Carolina Bolado 12.31.24MI 1 BE
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Carolina Bolado
BOARD/COMMITTEE: Transportation, Parking and Bic
DATE OF APPOINTMENT. 1/9/2023
FOR SCANNER
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RECEIVED
FEB 10 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
° PP} p9{ letter of Appointment/Reappointment e-mailed
l[ [>
o Board and Committee Application (Completed on _
o R~sum~/Curriculum Vitae ](0])p2
o Diversity Statistics Reporting (Completed on ]LU l)
o Oath
Appointed by: Commissioner Ricky Arriola
renow own. n2[3)/0 TERM END: 12/31/2024
to Committee Liaison on
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
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
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 COPY in file and ORIGINAL for Annual Report.
Received on. 1/9/2023 stoneas, XCarolina!-Bolado
Scanned on:
Date Board .~mittee Member
Processed on: _._.11_._l _lD_)_)D By Employee:-------~-------------- v1 T» Clerk's Office Staff Initials
__________ By Employee: _,~,__ _
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:ICLER\BOARD AND COMMITTIES DATABASEICHECKLIST MASTERIB&C Checklist 2015 MASTER.docx
We care cormiited ts providing excellent pubic service and sale#y to oll who live, work, and ploy in our vibrant, iropiccal, historic community
I
City of Miami Beach, I/0O Convonlion Canter Drive, Miami Beach, Florida 33139 yxyw_miamihaachl.gov
OF FICE OF THE CI TY CLERK, Ra~al E. Gr an ado, Ciy Clark
Tel 305.673.7411, Fax. 305.673.7254
Emai l: Cit Clerk@miamiboochll.gov
January 09, 2023
Ms. Carolina Bolado
2939 Indian Creek Drive, Apt 502
Miami Beach, Florida 33140
SUBJECT: Tran spor tation, Parking and Bicycle-Pedestrian Facilities Committee
Congratulations! You have been reappointed by Commissioner Ricky Arriola to the above referenced,
board or committee named above, 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 Jan uary 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.
Congratulations and good luck.
7%
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Monica Beltran, 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 Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
City of Miami Beach, 1/O Convention Conlar Diva, Miami Beach, Florida 33 139 ygwy_IiaIribgachf]_go
OFFICE OF THE CITY CLERK, R0fool E. Granado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: C iyCl erk @m iam i beach fl.g ov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Carolina Bolado
RE: Transportation, Parking and Bicycle-Pedestrian Facilities Committee
I d o so le m n ly sw ear o r affi rm to bea r true fa ith, lo y alty 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 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 July 1st, following the closing
of the calendar year on which I have served.
Ms. Carolina Bolado
S w orn to and subscribe d befo re me this ')Qy of J~nuary, 2023 • Charles D'Agostin
Deputy Clerk
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and
C o m m itt ee s fo r a dditio nal info rm ation rega rding the F in a nci a l D iscl osure R equirements.
iv iu/\ji BE A Cr
City of Miami Beach
)700 Convention Center Drive
Miomi Beach, Florido 33139
OFFICE OF THE CITY CERK
Emai l: BG@myamibeachf, qov
Telephone: 305.673.741)
RECEIVED
FE3 10:2:3
C/'h
i' ar Ni i tr» or ore'ii&r
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). e am a resident of the City of Miami Beach for six months or longer.
Home Asa«es. 24341d2an rel Di y Pl 7
O 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 _
[1,[PS (][[Si
o 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 _
Business Address _
"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
ii scads 4llanos
Signature Dal 7
Carolina 1. Bola4o
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of o physical presence or online notarization,
mu5/ day or JAQAY_ ,20?23_y AAA)MA 2Ag
(City of Miami Beach Board/Committee Member).
Produced ID
" Form of Identification
<Mgr
Signature of Notary Public
L /DA rpzo
(NOTARY SEAL)
Name of Notary, Typed, Printed, or Stamped
MIA/V\I E
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 REPORT
Bolado Carolina
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 at e
[l Female
0 Other
Ll t prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
0 Asian or Pacific Islander
El Caucasian/white
0 Native American/American Indian
OJ Other- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
(l Yves
[Jo
Ll1 prefer not to answer.
Do you consider yourself Physically Disabled?
Ives
Ezo
Ll;prefer not to answer this question.
Page 6 of 6
F:\CLER \$A LL\RE G\B O A RD A N D C O M M ITT E E A P P LI C A TIO N S FIN A L D RA FTS\BO A R D A ND C O M M ITT E E A P P LI CA TIO N R E G FINA L.docx
Updated: June 2020
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
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() (2)
Bolado Carolina
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 no more than $500, 60 days in jail, or both.
Carolina I. Bolado 1/25/2023
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:IC LE R\$A LL\RE G \BO A RD A ND CO M M ITT E E A P P LI C A TIO NS FIN A L D RA FTS\BO A RD A N D CO M M ITT E E A PP LI C A TIO N RE G FINAL .d ocx
Updated: June 2020
MIAMl·DAD E-
EII SOURCE OF INCOME STATEMENT
Section 2-11.1(@) 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 Bolado Carolina Ivette
Mailing Address - Street Number, Street Name, or P.O. Box
2939 Indian Creek Drive Apt 502
City, State, Zip
Miami Beach, FL 33140
If your hom e addre ss is your m ailing address, and your hom e addre ss is exem pt fro m public re cords pursuant to Fla . Stat. $119.07, read
instru ctions on the follow ing page and check here. D
Filing as an Em ployee (check one)
[] county □Public Health Trust [] Municipal :
(M un i cip alit y)
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 E] Municipal: Miami Beach
(Municipality)
Board where serving
Transportation, Parking and Bicycle-Pedestrian Facilities Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
(305) 209-2282 1/9/2023-12/31/2024
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
Portfolio Media/Law360 111W. 19th Street, 5th Floor legal journalism
New York, NY 10011
White Paper Films 110 Ainslie Street #1 documentary filmmaking
Brooklyn, NY 11211
I hereby sw ear (or affi rm ) that the info rm ation above is a tru e and corre ct statem ent.
Signature of Person Disclosing
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
□Hardcopy RECEIVED
[] Electron ic Copy
FEB 10 2023
CIT Y O F M IA M I BEA CH
OFFICE OF TH
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138_SP-14 COE 2016
MIA CITYW IDE {CW ) BOARD & COMMITTEES
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 e4. 6200
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: 11912023
Applicant Name: Carolina Bolado
Board/Committee Name: Transportation, Parking and Bicycle-Pe
Address:
E-Mail Address:
Work Phone:
Cell Phone:
Vehicle Information
Tag:
State:
Make:
Contact Method:
Color:
Year:
Model:
Applicant siaanu. 2arolina I. Bolado
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
p, d D ar Ina eparmen econ
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: e Signature: e
Date Issued: Date Completed:
t t S:ti
. pmng man rar torms cw oatdsecommtees par4gtorm.doc