Bradley Golden 12.31.26F O R S C A N N ER
Scan o
BOARD AND COMMITTEE CHECKLIST
APPoIrE. Bradley G olden DATE OF APPOINTMENr. (9 2 0 )23
oARDrcoMwwmrreEe. Hzol b {«@glki o wit\ Ao»ointea oy. (lq Donni
TERM END. (2[3]h2 rrM LiMr r: -
Scan o
Scan o
Scan o
Scan o
FOR CLERK STAFF
o Letter of Appo intm en t
o Letter of Reappointment " #" $.)" Aomooowe»onm«ent c-mates
o o ar@ and cortee Application completed on _o[@ [2
o Resume/curriculum Vitae 1[, [
o Diversity Statistics Reporting (Completed on )3
o Oath
to Committee Liaison on
RE CE I VE D
JUL -6 2023
CI T Y OF MIAM I BE A CH
OFFICE OF TE CITY CLERK
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 an d 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 Commi ttee Members
Scan O
Scan 0
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
Scanned on:
O Acknowledgment of Financial Disclosure Requirement
O Board and Committees Liaison Responsi~!i,' /.
. . 0 DIVERSITY STATISTICS REPORTING / ~otYin file and ORIGINAL for Annu,al Report.
7/e/a3 sorer.
+1af "z [rgss,d on. [}y [mp[O/Ce,
1 f. " By Employee:[""
Received on:
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:\CL ER\B O AR D AND COMMIT TIES DATABASE\CHECKLIST MASTER\B&C Ch ecklis t 2015 MASTER.doc
We or e committed to providing excellei pcbc service ond sale»y to cil who live, work, and ploy in our vibrant, tooical, historic community.
MIA MIBE
City of Miami Beach, I/OO Convention Canlar Drive, Miami Boach, Horida 33 139 yxwy.miaibaachll_go
OFFICE OF THE CITY CIERK, Ralaal E. Granado, City Clerk
Tel 305.673.7411, Fox: 305.673.7254
Email: CityClerk@miamiboochfl.gov
June 30, 2023
Mr. Bradley Golden
5003 Delaware Avenue
Miami Beach, FL 33140
RE: Health Facilities Authority Board
Dear Mr. Bradley Golden:
Congratulations! You have been appointed by the City Commission to the agency, board or committee
named above for a term ending: 12/31/2026.
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.
Reg?A
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Jason Greene, 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 Mimi Beach, !/00 Conwcnion Cantor Drive, Mi ami Bach, Florida 33139 guy2x._miamibcaachll.gay
OFFICE OF THE CITY CIFRK, Ralaal E. Granado, City Ciak
1el 305.673.711, Fax 305.673.7254
Email: City/Clerk@miamibear.hfl.gov
Oath of Office
O ath of Ci vi lity
and
Acknowledgements
TO : Mr. Bra dley G olden
RE: Health Facilities Authority Board
I do sol emn ly sw ear or affi rm to bear tru e faith , loyal ty and alle giance to th e Govern m en t of the United
States, th e State of Fl orida, an d th e City of Miami Beach, and to perform all the duties of a m emb er of the
above-m entioned board or com m ittee of th e City of M iam i Beach to which I have been app oi nted for a
term en ding : 12/31/2026.
To my colleagues and to all of those l rep resent and serve, I pledge fairness, integrity and civility, in all
actions taken an d all com m u nication s made by me as a public serv ant.
have been issued a copy of section 2-11.1 of the M iami -D ade County Code (Conflict of Interest and
Code of Ethi cs Or di n ance), as well as Florida Comm ission on Eth ics Guide to the Sunshin e Am en dment
and Code of Eth ics for Pub lic O ffi cers and unders tan d that as a m em ber of a Ci ty of Mi ami Beach Board
and /or Com mi ttee, I m ust com ply with th e financ ial disclosure requirem ents of M iami -D ade County or th e
State of Florida (depending on the board or com m ittee on which I s.erve.))1/l'l'.7✓' , fullowing1he closing
of the ca lendar year on wh ich I have se,v ed. $ ( .
M r. Bradley Golden
Sw orn to and subs cribe d befor e m e + day of /r- 4,2 023
Pl e ase visit the City of Miami Beach website at www.miami beach fl .gov under City Clerk/Board and
Com m ittees fo r additional infor m ation regarding the Financial Disclosure Requirements.
H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
JUL -6 2023
1Ty OF MIAM I BEAGH 5eict or iii cir cER
OFFICE OF THE CITY CLERK
Email:. BC@miamibeachfl.go
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
l am in com pliance with the affiliation requirem ent of Miami Beach City Code Sections 2-22 (4),
as (che /) all that apply):
lam a resident of the City of Miami Beach for six months or longer.
Home Address: -------------------------- [ Et 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: -------------------------
P[A,[[)·g,, [k}}f@,,
[1am 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 that is physically located in Miami Beach (for a
minimum of six months).
[Jr ] [A1[)·S,S,,
(IS,[[]9S,SS J\([]Fe5,
"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 en)ity or usiness association.
Under peA //s perjury, I declare that I have read the foregoing document and that the facts ajyyf 7/.03
Signature <ale Gt
Date
Printed Name
g%:?pye., Eila Ktaoka a Sa
$ ~"6? Comm.#HH048174
2jgig oes; sey. 29,2024
.,.- .. - __ ,.....,.,'tl-7f1>h--m_n: -v~dei Thru~ron Nola~
( ,,
MIAMIB
C ity of Miami Beach
1700 Con vention Center Drive
Miami Beach, Florida 33139
www.miamibeachtl.gov
OFFICE OF THE CITY CLERK
Em ai l: BC@m i am i beachfl.gov
Telephone: 305.673.7411
DI VER S ITY STA TI S T IC S RE P OR T - Last N a m e First N a m e Middle Initial
The following information is voluntary and has no bearing on your consideration for appointment It is being
asked to comply wi th City diversi ty reporting req ui rem en t s.
Gender: a
Ll remate □Other
0 I prefer not to an sw e r.
Race/Ethnic Categories:
What is your race?
[l A frican American/Black
L. Asta or Pacific Islander
[El,cauc astan/white
Ll Native Ame ric an/Am er ican Indian
[] O the r - P rint R ace .
El prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Eves
LJfo
Ll prefer not to answer.
Do you consider yourself Physically Disabled?
Cr
L}1 pr e fer not to an s w er this question.
Page 6 of 6
F \CLERISALLREG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMI BE
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miomibeachll.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT
Acknowledgement of fines/suspension for Board/Committee Mem bers for failure to comply with Miami-
D ade Co unty Finan cial Disclosure Code Provision Code Section 2-11.1(i) (2)
L
Last N am e First Name Middle Initial
l understand that no later than July 1. of e ach year all members of Boards and Committees of the City of Miami
Beach, includin g those of a purely advisory nature, are required to comply with Miami-Dade County Financial
Di sclo sure Requirem ents.
One of the following form s must be file d with the City Clerk of Miami Beach, 1700 C onv ention 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 late~t Fed ral Income Tax Return.
Failure. to ti.le.~~/- o. th e forms, pursuant to the Miami-Dade County Code, may. subject the person to a fine
of no more th n IO,6O days in jail, or both.
(la -,---------------- 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 Fin an ci al Interests (For m 1) with the Miami-Dade C ounty
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
requirem ent 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 of6
F:CLER \SALL'R EG\BOAR D AND COMM ITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITT EE APPLICATION RE G FINAL.docx
Updated: June 2020
M I A ME
&EI SOURCE OF INCOME STATEMENT
Section 2-111(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 I Last Name First Name Middle Name/initial
2022 G e - -- 2 a &le -L
Mailing Address - Street Number, Street Name, or P,0, Box ·-- '- - ? o 3 ( « a«& (\eu? ~ De ,,. .
City, State, Zip
,~L S) L/ I- ( x/-- t Te « ( -
lf your home address is your m ai ling address, and your hom e address is exem pt from public record s pursuant to Fla. Stat. 119.07, read
instructions on the following page and ch eck here.[]
Filing as an Employee (check one)
[] county I] Public Health Trust [] Municipal:
(M un icipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (ch eck one)
[] county LI Municipal: f- { « - t .A
(Municipality)
Board where serving A .k, He« IP, +e 0 > cl,
Alternate address (it hom e address is exempt) I Work telephone I Term began on/ended on
353 G 6a -ls(a 3
List below every source of income you received, along wi th 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 ddress Description of the Principal Business Activity
( , ( p.ht 407 no-.a' « fsd Q·- }p>sci}
' 1 .3 4 - ?303« ?4- t «.vs.I t-« S
e
(,__..;,,
,,.,
I hereby swea# ~formafon abo"' Is a true and correct statement RECEIVE D BY ELE CTI ON S DEPAR TM ENT:
// Taryn9ECEIVED
[] Electronic Copy
Signattfe of Person Disclosing
Date signe d
JUL -6 2023
CITY OF IVIIAMI BEACH
OFFICE USE ONLY Accepted, Y } N Deficiency: Processed Date/initials:. Scanned Date/Initials:
13 8 _SP -14 C O E 20 16
/vl I 1
City of Miami Beach, PARKI N G DEPA RTM ENT
17 55 M eridia n Aven ue, Suite 200/Mi om i Beach , FL 33139/Ph : (305] 673-7 505 or (305) 673-7 000 ext. 6200
CITYWIDE (CW} BO ARD & CO M M ITTEES
PARKING APPLICATION
A citywi de (CW) parking permit is honor e d at metered parking spaces and restricted residential zones
parking spaces. A CW parking perm it IS NOT honor ed in prohibited areas. An Access Card will be
provided to you for City Hall Garage (G7) access.
IMP O R T A N T NO TE: Your vehicle license plate serves as your "parking permil". In order to avoid
any unnecessary enforcement actions, it is imp ortant that our record s reflect the most current and
accurate information regarding your vehicle license plate. Inaccurate and/or outdated vehicle
information may lead to the issuance ol parking citation(s) and/or the towing of your vehicle.
Please note that this new access card C A N N O T be hole-p unched 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 surlace of the card against the reader
until the gate opens.
A C K N O W LE D G EM EN T : I ack nowle d g e that sh o u ld m y access card be lo st, sto len or
damage, I will be resp o nsib le to pay a $10.00 replacement fee.
Board Member Information
Date of Application : lo la3» .
App licant Name: Bradley Golden \la\ , @0.dis #9Luo.·- .-a
Board/Committee Name:
Address: « 3 D lo.s /A eo< > 7 a pf
E-M ail A ddre ss: L elk- ,-h /> Sc A-
work Phone.25-5 - Home Phone
Cell Phone: 3es,- 3 7 no -7 Preferred Contact Method: « \. \ ./ v' <e (
Vehicle Inform ation
Tag: } D / > a Color: • St ate : ( Year: > o9
Make: /«
a Model: A 8 L
Applicant Sianature: e
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@miamileachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P ki D ar mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #E:
lssued By Print Name: Print Name:
Signature: Si gna ture: S
D ate lssued: Date Completed:
s
:p ang m an wantons cw boar!socmutt@us por g rtmn . aoc