Gustavo Briand 12.31.241B
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Gustavo Briand
BOARD/COMMITTEE: Hispanic Affairs Committee
Are or APPorweNr._El3
Appointed by. Commissioner Rosen Gonzale
FOR SCANNER
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RECEIVED
MAR 3 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o OQPy P!, letter of Appointment/Reappointment e-mailed
]~y[23
o Board and Committee Application (Completed on - _
o Resume/curriculum Vitae ,Jg J
o Diversity Statistics Reporting (Completed on _3(3 2$
o Oath
rERw to: Al/2£ rEerRw Lu»rr. $2[/%
to Committee 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
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Scan o
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 STATISTICS REPORTI!" Kee COPY in file and ORIGINAL for Annual Report.
Received on: 3 pea 23 Signed by X
Date mittee Member
Processed on: 3l3]13 By Employee: (2A
Date City Clerk's Office Staff Initials
Scanned on: 3/3h3 By Employee: KM
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:ICLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTERIB&C Checklist 2015 MASTER.docx
We care committed to providing excellent public service and safety to ol who iive, work, and play in our vibroani, tropical, historic community.
City of Miami Beach, 1OO Convention Coner Diva, Miami Booch, Florida 33 139 yNywwy_miaIibachfl_gov
OFFICE OF THE CITY CLERK , Rafael E. Granado, Cinly Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: Cit/Clerk@miamibeochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO : M r. G ustavo B riand
RE : Hispanic A ffairs C om m ittee
I do solem nly sw ear or affi rm to bear true faith, loyalty and allegiance to the G overnment 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-m entioned board or com m ittee of the C ity of M iam i B each to w hich I have been appointed for a
term ending: 12/31/2024.
To m y colleagues and to all of those I represent and serve, I pledge fairn ess, integrity and civility, in all
actions taken and all com m unications m ade by m e as a public servant.
I have been issued a copy of section 2-11.1 of the M iam i-D ade C ounty C ode (C onfli ct of Interest and
C ode of Ethics O rdinance), as w ell as Florida Com m ission on Ethics G uide to the S unshine A m endm ent
and C ode of Ethics fo r P ublic O ffi cers and understand that as a m em ber of a C ity of M iam i Beach Board
and/or Com m ittee, I m ust com ply w ith the financial discl osure* requirem ents of M iam i-Dade C ounty or the
State of Florida (depending on the board or com m ittee on w hich I serve) on July 1st, fo llow ing the cl osing
of the calendar year on w hich I have served. ~
~B riand
Sw or t o an d subs cribe d before m e this _l.
*P lease visit the C ity of M iam i B each w ebsite at w w w .m iami beachfl.gov under C ity C lerk/B oard and
Com m ittees for additional info rm ation regarding the Financial D isclosure Requirem ents.
City of Miami Beach, /O) Convention Canter Drive, Miami Beach, Florida 33 139 yyy_miaIniboachll_gov
OFFICE OF THE CITY CLERK, Rafoal E. Granado, Cy Clark
Tel: 305.673.711, Fax: 305.673.7254
Email: Ci#yClark@miamiboochll.gov
January 10, 2023
Mr. Gustavo Briand
947 Lenox Ave. Apt 503
Miami Beach, Florida 33139
SUBJECT: Hispanic Affairs Committee
Congratulations! You have been reappointed by Commissioner Kristen Rosen Gonzalez 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.
cc: Monica Beltran, Parking Director
Leonor Hernandez, 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 endment 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 A\M l
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 MIAM I 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):
I am a resident of the City of Miami Beach for six months or longer.
ton e A«o. 74} yUoY At er S03 JI 1 ' 2312q
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 or oses GU<1Au0 f2LA/D
Business Address [}o]
SUD)O
Se 4n2 Yo o2 DO. - to
□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 -----------------------
[[S[[es,S, J\([]f5
"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.
eclare that I have read the foregoing document and that the facts stated in it
Signature
Gustavo Briand
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of o physical presence or o online notarization,
a.3 aa a Norh_ _,o2ss, ouHvo Baron }
________ (City of Miami Beach Board/Committee Member).
( Orv's nP / Produced ID
Form of I
Personally Know
Name of Notary, Typed, Printed, or Stamped
M IA M IB E H
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 & 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)
Briand
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, 0 days in jail, or both.
Signature
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:ICLER\$ALLIREGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
M\LAI B
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeacht]._gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Briand
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:
L uae
Ll Female
D Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
LJ Asta or Pacific Islander
El Caucasian/White
D Native American/American Indian
Ll oh er - Print Race: ------------- El prefer not to an swer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
[aves
Jo
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
l e
Eh
D I prefer not to answer this question.
Page 6 of 6
F:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DADE- EI 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 Last Name
2022 Briand
First Name
Gustavo
Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
d we e1 So 1tat e»
City, State, Zip
231
If your home address is your mailing address, and your home address is exempt from public records pursuant to Fla. Stat. $119.07, read
instructions on the following page and check here. D
Filing as an Employee (check one)
[] county □Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[] county E] Municipal: Miami Beach
(Municipality)
Board where serving
Hispanic Affairs Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
List below every source of income you received, along with the address and the principal activity of each source. Include your public salary. Place the sources of
income in descending order, with the largest source first. Examples of sources of income include: compensation for services, income from business, gains from
property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. Also, include any source of income received by another
person for your benefit. However, the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet, check here.[]
Name of Source of Income Address Description of the Principal Business Activity
\9o \ <S'S)$T Ip¢-0 02 [Htn sni o 0
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rmation above is a true and correct statement.
Signature of Perso
42>
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
□Hardcopy
J Electronic co6E CEIVED
MAR 3 2023
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/initials:
138_SP-14 COE 2016
...#2 ::.±
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 6r (305) 673-7000 e4. 6200 PARKHIG
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: 3- 3-23
Applicant Name: Gustavo Briand
Board/Committee Name: Hispanic Affairs Committee
Address: 43 L A X 4v~ 4e sc? Mt8 T 32134
E-Mail Address 110 , o CMa\IL· sU O 2 4 D>
work Phone 3o5- ?23Co Home Phone
Cell Phone: +, 8$1- 204 Preferred Contact Method:
Vehicle Information DN H IO
Ta g: 5we ( q, Color: 0He O
State: >ope Year: 2olo
Make: lloL Model: Mzr
Applicant Sianature: ef , lat»
Please provide signed fl to tfe Parking Department located at 1755 Meridian Avenue, 2d floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.go
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
p, ·kd D S ar mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signat ure: e
Date Issued: Date Completed:
'«pmng man rar toms cw atds commtees parmgtotm.doc
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