Josephine Manning 2.1.24MIAMIBE
BOARD AND COMMITTEE CHECKLIST
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oARD/coMMmrre. 20 23 LA/[_£lay
FOR SCANNER
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RECEIVED
APR v 2023
FOR CLERK STAFF
DATE OF APPOINTMENr: ]23
Appointed by. Um o ow_0
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reRwENo. /]/ reRwuwr./pp2/ o Letter of Appointment
o Letter of Reappointment {f )!'3," s Aron«newnesnoners crates
o Board and Committee Application (Completed on -
o R~sum~/Curriculum Vitae
o Diversity Statistics Reporting (Completed on _
o Oath
to Committee Liaison on
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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 MIAMI BEACH
OFFICE OF THE CITY CLERK
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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:
Processed on:
Scanned on:
o Board and Committees Liaison Responsibilities
O DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report.
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Date ()saar rlPr Committee Member
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Date ciy Clef's 9ffce stat initials
l[> so " 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 MASTERIB&C Checklist 2015 MASTER.docx
We re committed to providing excellent public service and salty to ol who live, work, and ploy in our vibrani, iopiccol, historic community.
C ity o f M ia m i B e a ch , 1/00 Convention Canter Drivo, Miami Boo.h, Florida 33 139 gays_miamnihgachll_gay
OFFICE OF T HE CITY CLERK, Rafol E. Granado, City Clerk
Tl: 305.673.741I, Fax 305.673.7254
Emai l: City/Cl erk@miam ibeach ll.gov
April 05, 2023
Ms. Josephine Manning
1460 Ocean Drive #408
Miami Beach, Florida 33139
RE: 2023 Hall of Fame Selection Committee
Dear Ms. Josephine Manning:
Congratulations! You have been appointed by Commissioner Kristen Rosen Gonzalezto the above-
referenced Board or Committee, for a term ending: 02/01/2024.
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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards,
/ Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Brandi Reddick, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
City Code/Ordinance section applicable to agency, board or committee
City Code Sections 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
C ity o f M ia m i B e a ch, 1700 Convention Conlor Drivo, Miami Boach, Florida 33139 gee_miamnilgachll.go
OFFICE OF THE CITY CLERK, Ralaol E. Granado, Ciy Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: Cit/Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Josephine Manning
RE: 2023 Hall of Fame Selection 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: 02/01/2024.
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.
#st=
Sworn to and subscribed before me this -fY) day of M. 2023 s ma Mena acores
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.
MIA» 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
#EcE vE
A4PR 05 2023
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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 l am a resident of the City of Miami Beach for six months or longer.
arr-.w oo.. l'lo Oc a DO«utC. MU 33f
J □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 __ ~\~~+-+1~c--------------------
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 phy ·cal 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
atg Ao@4, 4/s/23
Signature Date
hie
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or online notarization,
n&b ay or_Npi\ 1 h i _M .2028». tile 10)nl h, .mi».
(City of Mi am i each Board/committee Member). siMjf", - ha I /,#mi@a, \ Produced ID L.-0 l/h V ,~ /~O t' \ .. ,
Yorm;/ l~fition i .. f MY COMMI SSION \
Persona "" l// f ii~sis@ j j - log s»s/g/
sionore aoav owe %%jg2zf%$¥
$;#i8%" il}}Ny NUM},Gs "u i ««it Name of Notary, Typed, Printed, or Stamped
MIAM I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC @ m iam ibeachfl.gov
Telephone: 305.673.7 41 1
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 I 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 .,7". me
Si6nEur I at e
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.
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F:IC LE R \$A LL\RE G IBO A R D A ND C O M M ITT E E A P P LI C A TIO N S FINA L D R A FTS \BO A RD A ND C O M M ITT E E A PP LI C A TIO N RE G FINA L.docx
U p da ted : Ju ne 20 20
MIAMI BEACH
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
Last Name
DIVERSITY STATISTICS REP ORI
\' Js2pate
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:
Late
J2A-Female
loner
0 I prefer not to answer .
i
Race/Ethnic Categories:
What is your race?
0 African American/Black
LJ-Asian or Pacific Islander
[rcaucastan/white
0 Native American/American Indian D other- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
9ves
g±No
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
lves 2 o
0 I prefer not to answer this question.
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U pda te d : Ju ne 20 2 0