Jean Marie Echemendia 12.31.24MI A MI BE
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: JEAN MARIE ECHEMENDIA
BOARD/COMMITTEE: AFFORDABLE HOUSING
DATE OF APPOINTMENr; /[23
Appointed y. AH) COm
FOR SCANNER
Scan o
Scan o
Scan o
Scan o
Scan o
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
0 ~2i uetter of Appointment/Reappointment e-mailed to
o Board aid Committee Application (Completed on •_2/!]2
o R~sum~/Curriculum Vitae l
o Diversity statistics Reporting (completed on _2]2/,_23_
o Oath
TERM ENo. (31/{ rRM LuMur. Pl3l/
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
CITY OF MIAMI BEACH ✓Sunshine Law and Public Records - Frequently Asked Questions
OFFICE OF THE CITY CLERK ✓Memorandum - Solicitation by City Board and Committee Members
RECEIVED
FEB 10 2023
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 REPORTING Keep ~QPy in file and ORIGINAL for Annual Report.
Received o. 02/08/23 Signed by / n4
Date Board or o mittee Member
Processed on. lO82 By Employee:
Date
Scanned on:
City Clerk's Office Staff Initials
_0_21_0_8_!2_3 By Employee: k;V)-'---"· _
City Clerk's Office Staff Initials 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 pubic service and sale!y to all who live, work, and play in our vibrani, tropical, historic community.
City of Miami Beach, ZOO Convention Canter Drive, Miami Bach, Florida 33 139 yyy.miaribaachllgov
OFFICE OF THE CITY CLERK, Raal E. Granado, Cy Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: Ci#yClerk@miamiboochfl.gov
February 02, 2023
Ms. Jean Marie Echemendia
5396 N Bay Rd
Miami Beach, FL 33140
SUBJECT: Affordable Housing Advisory Committee
Dear Ms. Jean Marie Echemendia :
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.
R esp~
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Marcela Rubio, 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 - Am en dment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance
City Wi de Permit Application - (Par king Depa rtm en t Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
City o f M ia m i Beach, ZOO Convention Coner Drive, Miami Poach, Florida 33 139 yNwwy_miaIIibachfl_gov
OFFICE OF THE CITY CLERK, Rofaol E. Granado, City Clerk
Tel: 305.673.7411, Fox. 305.673.7254
Email: City Cl erk@miamibeach ll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Jean Marie Echemendia
RE: Affordable Housing Advisory 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 C ity of M iam i B each, and to perf orm all the duties of a member of the
above-m entioned board or com m ittee of the C ity of M iam i B each to w hich I have been appointed fo r a
term ending: 12/31/2024.
To m y colleagues and to all of those I represent and serve, I pledge fa irn ess, integrity and ci vility, in all
actions taken and all com m unications m ade by m e as a public servant.
I have been issued a copy of section 2-11.1 of the M iam i-D ade C ounty C ode (C onfli ct of Interest and
Code of Ethics O rdinance), as w ell as Florida Com m ission on Ethics G uide to the S unshine A m endm ent
and C ode of Ethics fo r P ublic Officers and understand that as a m em ber of a C ity of M iam i B each Board
and/or C om m ittee, I m ust com ply w ith the financial disclosure* requirem ents of M iam i-D ade C ounty or the
State of Florida (depending on the board or com m ittee on w hich I serve) on July 1st, fo llow ing the cl osing
of the calendar year on w hich I have serv ed.
sw om t o an d subs cribe d befor e m e this _ r fez0zs
*P lease visit the C ity of M iam i B each w ebsite at w w w .m iam ibeachfl.gov under C ity C lerk/B oard and
C om m ittees fo r additional info rm ation regarding the Financial D isclosure Requirem ents.
MIA]
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florido 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 411
RECEIVED
FEB 10 2023
CITY Or M
office 6 3,Ml BEe4or
E CITY OLER
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):
IZI I am a resident of the City of Miami Beach for six months or longer.
Home Address396 N Bay Rd, Miami Beach, FL 33140
□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).
[[Qr (9f [/I[[eS,
Pg[[@,, J\(](]re,S_
121 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 Businesouglas Elliman
Business Addres1111 Lincoln Road, Miami Beach, FL 33139
"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.
rjury, I declare that I have read the foregoing document and that the facts stated in it
02/08/23
Date
JEAN MARIE ECHEMENDIA
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of o physical presence or o online notarization,
he l_cay or Fe .o23 _Tea /ace L e ne4 a
Produced ID
Form of Identification
PATRICK D. CAMM
MY COMMISSION # HH 254869
EXPIRES: April 19, 2026
(NOTARY SEAL)
Name of Notary, Typed, Printed, or Stamped
M IA M I
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: 305.673.7411
DIVERSITY STATISTICS REPORT
Echemendia Jean Marie
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:
L Jae
Z rem ale
D Other
DI I prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
D Asian or Pacific Islander
El Caucasian/white
D 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?
lves
(J o
Ll prefer not to answer.
Do you consider yourself Physically Disabled?
Jves
0Ro t prefer not to answer this question.
Page 6 of 6
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Updated: June 2020
1LAIB H
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.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)
Echemendia Jean Marie
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 Statem ent;" 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 more than $500, 60 days in jail, or both.
~1~ =-----ov_o_a_,2_3 _
Date Signature
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
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Updated: June 2020
MIAMI-DADE- EIII 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 Echemendia Jean Marie
Mailing Address - Street Number, Street Name, or P.O. Box
5396 N Bay Rd
City, State, Zip
Miami Beach, FL. 33140
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 Z] Municipal: Miami Beach
(Municipality)
Board where serving
Affordable Housing
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
305-903-4050
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
5800 La Goree Drive LLC 5800 La Goree Drive RENTAL INCOME
Miami Beach, FL 33140
Real Estate Holdings 5711 N Bay Rd RENTAL INCOME
Miami Beach, FL 33140
Douglas Flliman 1111Lincoln Road REAL ESTATE BROKERAGE
Miami Beach, FL 33139
I hereby swear (or affirm) that the information above is a true and correct statement.
signature ot Per&ekbois@losing
02/08/23
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
□Hardcopy RECEIVED
[] Electronic Copy
FEB 10 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
cwIE (Cw OARD & C0M Mw E es EEE
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION -
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 6200 PARI IG
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'92/08/23
A pplicant N am e: JE A N M A R IE E C H E M E N D IA
Board/Com m ittee N am e: A F F O R D A B LE H O U S IN G
A ddress: 5396 N B A Y R D M IA M I B E A C H FL 3314 0 ' '
E-M ail A ddress: JE A N K O U R l@ Y A H O O .C O M
W ork Phone: 305.903.4 050 Horne Phone 305. 903 .4 050
C ell Phone: 305.903.4 050 Preferred C ontact M ethod:
Vehicle Information
Ta g: PLU G 1IN C olor: R E D
State: FL Year : 2008
M ake: TE S LA M odel: RO A D S T E R
Appl icant Sianature : e C}i,1 '~
Please pro vide sig ned for'f6 th e Parking Depa rtm ent located at 1755 M eridi a n A ven ue, 2d floor. W orking
hours are 8:30 to 5:00 p.m . or em a il to: PgrkingReception@miamibeachfl.go
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
p, ·ki D ar Ina epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature: e
Date Issued: Date Completed:
s
:p ing m an far torm s cw oatis commmttees parmgtorm,doc