Barbara Montero 12.31.24IB
BOARD AND COMMITTEE CHECKLIST
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B O AR D /C O MM I T TE E : A- ]l Ap p oi nt e d y. _(h_Cu 0&n
re eN o: pl 3 1h{ reRwuwrr. p/31/{ FOR SCANNER
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RE CE IVE D
MAR 2 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment 3';PP/3" "" ot AppointmenuReappointment e-mailed to committee
o Board and Committee Application (Completed on _
o R6sum~/Curriculum Vitae J .[
o Diversity Statistics Reporting (Completed on 3 2, 23
o Oath
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 CIT Y O F MI AM I BE A CH
OFFICE CF THE CITY CLERK
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Received on:
Processed on:
Scanned on:
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 STA TISTI CS REPORTING Keep COPY in me and ORIGINAL for Annual Report.
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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:\C LER\BO A R D A ND CO M M ITT IES DATA BA SE\C HEC KLI ST M A STE R\B&C Checklist 2015 M A STER .docx
We re committed to providing excellent public service and salty to oll who live, work, and play in our vibrant, tropical, historic community.
City of Miami Reach, !/OU Convenlion Cenlc1r Drfvn, Woomi 13Grn:h, Florida 33139 W\¥w,miamibc'.lachll.gov
orncf OF THF. CITY CLERK, Rofool E Granado, Cily Clnrk Toi:_ 305.673.741 1, Fax:. 3:05.673.7.254 Email: CitydorMrmiamiboo::Ul.gov
February 02, 2023
Ms, Barbara Montero
1900 Sunset Harbour Drive #2208
Miami Beach, Florida 33139
SUBJECT: Affordable Housing Advisory Committee
Dear Ms. Barbara Montero:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/20 .
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.
Res121
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Marcela Rubio, 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
24
City of Miami Beach, I/OO Convonlion Coner Drive, Miami Boach, Honda 33 139 ygwy_miamnibggchf_go
OFFICE OF THE CITY CIERK, Rofaal E. Granado, City Clerk
Tel: 305.673.7411, Fox. 305.673.7254
Email: CityClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M s. B a rbara M o ntero
R E : A ff o rda ble H o using A dvisory C o m m itt ee
I d o so le m n ly sw e ar or a ffi rm to b e a r true faith, lo yalty and a lle gia nce to the G o vern m e nt o f the U nited
S tates, the S tate of F lorid a , and the C ity o f M ia m i B e ach , a nd to pe rf orm a ll the d uties o f a m e m b e r o f the
ab ove-m e ntio n e d b o a rd o r co m m itt e e o f the C ity o f M ia m i B e a ch to w hich I h ave b e en app o inte d fo r a
term e nding: 12/31/2023.
T o m y colle ag ue s a nd to a ll o f tho se I represe nt and se rve , I p le dg e fairn e ss, integrity and ci vility, in all
a ctions taken a nd a ll com m u nicatio ns m a de by m e a s a p ublic servant.
I h a ve b e e n issue d a co py o f se ctio n 2-1 1.1 of the M ia m i-D a d e C o u nty C o d e (C o nflict o f In te rest and
C o de of E thics O rdin a nce), as w ell a s F lo rid a C o m m issio n on E thics G u id e to the S un shin e A m e ndm e n t
and C o de of E thics for P u b lic O ffi ce rs and un de rsta nd that as a m e m b e r o f a C ity o f M ia m i B e ach B o ard
and/or C o m m itt ee , I m u st com p ly w ith the fina nci al discl osure* requirem e nts o f M ia m i-D a de C o unty o r the
S tate of Fl o rid a (de pending o n the b oa rd or com m itt ee on w hich I se rve) on Ju ly 1s t, fo llow ing the cl o sing
of the calendar year on which I have served. ~ __
,. Ms.Barb~
S w orn to and subscribe d before m e this ~day o f.,µ,-=::~• 2023
Kei
*P le a se visit th e C ity o f M ia m i B e a c h w eb site a t w w w .m ia m ib e a c hfl.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 rd in g the Fina nci a l D iscl osure R equirem ents.
MI AMI B
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 .7 411
RECEIVED
MAR 22023
CITY OF MIAMI BEACH
OFFICE OF TH E 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):
V I am a resident of the City of Miami Beach for six months or po d
cs.. 1909 s33pye.[ tfheu, [. 22ex
//w I-00- ?2n27 □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 _
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 _
"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 documrt and that the facts stated in it
""J2hoot /23
~ • $ Mc+efo
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of physical presence or online notarization,
us?nl day or Mo h _,ao3 orlo Moler
_________ (City of Miami Beach Board/Committee Member).
Produced ID R 1C
Name of Notary, Typed, Printed, or Stamped
1IA MI
C ity of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
wwwmiamibeachfl,goy
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(i) (2)
M ok@
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 Requirem ents.
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~- an $5~~• ~O::y_s i_n ja_i_i __ '_ or both. /
(Wt» 3312
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 require ment does not satisfy the State
requirement.
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F:\C LE R \$A L L\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 RE G FINAL .d o cx
Updated: June 2020
MI AMI BE H
City of Miami Beach
1700 Convention Center Drive
Mi ami Beach, Flor id a 33139
www.miamibeachll.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
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:
Late
L Female
0 Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D I African American/Black
L} Asian or Pacific Islander
luI Caucasian/White
DI Native American/American Indian D I Other -- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
~. ,...Yes
No
El prefer not to answer.
Do you consider yourself Physically Disabled?
Des ti
D I prefer not to answer this question.
Page 6 of 6
F:IC LER \$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 FT 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 d o cx
Updated: June 2020
MIAMl·DADE- EIII 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
Middle ~me/Initial
Mailing Address - Street Number, Street Name, Jr P.0. Box,
loo D ose T Harbor pr.
City, State, Zip
2309
If your hom e addre ss is your m ailing addre ss, and your ome address is exempt from public records 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 uni ci palit 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 [p)uncial. N1or R ec
(M unicipality)
Work telephone Term began on/ended on
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
CA
(t
I hereby swear (or affirm) that the information above is a true and correct statement.
f».s son#re arson sctosio
RECEIVED BY ELECTIONS DEPARTMENT:
L] Hardcopy p
tu«cone elf,CEIVED
MAR 2 2023
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/Initials: Scanned Date/Initials:
138_SP-14 COE 2016
/\/\/,/\/\/ CI T YWI DE (C W) BO AR D & 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: <,
Applicant Name:
Address: /
E-Mail Addre
Work Phone:
Cell Phone: /12
Vehicle Information
Home Phone
Preferred Contact Method:
Tao: Gt
State:
Make:
Color:
Year:
Model: )
Applicant St+nature: e
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 Ina enartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature:
Date Issued: Date Completed:
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