Laura Weinstein-Berman 12.31.24lAMl H \
BOARD AND COMMITTEE CH E CK LI ST
S can o
Scan o
Scan o
APPOINTEE: 0A WIT1 ) -Bcw/) DATE OF APPOINTMENT: 02/07)2023
BOARD/COMMITTEE: '1\~l. ~ Appointed by: M D'P l-- u+) c:, JY\ IYU@ V}1
FOR SCANNER FOR cLERKsrAFr ] )3J ) J
scan o o Letter of Appointment TERM END. ) GlQl TERMLIMrr. , l '2{¢
S ca n o o Letter of Reappointment -f,' ot Aooimenveaoooi«m et e-mpied to committee uason on
o Board and Committee Application (Completed on I /'vi ) 1,, J
o Resume/Curriculum Vitae l I
o Diversity statistics Reporting (completed on _ ]23_)
o Oath
RECEIVED
4R 13 2023
crv or 4.9Eg2$2g
OFFICE OF THE IT
Scan o
S can O
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
t Memorandum - Solicitation by City Board and Committee Members
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 DIVE RSITY STATISTICS REPORTI
Ob]1/2 s ton e d by _/ft4,lq68£2
bate
Processed on: _3_.a..}_16___,_/_l_~=---- By Employee: _
Date City Clerk's Office Staff Initials
?hhl3 sorer k]
G e cycle s sure
Received on:
Scanned on:
CO NC L UD E D & RESIG NATIO N LETTER S
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
I
City of Miami Beach, 1/OO Convention Canter Drive, Miami Boch, Florida 33 139 yyy._miaribaachfla
OFFICE OF THE CITY CLERK, Rafaal E. Granado, Cly Clerk
Tel: 305.673.7411, Fox: 305.673.7254
Email: CityClerk@miamiboochfl.gov
February 03, 2023
Ms. Laura Weinstein-Berman
6103 Aqua Ave Apt 602
Miami Beach, FL 33141
SUBJECT: Historic Preservation Board
Dear Ms. Laura Weinstein-Berman:
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.
Respectfully,
Rakinado
City Clerk
cc: Monica Beltran, Parking Director
Deborah Tackett, City Liaison
ATT ACHMENTS:
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 B
City of Miami Beach, 1/OO Convention Conler Drive, Miami Boach, Florida 33 139 ywy_miaIribaachfl_go
OFFICE OF THE CITY CLERK, Rofool E. Granado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: CiyClerk@miamibeochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Laura Weinstein-Berman
RE: Historic Preservation Board
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 Weinstein-Berman
Sworn to and subscribed before me +u [h I" 1'4,'2023
*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.
1I \I E H
City o f Miami Be a ch
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: B C @ mi am i b eachfl.gov
Telephone: 305.673.7411
RE C EI VE D
MAR 13 2023
CITY O F M IA M I 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):
✓I am a resident of the City of Miami Beach for six months or longer.
Home A«res_I tu#_ii g0- M L/Ml BM44, {1 33/4l
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 ot Business u6SIM-.
(13 K u € a02 MI MI RH # 33E l I 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).
[]qr9 t[ [J S [[]@ S S
[[J g [m e s,s, ({]fo S
"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 lties of rju
are tr
eclare that I have read the foregoing document and that the facts stated in it
03/7/2223
Sig Date 7
HZ4A Le7RTE7N U - BB/am!
Printed Name
N O TA R Y
Sworn to (or affirmed) and subscribed before me, b eans of o physical presence or o online notarization,
7-. , l, 03. '. this _/-day of [! {(UC() 2ozd y a 2,
(City of Miami Beach Board/Committee Member).
Produced ID
/'.l Form of Identification
s
h L el 7
Name of Notary, Typed, Printed, or Stamped
re4,, AN M WALTZ/KQJT AR{ SEAL) %pi; oery Pol e · sad'rhd 393$/ commission. + + 19984s 25$% y comm. Expires Jan 12, 2026
Boded through National Notary Assn.
I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachll.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Rve A
Last Name First Name Middle Initial
The following information is voluntary and has no bearing on your consideration for appointment. It is being
asked to comply with City diversity reporting requirements.
Gender:
LJae
LZl remale
Ll oner
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
[]Af rican Am erican /Bla ck
EI A si an or Pacific Islander
LI Caucasian/white
L}N ativ e American/American Indi an D Other- Print R ace: _
D I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Dpee Lt No
Ll prefer not to answer.
Do you consider yourself Physically Disabled?
De,
LA No
D I prefer not to answer this question.
Page6 of6
FACLERI$ALL REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Upd at ed : June 2020
I
11A40\41B
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
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT
Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Mliamni-
Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
WO MEN)- 002%4nwd A
Last Name First Name Middle Initial
l understand that no later than duly_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 S tatem ent;" or
2. A "Statement of Financial Interests (Form 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, 1ore than $5)0, 60 days in jail, or both.
Date I
' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
pursuant to F.S. $112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County
Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their
Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure
requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office
of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State
requirement.
Page 5 of6
F:ACLERI$ALL\REG\BOARD AND COMMIT TEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
L
MIAMI
El S O U R C E OF IN C O M E S TATE ME N T
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 I Last Name First Name Middle Name/initial
2o022 WEN610-B2im) U2A A-
Mailing Address -- Street Number, Street Name, or P.0. Box
(0403 Fon ft e2
City, State, Zip
MI K l Pt, 3 31 4 1
If your home address is your malling 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.[]
Filing as an Employee (check one)
[] co un t y I Public Health Trust [] Municipal:
(M unicipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Wember (check one)
[] county L]nunicitat M L/1) £7H
(M unicipal ity)
Board where serving
Et P00mN
Alternate address (if home address is exemp t) p" !Term began on/ended on
S-o 0le»-81 4 % 02/2022- 0 2 /2 zs
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 partn er need not be disclosed. if con tinued on a separ ate sheet, check here.[]
Name of Source of Income Address Description of the Principal Business Activity
w! sum, I. o AH € eo2- 0 Te
MHt 8#t, P 3314/ Data Pe
Po23,u] creetos A It ~ #
I hereby swear (or affirm) that the information above is a true and correct statement. ~el~die
3/7/27
Date signed
RECEIVED BY E
[] Hardcopy
J ectromie gm9Pf 13 2023
CITY OF MIAiVli BEACH
O FFI C E OF THE CI TY CL ER K
OFFICE USE ONLY Accep te d: Y / N Deficiency.-.. Processed Date/initials:...------.. Scanned Date/initials:
138_SP-14 COE 2016
/\//\/\/\/ CITwI DE (CW) BOARD & COM MITTEES
cy st Miami sea+, ARKING DEPARTMENT PARKING PP[[CAT[ON
1755 Meridion Avenue, Suite 200/Mi0mi Beach, FL 33139/Ph. (305) 673-7505 or (305) 673.7000 1. 6200
A cilywide (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 [GZ) 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 $10.00 replacement fee.
Board Member information
Date of Application: v3/07/202
Applicant Name: Uk)2A WM9ST- €u m)
Board/Committee Name: pl(1112 PP0&4\n wl
Address: (»[02 /ut e 6O2, MI#M pd4,Ru 331
E-Mail Address: UAb#Au\sUM.ow
Work Phone: Home Phone
Cell Phone: 30-uou-84K Preferred Contact Method: Pt-
f'ahjcle lnkotrrtgtiot
Tag: LVVIg Color:
State: Year:
Make: vp\ Model:
Applicant St+nature:
Please provide signe torm t the Pafking Department located at 1755 Meridian Avenue, 2 floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibegchfl.gov
e-mail subiect: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
Parking Department bieciion
PERMIT SYSTM GARAGE ACCESS
Expiration Date: ID Cord Serial #:
Issued By Print Name: Print Name:
Signature; ei Signature:
Date Issued: Date Completed:
or6$ cw rs cremit pat0sgrm.+toc
I