Jose Obando 07.31.25M A MI BE
BOARD AND COMMITTEE CHECKLIST
APP OINTEE. Se 0bndO
BOARD/coM MrrrEE: _gov01L or cl
FOR SCANNER
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FOR CLERK STAFF
DATE OF APPOINTMENT: 2/b[3
Anointed by. (al AA
TERM ND. 2[3lJ26 reRM LuMrr: ------ o Letter of Appointment
o Letter of Reappointment
o COrlx'. r Letter of Appointment/Reappointment e-mailed to
I[3 {],]
o Board and Committee Application (Completed on [3')
o R6sum~/curriculum Vitae J#}
o Diversity Statistics Reporting (Completed on )[jb
o Oath
Committee Liaison on
RECEIVED
FEB 10 2023
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 MIAMI BEACH ✓
OFFICE OF THE CITY CLER K
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o Citywide Permit Application (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 Disclosure Requirement
O Board and Committees Liaison Responsibilities
o DIVERSITY STATISTICS REPO Keep COPY in file and ORIGINAL for Annual Report.
- '\
Received on: -1o- 2> Signed by X
Date Bo rd oK)/]tee Member
Processed on: vi0 )3 By Employee:
Date City Clerk's Office Staff Initials
Scanned on: 1(0 [> By Employee:
City ~ffice 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:\CLERIBOARD AND COMMITTIES DATABASE\CHECKLIST MASTERIB&C Checklist 2015 MASTE R.docx
We are committed to providing excellent public service and safety to oll who live, work, and ploy in our vibrant, topical, historic community.
City of Miami Beach, I/OO Convonfion Coner Drive, Miami
OFFICE OF THE CITY CLERK, Rafaal E. Granado, Cy Clerk
Tel 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamiboochfl.gov
Florida 33 139 yyw_miaIIihggrchl]_go
February 08, 2023
Mr. Jose Obando
1590 71 st Street
Miami Beach, Florida 33141
RE: Personnel Board
Dear Mr. Jose Obando:
Congratulations! You have been appointed by to the above-referenced Board or Committee, for a term
ending: 07/31/2025.
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. 7 411.
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.
R~do tt%
cc: Monica Beltran, Parking Director
Marla Alpizar, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
City Code/Ordinance section applicable to agency, board or committee
City Code Section s 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
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
Ml IBE
City of Miami Beach, 1/O0 Convention Center Drive, Miami Boach, Florida 33 139 yyyw_miaIibgachf]_go
OFFKCE OF THE CITY CLERK, Rafal E. Gran ado, Cly Clark
Tel: 305.673.7411, F0x. 305.673.7254
Email: Ci#yClerk@miamibeach fl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Jose Obando
RE: Personnel Board
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 which I have been appointed for a
term ending: 07/31/2025.
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 Ordinan ce), 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 1, it, following the closing
of the calendar year on which I have served.
Sworn to and subscribed before me this __ ''t2023
*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.
ML AM
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
FEB 10 2023
CITY OF MIAMI BEACH
OFF E T+F 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 -------------------------
□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 _
[[n@Ss J (]re8S
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 ot s @ sm e ss C h, a Mia: 1..
usmess Address. \(Q O Coe_lo e b
"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.
of perjury, I declare that I have read the foregoing document and that the facts stated in it
21073
Signature Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or□online notarization,
etHuaay or #orvor-up, 2023 ».006- 0loo ndO
_________ (City of Miami Beach Board/Committee Member).
L Ion v L €nu Produced ID
Signature of
Name of Notary, Typed, Printed, or Stamped
MI A MI BE
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
#ass L
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
Lh ate
Ll remale
Llomher
El prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
Ll Asta or Pacific Islander
0 Caucasian/White
L_l Native American/American Indian
[-/other - Print Race: !2
D I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
/' tr.
Jo
D I prefer not to answer.
Do you consider yourself Physically Disabled?
B
0 I prefer not to answer this question.
Page 6 of 6
F:ICLER \$ALL\REG\BOARD AND COMMITT EE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
/\1\IAM I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
wwwmiamibeach fl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673.741 1
BOARD & COMMITTEE FINANCIAL ACKNOW LEDGEMENT STATEMENT
Acknowledgement of fines/suspension fo r Board/Committee Members for failure to comply with Miami-
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) s c
Last Name First Name
L
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.
Fail re to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no o than $500, 60 days in jail, or both.
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 COMMITT EE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DADE-
EI 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 Last Name
2022 Ou ,S0 O e
-- ------=-=-:c-------b,">-L>"'-='-'-~------------------l
Mailing Address - Street Number, Street Name, or P.O. Box
d
Middle Name/Initial
L
City, State, Zip
(
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. 0
Filing as an Employee (check one)
[] county I] 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 [] Municipal: {a; Hae+
(Municipality)
Board where serving
De $on»/ p t>
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
2 .21. (69
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
Cu3 plo yea I100 Co.ha, Cat D.. vhf
r affirm) that the information above is a true and correct statement.
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
[] Hardcopy,
eo.RE;CEIVED
FEB 10 2023
CITY OF MIAM I BEACH
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/Initials: Scanned Date/initials:
138_SP-14 COE 2016
M IAM I CITYWIDE {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: 9.
Applicant Name:
Board/Committee Name: -- Address: F
E-Mail Address: \
J0Se; a
Work Phone: 30- 2- £89% Home Phone
cell Phone: 74.09. 80
Vehicle lnfor ·
Ta g:
State:
Make:
F
Preferred Contact Method: 49oe- (cl(
Applicant St+nature: es
Color:
Year:
Model:
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 ·ki D ar Ina epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature:
Date Issued: Date Completed:
s
.«pmng ·man rar' toms cw aardscommntees par+tgtom.doc