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Shannon Koonin 12.31.25B O A R D A N D C O M M ITT E E C H E C K L IS T APPOINTEE: Shannon Koonin DATE OF APPOINTM EN T. 6/28/2023 BOARD/COMMITTEE: _P_o_rk_.,,, -""_n_K_ct_.r.;,_;:ii_,o_NJ_. E'_·,,_Cli-Jll_O',_ll_oa_:"_ Appointed by: CA..\-:1: Covn YJ\'t r (\ CAil run, l)h FO R SC AN N E R Scan a Scan • FOR CLERK STAFF Letter ot Appointment Letter of Reappointment o Copy of Letter of Appointment!Feappointment reRu en, Pl/ e-mailed - to Committee Liaison on Scan a Scan ·a Scan a Board and Committee Application (Completed on ,, R.esume/Cumcu1um \/itae ...... .A I • Diers/ty Statistics Reporting (com peted on K[ 'QG , o Oath RECEIVED JUL 1 7 2023 CI TY OF MI AMI BEACH OFFICE OF THE 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, 2-2, 2-458 and 2459 « County Code Secton 2111 - Contct of Interest and Code o! Ethics Ordinance (as amended through December 2010) Am endments to the Code ot Ethics Ordnan ce (September 2009 through July 2012) Highlights of the Miami-Dade County Ethics Code Sunshine Law and Pub#c Records - Frequently Asked Questons Memorandum - Solicitation by City Board and Committee Members Scan 2 Scan Received on 0 Citywide Permit Application (Parkmg Department Form) • Booklet - Guide to Sunsh ine Amendment & Code of Ethics for Public Officers and Employees CG Source of Income Statement 3 Acknowledgment of Financial Disclosure Requirement .» Board and Committees Liaison Responsiblties » DIVERSITY STATISTICS REPORTING Keep COPY in fit and ORIGINAL for Ann0»! R«port 7/17/2023 .ssnea X Shannon Koonin Date Processed on Scanned on. Date 1 14/3 Date Board or Committee Member By E.mployee (JV)....;;.. _ City Clerk's Office Stat initials ···-·-· By Employee: __._{-N\ _ City Clerk's Ote Stat ini tias CONCLUDED & RESIGNATION LETTERS Term Expired Let ter Date Processed Initials $can Resgnaton Letter Date Processed Initials Scan - Removal Letter due to absences Date processed Initials Scan > ·- F XC AE R O AR AN COMMIT/ES DATABASE!CHECKLIST MASTERSSC Chckl: 22 15 M4 4 3 TER &x City of Miami Beach, !/0O Convention Canter Drive, Miami Bach, Horida 33139 yy_miamibachll_go OFFICE OF THE CITY CLERK, Ral0al E. Granado, Ciy Clerk Tl: 305.673.7411, Fax. 305.673.7254 Email: Ci/Clerk@miamibeochfi.gov June 30, 2023 Ms. Shannon Koonin 645 W. 51st Street Miami Beach, United States 33140 SUBJECT: Parks and Recreational Facilities Board Dear Ms. Shannon Koonin: Congratulations! You have been reappointed by the City Commission to the above referenced board or committee, for a term ending: 12/31/2025. 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. Rafa Gr City Clerk cc: Monica Beltran, Parking Director Cynthia Casanova, 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 - Amendment 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 M IAMIBEACH City of Miami Be ach, 1ZOO Convention Conto Dwvo, Miami Boa h, florida 33139 xx_riomiboachfl qui OHFKE OF TH CITY CLERK, Rofol E Gronodo, Cy Ck Ta 305.673.7411, Fax 305.673.7254 (moil. Ci Clari @miamibeochfl gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Shannon Koonin RE: Parks and Recreational Facilities Board 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. 12/31/2025. 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. Sworn to and subscribed before me tug [b "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 MIBEA CH City of Miami Beach 1700 Convention Center Drive Miami Beach, Flor ido 33139 www.miamibeach[l.gov OFFICE OF THE CITY CLERK Email: C@miamibeachfL_gov Telephon e: 305.673.7411 DIVERSITY STATISTICS REPORT Koonin Shannon E 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: [J a e El remale loner 0 I prefer not to answer. Race/Ethnic Categories: What is your race? []African American/Black D Asian or Pacific Islander l Caucasian/white 0 Native American/American Indian D Other- Print Race: _ D I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latinola? Jves (ho 0 I prefer not to answer. Do you consider yourself Physically Disabled? Te, G o D I prefer not to answer this question. Page 6 of 6 F ACLERSALLREGBOARD AN D C OMMI TT EE AP PL I C A T ION S FI N AL DRAF TS\B OARD AND CO MMI T IEE APPL ICATION REG FINAL docx Updated: June 202 0 M\]A/\[ BEACH CITYWIDE (CW) OARD & COMMITTEES a ca« « w« s«ad, skivo Aro PARKING APPLICATION 1755 Meridian Avenue, Suit 200/Miomi Beach, FL 33139/Ph. (305) 673.7505 or [305) 673.7000 64. 6200 PARKING 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 ol 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 $10.00 replacement fee. Board Member information Date of Application:7/17/2023 Applicant Name: Shannon Koonin Board/Committee Norne:Parks and Recreational Facilities Board Address: Nine Island Avenue, #1109 E-Mail Address: koonineducationservices@gmail.com Work Phone: Home Phone Cell Phone: 3057900259 Preferred Contact Method: Vehicle Information Tag: NDGN47 Color: black State: FL Year: '2023 take: NW Model: Atlas Shannon Koonin Applicant Sianature: Please provide signed form to the Parking Depar tment located at 1755 Meridian Avenue, 2" floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME Parking Department Section PERMIT SYSri GARAGE ACCE SS Expiration Date: ID Card Serial #. lssued By Print Name. Print Name. -- .. ---•-•·-•·· - --------- - ·- - . Signature:. Signature. Date Issued. • Dote Completed. -··· - -~-······-··~ ··----- ·--···- peg 9man + i+ .» mtte@$ pa n[J u Tnm %0t% '/-'«''t