Citywide Permit Application (Parking DeportmentFo,m) 0 Booklet — Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees Scan oSource ofIncome Statement Scan OAcknowledgment ofFinancial Disclosure Requirement 0 Board and Committees Liaison Reo Responsibilities eo kidtNAL'tor Annual Report. 0 DIVERSITY STATISTICS REPORTING Keep COPY in �1/�1/���� Reoohedpn: Signed by Data 4?oaodorCom |Uee/Wember 01/U��O�3 �'/ Processed on: =� By Employee: y`� ' ( Scanned on: ' '' Date City Clerk's 0 ice Staff Initials 01/002O23 Date City Clerk's Office Staff Initials CONCLUDED NDED & RESIGNATION LETTERS Term Expired Letter Date Processed Initials Scan 0 Resignation Letter Date Processed Initials Scan 0 Removal Letter due to absences Date processed Initials Scan 0 p:\CLsnxsOAnoAND COMMnT/sao/TAo^asx;HcCwuSTMxorsnB&oCneckhs/un1omaSTsnwpr City of Miami Beach, .I ZGG C ortven3Ecm Cbnler [,kivo,. Mami 1 6, [land a 33 139 wmw.miamibcaffifl.,acy OfflCE OF THE CITY CLERK, Rufm.1 F. Granad , City Ckt rk Tel: 305,673.7411, Fax 305,67;1.7254 Email: C�tyC��k�+rr�i�rr<rsb�.h31x January 05, 2023 Elizabeth Latone 6515 Collins Ave. #1702 Miami Beach, FL 33141 RE: Ad Hoc Advisory Charter Review and Revision Board Dear Elizabeth Latone: Congratulations! You have been appointed by Commissioner Laura Dominguez to the above - referenced Board or Committee, for a term ending: 08/01/2023. 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. Regards Rafa I Granado City Clerk cc: Monica Beltran, Parking Director Nick Kallergis, 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 City of Miami Beach, ) AV) 0on^c�oumCmnk-,Dm*'^wmm/NxIf4Ho*&l33��� OFFICE OF 04 CrFY CLERK, Wad E, Gfafiodo, ow, ciork Y4 30,5-673.7411, fax� 305 673 7254 Oath *YOffice Oath ufCivility and Acknowledgements TO�Elizabeth Latone RE: AdHoc Advisory Charter Review and Revision Board |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: 08/01/2023. Tomycolleagues and 0oall ofthose | represent and serve, | pledge fairness, integrity and civility, |nall actions taken and all communications made bymeaoapublic 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 nfEthics for Public Officers and understand that asamember ofa City ofMiami 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 ofthe calendar year onwhich |have served. Sworn toand subscribed before me this day of 1;0404, 2023 Deputy Clerk *Please visit the City ufMiami Beach website atwwwm)amibeachfl.govunder City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Emalt: BC@bmiarnib��,achfqov Telephone.- 305,673 .741 1 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): M I am a resident of the City of Miami Beach for six months or longer. Home Address6515 Collins Ave. #1702, Miami Beach, FL 33141 EI 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 Pantheon Partners, LLC Business Address 6515 Collins Ave. #1702, Miami Beach, FL 33141 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). Name of Business Business 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 1; arjrue 01/01/2023 , '4414-07 Si*g-n—at7e — Date Elizabeth Kimbell Latone Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of m physical presence oro online notarization, this (#'- day of 20 by ttt,"" 'u. 1.4 (City of Miami Beach Board/Committee Member). Marto PanteWes NOTARY PUBLIC Produced ID STATE OF FLORIDA Form of Identification Comm# GG327654 VPerson Known Expires 8/19/2023 (NOTARY SEAL) Signatu4-of Noter Public Name of Notary, Typed, Printed, or Stamped MIAMI BEACH City of Miami Beach l7)0Convention Center Drive Miami Beach, Florida 33139 OFFICE OFTHE CITY CLERK Email: 305.873.7411 Acknowledgement nffines/suspension for Board/Committee Members for failure to comply with MiamiDade County Financial Disclosure Code Provision Code Section 2-11.1 (i) (2) - L@tone Elizabeth K Last Name First Name Middle Initial | understand that nolater than July 1. of each year all members ofBoards and Committees cfthe City ofMiami Beach, including 0lOGe of purely advisory nature, are required to comply with Miami -Dade County Financial O|sn|mauna Requirements. Q= of the following forms joijal be filed with the City Clerk of Miami Beach, 10OConvention Center Drive, K4|emn| Beach, Florida, no later than 12:00 noon of July 1. sfeach year: 1. A"Source ofIncome StatenOeOt|"pr 2. A"Statement ofFinancial Interests (Form 1)1;" or 3. A Copy of your latest Federal |Uoonna Tax Return, Failure tofile one of these forms, pursuant tothe Miami -Dade County Code, may subject the person 1oafine ofDumore than $5O0.0Odays |njail, o[both. 4;rj�, " 14 t /1, /1 _% / Members of the Planning Board and Board of Adjustment will benotified directly bythe State of Florida` pursuant b}F.3.§112.3145MX@>.tofile aStatement ofFinancial 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 mudonnaUce||y 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 Qty Clerk. Hovvever, compliance with the County disclosure requirement does not mmdoh/ the 8tohs naquinanoenL Page 5 of 0 F�\CLAND COMMITTEE APPLICATIONS FINAL uRAFTSWARD AND COMMITTEE APPLICATION REG FINAL,docx MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: 13C@M:tgrnflb jgqhfIqov Telephone.- 305.673,7411 Latone Last Name Elizabeth K 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: Male Female Other I prefer not to answer. Race/Ethnic Categories: What is your race? [3, African Americansack Cli" Asian or Pacific Islander 1D'CaucasianNVhite Native American/American Indian E31 Other — Print Race: E] I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? 0,'Yes D No Oi I prefer not to answer. Do you consider yourself Physically Disabled? Yes No I prefer not to answer this question. Page 6 of 6 F,%CLER\SAWREG1SOARD AND COMMITTEE APPLICATIONS FINAL DRAFISNSOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 COUNTY 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 First Name Middle Name/initial 2021 Latone Elizabeth Kimbell Mailing Address Street Number, Street Name, or P.O. Box_ 6515 Collins Ave. #1702 Miami Beach, FL 33141 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. ❑ Filing as an Employee (check one) M County Q Public Health Trust Municipal: (Municipality) Department Position or Title Employee ID Number Work address Work telephone Employment began onlonded on Filing as a Board Mem1w (check one) El County unicipai: *1_(A V► (A )rYl i 8U4, (Municipality) YVaI Y "Iful6 OUR nnU Alternate address (if home address is ex mpt) lWorktelophone Term began on/ended an 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 Various Investment Income � Janney, Montgomery, 4064 Colony Road Suite 450 Charlotte, NC 28211 Investments I hereby swear (or affirm) that the information above is a true and correct statement. Sig/natur4of Person Disclosing _f A 4" Dat sign RECEIVED BY ELECTIONS DEPARTMENT: Hardcopy ❑ Electronic Copy OFFICE USE ONLY Accepted: Y / N OeBciencY ._._ ...._.__.___ _ Processed Date/Initials:___,_ .__, Scanned Date/Initials: 138 SP -14 C08 2U16 r% 1 1, CITYWIDE (CW) BOARD & COMMITTEES City of Miami Beath, PARKING DEPARTMENT PARKING APPLICATION 1755 Meridian Avenue, Suite 200/Miami Beach, Ft. 33139/Ph: 1305) 673-7505 or (305) 673-7000 exi, 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. R,%rtr,.4 Mat"kme Date of Application: 01/01/2023 Applicant Name: Elizabeth Kimbell Latone Board/Committee Name: Ad Hoc Advisory Charter Review and Revision Board Address: 6515 Collins Ave. #1702, Miami Beach, FL 33141 E -Mail Address: kplatone@gmail.com Work Phone: 404-697-5704 Home Phone N/A Cell Phone: N/A Preferred Contact Method: email V,ftkl.rl,u InG%vr"rq#;r%n -Tag': ---]44KJP Color: Black State: Florida Year: 2015 Make: Mercedes Model: S550 Applicant Signature: K �iAdt"4 Please provide signed form To the Parking Department located at 1755 Meridian Avenue, 2"d floor, Working hours are 8:30 to 5:00 p.m. or email to: Parkin .1 Recepfoq_p@miarnibeachf1,g e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME Pnrle;nrs r3annir4m^nt qP_r#;nn PERMIT SYSTEM GARAGE ACCESS Expiration Dote: ID Card Serial i": Issued By Print Name: Print Name: Signature; 6 ...... ....... ......... . . I.—I. . ...... Signature: K Dote Issued: Date Completed-........ . .....