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Curt Dyer 12.31.23MIAMSEACH BOARD AND COMMITTEE CHECKLIST APPOINTEE: Curt Dyer DATE OF APPOINTMENT: 01/12/2023 BOARD/COMMITTEE: Ad, Hoc Neighborhood Resilienc Appointed by: Ricky Arriola FOR SCANNER FOR CLERK STAFF p Scan o o Letter of Appointment TERM END: I Z 1 3 2-3 TERM LIMIT: W 3 2 Scan o o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on 01 /12/2023 01/12/2023 Scan o o Board and Committee Application (Completed on ) Scan o o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on 01/12/2023 ) 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 RECEIVED ✓ County Code Section 2-11.1 - Conflict of Interest and Code of Ethics. Ordinance (as amended through December 2010) JAN 12 2023 ✓ 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 OF MIAMI BEACH ✓ Memorandum - Solicitation by City Board and Committee Members OFFICE OF THE CITY CLERK Received on: 01112/2023 Date Processed on: 01/12/2023 Date Scanned on: 01/12/2023 Date _ Signed by Board or Committee Member By Employee: City Clerk's nOffice Staff Initials By Employee: City Clerk's Office Staff Initials 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:ICLERWOARD AND COMMITTIES DATABASEICHECKLIST MASTEMB&C Checklist 2015 MASTER.docx We are committed to providing excellent public service and safely to all who live, work, and play in our vibrant, tropical, historic community. tVAAMBEACH City of Miami Beach, 1700 C anvenlion C onim Niw,. Miami Much, l loiki a 33131 v,Nti^^a migMi1M achfl.9(N OFFICE OF THE CITY CLERK, RAtant E. Grrana&,. C q Clerk Tei:. 3'05A73.7A11, Fax: 305.673.7254 Email: Cty41cA mIamilae hfl.9oy January 11, 2023 Mr. Curt Dyer 5900 Alton Road Miami Beach, Florida 33140 RE: Ad Hoc Neighborhood Resiliency Projects Advisory Committee Dear Mr. Curt Dyer: Congratulations! You have been appointed by Commissioner Ricky Arriola to the above -referenced Board or Committee, 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 as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations again and good luck. RegAGrana Raf City Clerk cc: Monica Beltran, Parking Director Amy Knowles, 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 MA/01BEACH City of Miami Reach, 1700 Convention Canler Drrvo; Mum! Beach, Florida 33139 www.miomibcachfl.g-- OFFICE OF WE CITY CLERK, Rafael E. Granada, Ciiy Clark TA 305.673.74.11, Foix= 345.673.7254 Email: CityC1ark@m1amibwchll.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Curt Dyer RE: Ad Hoc Neighborhood Resiliency Projects Advisory Committee 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: 12/31/2023. 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. t? Mr. Curt Dyer Sworn to and subscribed before me this QAh day of" , 2023 kjj� Charles 'Agostin Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfi.gov under 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 Email: BCAnniarnibeachfl.gov Telephone: 305.673.7411 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) all that apply): p I am a resident of the City of Miami Beach for six months or longer. Home Address 5900 Alton Road, Miami Beach, Florida 33141 El 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 Southeast Bankers Mortgage Corp. Business Address 1666 79th St. CSWY #505, North Bay Village, FL 33141 p 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 are true.j 01/12/2022 Signature Date Curt W Dyer Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of ❑ physical presence or to online notarization, this i Z day of Ciy Vav- s-4 LrT w (City of Miami Beach Board/Committee Member). >I-' Produced ID V_L'bCi l_\ (� :'He�:. CLAUDIA HUGHES Notary Duoiic • State of Ftorida Form of Identification =:; e.- Commission I HH 168988 ers n wn` •�..,orr+;,. My Con•m. Expires Nov 17, 2025 1 Bonded through National Notary Assn, (NOTARY SEAL) Sianatlere of Notary _ublic Name of Notary, Typed, Printed, or Stamped MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 vry w.miam1beachfl.90v OFFICE OF THE CITY CLERK Email: BC@rniamibeachfi.gov Telephone: 305.673.7411 BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMEN 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) Dyer Curt W 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 $500, 60 days in jail, or both. 01/12/2023 Signature Date Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami -Dade County Supervisor of Elections by 12:00. noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 5 of 6 F:ICLERI$ALLIREGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.doex Updated: June 2020 1.. City of Miami: Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.aov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.741 1 Dyer Last Name DIVERSITY STATISTICS REPORT Curt W 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: ED Male O.Female 0 Other �Jl I prefer not to answer. Race/Ethnic Categories: What is your race? []1 African American/Black Asian or Pacific Islander ✓� Caucasian/White �) Native American/American Indian Other — Print Race: [tel 1 prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? 0 Yes No �l I prefer not to answer. Do you consider yourself Physically Disabled? U Yes No 1 prefer not to answer this question. Page 6 of 6 F:NCLERN$ALLNREGNBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSNBOARD AND COMMITTEE APPLICATION REG FINAL.doex Updated: June 2020 MIAMI•DADE SOURCE OF INCOME STATEMENT WM 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 2020 Ej Dyer Curt W Mailing Address -- Street Number, Street Name, or P.O. Box 1666 79th Street Causeway, Suite 505, City, State, Zip North Bay Village, FI.33141 If your home address Is your mailing address, and your home address is exempt from public records pursuant.to r1a. Stat. §119.07, read instructions on the following page and check here. ❑ Filing as. an Employee (check one) 0 County E3 Public Health Trust E3 Municipal: (Municipality) Department Position or Title Employee ID Number Work address Work telephone Employment began on/ended on Filing as a Board Member (check one) 0 County Board where serving Municipal: (Municipality) Ad Hoc Neighborhood Resiliency Projects Advisory Committee Alternate address (if home address is exempt) Work telephone Term began on/ended on 1(305) 672-1123 01/12/2023 List below every sourmof 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 Southeast Bankers Mortgage 1666 79th Street CSWY #505 North Bay Village, FL 33141 Mortgage Brokerage Business I hereby swear (or affirm) that the information above is a true and correct statement. V\"- Signature of Person Disclosing Datesigned RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ['Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: scanned Date/Initials: 136_SP-14 .COE 2016 MIAMI BEACH CITYWIDE (CW) BOARD & City of Miami Beach, PARKING DEPARTMENT PARKING 1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: 13051673-7505 or (305) 673-7000 ext. COMMITTEES APPLICATION Le 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: 01/12/2023 Applicant Name: Curt Dyer Board/Committee.Name.:Ad Hoc Neighborhood Resiliency Projects Advisory CMTE Address: 5900 Alton Road E -Mail Address: curtdyer305@gmail.com Work Phone: 305-672-1123 Home Phone 305-975-0003 Cell Phone: 305-975-0003 Preferred Contact Method: cell Vehicle Information Tag: EBTD68 Color: Silver State: Florida Year: 1997 Make: Mercedes Model: 50.0SL Applicant Signature: �r- Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 211d floor. Working hours are 8:30 to 5:00 p,m, or email to: ParkingReception@miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION -- APPLICANT NAME Parkina Deuartment Section PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: Af Signature: ,K Date Issued: Date Completed: