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Randi Freedman 12.31.24Ml MIBE BOARD AND COMMITTEE CHECKLIST APPOINTEE:. Randi Freedman DATE OF APPOINTMENT:. 1[21]22- soARD/co»Murree: Production Indus Counol Arrott«ea by.._[\oq(a @blbn FOR SCANNER Scan o Scan o Scan o Scan o Scan 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 CITY OF MIAMI BEACH ✓Memorandum - Solicitation by City Board and Committee Members OFFICE OF THE CITY CLERK RECEIVED 4AR 22 7023 FOR CLERK STAFF o Letter of Appointment o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed 2]13p2 ) [ o Board and Committee Application (Completed on [ t') o Resume/carricutum Vitae ,Jf,3 o Diversity Statistics Reporting (Completed on 3, ')~ o Oath rerRM No: pl31/24 rR uwmr.t2la /% to Committee Liaison on Scan o 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 Received on: Scanned on: O Board and Committees Liaison Responsibilities O DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report. l)9/)2 sea», X_ Ra.acoda.. } Datte Boar13r J~mmittee Member Processed on:_3, 1lul yEmoree: T" / Da,te City,;ler~'~ffice Staff Initials 3.2l,2 B»Emo»eer DH! 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:\CLERIBOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx We are commiited ts providing excellent public service and safety to ol who live, work, and play in our vibrant, topical, historic community. 7 City of Miami Beach, 1/O) Convonlion Canter Drive, Miami Bsach, Florida 33 139 yyywy_miamnibaachllgo OFFICE OF THE CITY CIERK, Raloal E. Gran ado, Ciy Clerk Tel: 305.673.7AI, Fox 305.673.7254 Email: Cit/Clerk@miamibeochll.gov December 27, 2022 Ms. Randi Freedman 860 E Coco Plum Cir PLANTATION, FL 33324 SUBJECT: Production Industry Council Congratulations! You have been reappointed by Mayor Dan Gelber 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 305.673.7411. Please read the enclosed materials carefully. Congratulations and good luck. cc: Monica Beltran, Parking Director Veronica Hennig, 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 - 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 t I City of Miami Beach, 1/OO Convention Canter Drive, Miami Boch, Florida 33 139 yyyewy_miariboachfl_go OFFKCE OF THE CITY CLERK, Rfaal E. Granado, Ciiy Clerk Tel: 305.673.7411, Fax. 305.673.7254 Email: CiyClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Randi Freedman RE: Production Industry Council I d o so le m n ly sw ea r or a ffi rm to b e a r 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 b o a rd o r com m itt e e o f the C ity o f M ia m i B e a ch to w hich I have been appointed for a term e nding: 12/31/2024. T o m y co lle agu e s a nd to a ll of tho se I rep re se nt and se rve , I p le dg e fairn e ss, inte grity and civility, in a ll a ctio ns taken a nd a ll com m unicatio ns m ade by m e as a p ublic serv an t. I h a ve b e e n issue d a cop y of se cti on 2-1 1 .1 o f the M ia m i-D a d e C o u nty C o d e (C o nfl ict o f In terest a n d C o de of E thics O rdin a nce), as w ell a s Flo rid a C o m m issio n on E thics G u id e to the S un shine A m e ndm e nt and C o de o f E thics fo r P ub lic O ffi cers and u nd e rstand tha t as a m e m b e r of a C ity o f M ia m i B ea ch B o a rd and/or C o m m itt ee, I m ust com p ly w ith the fina ncia l d isclosure* requirements of Miami-Dade County or the S tate o f F lo rida (de pe nd ing on the b oa rd or co m m itt ee on w hich I serve) on Ju ly 1st, fo llow ing the cl o sin g of the cale nd ar yea r on w hich I h ave serv ed . .2- ______ _. . and i F ree dm a n S w orn to an d sub s cribe d b ef or e m e thi s Q d ay «('y0M, 2 023 AC -chartes D'Agostin of Deputy Clerk *P le a se visit th e C ity o f M ia m i B e a ch w eb site at w w w .m ia m ib e a c hfl.g o v u n d e r C ity C le rk/B o a rd an d C om m ittees fo r add itio nal info rm a tio n rega rding the F ina ncia l D iscl o sure R equirem e n ts. Ml Ml City of Miami Beach 1 700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Em ail: BC@m iamibeachfl.gov Telephone: 305.673 .7 411 RECEIVED MAR 22 2a23 CITY OF Ml inc± 6, #/,%%/EAct - ·ITY CLERR 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 Address _ □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 ------------------------ [J S 1Po ss []reS S □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). ---=#@a a..• ta.W ee f t )) "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. rj ·,I declare that I have read the foregoing document and that the facts stated in it - 3/1/23 Date Printed Name NOTARY »2 y [\orh (City of Miami Beach Board/Committee Member). b, ybdJ uwfC Sworn to (or affirmed) and subscribed before me, by means of□physical presence or□online notarization, .o2• {anh felon ,+wwwwww s%!'qr A MEji{""o, s"}?"!!4. "e, 3@Y Pi;:.. $ 'o" "VO: I~ •• ~ .• . . i co»MissloN ? i EXPIRES 1-3-2027 } }.oyrARY spa3 32or «%%?? :++ii5±5:;gt% NUMEEq;w" tijjjjjjj~ii • Produced ID ntification Name of Notary, Typed, Printed, or Stamped 1\1\IA N\I HI I City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachhl.gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORT Freedman Randi 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: M ale [XO Female Lother OJ I prefer not to answer. Race/Ethnic Categories: What is your race? LO Amnican American/Black D Asian or Pacific Islander D Caucasian/White OJ Native American/American Indian D Other- Print Race: _ [ prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? LJves L.Jo DH 1 prefer not to answer. Do you consider yourself Physically Disabled? .lves 50o L l1prefer not to answer this question. Page 6 of 6 F:\CLER\$ALLIREG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 1l/A M/ City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Em ail: BC @m iamibeachfl._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) Freedman Randi 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 than $500, 60 days in jail, or both. Fwd Feedwwav 1-24-23 Signature Date 1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuantto 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:\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 FINA L D RA FTS \BO A RD A ND CO M M ITT E E A P P LI C A TIO N REG FINAL.docx U p da te d : Ju ne 20 2 0 MIAMl·DADE- EMI SOURCE OF INCOME STATEMENT S ection 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 2022 Middle Name/Initial If your home address is your mailing fl ess, and your home addres is exempt from public records pursuant to Fla. Stat. $119.07, read instru ctions on the following page and check here. D Fili ng as an Em ployee (check one) [] county □Public Health Trust [] Municipal: (Municipality) Departm ent Position or Titl e Employee ID Number W ork address I Work telephone Employment began on/ended on Fili ng as a Board M em ber (check one) [] county [] Municipal: City of Miami Beach (Municipality) here servin g \ r CT Altern ate address (if hom e address is exem pt) - 1Q 0 - Li st below every source of incom e you received, along w ith the address and the principal activity of each source. Include your public salary. Place the sources of incom e in descending order, w ith the largest source first. Examples of sources of income include: compensation for services, income from business, gains from pro pert y 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.□ Address the Principal Business Activity I hereby swear (or affirm) that the information above is a true and correct statement. Rod, Feeduwav Signature of Person Disclosing 1-24-23 Date signed RECEIVED BY ELECTIONS DEPARTMENT: L] Hardcopy pr ·-, t) ecrone «kl CEIVED MAR 22 2023 CITY OF MIAMI BEACH OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/Initials: _ 138_SP-14 COE 2016 /\/\//\/\/' CI WI DE (CW) BOARD & COM MI TTEES 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 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. Board Member Information Date of Application: 1-24-23 Applicant Name: Randi Freedman Board/Committee Name: Production Industry Council Address: 7901 Hispanola Ave, #1804 North bay Village FL 33141 E-Mail Address: Lmgrandi@aol.com Work Phone: 305-790-3356 Home Phone Cell Phone: 305-790-3356 Preferred Contact Method: email Vehicle Information Ta g : KNQV18 Color: GRAY State: FL Year: 2020 Make: NISSAN Model: ALTIMA ---- 'I Applicant Sianature~ ~~ ', ~ - I Please provide sigh ed form to'#fe Parking Department located at 1755 Meridian Avenue, 2d floor. Working hours are 8:30 to 5:00 p.m. or email to: P a rk ingR e cep tio n @miamibeachfl.gov e -m ai l su bj e ct: BO A R D & C O M M ITT EE PAR KING APPLICATION - APPLICANT NAME P, ·ki D a r In a eparmen ec'1on PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial #: Issued By Print Name: Print Name: Signature: Signature: Date Issued: Date Completed: t t St . .pmg ·man rar forms cw oat@s commtees par gtorm,do