Spencer Hennings 12.31.23'� "I 'A/AAMEACH
lvlli
BOARD AND COMMITTEE CHECKLIST
Spencer E. Hennings 1/6/23
APPOINTEE: DATE OF APPOINTMENT:
Ad Floc NAWI14 f6(N6i 1 8tt' gl �Yi r Committee Commissioner Richardson
BOARD/COMMITTEE: ppointed by:
FOR SCANNER FOR CLERK STAFF,
--% � ��
Scan o o Letter of Appointment TERM END: TERM LIMIT:
Scan o o Letter of Reappointment
-&/6f et er,, of Appointment/Reappointment e-mailed to Committee Liaison on
Scan o 0 E3oard and Committee Application (Completed on j)
Scan o o Resume/Curriculum Vitae
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
RECEIVED amended through December 2010)
✓ Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
,IAN 2 6 2023 ✓ Highlights of the Miami -Dade County Ethics Code
✓ Sunshine Law and Public Records — Frequently Asked Questions
✓ Memorandum - Solicitation by City Board and Committee Members
011-y c)E� MIAIViI BEACH
QF ICE.OF J'HE CRY G'_"�KCitywide Permit Application (Parking Department Form)
Scan O
Scan o
Received on:
Processed on
Scanned on:
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 REPORTING Keep COPY in
1/6/23 Signed by X
z
jDa,1;e o dor Co
�� By Employee:
"te��� It Jerk' fficl
By Employee:
Date Citv erk' la
SINAL for Annual Report.
Staff Initials
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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VkJAPOIBEACH
City of Miami Reacht I 7 Convonikan Conto Drivo, Miami lkach, 1lorida 33139vrwvr.rrriarriil ackil.gon,
OFFICE OF THE CffY CLE RK '
ERK, Rafmi E. Orcmado, CRY CIPFk
Tel:. 305.573.7.1 I , Fax: 305.673,7254
rinail: 00,ork mIamib hdl goy
January 05, 2023
Mr. Spencer Hennings
5055 COLLINS AVE. APT 12C
MIAMI BEACH, FL 33140
SUBJECT: Ad Hoc Neighborhood Resiliency Projects Advisory Committee
Congratulations! You have been reappointed by Commissioner David Richardson to 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,
R ael ranado
City Clerk
cc: Monica Beltran, Parking Director
Amy Knowles, 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
1\A I A AA I B E A C, HE
City of Miaani Beach, 1 /W Convention C:eniei l viva, Miami Lloach, Florida 33139 rvww.miamibeachfl. g.,
OFFICE Of THf CITY CLERK, Rafael E. Grande, Cly irk
Tef: 305673_7,41 1, Fax: 305,673,724
Email: CioerkEhiamibeachfi.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Spencer Hennings
RE: Ad Hoc Neighborhood Resiliency Projects 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.
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.
�r7��
Mr. Spencer Hennings
-),4�
Sworn to and subscribed before me this(5;,, day , 2023
K D'Agostin
puty 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.
BEACH
n l �rCEIVED
MIAMI JAN 262023
City of Miami Beach
1700 Convention Center Drive CITY OF MIAMI BEACH
Miami Beach, Florida 33134 OFFICE_ OF THE CITY CLERK
OFFICE OF THE CITY CLERK
Email: BC anmiamibeachfl.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
(✓) all that apply):
ta I am a resident of the City of Miami Beach for six months or longer.
Home Address5055 Collins Ave. Apt 12C. Miami Beach, FI. 33140.
Q 1 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 Address
d 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, cotporatlon, 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 trues /z Z d, b f 3
Signatu-reu Date
Spencer E. Hennings
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of p physical presence or o online notarization,
this a 4 day of D-01 h , 20a3by *111C& E • rt e k)m li CL�.
% Produced ID
(City of Miami Beach Board/Committee Member).
Et- DYNeb L_ c ejj e
Form of Identification
Personally Known
�Si na ure of Notary Public
y5�;vt NAYS
Name of Notary, Typed, Printed, or Stamped
.as.mn.�ir„
AGUSTIN HAYS
�• ��Notary Public • State of Florida
Commission N HH 312006
(NOTARY SEAL)
MIAAM BEACF'
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC(a)miamibeachfl.gov
Telephone: 305.673.741 1
Hennings
Last Name
DIVERSITY STATISTICS REPORT
Spencer
First Name
E.
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
1 Female
Other
I I prefer not to answer.
Race/Ethnic Categories:
What is your race?
F-3 African American/Black
[ Asian or Pacific Islander
Caucasian/White
( Native American/American Indian
Other — Print Race:
1 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?
CAI Yes
No
E:1 I 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 BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miomibeochFl.gov
OFFICE OF THE CITY CLERK
Email: EC(a)miamibeachfl.gov
Telephone: 305.673.741 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(i) (2)
Hennings Spencer E.
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 da in jail, or both.
zz 1/26/23
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:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
FORM 1 STATEMENT OF 2021
Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY:
address, agency name, and position below:
LAST NAME -- FIRST NAME -- MIDDLE NAME:
Hennings -Spencer - E.
MAILING ADDRESS :�('"��� ED
5055 Collins Ave. Apt 12C
JAN 2 6 2023
CITY: ZIP: COUNTY: CITY OF MIAMI BEACH
Miami Beach 33140 Miami Dade OFFICE OF THE CITY CLERK
NAME OF AGENCY:
Department of Business and Professional Regulation
NAME OF OFFICE OR POSITION HELD OR SOUGHT:
Chief Ombudsman - Office of the Condominium Ombudsman
CHECK ONLY IF ❑ CANDIDATE OR ❑ NEW EMPLOYEE OR APPOINTEE
**** THIS SECTION MUST BE COMPLETED ****
DISCLOSURE PERIOD:
THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2021.
MANNER OF CALCULATING REPORTABLE INTERESTS:
FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES
FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES
(see instructions for further details). CHECK THE ONE YOU ARE USING (must check one):
11 COMPARATIVE (PERCENTAGE) THRESHOLDS OR ❑✓ DOLLAR VALUE THRESHOLDS
PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S
OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY
Sale of primary residence
690 SW 1st Ct. Phl10. Miami, Fl. 33130
Buyer's profession is unknown.
PART B -- SECONDARY SOURCES OF INCOME
[Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions]
(If you have nothing to report, write "none" or "n/a")
NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS
BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE
N/A
PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions]
You are not limited to the space on the
(If you have nothing to report, write "none" or "n/a")
lines on this form. Attach additional
N/A
sheets, if necessary.
FILING INSTRUCTIONS for when
and where to file this form are
located at the bottom of page 2.
INSTRUCTIONS on who must file
this form and how to fill it out
begin on page 3.
CE FORM 1 - Effective: January i, 2022 (Continued on reverse side) PAGE 1
Incorporated by reference in Rule 34-8.202(1), F.A.C.
PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] j
(if you have nothing to report, write "none' or "nla") I
TYPE OF INTANGIBLE I BUSINESS ENTITY TO WHICH THE PROPERTY RELATES
Please see attached.
PART E — LIABILITIES (Major debts - See instructions)
(If you have nothing to report, write "none" or "nfa")
NAME OF CREDITOR
None
ADDRESS OF CREDITOR
PART F —INTERESTS IN SPECIFIED BUSINESSES (Ownership or positions In certain types of businosses -See instructions]
lit vett haves nnihinn to rnnnrt write "nnna" nr "nla"l
BUSINESS ENTITY # 1
NAME OF BUSINESS ENTITY
PRINCIPAL BUSINESS ACTIVITY
POSITION HELD WITH ENTITY
I OWN MORE THAN A 5% INTEREST IN THE BUSINESS
NATURE OF MY OWNERSHIP INTEREST
BUSINESS ENTITY # 2
PART G — TRAINING For elected municipal officers, appointed school superintendonts, and commissioners of a community redevelopment
agency created under Part III, Chapter 163 required to complete annual ethics training pursuant to section 112.3142, F.S.
Q I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING.
I IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE CI
SIGNATURE OF FILER:
Signature:
Date Signed:
301 -z.-
FILING INSTRUCTION,;:
If you were mailed the form by the Commission on Ethics or a County
Supervisor of Elections for your annual disclosure filing, return the
form to that location. To determine what category your position falls
under, see page 3 of instructions.
Local officers/employees file with the Supervisor of Elections
of the county in which they permanently reside. (If you do not
permanently reside in Florida, file with the Supervisor of the county
where your agency has its headquarters.) Form 1 filers who file with
the Supervisor of Elections may file by mail or email. Contact your
Supervisor of Elections for the mailing address or email address to
use. Do not e;maiLyour form to the Commission on Ethics it will be
returned.
State officers or specified state employees who file with the
Commission on Ethics may file by mail or email. To file by mail,
send the completed form to P.Q. Drawer 15709, Tallahassee, FL
32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200,
Tallahassee, FL 32303. To file with the Commission by entail, scan
your completed form and any attachments as a pdf (do not use any
other formal), send it to CEFonmi@leg.state.f,us and retain a copy
for your records. Do no fi]e by both mail and email Choose only one
filing method. Form 6s will not be accepted via email,
CE FORM( Fft�N:!:�o Janusuy +. ;022
tsxnt„+orAtixl Uy rWt tf,vYA v Rine 3.1. ,102,1). r AC
CPA or ATTORNEY SIGNATURE ONLY
If a certified public accountant licensed under Chapter 473, or attorney
in good standing with the Florida Bat prepared this form for you, he or
she must complete the following statement.
1, , prepared the CE
Form i in accordance with Section 112.3145, Fionda Statutes, and the
instructions to the form. Upon my reasonable knowledge and belief, the
disclosure herein is true and correct.
CPA/Attomey Signature:
Date Signed:
Candidates file this form together with their filing papers.
MULTIPLE FILING UNNECESSARY: A candidate who files a Form
1 with a qualifying officer is not required to file with the Commission
or Supervisor of Elections.
WHEN TO FILE: Initially, each local officer/employee, state officer,
and specified state employee must file within 30 days of the
date of his or her appointment or of the beginning of employment.
Appointees who must be confirmed by the Senate must file prior to
confirmation, even if that is less than 30 days from the date of their
appointment.
Candidates must file at the same time they file their qualifying
papers.
Thereafter, file by July 1 following each calendar year in which they
hold their positions.
Finally, file a final disclosure form (Form 1F) within 60 days of
leaving office or employment. Filing a CE Form 1 F (Final Statement
of Financial Interests) does = relieve the filer of filing a CE Form 1
if the filer was in his or her position on December 31, 2021,
OESCRIPTION r�--+s
RBC INSURED DEPOSITS 1 . 1kec
NOT SIPC COVERED
DEPOSITS ARE HELD AT:
M and T Trust Company Buffalo, NY
Citibank NA _ Sioux Falls, SD I
(�
TOTAL RBC INSURED DEPOSITS
CASH AND MONEY MARKET
DESCRIPTION SYMBOL/CUSIP`
TOTAL CASH AND MONEY MARKET
US EQUITIES
E
DESCRIPTION
SYMBOL/CUSIP
ARK ETF TRUST
ARKK
ARK INNOVATION ETF
BASANITE INC
8ASA
COMMON STOCK
i
ISHARES CORE S&P 500 ETF
IIA j
ISHARES RUSSELL 2000 ETF
IWM
(SHARES TRUST
IUSV I
ISHARES CORE S&P U S VALUE ETF
US EQUITIES
y
(continued)
a
DESCRIPTION
i
SYMBOL/CUSIp
(SHARES TRUST
IUSG
!SHARES CORE S&P U S GROWTH
EFF
SCHWAB STRATEGIC TR
SCHD
US DIVIDEND EQUITY ETF
TOTAL US EQUITIES
INTERNATIONAL EQUITIES
DESCRIPTION
SYMBOL/CUSIp
(SHARES CORE MSCI EMERGING
IEMG
MARKETS ETF
TOTAL INTERNATIONAL EQUITIES
TAXABLE FIXED INCOME
DESCRIPTION
SYMBOLJCUSIP
NEW AMERICA HIGH INCOME FUND
HYB
INC (THE) NEW
(SHARES TR
IAGG
CORE INTL AGGREGATE 80 ETF
(SHARES TR
ISTB
ISHARES CORE 1 5 YEAR USD
BOND ETF
TOTAL TAXABLE FIXED INCOME
s
OTHER ASSETS
DESCRIPTION
SITBOL /CUSip
(SHARES TRUST
USRT
[SHARES CORE U S REIT ETF
,M AM I B EAC H CITYWIDE (CW) BOARD & COMMITTEES
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beach, F1 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.
RnnrA Marnhar Inf#%rmrsfir%n
Date of Application:
Applicant Name: Spencer E. Hennings
Board/Committee Name:Ad Hoc Neighborhood Resiliency Projects Advisory Committee
Address: 5055 Collins Ave. Apt 12C. Miami Beach, FI. 33140
E -Mail Address: s.e.hennings@gmail.com
Work Phone: n/a
Nome Phone n/a
Cell Phone: 954 260 9996
Preferred Contact Method: Cell Phone
Vakirla Infnrm"r%n
Tag: HYDS33
Color:
White
State: Florida
Year:
2018
Make: Porsche
Model:
Macan S
Applicant Si nature: e�-
Please provide signed form to the Parki q --Department located at 1755 Meridian Avenue, 2°1 floor. Working
hours are 8:30 to 5:00 p.m. or email to:.ParkingReception@miamibeachfi.gov
email subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
D~I,;"w Cmef.nn
PERMIT SYSTEM
GARAGE ACCESS
Expiration Date:
ID Card Serial #:
Issued By Print Name:
Print Name:
Signature: -s
Signature: zs
Date Issued:
[late Completed: