Marcia Duprat Lepori 12.31.23MIAMI BEACH
BOARD AND COM MITTEE CHECKLIST
APPOINTEE: X [NO A DU[QA_L Lg»Q__ DATE OF APPOINTMENT: E A_ ,_23
BOARD/COMMITTEE:X CS \_ 1@AN S@UghM Appointed by:t OEM6SOM 2
Pkg9 ,) lo
FOR SCAN NER FOR CLERK STAFF p42)J3 )Ji))
Scan o o Letter of Appointment TERM END: .'T°' TERM LIMIT:l fP~
Scan o o Letter of Reappointment
o CoP,Y y Letter of Appointment/Reappointment e-mailed to
1313
o Board and Committee Application (Completed on [/] I//22
o R~sum~/Curriculum Vitae JJ
o Diversity Statistics Reporting (Completed on '? 3
o Oath
Scan o
Scan o
Scan o
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
RECEIVED ✓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) FEB 1 0 2023 ✓Highlights of the Miami-Dade County Ethics Code
✓Sunshine Law and Public Records - Frequently Asked Questions
CITY OF MIAMI BEACH ✓Memorandum - Solicitation by City Board and Committee Members
OFFICE OF THE CITY CLERK
o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o
Scan o
Received on:
Scanned on:
o Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
o Board and Committees Liaison Responsibilities
O DIVERSITY STATISTICS REPORTING Keep ~~n file and ORIGINAL fo r Annual Report.
±el ,23 sons,X_loo@ v.
i -----~~-------------
Date
Processed on: _ri..-,~/_t_/J~}_w By Employee: --~J{/1/)_~-------------
Date Cy9erk's oce sat initials 10l? savors '-'1
City Clerk's Office Staff Initials
Board or Committee Member
Date
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
We 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, I700 Convention Conlon Drivo, Miami Beach, Florida 33139 yyywy_miaIihgachll.gay
OFFICE OF THE CITY CIERK, Ralaol E. Granado, City Clerk
Tel: 305.673.741I, Fax:. 305.673.7254
Email: CityClerk@miamibeochll.gov
February 06, 2023
Marcia Duprat Lepori
1754 Meridian Avenue Apt 101
Miami Beach, FL 33139
RE: Transportation. Parking and Bicycle-Pedestrian Facilities Committee
Dear Marcia Duprat Lepori:
Congratulations! You have been appointed by the City Commission 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.
Reg~
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Monica Beltran, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
City Code/Ordinance section applicable to agency, board or com mittee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Ordinance No. 2006-3543 - Amendmen t 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
C ity o f Mi a m i Beach, /OO Con v on fion Can tor Drivo, Miam i Bo ch , Flor ida 33 139 yyww._miam iboa chll.go
OFFICE OF THE CITY CLERK, Raf0ol E. Granado, Cly Clerk
Tel: 305 .673.7411, Fax€ 305.673.72 54
Emall: Ci t Clerk@miamtbeachll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M a rci a D up rat Lepo ri
R E : Transpo rt atio n , Parkin g and Bicycl e-P edestrian Facilities C om m ittee
I do so le m n ly sw ear or affi rm to be a r true faith, loyalty and allegiance to the G overn m ent of the U nited
States, the State of Flo rid a, and the C ity of M iam i Beach, and to perform all the duties of a m em ber of the
ab ove-m e ntio n e d bo a rd or com m itte e of the C ity of M iam i Beach to w hich I have been appointed fo r a
term ending : 12/31/2023.
T o m y colle a gu e s and to all of those I represent and serve, I pledge fa irn ess, integrity and civility, in all
actions taken and all com m unicatio ns m a de by m e as a public servant.
I ha ve be e n issued a co p y of se ction 2-11.1 of the M iam i-D ade C ounty C ode (C onfli ct of Interest and
C o de of Ethics O rdinance ), as w ell as Florida C om m ission on Ethics G uide to the Sunshine A m endm ent
and C o de of Ethics fo r Pub lic O ffi ce rs and understand that as a m em ber of a C ity of M iam i Beach Board
and/or C o m m itt ee, I m ust com p ly w ith the financi al disclosure* requirem ents of M iam i-D ade C ounty or the
State of F lo rida (de pe nd ing on the boa rd or com m itt ee on w hich I serve) on July 1st, fo llow ing the cl osing
of th e cal e nd ar ye ar on wh i ch I have served.
M arcia D uprat Lepori
Sw orn to and subscribed before m e this O°\
au a a,,,..Ge
erk
*P le a se vis it th e C ity of M iam i Bea ch w ebsite at w w w .m ia m ibeachfl.g ov under C ity C lerk/B oard and
C o m m ittees fo r additio na l info rm atio n regarding the Financial D iscl osure R equirem ents.
M IA M I BEA C H
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 411
RE CE IVE D
FEB 10 2023
CITY O F MIAM I 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.
Home Address fl He(__duo Qug ll oy
□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).
[]arr9 (f [111mes,S
[I,1Pe,, J\[]foS
□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).
[[ar e (f [[y g [P S S
[[1me,, J\(]]f9,S
"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
aero (to, h) oa1of\03
Signature Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or online notarization,
_________ (City of Miami Beach Board/Committee Member).
f Dae t;c Produced ID
Form of Identification
Personally Known
s;gn~c G,.
(NOT ARY SEAL)
Name of Notary, Typed, Printed, or Stamped PATRICK D. CAMM
MY COMMISSION # HH 254860
EXPIRES: Apr1 19, 2028
M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachll.gov
OFFICE OF THE CITY CLERK
Email: BC@m iamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Last Name First Name
o2 \64\09
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
El Female
D Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
D Asian or Pacific Islander
[ Caucasian/white
0 Native American/American Indian D Other- Print Race: _
D I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
DJ ves
Jo
El prefer not to answer.
Do you consider yourself Physically Disabled?
v es z
D I prefer not to answer this question.
Page 6 of 6
F:\C LER \$ALL\REG \BO ARD AND CO M M ITT EE APPLI C ATIO NS FINAL DRAFTS\BO ARD AND CO M MITT EE APPLI CATIO N REG FINAL.docx
U p da te d : Ju ne 2020
MIAM I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach!l.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 41 l
BOARD & COMMIT TEE 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)
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 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 mo~n $500, 60 days in jail, or both.
[itb> c\a\03
Signature Date
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.
Page 5 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DADE- 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
2022
Last Name
Di cl
First Name
Hu>
Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
F S A H I cli
City, State, Zip
If your home address is your mailing address, and your hom e address is exem pt from public records pursuant to Fla. Stat. §119.07, read
instructions on the follow ing 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 ~unicipal:
(Municipality)
Board where serving
Alternate address (if home address is exempt) Work telephone 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
q0 O)on Vd lo r ake@ P?0tu9«k D r.8 €0 MOw- ac, T 32d [an9n
U -
I hereby sw ear (or affi rm ) that the info rm ation above is a true and correct statem ent. es..b
Signature of Person Disclosing
o)0q )03
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
□Hardcopy RECEIVED
[ ] El ectr on ic Copy
FE B 10 2023
C ITY O F M IA M I BE A C H
O FFIC E O F TH E C ITY C LER K
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/initials: Scanned Date/initials:
13 8 _S P -14 C O E 20 16