Carolina Jones 12.31.23MIAMIBE
BOARD AND COMMITTEE CHECKLIST
APPOINTEE. Carolina Jones DATE OF APPOINTMENT. 2/21/23 -------
BOARD/COMMITTEE. Paris&d"Gee Appointed by. @Gebo
FOR SCANNER
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RECEIVED
272023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed
2/21/23
row vo. _(/1l3 reRow tun«ll h3
to Committee Liaison on
o Board and Committee Application (Completed on _3_13_1_2_3 _
o R~sum~/Curriculum Vitae
o Diversity statistics Reporting (Completed on ???
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 CI OF MIAMI BEACH},
OFFICE OF T#E CIT CLER
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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 REPORTIN Keep1OPY in file and ORIGINAL for Annual Report.
Received on: _3_13_1_2_3 Signed by X. __ -+_,_,~c....:;_ _ _,__-:=_-=--------------
Date oard or Committee Member
Processed on: 3/3/23 By Employee: K
Date City Clerl(jJ\e Staff Initials
Scanned on: 3/3/23 By Employee:
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 re commiited to providing excellent public service and sale!y to al who live, work, and ploy in our vibrani, topical, historic community.
MI MIBE
City of Miami Beach, 1ZOO Convonlion Canter Drive, Miami Beach, Horida 33 139 yywy_miamibaachll_gov
OFFICE OF THE CITY CLERK, Raf0al E. Granado, Cy Clerk
Tel: 305.673.7411, Fox 305.673.7254
Email:. Ci#yClerk@miamiboochfl.gov
February 21, 2023
Ms. Carolina Jones
1101 Stillwater Drive
Miami Beach, Florida 33141
SUBJECT; Parks and Recreational Facilities Board
Congratulations! You have been reappointed by Mayor Dan Gelber to the above referenced, board or
committee named above, for a term ending: 12/31/2023.
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
Cynthia Casanova, 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, I/OO Convention Conler Drive, Miami Beach, Honda 33 139 yyyy_miaIribaach[l_go
OFFICE OF THE CITY CLERK, Rofaol E. Gran ado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: CiyClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M s. C a ro lina Jo ne s
R E : P a rks a nd R ecreational Facilities Board
I do so le m n ly sw ea r o r affi rm to b e a r true faith, loy alty and allegiance to the Government of the United
S tates, the S tate of Florid a , a nd 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: 12/31/2023.
T o m y 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
C o de o f E thics O rdina nce), a s w ell a s F lo rid a C o mmission on Ethics Guide to the Sunshine Amendment
and C o de o f E thics for P ub lic O ffi ce rs and und erstand that as a member of a City of Miami Beach Board
a nd/or C o m m itt ee , I m ust com ply w ith the financial disclosure* requirements of Miami-Dade County or the
S tate of F lo rid a (de pe nding o n the b oard or co m m itt e e on w hich I serve) o n July 1s t, fo llow ing the cl o sing
of the cale nda r yea r o n w hich I have se rv ed.
M s. C a ro lina Jo ne s
S w orn to and subs cr ibe d b ef o re m e thi s }_ d ay orly4 2 023
±PA t
Keila Mena Caceres
Deputy Clerk
*P le a se visit the C ity o f M ia m i B e a ch w e b site a t 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 o m m itt ee s fo r a dditio na l info rm atio n regarding the Fina ncia l D iscl osure R equirem e n ts.
M IA M I H
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
AR 27 2023
CITY OF MIAM 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):
IZI I am a resident of the City of Miami Beach for six months or longer.
Home Address 1101 Stillwater Drive Miami Beach FL 33141
□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 penal(ie$ of/perjury, I declare that l have read the foregoing document and that the facts stated in it
are true. ad \ l 3/3/23
-------------- Signature Date
Carolina Jones
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of o physical presence or online notarization,
+2 day a Mu/ .zo3 » (r nc Juhl!
_________ (City of Miami Beach Board/Committee Member).
(t ovuf ✓Produced ID
u..37 Persona~-
Signature of Notary Public
Name of Notary, Typed, Printed, or Stamped
M IA M I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www_miamibeach!],_gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfL.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Jones Carolina
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:
LJ M a e
Ll Female
0 Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
LAstan or Pacific Islander
El Caucasian/white
0 Native American/American Indian
0 Other - Print Race: ------------- □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
(l Yves
Jo
El prefer not to answer.
Do you consider yourself Physically Disabled?
Ives
Lo
Llt prefer not to answer this question.
Page 6 of 6
F:\C LE R \$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 FIN A L DR A FT S \BO A RD A ND CO M M ITT E E A P P LI C A TIO N RE G FINAL .docx
Updated: June 2020
MIAMI BE 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: 305.673.7 411
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)
Jones Carolina
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~hann ~00, 60 days in jail, or both.
[l-\: 3/3/23
Signature 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:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DADE- EII 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 I Last Name First Name Middle Name/Initial
2022 Jones Carolina I
Mailing Address - Street Number, Street Name, or P.O. Box
1101 Stillwater Drive
City, State, Zip
Miami Beach FL 33141
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
Parks & Rec
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
(305) 772-3330 2/21/123
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
Wencor Peachtree City AT Aerospace Sales & Marketing
I hereby swear (or affirm) that the information above is a true and correct statement. :±
Signature of Person Disclosing
3 /3/23
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
are#ECEIVED
[] Electronic Copy
MAR 2 7 2023
CITY OF MIAIVII BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/Initials: Scanned Date/initials:
138_SP-14 COE 2016
/\/\//\/\/\/ CI7 WI DE (CW) BOARD & COMMITTEES
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 e1. 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.
Board Member Information
Date of Application: 313123
Applicant Name: Carolina Jones
Board/Committee Name: Parks & Rec
Address: 4101 Stillwater Drive Miami Beach FL 33141
E-Mail Address' carolina@twincribz.com
Work Phone: Home Phone
Cell Phone: 305 772 3330 Preferred Contact Method:
Vehicle Information
Tag: RMB58 Color: Grey
State: FL Year: 2017
Make: Audi Model: Q7
Applicant Sianature: f "1
Please provide signed form to the Parking 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 & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P ·ki D ar Ina epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature:
Date Issued: Date Completed:
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