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Mike Gibaldi 12.31.24MIAMIBE BOARD AND COMMITTEE CHECKLIST APPOINTEE: Mike Gibaldi ----------------- BO ARD/COMM ITT EE: Marine and Waterfront PA DATE OF AP POI NTMENT . 1/10/23 ------- Appointed by: Commissioner Arriola FOR SCANNER Scan o Scan o Scan o Scan o Scan o RECEIVED MAR 10 2023 FOR CLERK STAFF o Letter of Appointment o Letter of Reappointment o Copy of Letter of Appointment/Reappointment 1/10/23 TERM END. 12/31/24 TERM LIMIT: 12/31/29 e-mailed to Committee Liaison on o Board and Committee Application (Completed on _ o R~sum~/Curriculum Vitae o Diversity Statistics Reporting (Completed 6, 3/10/23 o Oath 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) Scan o Scan o 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 REPORTIN copY in file and ORIGINAJ-for ~nual Report. h0[3 sones»X L ) Date Board o ahol3 .kg Processed on. By Employee. /j 0ae ciy 6ij# on ce sarias al1ol23 to " Received on: Scanned on: 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 ore cormiited to providing excellent public service and safety to oll who live, work, and play in our vibrant, tropical, histoic community. Ml M l City of Miami Beach, I/OO C onv on lion Canter Drive, Mia m i Bach, Florida 33 139 ywwy_mi am ibaa chfl.gov OFFICE OF THE CITY CLERK, Ralaal E. Granado, Ciy Clark Tel 305.673.7411, Fox 305.673.7254 Email: CilyClerk@miamibeochfl.gov January 09, 2023 Mr. Mike Gibaldi 4780 Pine Tree Dr., Apt 1 MIAMI BEACH, FL 33140 SUBJECT: Marine and Waterfront Pro tection Authority Congratulations! You have been reappointed by Commissioner Ricky Arriola 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. 7 411. Please read the enclosed materials carefully. Congratulations and good luck. Rega?J/ R~anado City Clerk cc: Monica Beltran, Parking Director Tasha Byars, 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 C ity of Miami Beach, MOO Convention Coner Drive, Miami Boch, Florida 33 139 yNy_yy_miarIiLggchf]_go OFFICE OF THE CITY CLERK, Rofal E. Granado, City Clerk Tel: 305.673.7411, Fax. 305.673.7254 Email: Cit/Cl erk@miamibeach fl.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Mike Gibaldi RE: Marine and Waterfront Protection Authority 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 a b ove-m e ntio n e d boa rd o r committee of the City of Miami Beach to which I have been appointed for a term e nding : 12/31/2024. T o m y colle agu e s a nd to a ll of tho se I represent and se rve , I ple dge fairn e ss, integ rity a nd ci vility, in a ll a ctio ns taken a nd a ll com m unicatio ns m a de b y m e as a public se rv ant. I ha ve b e e n issu e d a co p y o f se ction 2 -1 1.1 of the M ia m i-D a d e C o u nty C o d e (C o nfli ct o f In tere st a nd C o de o f E thics O rdina nce), a s w ell a s Flo rida C o m m issio n o n E thics G uide to the S u nshin e A m e nd m e nt a nd C o de o f E thics fo r P ub lic O ffi cers a nd u nde rstand that as a m e m b er o f a C ity o f M ia m i B each B o ard a nd/or C o m m itt ee , I m ust com p ly w ith the fina ncia l d iscl osure* requ irem e nts o f M ia m i-D a de C o unty or the S tate o f F lorid a (de pen di ng o n the b oard or com mi tt e e on wh ich I serve)or ly 1st, followi ng the cl o si ng of the cale nda r year o n w hich I h ave se rve d. ,.,-· ,/ ,,..,, ------r--~- ~ - S w orn to and subscribe d befo re m e this (ef Ghgrles D'Agostin Deputy Clerk *P le a se visit the C ity o f M ia m i B e a ch w e b site at 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 om m itt ees fo r a dditio nal info rm a tio n rega rding the F ina ncia l D iscl osure R equirem e n ts. MIAMI BE 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 10 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 (/) all that apply): am a resident of the City of Miami Beach for six months or longer. Fore Address. 478o}Ne Tac )y<BL,Ao Kc ) □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. U. 'th t I have read the foregoing document and that the facts stated in it I '-------;,-9-----=:....--=-~--;;,-'4'----- 3_,,,. (02_ Date Mike Gibaldi Printed Name NOTARY (City of Miami Beach Board/Committee Member). U eoaces ft Sworn to (or affirmed) and subscribed before me, by me~□physical presence or online notarization, vsknasr or Moh ,zo23,Mont 3bld uwwwwu, ,sLA ME, / -ii' ~ ~ If£, ' «¢ ', , $ w'Py. % e "? f r coiusso ? 4 EXPIRES 1-3-2027 j 23yg3Y SE,y 0$gores%%% tiii±i} "iijijjiit Signature of Notary Pu lie bomn} Name of Notary, Typed, Printed, or Stamped M IA M I H City of Miami Beach 1700 Convention Center Drive Mi ami Beach , Flor ida 33139 www.miamibeachll.gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORT Gilbaldi Mike 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; 3~e LI Female D Other OJ I prefer not to answer. Race/Ethnic Categories: What is your race? Di African American/Black L_l Asian or Pacific Islan der Lf Caucasian/Wh ite Dl Native American/American Indian LI other-- Print Race: _ DI I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? Dees LL±to D I pre fer not to answer. Do you consider yourself Physically Disabled? Di -- tr D I prefer not to answer this question. Page 6 of 6 F:\C LER \$A LL\RE G\BO A RD A ND C O M M ITT E E A P P LI C A TIO N S FINA L D RA FT S \BO A RD A ND C O M M ITT E E A P P LI C A TIO N RE G FINAL .docx Updated: June 2020 M IA M IBE C 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) Gilbaldi Mike 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. form suant to the Miami-Dade County Code, may subject the person to a fine sin. rth. 3-1o23 lo [)9[9 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. Page 5 of 6 F:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL .docx Updated: June 2020 MIAMI-DADE- EII 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 Last Name 2022 Gilbaldi First Name Mike Middle Name/Initial Mailing Address - Street Number, Street Name, or P.O. Box II L 33 0 City, State, Zip 1\../\ ( is Ac+ F 3531 o 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 Marine and Waterfront Protection Authority Alternate address (if home address is exempt) I Work telephone I Term began on/ended on 12/31/24 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 (95/ NJ 7 e rRn c face JRe. t4 F 33t VE=fcL +oR I hereby swe'a;i;; aff;~nform ion a~e is,,, •~ct st:1: -(# nt. < Signature of Person Disclosing 3- JO-2 3 Date signed RECEIVED BY ELECTIONS DEPARTMENT: □Hardcopy RECEIVED [] Electronic Copy MAR 10 2023 CITY OF MIAMI BEACH OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: _ 138_SP-14 COE 2016 /\/\//\/\/\/ WI DE (CW) BOARD & COMMITTEES City of M ia m i Bea ch , P A R K IN G DEPARTMENT PARKING APPLICATION 1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ex4. 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. B oard Member Info rmation Dote of Applicator: .3)-- 23 Applicant Name: Mike Gibaldi Board/Committee Name: Marine and Waterfront PA E-Mail Address: W7le e l/.o Work Phone: 305- °' -#e Home Phone A Cell Phone: <A Preferred Contact Method: { Vehicle Information Tag: State: Make: Color: •• Applicant Si+nature: e Please provide signed form to tl 'arking Department 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 & COMM ITT EE PARKING AP PLICATION - AP PLICANT NAM E p, ·ki D ar Ina epartment ection PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: Signature: e Date Issued: Date Completed: s : ping man ra torms cw oatds committees par+mglorm,doc orm upaored O, 'U FI-' I« iR " ·e f E I le ,J.1.:· A \~ °,es' ta dllaado , .. s M nstututs quired by iaw »