Jonathan Welsh 12.31.24MI AMIB
BOARD AND COM MITTEE CHECKLIST
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BOARD/coMMIrrEEe. [/oz f la[S
FOR SCANNER
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FOR CLERK STAFF
DATE OF APPOINTMENT. 2[2y_[13
Appointed by: fr(¾ h (1 Mi/,IYL
C- Comm«o
reno No. n2 /31/24 reow uwn. 12/) h4
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o Letter of Appointment
o Letter of Reappointment " £P(]/'{4 " Aoononveavomnoent e-mates
o Board and Committee Application (Completed 6, 2[ ]2l
o Resume/curriculum Vitae } J
o Diversity Statistics Reporting (Completed on 3 l 25
o Oath
to Committee Liaison on
RECEIVED
MAR 16 2023
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 MIAM I BEACH
OFFICE OF THE CITY CLERK
o Citywide Permit Application (Parking Department Form)
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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
Received on:
Scanned on:
o Board and Committees Liaison Responsibilities
O DIVERSITY STATISTICS REPORT, Keep COPY in file and ORIGINAL for Annual Report
2]2//23 seneaoX +.o /.
Date Board or Committee Member
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Date City Clerk's Office Staff Initials
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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
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F:\CLER\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are committed to providing excellent public service and safety to oll who live, work, and ploy in our vibrant, tropical, historic community.
MI MI BE
City of Miami Beach, I0O Convention Cantor Drive, Miami Boach, Horida 33 139 yxwy_miaIibachllgo
OFFICE OF THE CITY CIERK, Ralal E. Granado, Ciy Clerk
Tel: 305.673.7411, Fox: 305.673.7254
Email: City Clerk@miamiboochfl.gov
February 23, 2023
Mr. Jonathan Welsh
1022 Euclid Avenue
Miami Beach, Florida 33139
SUBJECT: Human Rights Committee
Dear Mr. Jonathan Welsh:
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,
cc: Monica Beltran, Parking Director
Lidyce Grana, 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 i t y of Miami Beach, MOO Convonlion Conlar Drive, Miami Boo ch, Florida 33 139 yyywy_miamibcachfl_go
OFFKCE OF THE CITY CI ERK, Rofaol E. Granado, City Cler k
Tel: 305.673.7411, Fox. 305.673.7254
Email: City Cl erk@miam ibeoch fl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Jonathan Welsh
RE: Human Rights Committee
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United
S tates, the S tate of Florida, and the City of Miami Beach, and to perform all the duties of a member of the
ab o ve-m e ntio n e d boa rd or co m m ittee o f the C ity o f M ia m i B e a ch to w hich I h a ve b e e n app o inte d for a
term e nding : 12/31/2024.
T o m y colle agu e s and to all o f tho se I represe n t and serve , I p le dge fairn e ss, inte grity a nd civility, in all
actio ns taken a nd a ll com m unicatio ns m a de by m e a s a p ub lic se rv ant.
I h a ve bee n issue d a co p y o f se cti on 2-1 1.1 of the M ia m i-D a d e C o u nty C o d e (C o nflict o f Intere st a n d
C o de o f E thics O rdina nce), a s w ell a s F lo rid a C o m m issio n o n E thics G u id e to the S u nshin e A m e nd m e nt
a n d C o de of E thics fo r P ub lic O ffice rs and un de rsta nd that as a m e m b er o f a C ity of M ia m i B ea ch B o a rd
and/or C o m m itt ee, I m ust co m p ly w ith the fina nci a l discl osure* requirem e nts o f M ia m i-D ade C o unty or the
S tate o f F lo rid a (de pendin g on the b oa rd o r com m itt ee on w hich I serve) on July 1s t, fo llow ing the cl o sin g
o f the cale nda r yea r o n w hich I have serv ed.
swom t o an d sub s cr ibe d before m e [of\ ash oa
*P le a se visit the C ity of M ia m i B e a ch w eb site a t w w w .m ia m ib e a c hfl.g o v un d e r C ity C le rk/B o a rd an d
C o m m itt ees fo r a dditio na l info rm a tio n regarding the F ina ncia l D iscl osure R equirem e n ts.
MIAMI H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeacllfl.gov
Telephone: 305 .673 7411
RECEIVED
MAR 16 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):
k I am a resident of the City of Miami Beach for six months or longer.
ore ares [o a2 £old Are hf 12
□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 .
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it "2?ht 3no.ss
Sign ur Date ' "en, vtl Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or□online notarization,
he lo hay r _Norco_ _,oz2 ».)0ton Lo/rh
.(City of Miami Beach Board/Committee Member).
/ eaoceso bnvt Lor C
Form of Identification
Personal Kn9% /]
' '
Name of Notary, Typed, Printed, or Stamped
MIAMIB
City of Miami Beach
1700 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
v 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:
5fate
Ll Female
0 Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D I African American/Black
LJ Asta or Pacific Islander
caucastan/white
0 Native American/American Indian
El other - Print Race: ------------- □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
LTves
3Ro
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
aves
W±4
D I prefer not to answer this question.
Page 6 of 6
F:\C LE R \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A F T S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N R E G FIN A L.do cx
Updated: June 2020
M IA M I H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach fl.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)
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 ~:;:;I, or both. J ~ ( {o r;) o' ;) .J
atur Date
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:\CLER\$ALL\REG\BOARD AND COMMITT EE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMI-DAD E-
EMEI 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
2022
First Name Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
c.- - A 4tt2
City, State, Zip
[\ '-k •3513
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.Ll
Filing as an Employee (check one)
[] county ] Public Health Trust [] Municipal:
(Mun icipality)
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~ iwonteta:
(Municipality)
Board where serving
Dv 0 r mwwwel
Alternate address (if home address is exempt) Work telephone Term began on/ended on
12/31h
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
Core Resos te ConwoH-( 5o satrue: w (+oa(/ co€
ea«tk Ceke6 Tac f2a.', (-. 35/3
I hereby swear (or affirm) that the information above is a true and correct statement.
~--·· W..-...__- sat.....
3-2923
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
D Hardcopy
teaiio EE=IVED
MAR 16 2023
TY OF MIAMI BEACH
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/initials:
138_SP-14 COE 2016
/420-43
NATHAN JOSEPH
LSH
22 EUCLID AVE APT 12
AMI BEACH, FL 33139-4
·11-27-1980 SEX. M
2017 +at5-1
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Operation ot a motor vehicle tor»titute crvsent to ary sobriety test requited by iww