Mark Rabinowitz 12.31.23MI A MA[BE iv /. -
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: M a rk R a b ino w itz
BOARD/COMMITTEE: Health A dvisory Com m ittee
DATE OF APPOINTMENT. 02/03/2023
Aomt«ea y 23"9o"
FOR SCANNER
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FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment jf'34" ot AroomenuReaomoment e-mates
Board and Committee Application (Completed on _1J)2)
o Resume/Curriculum Vi ta e ,] [
c Diversity Statistics Reporting (Completed on 4 20 )3
o Oath
TERM END. 12/31/2023 reRour. ([31/23
to Committee Liaison on
RECEIVED
FEB 1 2023
CITY O F MIA M I BEAC H
OFFICE OF THE CITY CLER!_, citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics fo r Public Officers and Employees
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Received on:
Processed on:
Scanned 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
Sunshine Law and Public Records - Frequently Asked Questions
v Memorandum - Solicitation by City Board and Committee Members
O Source of Income Statement
o Acknowledgment of Financial Disclosure Requirement
O Board and Committees Liaison Responsibilities
O DIVERSITY STATISTICS REPORTING Keep COE.in fjle and ORIGINAL for Annual Report.
Febru ary 20, 2023 .sore+syX _[lo. _Lal ve/e[0.3
Date 9ad9fommittee Member
February 24, 2023 yEmployee:. _K/]
Date c(;~s Office Staff Initials
Febru ary 29, 2023 ytrioyeer [/l
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:CLER\BOARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\LB&C Checklist 2015 MASTER.docX
City of Miami Beach, I/OO Convention Canter Drive, Miami Beach, Florida 33139 ywy_miIIibgachll_go
OFFICE OF THE CITY CLERK, Raf0al E. Granado, Cy Clerk
Tel 305.673.7411, Fax 305.673.7254
Email: City Clerk@miamiboochfl.gov
February 03, 2023
Mr. Mark Rabinowitz
1550 N.E. Quayside Terrace
Miami, FL 33138
SUBJECT: Health Advisory Committee
Dear Mr. Mark Rabinowitz:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, 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. Congratulations and good luck.
Respectfully,
R a f~d o
City Clerk
cc: Monica Beltran, Parking Director
Marc Chevalier, 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 an d 2-459
Ordinance No. 2006-3543 - Amen 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
1W 4AMI
City of Miami Beach, !/00 Convcnton Cantor Dive, Miami Bsach, Florido 33 139 yyyy_miumibggchll.gov
OFFICE OF THE CITY CIERK, Rafael E. Granado, Chy Clark
Tel: 305.673.7411, Fax 305.673.7254
Email: Ci#Clerk@miambeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgeme nts
TO: Mr. Mark Rabinowitz
RE: Health 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 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: 12/31/2023.
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 July 1st, following the closing
of the calendar year on which I have served.
:.e:_·.i-=_-".·"~::,~,;~_-..,,_ DIANA L HERNANDEZ
}f Notary Public - State of Florida ~ii@j ii c@riser i 5«s51 P~;kf ,comm. tires an 3, 2027
Bonded through
Also get
ir. Mark RabinowiG 7
sworn to and subscribed before me this _'' day or Fh._, 2023
Kei~-
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.
MIA#IBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachf] go
Telephone: 305.673.7411
RECEIVED
FEB 21 2023
CITY OF MIAMI 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 Section s 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 month s).
Name of Business _
P1Jg[PS \[(f9Sa»
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 Miami Beach Community Health Center, Inc.
Business Address 710 Alton 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.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it
are true al... February 20, 2023
Sig nature 7 ,...'""11! .. -'1!-. ii· ~ii;;,i;;.;;;.;;;;;:;..;;;;;;;;;;::;;;;~----
. $?¢, DAL HERANDEZ
Mark Rabinowitz ; '? Notary Pubic · Sate o' Florida #, $; commton # HH 34551
Printed Nam e •• yComm. Expires Jan 3, 2027
NOTARY onded through National Notary Assn.
Sworn to (or affirm ed) an d subs cribe d before me, by means of ph ysical presen ce or a online notarization,
us.U aay or fbroar y_ , 2o23y Mak kbiowi:z
_________ (City of Miami Beach Board/Com mittee Mem ber).
Produced ID
Form of Identification
/ personal ly Kn own
#ssf (NOT ARY SEAL)
Name of Notary, Typed, Printed. or Stamped
MIAMI BE, CH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florido 33139
w.miamibeachfl.goy
OFFICE OF THE CITY CLERK
Emil: 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)
Rabinowitz Mark L
Last Name First Name Middle Initial
I understand that no later than July1of each year all member s 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.
4, '., 2/z._/zc_or
Signature 7 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 CLERISALLREGIBOARD AND COMMIT TEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMIT TEE APPLICATION REG FINAL.docx
Updated: June 2020
MI AMI BEA CH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachtl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REP ORT
R abinow itz Mark L
Last Nam e First Nam e Middle Initial
The fo llow ing info rm ation is voluntary and has no bearing on your consideration fo r appointm ent. It is being
asked to com ply w ith C ity diversity report ing requirem ents.
Gender:
[J Mate
[l remale
D O ther
D I prefer not to answ er.
Race/Ethnic Categories:
What is your race?
D A frican A m erican/B lack
0 A sian or P acific Islander
[l C aucasian /wh ite □Native American/American Indian D O th er - Print Race: _
0 I prefer not to answ er.
D o y o u co n s id e r yo u rse lf to be S p a n is h , H is p an ic , o r L a tin o /a ?
v es
r7 L'I No
El pr ef er not to an sw er.
Do you consider yourself Physically Disabled?
ve,
lo
D I prefer not to answ er this question.
Page 6 of 6
FACLERISALLREG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL. docx
Updated: June 2020
M IA M l·DAD E- 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 I Last Name First Name Middle Name/Initial
2022 Rabinowitz Mark L
Mailing Address - Street Number, Street Name, or P,0. BOx
11645 Biscayne Boulevard
City, State, Zip
Miami, FL 33181
It your hom e address is your mailing address, and your home address is exempt from public records pursuant to Fla. Stat. $119.07, read
instructions on the fo llow ing page and check here.Dl
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 E] Municipal: City of Miami Beach
(M unicipality)
Board where serving
Health Advisory Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
11645 Biscyane Boulevard, Miam i, FL 33181 (305) 538-8835 2023
List below every source of incom e you received, along with the address and the principal activity of each source. Incl ude your public salary. Place the sources of
Incom e in descendi ng order, with the largest source first. Exam ples of sources of incom e include: com pen sation for services, income from business, gains from
property dealings, interest, rents, dividen ds, pensions, IRA distributions, and social security paym ents. Also, include any source of incom e 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
Miami Beach Community Health 710 Alton Road, Miami Beach, Health Care
Center, Inc FL 33139
I hereby swear (or affirm} that the information above is a true and correct statement.
Signature of Person Disclosing
Date signed
«avow a"q%±I)Pb
Hardcopy
Electronic copy., ),1 FEB 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/initials: Scanned Date/Initials:
138.90-14 COE 2016
/\l/A/\/BE, (C} crwDE (Cw) OARD & CoMeEs
cy ct Miami seat, PARK I NG DEPARTMENT P AR KI N G AP P [[CATION
1755 Meridion Avenue, Suite 200/Mi ami Beach , FL 33139/Ph: (305) 673-7505 0r (305) 673.7 000 ea. 6200
A city wi d e (C W ) 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 Holl 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 pl at e . 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
Dote of Application: February 20, 2023
Applicant Name: Mark Rabinowitz
Board/Committee Name: Health Advisory Committee
Address: 41645 Biscayne Boulevard, Miami, FL 33181
E-Mail Address; mrabinowitz@MBCHC.com
Work Phone: 3055388835 Home Phone 7866965176
Cell Phone: 7866965176 Preferred Contact Method: 7866965176
Vehicle Information
Tag: IE G K 8 2 Color: Silver
State: F L Year: 20 10
Make: Lexus Model: LS 4 6 0 L
Applicant Si anat ur e : e o- .A
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2d floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@mniamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P, ·i D S ar mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Seriol #:
Issued By Print Name: Print Name:
Signature: Signature:
Dote Issued: Dote Completed: