Loading...
Daniel Nagler 12.31.24Ml Scan o Scan o Scan o BOARD AND COMMITTEE CHECKLIST APPOI NTEE: ~ ~ . DATEOFAPPOINTMENT:11//),"]. }1,,3 soRDco»MrrreEe.. ttl\LC #tea y._(H} (onm.~ FOR SCANNER FOR CLERK STAFF } y J Jr, Scan o o Letter of Appoi ntm ent TERM END: (/3/ l TERM LIMIT; [Jl A Scan o o Letter of Reappointment 'ff"\'2" o Aooomtm env e apom tm ent e-m ated to committee Lason on o B o a rd and C om m i tt ee Ap plication (Completed on 2/0 [] o Resum e/curriculum Vitae J ) o Diversity Statistics Reporting (Complet ed on 3/3 03 o Oath RECEIVED 3 2023 MAR 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 ✓C o unty C o de S ection 2 -1 1.1 -- C on fl ic t o f Inte rest and C o de of E thics O rdinance (as am e nd e d thro ugh D ecem b e r 2 0 10 ) ✓A m e nd m e n ts to the C o de o f E thics O rdina nce (S e pte m be r 2 0 0 9 thro u g h July 2 0 12 ) ✓H ig hlig hts o f th e M iam i-D ade C o unty E thics C o de ✓S unshine Law a nd P ublic R e co rds - Fr e q uen t ly A ske d Q ue stio ns ✓M e m or a nd um - S ol ici tation by C ity B oa rd and C o m m itte e M e m be rs C ITY OF MI AMI BE A CH OFFICE OF THE CITY CLERK • O C itywi de P e rm it Ap pl ic at ion (P ar kin g D ep artm en t F orm ) Scan o Scan o o B o ok le t - G uid e to S unshine A m e nd m e n t & C o de o f E thics for P ub lic O fficers and E m p lo ye es o S o urce o f In co m e S tate m e n t o A ckno w le dg m e nt o f F ina ncia l D isclo sure R eq u ire m e nt O B o ard and C om m itt e es Li ai son R espo nsibi litie s O DIVERSITY STATISTICS REPORTING Keep ~QPy in file and O RI GI NAL for Annual Report. 3/1/2oz s e a -tr l D ate em be r P rocessed on: _3_}_3_/_L_3 B y E m p loyee: -------'---L------------- D ate C ity C le r<M S taff In itia ls /2/? s»en»ores I C ity C le rk's O ffi ce S taff Initia ls R eceived on: S canne d on: D ate CONCLUDED & RESIGNATION LETTERS T e rm E xpired Lette r D ate P rocessed In itia ls Scan o R esigna tio n Lett e r D ate P roce ssed In itia ls Scan o R em ova l Lett er d ue to abse nce s D ate processe d In itia ls Scan o F:\CLERIBOARD AND COMMITTIES DATABASEICHECKLIST MASTERIB&C Checklist 2015 MASTER.docx WVe ore committed to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community. City of Miami Beach, !/OO Convention Canter Drive, Miami Bach, Florida 33139 yyw._iaibaachll gov OFFICE OF THE CITY CLERK, Ralaal E. Granado, Chy Clerk Tel: 305.673.741I, Fax 305.673.7254 Emai l:. Ci#yClerk@miam ibooch fl.go v February 23, 2023 Mr. Daniel Nagler 245 Fairw ay Drive Miami Beach, Florida 33141 SUBJECT: Board of Adjustment Dear Mr. Daniel Nagler: Congratulations! You have been reappointed by the City Commission to the above referenced board or committee, 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. Congratulations and good luck. Respe1A Rafael Granado City Clerk cc: Monica Beltran, Parking Director Mich ael Belush , 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 - Am en 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 MI City of Miami Beach, /OO Convention Conler Drive, Mia mi Beach, Florida 33 139 yywy _miaIihgachll.gov OFFICE OF THE CITY CLERK, Rafaol E. Granado, City Clork Tol: 305.673.7411, F. 305.673.7254 Email: CilyClerk@miamiboachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Daniel Nagler RE: Board of Adjustment 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: 12/31/2024. 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. Sworn to and subscribe d before me ++ &rl -/- 'O23 *Please visit the City of Miami Beach website at www.miamibe ach fl.gov und er City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. M IA N\I 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 MAR 3 2023 CITY OF M IAMI BEA CH 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 (/) all that apply): t<Tam a resident of the City of Miami Beach for six months or longer. •• 3IS f caoy D c 1 4] □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). [Q[ ()f [/[][@ j HJ[Pe,g J\(]fS. □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). Q/ ()[ [/][[j- /][S,S, J\(][Tb3 "O w nersh ip Intere st" m e a ns the ow nership of ten p ercen t (10 %) or m o re (includ ing the ow nership o f 10 % or m o re of the outstan d in g ca p ital stock) in a business. "B u siness" m e an s any so le p ro p rietorship, sp o nsorsh ip, corp o ration, lim it ed liability com p any, o r other e n tity o r bu siness a sso ciati on. Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it " 2a/a s,l _ells Signature / Date Io2l M o4\or Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of o physical presence or o online notarization, ha r Mr (([[/ of Miami Beach Board/Committee Member). o ✓Produced ID tification Name of Notary, Typed, Printed, or Stamped MIAN\I 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 BOARD & COM MITTEE FINANCI AL ACKNOWLEDGE MENT STATE MENT 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) 0.el First Name Middle Initial I understand that no later than July1of 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. Qne 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. ..OlAs 9 Date 3/1/oz3 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. P a g e 5 o f6 F:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx U p d ated : Ju ne 20 2 0 1I A\MAI City of Miami Beach l 700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeach/l.gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORT Dal r 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: (G e [] Female 0 Other DI I prefer not to answer. Race/Ethnic Categories: What is your race? D African American/Black L Asian or Pacific Islander [?Caucasian/white Dl Native American/American Indian [l other -Print Race:. ------------- □I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? Jves HG D I prefer not to answer. Do you consider yourself Physically Disabled? Faz Lo t prefer not to answer this question. Page 6 of6 F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx U p d a te d : Ju ne 20 2 0 MIAMl·DADE. EII SOURCE OF INCOME STATEMENT Section 2-11.1() 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 Name/Initial r Mailing Addre City, State, Zip L- 33I4l If your home address is your mailing address, an your home address is exempt from public records pursuant to Fla. Stat. $119.07, read instructions on the following page and check here. D Filing as an Employee (check one) D 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 [Yiunicipal: (Municipality) Board where serving us bent Alternate address (if home address is exempt) Work telephone Term began on/ended on 786-353-0%6 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 Les Bl.¢ , 2b ±a Pt«ze la») is4oar.l 2 S t :'}?t.r ss4 J I I hereby swear (or affirm) that the information above is a true and correct statement. .g2a.@yl- .2/lzsze RECEIVED BY ELECTIONS DEPARTMENT: D Hardcopy RECEIVED [ ] Electronic Copy MAR 3 2023 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 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 ext. 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 lnformati n Dae ·' Ao»leano: h/7o23 Applicant Name: ] l/o • Board/Committee Name: Address Q E-Mail Address: M• wor mos78- Z52 cl Phone·ZS-S4z-029 Home Phone Preferred Contact Method: Vehicle Information Tag: State: Make: Color: Year: Model: a € Applicant Si@nature: e Please provide signed form to the Parking Dy!partm ent located at 1755 Meridian Avenue, 2d floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov e-mail subject: BOARD 8 COMMITTEE PARKING APPLICATION - APPLICANT NAME p, d D ar mna eparmen ec Ion PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: 6 Signature: 6 Date Issued: Date Completed: t ts ·ti '«pg man roar torms cw poarrts «comm tees par+mg um,«toc orm update l . a ,. ,', ~ 1 £ \ , 1 r % C Ft .e sons .'Qi-=i d-.sci@ fi \' /1 !