Sara de los Reyes 12.31.244 # I l I l
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Sara de los Reyes
BOARD/COMMITTEE: Art in Public Spaces
DATE OF APPOINTMENT. -22-23 -------
F O R S C A N N E R
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RECEIVED
FEB 27 2023
Appointed by: Meiner & Dominquez H, on (
TERM END: n2[31)4 TERM LuMr: p/3 1/2o F O R C L E R K S TA FF
o Letter of Appointment
o Letter of Reappointment $/1','€" " Anomenrearowent e-mates
o Board and Committee Application (Completed on p2/ )JI
o R~sum~/Curriculum Vitae -J
o Diversity statistics Reporting (Completed on 2-) 2+]
o Oath
to Committee Liaison on
IM PO RTA NT INFO RMATION FOR BO ARD 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 C IT Y O F M IA M I B E A C H
OFFICE OF TH E CITY CLERK o Citywide Permit Application (Parking Department Form)
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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
Received on:
o Board and Committees Liaison Responsibilities
o DIVERSITY STATISTICS REPORTIN
2-24-23 X A,J Signed by Hr_ er" ")c
rd or Committee Date
Processed on: < By Employee:/
Date itials
Scanned on: 2-24-23 [\y p[Pl\/},
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:\C L E R \B O A R D A N D C O M M ITT IE S D A T A B A S E \C H E C K LI S T M A ST E R \B&C C hecklist 2015 M A ST ER.docx
We are committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
MI M/BE
City of Miami Beach, I/OO Convention Caner Drive, Miami Bach, Florida 33139 yxwy_miamibaachllao
OFFICE OF THE CITY CLERK, Roal E. Gran ado, Ciy Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CilyClerk@miamibooch fl.gov
February 23, 2023
Ms. Sara de los Reyes
1800 Sunset Harbour Drive #901
Miami Beach, Florida 33139
RE: Art in Public Place s Committee
Dear Ms. Sara de los Reyes:
Congratulations! You have been appointed by the City Commission to the agency, board or committee
named above 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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards,
Ran!.nado
City Clerk
cc: Monica Beltran, Parking Director
Brandi Reddick, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
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 - Amendment 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 of Miami Beach, /O0 Con ven tion Can ter Drive, Mi ami Be ach, Horida 33 139 yww.miam ibg achll.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.741I, Fax 305.673.7254
Email: CilyClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M s. S ara de los R eyes
R E : A rt in Pub lic Places C om m itt ee
I do solem n ly sw e a r or affi rm to bear true faith, loyalty and allegiance to the Govern m ent of the United
States, the State of Florida, 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 entioned board or com m ittee of the C ity of M iam i Beach to w hich I have been appointed fo r a
term ending : 12/31/2024.
To m y co lle ag u e s and to all of those I represent and serve, I pledge fairn ess, integrity and civility, in all
actio ns taken and all com m unications m ade by m e as a public servant.
I ha ve be en issu ed a copy of sect ion 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 Am endm ent
and C o de of Ethics fo r Public O ffi cers and understand that as a m em ber of a C ity of M iam i Beach Board
and/or C om m itt ee , I m ust com ply w ith the finan ci al dis cl osure requi rem ents of M iam i-Dade County or the
State of Florid a (de p ending on the board or com m ittee on which I serve) on July 1st, follow ing the closing
of the cale nda r year on w hich I have served.
Sw orn to and subscribed befo re m e thi'rf'-_/_ day o/~2023
*P le a se visit th e C ity of M iam i Beach w ebsite at w w w .m iam ibeachfl.gov under City Cler k/B oard an d
C o m m itt ee s fo r add itional info rm ation regarding the Financial D isclosure R equirem ents.
MIAMI BEACH
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 27 2023
CITY OF MIAMI BEACH
OFFICE or TH E cir ct#k
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 1800 Sunset Harbour Drive, Apt: 901 Miami Beach, FL 331
□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/ A ------------------------
Business Address'
□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 N/ A ------------------------
"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.
at I have read the foregoing document and that the facts stated in it
2-24-23
Signature
Sara de los Reyes
Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribe~jore me, by means of)physical presence or online notarization,
27bee7 s _Saa betas he jes
________ (City of Miami Beach Board/Committee Member).
fBner) Aro,se Produced ID
Signa r
Form of Identification
(NOTARY SEAL)
Name of Notary, Typed, Printed, or Stamped
IAMl
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: 305.673.7 411
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)
de los Reyes Sara M
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);" 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 jai' or both.
•. %ln,a
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.
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F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
/lAl
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibea chfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
de los Reyes Sara M
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 ate
El remale
0 Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
Ll Amica American/Black
D Asian or Pacific Islander
El Caucasian/white
El Native American/American Indian
D Other - Print Race: ------------ □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
lves
Io
Dl I prefer not to answer.
Do you consider yourself Physically Disabled?
ves
lo
D I prefer not to answer this question.
Page 6 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
CITYWIDE (CW) BOARD & COMMITTEES lll-:JIII
City of Miami Beach, PARKING DEPARTMENT PA RKING APPLICATION 111111
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 6200 PARKING
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.
ACKNOW LEDGEMENT: 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: 2-24-23
Applicant Name: Sara de las Reyes
Board/Committee Name: Art in Public Spaces
Address: 1800 Sunset Harbour Drive #901 Miami Beach, Florida 33139
E-Mail Address: saradlr@outllook.com
Work Phone: Home Phone
Cell Phone: 305-607-7540 Preferred Contact Method: Cell
Vehicle Information
Tag: SDLR Color: GREY
State: FLORIDA Year: 2013
Make: LEXUS Model: 450H
Applicant Sianature: e dz>ao1» ., _, - -
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 S ' ar ana epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: e Signature: e
Date Issued: Date Completed:
' pig ·man rarrorms cw oars «commmees par+mgrorm.toc
M IA M l·DAD E.
EE 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
de las Reyes
First Name Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
0l
City, State, Zip
5lrami'
lf 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. li2r'
Filing as an Employee (check one)
[] county D 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 3iwunicipal: C.A op4r Bew
(Municipality)
Board where serving trr
Alternate address (if home address is exempt) I Work telephone I Term /an on/ended on
/ 2023
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
Social Security Social Security retired
Realtor 1800 Sunset Harbour Drive Realtor indipendent
#901 Miami Beach, FL 33139
I hereby swear (or affirm) that the information above is a true and correct statement.
le.±=
Date saned
RECEIVED BY ELECTIONS DEPARTMENT:
Jar4co»ECEIVED □Electronic Copy
FEB 272023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y I N Deficiency. Processed Date/Initials: Scanned Date/Initials: _
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