David Nguah 12.31.24BOARD AND COMMITTEE CHECKLIST
APP OINTE E . David Nguah DATE OF APP OINTM ENT . l]23
BOARD/COMMITTEE: Parks and Rec Facilities Appointed by: Commissioner Arriola
FOR SCANNER
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FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o ,copy tf Letter of Appointment/Reappointment e-mailed to
,1'~,13 ]il
o Board and Committee Application (Completed on ll lcJ 'l--0
o Resume/curriculum vitae ] ].
o Diversity Statistics Reporting (Completed on 1 2j
o Oath
rrRM EN2[1)4 TERM uwrr. n2/3l /2
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Committee Liaison on
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓City Code Ordinance Section applicable to the agency, board or committee
RECEIVED ✓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) FEB 2 2023 ✓Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓Highlights of the Miami-Dade County Ethics Code
CITY OF MIAMI BEACH ✓Sunshine Law and Public Records -- Frequently Asked Questions
OFFICE OF THE CITY CLER K V Memorandum - Solicitation by City Board and Committee Members
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Received on:
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 R ~
o Board and Committees Liaison Responsj' ilities
o DIVERsrr srATsr1cs REPORTING] en-#' {GAL tor Annual Report.
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Date
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Date City Clerk's Office Staff Initials
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ate ciy Cle om Sa initials
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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 DATABASEICHECKLIST MASTERIB&C Checklist 2015 MASTER.docx
We are commit to providing excellent public service and salty to all who live, work, and ploy in our vibrant, tropical, historic community
City of Miami Beach, I/OO Convonlion Canter Drive, Miami Beach, Florida 33 139 yywy.miarihaachll go
OFFICE OF THE CITY CLERK, Raf0al E. Gran ado, City Clark
Tel: 305.673.7411, Fax: 305.673.7254
Email: Ci#yCl erk@miamibeoch ll.gov
January 09, 2023
Mr. David Nguah
1200 14th Street #4B
Miami Beach, FL 33139
SUBJECT; Parks and Recreational Facilities Board
Congratulations! You have been reappointed by Commissioner Ricky Arriola to the above referenced,
board or committee named above, for a term ending: 12/31/2024.
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.
"A •• City Clerk
cc: Monica Beltran, Parking Director
Cynthia Casanova, 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 an d 2-459
Ordinance No. 2006-3543 - Am en dmen t 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
Ml IB
City of Miami Beach, I/OO Convention Conler Drive, Miami Booch, Florida 33139 yaw_miariLgachf]_go
OFFICE OF THE CITY CLERK, Rofol E. Granado, Ciy Clerk Tel: 305.673.7411, Fax. 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. David Nguah
RE: Parks and Recreational Facilities Board
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: 12/31/2024.
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 Ordinan ce), as well as Florida Commission on Ethics Guide to the Sunshine Am endme nt
and Code of Ethics for Public Officers and understand that as a member6f a City of Mia i Beach Board
and/or Committee, I must comply with the financial disclosure* require e ts of Miami-Dade County or the
State of Florida (depending on the board or committee on which I se e) o July 1st, followi g the closing
of the calendar year on which I have served.
Sworn to and subscribed before me this r_ day or lb_ _, 2023
EL- Cnaes Agosti
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.
MIAMIBE
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 411
RECEIVE D
FEB 22023
CITY OF MIAMI BEACH
OFFICE OF THIE 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):
I am a resident of the City of Miami Beach for six months or longer.
ore Aaares L2o9 1¢ Sl H +, e,Ai ', 3313$
□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 Address _
□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 or Business. _Doge.s Lt .>
osmess Address Ii tao i> ot Al8Ql_,y e._ _Sep 4 3(3$
"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:;t sae proprietorship, sponsorship, corporation, limited liability company, or other
entity or business association.
r pbnalties of perjury, declare that l have read the foregoing document and that the facts stated in it
ab ls
Date
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of a physical presence or online notarization,
de 42-a r toruon_. 2o13 y DOoid Noc-/
0
([/ of Miami Beach Board/Committee Member).
P bon g Ano-4€C / Produced ID
Form of Identification
Signatur
Name of Notary, Typed, Printed, or Stamped
M IA M I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibeachll_gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfL.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Nguah David
Last Name 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:
LJ Mate
Ll Female
Ll oner Eh prefer not to answer.
Race/Ethnic Categories:
What is your race?
E] African American/Black
LJ Asta or Pacific Islander
0 Caucasian/White
DI Native American/American Indian
O ! Other- Print Race: _
,'431'1 prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Jves
Jo D prefer not to answer.
Do you consider yourself Physically Disabled?
Ives
[h o
. .JJ?1 prefer not to answer this question.
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F:\C LE R\$A LL\RE G \BO A RD A ND CO M M ITT E E A P P LI C A TIO NS FIN A L DR A FTS \BO A RD A ND C O M M ITT E E A P P LI C A TIO N R E G FIN A L.docx
U pd a te d : Ju ne 20 20
M IA M I H
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: B C @ m ia m ib eachfl.gov
Telephone: 305.673.7411
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)
Nguah 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.
3.
Failure t
of no mo
Tax Return.
nt to the Miami-Dade County Code, may subject the person to a fine
oth.
Date I
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.
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F:IC L ER \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A F T S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N RE G FI N AL .d o cx
U pd a ted : Ju ne 20 20
MIAMl·DADE. EEI SOURCE OF INCOME STATEMENT
Section 2-11.1(@) 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
2022 Nguah
First Name
David
Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
190 t }
City, State, Zip
(6» ft_
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. D
Filing as an Employee (check one)
[] county □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 Member (check one)
[] county [HR] Municipal:
(Municipality)
ea«vwere"" ope j 1
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
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
H\/ aau pt€o» n wa ,0AH 32)5-
ormation above is a true and correct statement.
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy RECEIVED
[] Electronic Copy
FEB 2 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: _
138_SP-14 COE 2016
/\/\//\/\/\/ CI 7 WI DE (CW) BO AR D & COMMITTEES
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beoch, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 e4. 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 rellect 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:
Applicant Name: David Nguah
Board/Committee Name: Parks and Rec Facilities
Address: 3Wt R, Or) «it
E.Mail Address: tr
Work Phone: l Home Phone
Cell Phone: I Preferred Contact Method:
Vehicle Information
Tag: S9
State:
Make:
Applicant St+nature: ef
f-l(....C Color: I
Year: t I
Model: l
Please provide signed form to
hours are 8:30 to 5.00 p.m. or
e-mail subject: BOAR
d4Far#itig'Department located at 1755 Meridian Avenue, 2d floor. Working
il t!: ParkingReception@miamibeachfl.gov
& 'OMMI TTE E PARKING APPLICATION - APPLICANT NAME
p ·ki D S ar' Ina epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Cord Serial #:
Issued By Print Name: Print Name:
Signature: e Signature:
Date Issued: Date Completed:
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