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Laura Taylor 12.31.24MU A I B EA C H Scan o Scan o Scan o BOARD AND COMMITTEE CHECKLIST AP o r ee.. _Lowry- T6(\n DATE OF APPowreNr.Ml1]23 BOARD/COMMITTEE: N ~ nY\ !':1:~ ~ Y\VKJ Appointed by: U tv}= WW\ ·TY\,,i.g (lc9V\.. l~ Gww. I0wn FOR SCANNER FOR cLERK sTAFr [ ] y E _] Scan o o Let ter of Ap poi ntme nt TERM END: l2 3l 2l TERM LIMIT: I2I3] Scan o o Letter of Reappointm ent o C.,:~Y~ i.'s tter of Appointm ent/Reappointment e,•mailet to Committee Liaison on o Board and Committe e Application (Completed on.t']1_[ y o Resume/curriculum vitae E 3] o Di versi ty St atistics Repor ting (comp let ed on 2 ()}3) o Oath REC EIV ED MAR 1 0 2023 CIT Y O F MI AM I BEACH OF FI CE OF THE CITY CLERK IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK ✓City Code Ordinance Section applicable to the agency, board or committee t City Code Section s 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 ✓County Code Section 2-11.1 - Con flict of Interest and Code of Ethics Ordinance (as am ended through December 2010) ✓Amendm ents to the Code of Ethics Ordinance (September 2009 through July 2012) ✓Highlights of the M iami-Dade County Ethics Code ✓Sunshine Law and Public Records - Frequently Asked Questions ✓Mem oran d um - Solici tation by City Board and Comm ittee Members o Citywide Perm it Application (Parking Departm ent Form) o Booklet - Guide to Sunshine Am endment & Code of Ethics for Public Officers and Employees o Source of Income Statement o Acknowledgm ent of Financial Disclosure Requirem ent o Board and Committees Liaison Responsibilities O DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report. 2/10/23 sr.»X Y l6l4 33fr s Processed on . er by Em ployee. ' I O Datf "\ 3 City Cieri~ ~ff~e Staff Initials 3 ,_[- By Emp loyee: ['b Date City Clerk's Office Staff Initials Scan o Scan o Received on: Scanned on: CONCLUDED & RESIGNATION LETTERS Term Expired Letter Date Processed Initials Scan o Resignation Letter Date Processed Initials Scan o Rem oval Letter due to absences Date processed Initials Scan o F:IC LE R IB O A R D A N D C O M M ITT IE S DA TA BA SEIC H EC K LI ST M A STER IB&C Checklist 2015 M ASTER.docx We are committed to providing excellent public service and safety to all who le, work, ond play in our vibrant, tropical, historic community C it y o f M i a m i B e a ch , 1ZOO Convention C onler Drivo, Miami Boach, Florida 33139 yyw y_mi amih a chll.go OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: Cit/Clerk@miamibeachll.gov February 06, 2023 Ms. Laura Taylor 925 Fairway Drive Miami Beach, FL 33141 RE: Normandy Shores Local Government Neighborhood Improvement Dear Ms. Laura Taylor: Congratulations! You have been appointed by the City Commission to the agency, board or committee named above 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 as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations again and good luck. Regards, J,A ,anado City Clerk cc: Monica Beltran, Parking Director Tameka Otto Stewart, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements 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 City Wide Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees MlAMIBEA CH City of Miami Beach, I/OO Convenlion Conler Diivo, Miami Beach, Florida 33139 yyyy_miaIihgachfl.go OFFICE OF THE CITY CIFRK, Rolael E. Granado, Cy Clork Tol: 305.673.7411, Fox: 305.673.7254 Email: CilyClerk@mlartbeach ll.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Laura Taylor RE: Normandy Shores Local Government Neighborhood Improvement 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. Ms. Laura Tayo// sworn to and subscribed before me us LJf_ day of1E- 023 please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. MI/\MI BEA CH 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 ap pl y): t lam a resident of the City of Mi a mi Beach for six months or longer. Hone Aaar._ 1 2 5 far9 Do_, Mar i Kach,fl 35 l 7 [] 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 mor e 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 document and that the facts stated in it are true. ~ ~ -p 1 2 ff HE»Ur,) '2,22_3 Signature Date al@qler Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of physical presence or o online notarization, ________ (City of Miami Beach Board/Committee Member). Produced ID _ Form of Identification Personally Known ~ • ENRIQUE Z. - ur+.. I},, ±4$jjjj@jj4 +H 257522 EXPIRES: August 20, 2028 (NOT ARY SEAL) MIA\I BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachll,gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORT Last Name First Name Middle Initial The following information is voluntary and has no bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. Gender: Llae [l Female loher 0 I prefer not to answer. Race/Ethnic Categories: What is your race? DI African Am erican/Black D Asian or Pacific Islander El Caucasian/white 0 Native American/American Indian [J Other - Print Race. 0 I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? LJves h D I prefer not to answer. Do you consider yourself Physically Disabled? Ege» - No t prefer not to answer this question. Page 6of 6 F:ICLERl$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 ML A\I BEA CH City of Miami Beach 1700 Convention Center Drive Mi ami Beach, Florida 33139 www.m iamibeachll.gov OFFICE OF THE CITY CLERK Email: BC@ miamibeachfl.gov Telephone: 305. 673 .7 41 1 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) D. Last Name First Name Middle Initial I understand that no later than July1, of each Vear all memb ers of Boards and Comm ittees 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 m ust be fil ed 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 Statemen t;" 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 t $500, 60 days in jail, or both. [Er«44 /3,2023 Date 7 1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. S112.3145(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:CLERISALLIREGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx U pdated: June 2020 M I A M l ·DAD E- EDI SOURCE OF INCOME STATEMENT Section 2-11.1(i) of the County Ethics Code requires that certain employees and public officials file a finan cial disclosure Statement on a yearly basis by July 1st of every year. Disclosure for Tax Year Ending I Last Name First Name Middle Name/Initial 2022 [yox Lu k4 D. Mailing Address -- Street Number, Street Name, or P.0. Box 925 FeuY re. City, State, Zip /(14Mt A H PL %/ 41 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.L] Filing as an Employee (check one) E] county D Public Health Trust [] M un i cipal : (Municipality) Department Position or Title Employee ID Number Work address I Work telephone Employment began on/ended on Flllng as a Board Member (check one) [] coun ty [K Municipal: 0it ·/ Haid «k (Municipality) Board where serving eek-oaad M orr «o Skoas locol vu /prove-ewL Alternate address (if home address is exempt) rork telephone I Term began on/ended on 73,2 -60o - 2224 Fe zczs-rz/sly 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 hero.[] Name of Source of Income Address Description of the Principal Business Activity Cl-foria 'nsyhhe a/ T2 el »lo 2qq s. Hollis/ /ve . Pasadle a, C qu2s Zoo«ic le~ear + lg#u€Apo_ oc lg lva-el Un , I hereby swear (or affirm) that the information above Is a true and correct statement. Sionaire or Person icioi@ ales" c/ah3 Date signed RECEIVED BY ELECTIONS DEPARTMENT: D Hardcopy RECEIVED L] Electronic Copy MAR 10 2023 CI TY OF MIAM I BE A CH OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/initials:- 13 8 _8P -14 C O E 20 16 \l/\/\\[BEACH awDE (cw oA & co»outs g. g cir si ii«ii ii. ioi@nio orwriwir PARKING APPLICATION EM./I 1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 6737000 e1. 6200 PARKING 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 replacem ent fee. Board Member Information Date of Application: 2/13/23 Applicant Name: (Aue+ )4Yuk Board/Committee Name: //a, 0hoar a 6ret lukbo kook/ hop ovuul Address: 42 Fore0Y DE. ; l./ MM $€CH F 3314 E-Mail Address: I @ NA_. 0M LAU€A BDIDor Work Phone: Home Phone Cell Phone: 132-0o 2221 Preferred Contact Method: Vehicle Information Tag: },Swx?q Color: bolt- State: rL Year: 21$ Make: bx0 s Model: Px3so Applicant Sianature: es 97 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 lo: ParkingReception@miamibeachfl.gov e-mail subject: BOARD 8 COMMITTEE PARKING APPLICATION - APPLICANT NAME P k' D 'ark.Ina epar%men ec'ion PERMIT SYSTEM GARAGE ACCESS · Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: e Signature: 6 Date Issued: Dote Completed: + S ti