Scott Needelman 12.31.24MIA M I BEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Scott Needelman
BOARD/COMMITTEE: GO Bond Oversight
FOR SCANNER
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RECEIVED
FEB 72073
DATE OF APPOINTMENT. Feb 1, 2023
Appointed by: City Commission
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
" {13 ['}'3/" o Avonmonvooooent em9es di an~ ~omitee Aopicat«on comoetea _3l//2/
o R~sum~/Curriculum Vitae J)1
o Diversity Statistics Reporting (Completed on IT2
o Oath
rRw No: D3h} TERM LIrr: p/1_)2@
to Committee Liaison on
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 CITY OF MIAM I BEACH
ICE OF THE CIT CLER K
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
O DIVERSITY STATISTICS REPORT ?IL!! and ORIGINAL for Annual Report.
Received • 2/7/23 Signed by /_4 ' "1 "1'us(/D
Boar~mittee Member
Processed on / By Employee:
Date
Date
Scanned on: 11° ByEmployee:
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
WVe are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community
City of Miami Beach, LOO Convention Con lar Drive, Miami
OFFICE OF THE CITY CLERK, Ralaal E. Granado, City Clerk
Tel 305.673.7411, Fax. 305.673.7254
Email: Ci#yCl erk@mi amibooch fl.gov
Florida 33139 yy_migribggchl]_gay
February 02, 2023
Mr. Scott Needelman
1455 Drexel Avenue #1
Miami Beach, Florida 33139
SUBJECT: General Obligation (G.O.) Bond Oversight Committee
Dear Mr. Scott Needelman:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/2024.
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.
cc: Monica Beltran, Parking Director
Maria Hernandez, 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
MIA MAI
City of Miami Beach, NO0 Convenlion Conlon Dive, Miami Beach, Florida 33139 yyy_IigIihQachllgov
OFFICE OF THE CITY CLERK, Ralaal E. Granado, Chy Clock
Tl 305.673.7411, Fx. 305.673.7254
Email: CilyClerk@miamibeochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Scott Needelman
RE: General Obligation (G.0.) Bond Oversight 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
abo ve-mentioned board or committee of the City of Miami Beach to wh ich I have been app ointed 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 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 finan cial disclosure requireme nts 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
ofthe calendar year on which I have served. (lJit ~ '
' Mr.Sco~an
Sworn to an d subscribe d before me this t Tb, 2o23
--
Keila Mena Caceres
Deputy Clerk
*Please visit the City of Miam i Beach website at www.miamibeachfl.gov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
MI A MI BE A CH
City of Miami Beach
1 700 Convention Center Drive
M iam i Beach, Flor ida 33139
O FFIC E O F TH E C ITY C LER K
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 411
RECEIVE D
FEB 12023
CITY OF MIAMI BEACH
OFFICE O 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):
121 I am a resident of the City of Miami Beach for six months or longer.
Home Address 1455 Drexel Avenue #1
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 SAN Development, Inc.
Business Address 1455 Drexel Avenue #1
El 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 York Towers Apartments
Business Address 1463 Drexel Avenue
"O wnership Interest" m e an s the ow nership of ten p e rcent (10 %) or m o re (including the ow nership of
10 % o r m ore of the outstan d ing cap ital stock) in a business.
"B usiness" m eans any so le p rop rietorship, spo nsorship, corp oration, lim ited liab ili ty com p any, or other
e n tity or bu sine ss association.
ry,I declare that I have read the foregoing document and that the facts stated in it
2/7/23
Signature
Scott Needelman
Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of physical presence or online notarization,
his 3 day or Po1Gr3_,20.23y colt A)edlwoe
(City of Miami peach Board/committee Member). +geeg"$'Sf£$7%7 ✓).,~~ . 'Ty \A¢¢ \,1, p) u s9" ;{y pk "·.
Produced ID I U Y "u" S w t }'iLA Mi$""«s "N'' VJ,· --------------~-""sJ"--"'P.~.- :,"'1 ,,,. "'
Form of Identification s RY Pi:.g "
_ Persona~ly no~- / /~0' ~«·· .. i cOMMlSE·•
- ? $ :; :yp1 RES1%
j i McoMMssoitNvprKR s~L)
Signature or Noa#y bu@ir e i xiREs 1-3-202,%:423,,,
\Cl '• ,ti. • - • ,,~•·.'t::OF~ .. l%%%.,' 4as9%j,%iGiii5i&
%;{$ OF F?<3 "iiiiwiwiiii" ,881;······".'a"" il} NuE!:}i" "in+wv8" •
Name of Notary, Typed, Printed, or Stamped
MIAMIBEA H
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: 305.673.7 411
DIVERSITY STATISTICS REPORT
Needelman Scott A
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:
[Zl Mate
L] remale
D Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
01 African American/Black
LJ Asta or Pacific Islander
El Caucasian/white
D Native American/American Indian Ll oher- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
LJves
ho
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
Ta» zR
D I prefer not to answer this question.
Page 6 of 6
F:ICLER\$ALLIREG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MI/AM/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: 305.673.7 411
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)
Needelman Scott A
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 ore th n $ , 60 days in jail, or both.
2/7/23
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:ICLER\$ALLIREG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M IA M l·DA D E. EII SOURCE OF INCOME STATEMENT
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 Needelman Scott A
Mailing Address - Street Number, Street Name, or P.O. Box
1455 Drexel Avenue #1
City, State, Zip
Miami Beach, FL 33139
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
Fili ng as an Em ployee (check one)
[] coun ty □Public Health Tru st D M unicipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Fili ng as a Board M em ber (check one)
D County E] M un i cipal : City of Miami Beach
(Municipality)
Board where serving
GO Bond Oversight Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
(305) 710-5584 May 2021-present
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
York Towe rs Apts 1463 Drexel Avenue, Miami Property Owner/Manager
Beach
Merril Lynch / TD Ameritrade / Mutual Funds/ Dividends /
Northwestern Mutual Capital Gains
Bank of America Interest
irm) th the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy RE C EIVE D
[ ] Electronic Copy
FE B 2023
CITY OF MIAMI BEACH
OFFICE Or TH E CIT CLERK
O FFIC E USE O N LY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: _
138_SP-14 COE 2016
l ±2I.A .4 + AR1%l La
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 PARKING
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: 2/7/23
Applicant Name: Scott Needelman
Board/Committee Name: GO Bond Oversight
Address: 1455 Drexel Avenue #1
E-Mail Address: san1455@att.net
W ork Phone: 305-710 -5584 Home Phone
Cell Phone: 305-710 -5584 Preferred Contact Method:
Vehicle Information
Tag: JNT Y25 Color: Gray
State: Florida Year: 2012
Make: lnfiniti Model: FX35
Applicant Si +nature: e
Please provide signed form to the 'arking Depa rtment located at 1755 Meridian Avenue, 2d floor. W orking
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@migmibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P ·ki D S · ar mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature: e
Date Issued: Date Completed:
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