Loading...
Dennis Scholl 12.31.23M IA MI BE C B O A R D AN D C OM M ITTEE C H ECKLIS T ar owr eEe 0uni Sh0l! Are orAPoreNr. 2l 1/]Lo so A R coM MrrTEE :_e.O. od Aprotea y._Ho om m@son FOR SCANNER Sca n o Sc an o S ca n o S ca n o TERM END: (l51)23 TERM Lum. _o/3y[28 to Committee Liaison on Scan o FOR CLERK STAFF o Letter of Appointment o Letter of Reappointment o Copy t Letter of Appointment/Reappointment e-mailed 213/13 ,] o Board and Committee Application (Completed on JI3/23 o R~sure/Curriculum Vitae ] ] o Di v ersi ty Statistics Reporting (Completed on 3,'ll o Oath RECEIVED M AR 3 1 2023 @TTY OF MI AMI BEACH OFFICE OF T HE C ITY C LE R K 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 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: L for An nual Repo rt. Scanned on: O Board an d Committees Liaison Responsibilities O DIVERSITY STATISTICS REPORTING Keep copy » j .. .. ·.·• ''\ •·· ·- .. ,·· 213/13 sonea»oX 1 Date ittee Mem Processed on: __ 4~}-3_/_i~3~-- By Employee: _,.}-'<)\/)'-__._ _ Dae Cy Ce$?/e stat tniias __ l/_. _/_-3_/_V; By Employee: ---~\J_ V_ I _ City Clerk's Office Staff Initials Date CONCLUDED & RESIGNATION LETTERS Term Expired Letter Date Processed Initials Scan o Resignation Letter Date Processed Initials Scan o Removal Le tter due to absences Date processed . -·-· -~~ Initials Scan o F:\C LER\BOAR D AND CO M M ITT IES DATABASEIC HECKLI ST M ASTER\B&C Checklist 2015 MASTER.docx We ore committod to providing excellent public service and solely to all who hive, wok, and play in our vibrant, ironical, historic community MIAMIB City of Miami Beach, /OO Convention Coner Drive, Miami Boach, Florida 33 139 yw_miaIiboachllao OFFICE OF THE CITY CLERK, Ra~al E. Granado, Cy Clerk Tel: 305.6737411, Fax: 305.673.7254 Email: CilyClerk@miamibooch fl.gov February 02, 2023 Mr. Dennis Scholl 2001 meridian ave, #301 miami beach, FL 33139 RE: General Obligation (G.0.) Bond Oversight Committee Dear Mr. Dennis Scholl : Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2023. 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. # Rafael Granado City Clerk cc: Monica Beltran, Parking Director Maria Hernandez, 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 M l M IB E City of Miami Beach, I/OO Convontion Canter Divo, Miami Boch, Florida 33139 yy.miamibgachll.gay OFF ICE OF THE CITY CIERK, Rfool E. Grona«do, Cy Clark Tel: 305.673.7A11, F: 305.673.7254 Email: Ci#yClark@miamtbeochll go Oath of Office Oath of Civility and Acknowledgements TO: Mr. Dennis Scholl RE: General Obligation (G.O.) Bond Oversight Committee 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: 12/31/2023. 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 Ame dment and Code of Ethics for Public Officers and understand that as a member of a City of Miami Bea Board and/or Committee, I must comply with the financial disclosure* requirements of Miami-Dade Cou or the State of Florida (depending on the board or committee on which I serve) on July 1st, follo ing th closing of the calendar year on which I have served. I I Swor t o and subscribed before me tis l aay r [/'( 2023 .k- Deputy Clerk 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. M IA M IB E A C RE E "T City of Miami Beach 1700 Convention Canter Drive Mi am i Beach, Florida 33139 O FFIC E O F THE CI TY C LERK Email: BC@miamlbeachfl.gov flehone: 305.673.7411 MAR 31 ZwZ3 C TT/ OF MIAMI BEACH OFFICE OF TH E ITV 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 Beac~for six months or Ion ~r 'C \ \ ( Lt':) , erase» 20o01 A.\»j lljl/2130I □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). [[q r [ P y [/e S {[/[2S- \(][[e Ss _- I am a full-time employee of a business (for a minimum of six months) and l am based in an office or other location of the business th at is physically o ted in Miami Beach (for minr of six mon ths). e"or oufe " in 4# O Business Address q-d,. l} t -~ ... .......,.....,_:. -~""-t-----(J.iuN ~/RO~ "Ownership Interest" means the ownership often 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 pen·es of perjury, I clar thft have read the foregoing docume t and tha the facts stated in it are true. . 3 20 23 Sianna,Gurr" Date 240401' 5c4 . Printed Name NOTARY Sworn to (or affirmed) and subscribed before me, by means of physical presence or online notarization, a 2f'a «M a c_ zo2%y (City of Miami Beach Board/Committee Member). Produced ID Form of Identification Personally Known ?@, 0ON NA AR IE EBANKS 8 pp%i , ko ar j ii«-s@ si fora 3i/ comm»so + sz45 9riS? My Comm. Expires May 5, 2026 an ded through National Notary Assn, (NOTARY SEAL) Name of Notary, Typed, Printed, or Stamped M IA M IB E H C ity o f Mi a mi Be ach 1700 Con vention Center Drive Miami Beach, Florida 33139 w,migmipegcht+,goy OF FI CE OF TH E CI TY CLERK Email: BCG@miamibeachfl.gov Telephone: 305.673.7411 DI V ER SI T Y STATISTICS REPORT 5at 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: f , Ll remale LJ oner El prefer not to answer. Race/Ethnic Categories: What is your race? []African American/Black [l Asian or Pacific Islander Lk Caucasian/White 0 Native American/American Indian [] Other Print Race. 0 I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? [Joe ko El 1 prefer not to answer. Do you consider yourself Physically Disabled? I•• ta# D I prefer not to answer this question. Page 6 of 6 F:IC L E 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 RA FT S IB 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.clocx Updated: June 2020 M IAM IBEA C City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.go¥ O FF IC E O F TH E C ITY C LERK 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 ....230 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. Qne 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);" or 3. A Copy of your latest Federal Income Tax Return. Failure file one of the of no m Signatur to the Miami-Dade County Code, may subject the person to a fine /2 b3 Date 7- 7 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 Election s automatically satisfy the County's financi al 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 COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL .d ocx Updated: Jun e 2020 M IA M l·D Ab E . EI 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 Malling Add If your home address is your mailing address, and your home a dress is exempt from public records pursuant to Fla. Stat. $119.07, read instructions on the following page and check here.L] Filing as an Emp l oyee (check one) [] county I] Public Heal th Trust [] Municipal: (Municipality) Department Position or Title Employee ID Mumber Work address I Work telephone Employment began on/ended on Filing as a Board Member (check one) [] county / E] M unicipal: Board where serving .0. oD Alternate address (if home address is exempt) Work telephone Term began on/ended on 30-4 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. Hf continued on a separate sheet, check here.[] Name of Source of Income Address Description of the Principal Business Activity nd correct statement. RECEIVED BY ELECTIONS DEPARTMENT: LJ artoy HECElVED I]Electronic Copy MAR 31 2023 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK OFFICE USE ONLY Accept ed: Y / N Deficien cy.- Processed Date/Initials: 138_SP.14 COE 2016 Scanned Date/initials: M IA M I B E A CITYWIDE {CW) BOARD & COMMITTEES cwy of tarsi seeach, PkRkG DEPARtNr PARKING PP]ICAT[ON 1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 e4. 6200 A ci ty w ide (C W } pa rking pe rm it is honored at m etered parking spaces and restrict ed residential zones p ar k ing spaces. A CW parking permit IS NOT honored in prohibited areas. An A ccess Card will be provided to yo u for Cily Hall G ara ge [G7] access. IM PORTA N T NOTE: Your veh icl e license plate serv es as your "parking permit". In order to avoi d a n y unnecessary enforcement actions, it is important that our records reflect the most current and a cc ura te in fo rm a tio n re g a rd in g your vehicl e lice nse plate. Inaccurate and/or outdated vehicl e in fo rm a tio n may le ad to the issuance of pa rking ci ta tion(s) and/or the tow ing of your vehicle. Please not e th a t this ne w access card CANNOT be hol e-p unch ed or perforated in any m ann er . To use the ne w ca rd p le a se ho ld the card at cl ose p roxim ity to the reader until the gate opens. You m ay need to try the o the r side o f the ca rd . Ple a se ensure yo u hold the entire surfa ce of the card against the reader until the g a te o p e ns . ACKNOWLEDGEMENT: I a ck nowl e d g e that should m y access card be lost, stolen or damage, I will be responsible to pay a $10.00 replacement fee. Board Dember In fo rm ation, , Date of Application: 33, ,ea"N v, <CO Board/Committee Name: Address: E-Mail Address: - Work Pho ne : Cell Phone: Vehicle Inform · Preferred Contact Method: <, 1-T-ag_:_--+-----"-__._ ---+--c-o_lo_r:_I--S_/.o.,:::_·._k_w7_~ --i State: Make: l--l.Ct...Aka. "e...a-- Year: 5 Applicant S;+nature: es Please provide signed form to the Parking Depdrtment locale at 1755 M eridian 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 -- APPLI CANT NAME Par mna epartment : ection PERMIT SYSTEM GARAGE ACCESS Expiration Date: ID Card Serial i: Issued By Print Name: Print N am e: Signature: 6 Signature: 6 Date Issued: Date Completed: ki D S · .' .p wg manirar' torms 'w oars «comm#tees pant ng atoc