Dorrie Foster 12.31.24MI MIB
B O AR D AN D C O M MI T TE E CHECKLIST
APPOtNTEE : Do,rte Foster DATE OF APPOiNTMeNT: .btb .. ,@)]1-o ...
BOAROICOMMITTEE~ BIHck Affairs Advisor C-0mrr,rttee Appointed by: ~¼ ·lqf'f)Y,l 1 lf~l {J/Y)
FOR SCANNER FOR CLERK STAFF J pp j/]2,,
scans ·tenter ot Anointment TERM END: [lL, rRwuwr: !]h)
Sc an a o Letter of Re appoi n tment
at.s" " $' " Scan o Boar d and Committee App lica tion (Completed on _ , I,
sane s Res ureicorriculum vitae cl9[)3
o Diversity Statistics Reporting (Completed on_>Jl, _
Scan o Oath
RECEIVED
MWAY 10 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CL ER
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
t City Code Ordinancs Section applicable to the agency, board or committee
Cy C ode Se ction s 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2.4 59
County Code Section 2-11.1 -- Conflict of Interest and Code of Ethics Ordinance (as
amended through Decem ber 2010)
Amendments to the Cod e of Ethi cs Ordinance (Septemb er 20 09 through July 2012)
Highlights of tho Miami-Dade County Ethics Code
Sun shin e Law an d Public Records -- Frequently Asked Questions
Memoran dum - Solicitation by City Bo ard and Committee Mem b ers
Scan O
Scan O
O Ci tywid e Permi t Ap pl ic ation (Parking Department Form)
0 Bo0kle t -- G uide to Suns hine Amendment & Code of Et hics for Publi c Officers and Employees
0 Source of Inco me Statement
Ack no wle dgme nt of Finan cial Disclosure Requirement
0 Board and Committees Liaison Responsibilities
o DvERstTY
05/09/2023
@ebb.ti, lie9foe
Date Board or Committee Member
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CONCLUDED & RESIGNA ION LETTERS
" " tr" Resignation Letter 0a te Proce ssed Initials
Removat Letter due to absences Date processed
Scan G
Initials Scan O
MI IBE
City of Miami Beach, 1700 Convention Cantor Drivo, Miami Boach, Florida 33 139 yywy_IiaIiboachll.gov
OFFICE OF THE CITY CLERK, Ralaol E. Gran ado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CityClerk@miamiboachll.gov
May 01, 2023
Ms. Dorrie Foster
6450 Collins Ave
Miami Beach, FL 33141
RE: Black Affairs Advisory Committee
Dear Ms. Dorrie Foster:
Congratulations! You have been appointed by the City Commission to the agency, board or committee
named above 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 as they concern your duties, responsibilities, and
requirements as a board or committee member.
Congratulations again and good luck.
Regards,
Rafa
City
cc: Monica Beltran, Parking Director
Lissette Arrogante, 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
City of Miami Beach, 1ZOO Convention Coner Drive, Miami Boch, Florida 33 139 yNy_miamibaachfl_gov
OFFICE OF THE CITY CIERK, Rofaol E. Granado, Cy Clark
Tel: 305.673.7411, fox. 305.673.7254
Email:. City Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO : Ms. Dorrie Foster
R E: Black Affairs Advisory 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: 12/31/2024.
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 w hich I have served.
%%
Ms. Dorrie Foster
Sworn to and subscribed before me this 1Q!h__ day of ........,-,11-• 2023
K
*Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and
C om m ittees fo r additional info rm ation regarding the Financial Disclosure Requirements.
0-MIBEAC
City of Miami Beach
1700 Convention Center Driv
Mi ami ch , florida 33139
RECEIVED
MAY 10 2023
OFFICE OF THE CITY CLERK
Email. 8cg_miamibeach.gos
Telephone: 305.673.7411
AFFIDAVIT or AFFILIATION yIIH THE CIT y OE MIAMI BEACH
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
S1TE OF FLORIA
COUNTY OF MIAMI-DAE€
t am in compliance with the affiliation requirement of Miami Beach City Cde Sections 2-22 (4), as ({check
(/) alt that apply):
a lam a resident of the Gty of Miami Beach for sx months or longer.
Home Adara,,450 Collins Ave, #906 Miami Beach, FL 3314
J {have an ownership interest (far a minimum of six months) in a business established in the City of
Miami Beach (for a minimum of six months).
q gsir1gs5s Jdf?Sf««our
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 Bach {for a minimum ot six months).
"Ownership Interest moans the ownership of ten porcont (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 iability company, or other
entity or business association.
Under penaltie
are true.
jury, A declare that I have read the foregoing document and that the tacts stated in it
05/09/2023
Signature
Dorie Foster
Printed Name
NOTARY
Swor to (or affirme d) and subscribed before me, by means ot 6tysical presence or o online notarization.
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US »A8UEL. TUE5AN O
ttury Public 5tote at Fri~a
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My {mm. Errs et 15, 2027
- Stant Nary Assn.
IBEA
C ity of Miami Bea ch
70Q Convention Cent er Dri ve
Miami Beach, Florida 33139
www.miamibeochfl.go
OFF ICE OF THE CITY CLERK
Email: C@miamiteachfl._gov
Telephone: 305.673,7411
BOAR D & COM M ITT EE FI NAN CI AL ACKNOWLEDGEMENT STATEM EN T
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)
Foster Dorrie
Last Name Middle Initial
l understand that no later than July1,gf each ygar a ll mem bers of Boards and Commi ttees of the City of Mia mi
Bcach, including those of a purely advisory nature, are required to comply with Miami-Dade County Financial
Disclosure Requirements.
One of the following forms mu st 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 "Sta temen t of Financial Interests (Form 1);" or
3. A Copy of your latest Federal Income Tax Return.
Failure to file one of these forms, pursuant to the Miam i-Dad e County Code, may subject the person to a fine
of m (e than $50 0, 60 days in jail, or both.
5/9/20 23
Date
' Mem bers of the Planning Board and Board of Adjustment wilt be notified dire ctl y by the State of Florida,
purs uant to F.S . $112.3145(1)a), to fil e a Statement ot Financial Interests (Form 1) with the Mi am i-Dade County
Supervisor of Elections by 12:00 noon, July 1. Planning Board and D oar d of Adjustment members who file their
Form 1 with the Coun ty Super visor of Elections automatically satisfy the County's financial disclosure
require m en t as a Miami Be ach Ci ty Boar d/Com mittee mem ber an d ne ed not file an additional form with th e O ffice
of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State
requirement.
Page 5 0t 6
CLER$ALL REC3EA€ AN9 €OM TEE APPLICATIONS; FINA4. ± 133CK AN0 C9MM/7TT£ A0.ACA TM HG FINAL 4a
up4tad: 4an 2120
MI AMIBE CH
City of Miami Bea ch
17 Corvention Cent er Dr ive
Miami Beach, Florida 33139
www.miamibegc hfl.gov
OFFICE OF THE CITY CLERK
Emal: BC@miamibgach_gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORI
Foster
Last Name First Name Middle Initial
The following informat io n is volunt ary and has no bearing on your consideration for appointment. It is being
asked to com pl y with City diversity re por tin g req uirem en ts.
Gender.
LO »ate El Fem al e
J o or
El prefer not to answer.
What is your race?
LI Ami can American/Black
L] Asi an or Pacific Isl ander
D Caucasian/white
L]N ativ e Amer ican /Am erica n Indi an
[}other - Prin t Race.
lt prefer not to answer.
Do you co nsider yourself to be Spanish, Hisp an ic , or Latinola?
v.
Go
[I preter not to answer.
Do you consider y o urse lf Physically Disabled?
es ca
Ll t prefer not to an swer this question.
Page 6 cf 6
££ER/$A4LL/RE3EMARD ANO 0MM LIE XPPUCA IC; MAL 0##/1&0 AND CCAAMITTEE APP,KA4 TXJ #EG FINL.49¥
up68t 4. Jun 2020
SOURCE OF INCOME STATEMENT
Sect 2-11,7/ ot the Cort y Ethws Code teq uires that or tain employe es and public official s file a finans i dsclosure Statement on a pearty basis by 4uty 1st
cd ewe year.
First tame
Dorrie
Middle tam e/initial
if your home address is your mailing address, and your home address is exempt trom public recards pursu ant to Fla, Stat. $119.07, read
in struction s on th e tolling page and check here. []
Filing as an Employee (che ck one)
Employee t Numter
[] county
rd whore servin g
wam i seen 6tao Alair
Alternate address (if home address is exempt)
CJDmrru#:u,_...,,.._- _
Work telephone 'Term began on/ended on
305-801-4165
List telw every source t hcore with the address and the principal activity at each source. Include your public salary. Place the sources oft
income in descending order, wth " include: compensation for sernces,
. dividends, pensions, IR?A
tte iomc ot your spu or arr business per tr need not te
Natt of Source of in come Address
Social Security 10f ion Road Miami Beach
33140
B each fro nf Realty 7w a++ Miami Bean 3 3140
t Ra# 1 rags West Xv, PH3 Miami
Beach 33139
M on thly Rent
.7.Me0ever°
Electronic Copy
MAY 10 2023
C ITY O F M IA M I BEA C H
C ITYWI DE (C W) BOARD & COMMITTEES
cs et ivii es+, PsxrG oPsriNr PARKING APPLICATION
1755 Mer&dion Averse, Suite 200/46mi Beach, FL 33139/P1. (305) 6737505 r (305) 673.7030 «4. 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 veh icle.
Please note that this new access cord CANNOT be hole-punched or perforated in any manner. To use
tho 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.
App licant Name: Dorie Foster
mmitee Name:lack Affairs Advisor Committee
xaa. Re3 oins Ave. 906 Miami each, FL. 33#a t
[E.Mal Aaa......a.a..a..a...... 4t dorriefoster@ mne.com
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Work Phone: Home Phone
Preferred Con tact Meth Cell cul P±one sos 301-4165
State:
Make:
Color: Mhite
Model:
Applicant Sta nature: e
Please provide signed form to the Parking Deportment locat ed at 1755 Meridian Avenue, 2° foor. 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