David Grieser 12.31.23BOARD AND COMMITTEE CHECKLIST
APPOINTEE: David Grieser DATE OF APPOINTMENT:
BOARD/COMMITTEE: Budget Advisory Committee Appointed by: Commissioner Dominguez
FOR SCANNER FOR CLERK STAFF 12/31/23 12/31/29
Scan o o Letter of Appointment TERM END: _ TERM LIMIT:
Scan o o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on
12/29/22 12/10/21
Scan o o Board and Committee Application (Completed on )
Scan o o Resume/Curriculum Vitae 1/6/23
o Diversity Statistics Reporting (Completed on )
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
✓ Memorandum - Solicitation by City Board and Committee Members
O Citywide Permit Application (Parking Department Form)
O Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o o Source of Income Statement
Scan o o Acknowledgment of Financial Disclosure Requirement
o Board and Committees Liaison Responsibilities
/ DIVERSITY STATISTICS REEP/ORTING de- COPY in file and ORIGINAL for Annual Report.
Received on: (. Si ned b /� '`-�-----" �-
Y �_ of
Date gbaro or Committee Member
Processed on: W 16 1 Z 5 By Employee: ''' I
ate City Clerk's Office Staff Initials
Scanned on: `\ 1 ) & `113 BY Employee: Em to ee:
Date City Clerk's Office Staff Initials
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 COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
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City of Miami Reach, 1AY0 C nv nibn. i.ani r Wye, Akcarni Ikucx;l�, I Ica€la 331439 ,wmw.aiiar€iibAnc_fxil.eae_r
OFFICE OF THF. CITY CLERK Raf ml F. Granado, City t knk
Tol:.305,6717.11,Fax: 36} ,6717251
Finail: Mi le€kornamibo hll.gov
December 29, 2022
Mr. David Grieser
1754 Meridian Ave, Apt. 201
MIAMI BEACH, FL 33139
SUBJECT: Budget Advisory Committee
Congratulations! You have been reappointed by Commissioner Laura Dominguezto the above
referenced, board or committee named above, for a term ending: 12/31/2023.
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.
Congratulations and good luck.
Regards,
7A
afael Granado
City Clerk
cc: Monica Beltran, Parking Director
Tameka Otto Stewart, 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 - Amendment to City Code Section 2-22
Miami -Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
F 3
City of Miami Beach, 1700 C onvoni�on, (_'onler lir€vt,, WaiTij Much, I lorOa 33139 worw.rriiarriit)rtOclfl.g yv
GHKE THE CHY CLEW, Wool E. G unado, City 004
'Tal: ;3(P5,671 ,411, Fax. 305.673.725A
Email. C#.yCI k 'aiamibe hll<9nv
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. David Grieser
RE: Budget Advisory Committee
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: 12/31/2023.
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 1 st, following the closing
of the calendar year on which I have served.
Mr. David Grieser
Sworn to and subscribed before me this 0(d day of 6L'Y), 202A-�
Char esb'Agostin
Deputy Clerk
*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.
MIAMI BEA
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC aamiamibeachfl.gov
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
(J) ..that apply):
I am a resident of the City of Miami Beach for six months or longer.
Home Address . `� ►-e. t `1a `, J`�_. , �� ✓� 1��.�.
p 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 Add
❑ 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<p,pnaities of perjury, I declare that I have read the foregoing document and that the facts stated in it
are tree,. -"
Signature Date
David Grieser
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means o ph sical presence or ❑ online notarization,
thi day ofT��(�20 by bd✓� �� ��
(City of Mia i Beach Board/Com ittee Member).
Z) Produced ID /- c-- /�/r�f2/��S 7/ `"e_ -L
Form of Identification
Per dally ow
Signatu e ota lic
Name of Notary, Typed, Printed, or Stamped
CHARLES J. DAOOSTIN
*a :, MY COMMISSION # HH 165705
EXPIRES: December 14, 2025
Bonded Thtu Notary Public Underwriters
(NOTARY SEAL)
M I AM I B EAC H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miomibeochfl,gov
OFFICE OF THE CITY CLERK
Email: BC(Mmiamibeachfi.gov
Telephone: 305.673.74.1 1
BOARD & COMMITTEE 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(1) (2)
Grieser David
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 more than $500, 60 days in jail, or both.
i"gnature 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 5 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www,miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: EIC(a)miamibeachfLgov
Telephone: 305.673.741 l
Grieser
Last Name
DIVERSITY STATISTICS REPORT
David
First Name
6..
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:
El Male
Q Female
Other
I prefer not to answer.
Race/Ethnic Categories:
What is your race?
❑i African American/Black
Asian or Pacific Islander
Caucasian/White
Native American/American Indian
❑ Other — Print Race:
❑ I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Yes
No
❑ I prefer not to answer.
Do you consider yourself Physically Disabled?
;Yes
No
1 prefer not to answer this question.
Page 6 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMI B(CW) BOARD & COMMITTEES
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 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.
Bneirel ME±mhcar Infnrmntinn
Date of Application: I — L- Z 3
Applicant Name: David Grieser
Board/Committee Name: Budget Advisory Committee
Address:
E -Mail Address:
Work Phone: L _ Sy'`i
Home Phone
Cell Phone: �3 _ S" ; k
Preferred Contact Method,
Whielp- Information
Tag:
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Color:
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State:
Year:
Signature: -e
Make:
,
Model:
Applicant Si nature: -e
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2nd floor. Working
hours are 8:30 to 5:00 p.m. or email to: Parking_Reception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION — APPLICANT NAME
Pnrlrinn nAnnrtmont Siurtinn
PERMIT SYSTEM
GARAGE ACCESS
Expiration Date:
ID Card Serial #:
Issued By Print Name:
Print Name:
Signature: A�
Signature: -e
Date Issued:
Date Completed:
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DAVID CONRAD
GRIESER
1754 MERIDIAN AVENUE. APT 201
MIAMI BEACH. FL 33139-0000
DOB -05-24-1989 Sex M
ISSUED: 04-03-2017 1-1131 5-11
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