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Susan Askew 12.31.23MIA MI B B O ARD A N D C O M M IT T E E C H E C KL IS T APPOINTEE. Susan Askew BOARD/COMMITTEE. GO Bond Oversight DATE OF APPOINTMENT. 2/1/2023 FOR S C AN N ER Scan o Scan o Scan o Scan o Sca n o R E C E IV E D FEB 2023 CITY OF MIAMI BEACH OFFICE Or IF CITY CLERK FOR CLERK STAFF o Letter of Ap pointment o Letter of Reappoi ntm ent o C9PYO! Letter of Appointment/Reappointment e-mailed //3 o Board and Committee Application (Completed on o R 6sum 6/C urri cul um Vi ta e 13h3 o Diversity Statistics Reporting (Completed on_ 2 o O a th Appointed by. Gity Com mission renown, pl31/0@ rerM Benno. /3 1/2 to Committee Liaison on Scan O Scan O IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK Ci ty C o de Or d inan ce Section app lic ab le to the agen cy, board or commi ttee City C o de Section s 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-4 58 and 2-459 C o u nty C o d e S e ction 2-11 .1 - C onfli c t of Intere st and C ode of Ethi cs Ordinance (as amended through December 2 0 10 ) Y Amendments to the Code of Ethics Ordinance (September 2009 thro ugh July 2012) t Hi gh ligh ts of the Mi am i -D ade C ounty Ethi cs Code S u n shin e Law and Pub lic R ecor d s - Frequently A ske d Q uestions M emo ran d um - Solicitation by City Board and C ommitt ee M emb ers O Ci tywi de Permi t Ap plication (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 D iscl osure Requirement Scanned on: ggegg__2geg___egg_gegg._ypg o DIVERSITY STATIS R eceiv ed on. 2/3/2023 sionea oX ,JAu one 254ct wans roosso ?l7/3 rors"< D at e City Cl erk's Of fi ce Staf f Initials 2/a/23 Employee: --=:+~-::-:---:--:L---:c=-,-----,-------- ate cy oh~ orco siai ii~as CONCLUDED & RESIGNATION LETTERS Term Expired Lett er 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 We are conmitted to providing excellent public service and salety to all who lve, work, and play in our vibrant, tropicoi, historic communiNy Ml City of Miami Beach, I/OO Convention Cantor Drive, Miami Beach, Florida 33 139 yxwy_miarIibaachllgo OFFICE OF THE CITY CLERK, Ralaol E. Granado, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Emai l: Ci#yClerk@miamiboochll.gov February 02, 2023 Ms. Susan Askew 9 Island Avenue, #407 Miami Beach, FL 33139 RE: Gen er al Ob ligati on (G.0.) Bond Oversight Committee Dear Ms. Susan Askew: Congratulations! You have been appointed by the City Com m ission to the agency, board or committee named above for a term ending: 12/31/2023. 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. $ Rafael Granado City Clerk cc: Monica Beltran, Parking Director Maria Hernandez, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements 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 City Wide Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees /IAMIBE City of Miami Beach, 1/oo Conortion Cont Dwvo, Mom» oath, Honda 33 139 ww.Iiamibaachll.gay OFTKCT OF TH CIY CIRK, Rotool t. Grando, City Clerk Tel: 30$.673.7a11, fox 305.673.7254 £moll. CmyCdork omtomtboochfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Susan Askew 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 above-mentioned board or committee of the City of Miami Beach to wh ich 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 ly 1st, following the closing of the calendar year on which I have served. Sworn to and subscribed before me this Keila Mena Caceres 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. 1lAMi City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: BC @mia m o achf\. gov Telephon e: 305.673.7411 RECEIVED FEB 12023 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK AFFIDAVIT OF AFFILIATION WI TH TH E CITY OF MI AMI BEACH STATE OF FLORIDA C O U N TY OF MI A MI -DAD E I am in compliance wi th (he affillation requireme nt of Miami Beach City Code Sections 2-22 (4), as (check () all that apply): ta lam a resident of the C ity of Miami Beach for six months or long er. H ome Adores O Island Ave, #407, Miami Beach, FL 33139 ] 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). N am e of B u si ne ss Feanimar LL woe B usin ess A ddres 9 Island Ave, #4 0 7, Miami Beach, FL 33139 lam a fu ll-tim e employee o f a bu sine ss (for a mi nim um of six months) an d I am based in an o ffi ce or other location of the bu sine ss th at is p hysi ca lly located in Mi am i Beach (for a minimum of six months). Name of B usine ss ---------------------- p115fess k (]}fe S Sr "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 enalties of perjury, I declare that I have read the foregoing document and that the facts stated in it 2/3/2023 D at e Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of a physical presence or on line notarization, »5 flruay,s73 s» Cu5an Pskl (Ci ty of Miami Beach Board/Committee Member). , ~·.. Notary Publl.c Sttto of Flotld• 4 ow#elks#ht3 +; • HH 27$48 •• p Exp. 7iii~iozs , MIAMIBEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florid 33139 www.miamibeachll.gov OFFICE OF THE CITY CIERK Emoil: BC@m iamibeachl.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(1) (2) Askew Susan w Last Name First Name Middle Initial l 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 he 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 moy than $500, 60 days in jail, or both. • Isle±; ' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. $112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional for with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 5of6 FACLERI$ALLREGBOARO AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARDO AND COMMITTEE APPLICATION REG FINAL.docx Updated: Juno 2020 MI AMIBE, CH City of Miami Beach 1700 C onvention Center Dr ive Miami Beach, Flor id o 33139 www.miamibeachfl,go OFFICE OF THE CITY CLERK Email: BC@miamibeachf.go Telephone: 305.673.7 411 DIVERSITY STATISTICS REPORT Askew Susan W Last Name First Name Middle Initial The following information is voluntary and has no bearing on yo ur consi derat ion for appointment. It is being asked to comply with City diversity reporting requirements. Gender: [JMuale Ll remale ) oner El t prefer not to answer. Race/Ethnic Categories: What is your race? [lAtican Am erican/Black El Asian or Pacific Islander El Caucasian/white L]Native American/American Indian l[Oth er - Print Race. Ell prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latinola? Jves [h o El prefer not to answer. Do you consider yourself Physically Disabled? va» zl Llt prefer not to answer this question. Page 6 of6 F:ACLERSALL RE GBOARD AND COMMITTEE APPLICATIONS FINAL DRAF T S\BOAR D AN D COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 .5» &I SOURCE OF INCOME STATEMENT Section 2-11.1(@) of the County Ethlcs Code requires that cortaln employees and public officials file a financial disclosure Statement on a yearly basis by July 1st of every year. msc1osu. re tor Tax Year Ending ltai;t Nii me 2022 Askew failing Address - Sir@t Number, Street Name, r Pi, fol 9 Island Ave, #407 1-_,..,~~------~------~·-~~··----~--~-----~------1 City, State, Zip Miami Beach, FL 33139 FIrst Name Susan Middle Name/Initial w I 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.L] FTg as an E~ . ..::..<clteck~·-· -•-•.....:.> __, [] county [] Public Heatth Trust [] Municipal: (Municipality) Department Positi on or Title Employee ID Number Work address I Work telephone Employment began on/ended on Filing as a Board ember (check one) [] county [] Municipal: City of Miami Beach (Municipality) Board where serving GO Bond Oversight Committee Alternate address (if home address is exempt) I Work telephone I Tenn began on/ended on (703) 966-6058 2/1/2023 List below every source of income you received, along with the address and the principal activity of each source. Include your public sal ary. 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 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 h Name of Source of Income Address Desc ription of the Prin cipal Business Activity Miami Beach Botanical Garden 2000 Convention Center Dr Non-profit Garden Conservancy (Nov 4, 2021 - Oct 31, 2022) Miami Beach, FL 33139 managing City-owned Botanical Garden (or affirm) that the information above is a true and correct statement. (lo gnature of Person Disclosing 2 /4/2023 Date sired RECEIVED BY ELECTIONS DEPARTMENT: narace RECEIVED [] Electronic Copy FEB 7 2023 CITY OF MIAM I BEACH OFFICE CF THE CITY CLERK OFFICE USE ONLY Accepted: Y I N Deficlency:. Processed Date/initials:. Scanned Date/initials: TH bl»[d [))[b oo- + \l, ([BE,_ CIw DE (CW) OARD & COMMITTEES cry or eri seed± Pinkie r i nrtNr _ PARKING APP[[CAT[ON 1755 Meridion Avenue, Soi 200/Miomi Beach, FL 33139/Pl- (305) 673.7505 o r (305) 673-7000 04. 6200 A citywide (CW] parking per mi t is honored al 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 retlect 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 o 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. ACKNOWLE DGEMEN T: I acknowl edge that sho uld my access card be lost, stolen or damage, I will be responsible to pay a $10.00 replacement fee. Board Member information Do te of Application: 2/3/2023 Applicant Name Susan Askew Board/Committee Name: GO Bond Oversight Address: g Island Ave, #407, Miami Beach, FL 33139 E-Moil Address susanWaskew@gmail.com Work Phone: Home Phone Cell Phone: 703.966.6058 Preferred Contact Method: Email Vehicle information Tag: HHFB51 Color: Gray State: Florida Year: 2009 Make: BMW Model: 328i Applicant Sianature: )4 S Please provide si gned form to the Parking Department located at 1755 Meridian Avenue, 28 floor. W orking hours are 8:30 to 5.00 p.m. or email to: P arking Re cep tion@ m iam ibe achfl .gov e-mail subject: BOARD 8 COMMITTEE PARKING APPLICATION - APPLICANT NAME a rl i n g D e p a rt m e n t S e ctio n PERMIT SYSTEM GARAGE ACCESS Expi ration D ate: ID C ard Serial #: Issued By Print Name: Print Name: Signature: S Signature: s S Dote lssued: Date Complet ed: P, ·d