Elba Machado 12.31.24M l+w1BE
BOARD AND COMMITTEE CHECKLIST
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reRn no:2/31]2l rer»wuw. p2/s1[3o FOR SCANNER
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FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o C1y oJ Letter of Appointment/Reappointment e-mailed to
2 2 ] o ~si@ an@ committee Application (cormptetea o03/} )$
o Resume/Curriculum Vitae J,]
o Diversity Statistics Reporting (Completed on 2\]) )
o Oath
Committee Liaison on
RECEIVED
FEB 3 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
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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)
V 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
o Source of Income Statement
Received on:
Scanned on:
O Acknowledgment of Financial Disclosure Requirement
O Board and Committees Liaison Responsibilities o vessrv sransncs keeore vs..
.2/2/2023 soeaoX
Date a:, or ~mmittee Member
Processed .. 2l3/3 Employee: _.t=:::J.___-+--------------
Date City,mler 's ffice Staff Initials
_l/_, _{_3_/_i,_3 By Employee:-----''-----+------------
Date ciy coins ore sa~finials
CONCLUDED & RE SIGNATION 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
£:\CLER\BOARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\&G Checklist 2015 MASTER. docx
We re committed to providing excellent pubic service and safety to all who live, work, ond ploy mn cur vtbrot, topical, histonc commundy
I M IB E
City of Miami Beach, I/OO Convention Conler Drive, Miami Bach, Florida 33 139 yyw._miamibaachllgo
OFFICE OF THE CITY CLERK, Rolaal E. Granado, Ciy Clerk
Tel 305.673.7411, Fox 305.673.7254
Email: Ci#yCl erk@mi amibooc hfl.gov
January 20, 2023
Ms. Elba Machado
8851 Sw 214th St
Cutler Bay, FL 33189
RE: Hispanic Affairs Committee
Dear Ms. Elba Machado:
Congratulations! You have been appointed by Commissioner Laura Dominguez to the above-
referenced Board or Committee, 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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
M
Raf' G,anado
City Clerk
cc: Monica Beltran, Parking Director
Leonor Hernandez, 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
M IA MI BEA H
City of Miami Beach, 1ZOO Convention Canter Diva, Miami Boach, Florida 33 139 wyw.miamibgachfl.gov
OFFICE OF THE CITY CLERK, Rafael E. Gran ado, Cy Clerk
1ol: 305.673.7411, Fax€ 305.673.7254
Emaid: Cit/Clerk @miamiboachll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Elba Machado
RE: Hispanic Affairs 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: 12/31/2024.
To my colleagues and to all of those l 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.
2##± wren waca
Swor to and subscribed before me th_ day of1r14 023
*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.
M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email. BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
FEB 3 2023
CITY OF MI AMI BEACH
OFFICE OF THE 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.
l{mm1 fkfmf]]S,j
□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).
[part tf P1g]PS-»
Pg[[eS,€ ]JfeS
✓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 otr osnoes. y R_TUI!I _or/Qy! [9yo
osmess Address._ 4440 vyASA@op0 4__Lg j kt- p 3,313$
"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 ".e. eve Signatur • Date
PP1 - 2 LAclle
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of a physical presence or n online notarization,
this 2 day ot_fora)j ,2023 by_D 2ea4po,
(City of Miami Beach Board/Committee Member). (@
(j) I )_ • /1 . / "'1d·•···~..i .. i-...~~dll···• •• r,,,dllll ... ._G,!lllRET~HE~L~SIL~V~A ,...~
0. r«i"/;61< t c-if7tv s G l!m~\ Notary Public. State of Florida
Form of Identification fgi i5 commission # HH 019932
nown 7}if$ y comm. Expires Nov 7, 2024
""gonded through National Notary Assn,
2g» 1%% ... _?JJ.:.
Name tary, Typed, Printed, or Stamped
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE Of THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REP ORI
E
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 ate
IS remale
LJ oner
0 I prefer not to answer.
'
Race/Ethnic Categories:
What is your race?
LAtican American/Black
D Asian or Pacific Islander
[3 Caucasian/white
0 Native American/American Indian
[Other - Print Race.
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Ives
ho
D I prefer not to answer.
Do you consider yourself Physically Disabled?
lves Jo
D I prefer not to answer this question.
Page 6 of 6
F:CLER\ALLREGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M IA M I B E A C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www,miami beachfl,goy
O FFIC E O F TH E C ITY C LERK
Emoi l: BC@miamibeachfl.go
Telephone: 305.673.7411
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATE MENT
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)
Last Name First Name Middle Initial
I understand that no later than Jul 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)';" 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.
~ Nl-< 3/3/7o->
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\SALL REGBOARD AN COMMIT TEE APPLICATIONS FINAL DRAFTS\BOARD ANDO COMMIT TEE APPLICATION REG FINAL docx
Updated: June 2020
MIAMM
EE S O U R C E O F IN C O M E S TAT E M E NT
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 I Last Name First Name Middle Name/Initial
2022 He@CO te PA Noy t
Mailing Address -- Street Number, Street Name, or P.O. Box
8 851 5)2 /1H S/
City, State, Zip
UT»t • t. 33 48
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 Em plo yee (check one)
[] county D 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 I] Municipal: Hi/l~ cl
(Municipality)
Board where serving Aic AFem# S cert } le
Alternate address (if home address is exempt) I Work telephone l 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.D]
Name of Source of Income Address Description of the Principal Business Activity
• tsraols soe, to s0 3ti n. +ti P33to Pru t - oPti
I hereby swear (or affirm) that the information above is a true and correct statement.
i oa
~ sii.arc or,osaci
RECEIVED BY ELECTIONS DEPARTMENT:
Hardcopy
t) e con»we c»/RECEIVED
FEB 3 2023
OFFICE USE ONLY Accep ted: Y / N Deficienc y......- Processed Date/initial s:.-Scann ed Date/initials: --
138 _SP.14 COE 2016
Ml Ml BE CITYWIDE (CW) BOARD & COMMITTEES
cy cot Miami seed, PARKING DAR7ENT PAR KING PP[[CATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 6200
A city wide (C W) parking per mi t is hon or ed at meter ed parking spaces and restricted residential zones
parking spaces. A CW parking per mit IS N O T honor e d in proh ibited are as. An Access Card will be
provided to you fo r C ity Hall Garage (G 7) access.
IMPORTANT NOTE: Your veh icle licen se plate serves as your "pa rking permit". In ord er to avoi d
any unnecessary entor cem ent action s, it is important that our recor ds reflect the most curre nt and
accurate inform ation regarding your vehicl e license plate. Ina ccura te and/or outdated veh icle
info rm ation may lead to the issuance of parking citation(s] and/or the towi ng of your veh icle.
Please not e that th is new access card CANNOT be hol e p unch ed or perfor at ed in any manner . To use
th e new card please hold the card at close pro xi mity to th e reader until the gate open s. You m ay need
to try the oth er side of th e card. Please en sure you hold the en tire surface oh th e card agai nst th e 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
Die 6f opicanion: 2./2/202.3
Applicant Name: EA E. HA4c4DO
Board/Committee N am e: lli<PA Art S
Addre ss: s] 0 24/1 $7. CU T n- -;:z. 3lj
E-Mail Address: ma dado oe@) oi(- co / em a h do) ye@esrauails. coco
W ork Phone: 20 5 2-/ 790) U Hom e Phone 36 3 4 99 3 92
Cell Phone: 30 6 81/772) Preferred Contact Method: Plot
Vehicle information
Tag: 7485e C olor: DOR A TE lute2
State: 0pl Year: 202{
Make: Re M odel: [A HJ G1
Applicant Si an a ture : e5
Please provi de signed form to the Parking Departm ent located at 1755 M eridi an Avenue, 2d floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD 8 COMMITTEE PARKING APPLICATION -- APPLICAN T NAME
p, ·i D rt ar tna epa men e Io n
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print N a m e : Print N a m e:
Si gna ture : e Signature:
D a te lssue d : D a te C o m p le ted :
t Socti