Hagai Gringarten 12.31.24M I
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Hagai Gringarten
BOARD/COMMITTEE: Budget Advisory Committee
DATE OF APPOINTMENT. 2/9/23 -------
Appointed by: Vice Mayor Meiner
FOR SCANNER
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HECEIED
FEB8 28 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee
2/9/23 )
o Board and Committee Application (Completed on 2-[3pl2020,
o Resume/Curriculum Vitae [ J
o Diversity Statistics Reporting (Completed on 2]20 23
o Oath
TERM END.n/31)24 TERM LuMrr. 2/al2o
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
✓Sunshine Law and Public Records - Frequently Asked Questions
✓Memorandum - Solicitation by City Board and Committee Members CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK o Citywide Permit Application (Parking Department Form)
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Received on:
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 REPORTING #keep COPY in tjle and ORIGINAL for Annual Report.
].a&.23 sores r vv
Scanned on:
Date
2[20/23 1A Processed on: By Employee:. ''L
Date City Clerk's Office Staff Initials
2-120/2° rotor Kt
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 COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are committed to providing excellent public service and safety to al who live, work, and in our vibrant, tropical, historic community.
M l MIB
City of Miami Beach, I/OO Convention Canter Drive, Miami Bach, Florida 33 139 4yyy_miamnibgachllgoy
OFFICE OF THE CITY CLERK, Rall E. Gran ado, Chy Clerk
Tel: 305.673.711, Fax. 305.673.7254
Email: Ci#yClerk@miamibeochfl.gov
February 09, 2023
Mr. Hagai Gringarten
4585 Adams Avenue
Miami Beach, FL 33140
SUBJECT: Budget Advisory Committee
Congratulations! You have been reappointed by Commissioner Steven Meiner 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 January 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.
Regards,
Raf~ do ac.±
cc: Monica Beltran, Parking Director
Tameka Otto Stewart, 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 - Amendment 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
I
City of Miami Beach, 1ZOO Convention Conlar Drive, Miami Boach, Florida 33 139 g_yy_migIibgachf]_go
OFFICE OF THE CITY CLERK, Rofal E. Gran ado, Cly Clerk
Tel: 305.673.7411, Fox. 305.673.7254
Email: CiyClerk@miamibeach fl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M r. H agai G ringart en
R E : B udget A d visory C o m m itt ee
I do so le m n ly sw ea r or affirm to b e a r true faith, loya lty and alle g iance to the Government of the United
S tates, the S tate of Flo rid a , and the C ity o f M ia m i B e ach, and to p e rf orm a ll the d utie s o f a m e m b er o f the
ab o ve-m e ntio ne d b o a rd or co m m itt e e o f the C ity of M ia m i B e a ch to w hich I h av e b e en a p p o inted fo r a
term ending : 12/31/2024.
T o m y colle agu e s and to all o f tho se I rep rese nt and serve , I ple dge fairness, integrity and civility, in all
actio ns take n a nd a ll com m unicatio ns m ade by m e a s a p ublic se rv ant.
I h a ve b e e n issue d a co p y o f se cti on 2-1 1 .1 o f the M ia m i-D a d e C o u nty C o de (C o nflict of In tere st an d
C o de of E thics O rdina nce), a s w ell a s Flo rida C o m m issio n on E thics G u id e to the S un shine A m e ndm e nt
and C o de o f E thics for P u b lic O ff icers a nd un de rsta nd that a s a m e m b er o f a C ity o f M ia m i B e a ch B o ard
and/or C o m m itt ee, I m ust co m p ly w ith the fin ancial d iscl o sure* requirem e n ts of M ia m i-D ade C o unty or the
S tate o f F lo rida (de pe nd in g o n the b oa rd or com m itt ee on w hich I se rve) o n July 1s t, fo llow in g the cl o sing
of the cale nda r year on w hich I have serv e d.
Sworn to and subscribed before me this~· 2023
K eila M e n a C ace res
D ep u ty C lerk
*P le a se visit the C ity o f M ia m i B e a ch w e b site a t w w w .m ia m ib e a chfl.g o v u n d e r C ity C le rk/B o a rd an d
C o m m itt ee s fo r additio nal info rm a tio n rega rding the Fina nci a l D iscl osure R e quirem e n ts.
MIAMIB
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
FEB 28 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 Sections 2-22 (4), as (check
(0 all that apply):
M am a resident of the City of Miami Beach for six months or longer.
or» Asa.. 7{5 _A/A3 AV'ti£,are/cl/
□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).
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PIS[[es,, J(]]foS5
□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).
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JS[mess [(]Sr@SS
"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 penaltie} of/erjury, I declare that I have read the foregoing document and that the facts stated in it
s o s. .• 2,8.27
Signature Date
Hagai Gringarten
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or online notarization,
his2o day or fbr»-\,,2023 y.H oo (on roa_1
(City of Miami Beach Board/Committee Member).
Luu _/ Produced ID
Signature of Notary Public
Name of Notary, Typed, Printed, or Stamped
M IA M IB E H
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl,gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.741 l
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)
Gringarten Hagai
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" jail, or both.
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.
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F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
Ml Ml
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Flor ida 33139
www_miamibeachhl_ gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Gringarten Hagai
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.
Gendef;
b.
Ll Fem al e
0 Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
El A fric an Am er i c an/B l ack
El Asian or Pacific Islander
LI Caucasian white
D Native American/American Indian Lloher-- Print Race: _
DI I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
HA
D I prefer not to answer.
Do you consider yourself Physically Disabled?
Llas
skG
Llt prefer not to answer this question.
Page 6 of 6
F :\C LE R \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A F T S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N R E G FIN A L.do cx
Updated: Jun e 2020
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City of Miami Beach, PARKING DEPARTMENT
17 55 Meridian A ven ue, Suite 200/Mi ami Beach , FL 33 139/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: 2, 1 3
Applicant Name: Hagai Gringarten
Board/Committee Name: Budget Advisory Committee
Address: (4 V' E-M ail Address:
word Phone: 304
Cell Phone:
Home Phone
Preferred Contact Method:
Vehicle Information
Tag: Color:
State: Year:
Make: Model:
Applicant S@nature: e .
Please provide signed form to the/Palking Dep ftm ent located at 1755 Meridian Avenue, 2d floor. W orking
hours are 8:30 to 5:00 p.m. or email to: PgrkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P kd D S ar un a e p a rtm e n t e ctio n
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature: e5
Date Issued: Date Completed:
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