Andres Asion 12.31.24M IA M I BEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Andres Asian
BOARD/COMMITTEE: Board of Adjustment
DATE OF APPOINTMENT. 2/1/23 -------
Appointed by: City Commission
FOR SCANNER
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RECEIVED
JUN 0% 2023
FOR CLERK STAFF 12/31 /24
o Letter of Appointment TERM END: TERM LIMr. 12/31/24
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on
2/3/23
o Board and Committee Application (Completed 223
o R6sum6/Curriculum Vitae (,[.[
o Diversity Statistics Reporting (Completed on o } ),
o Oath
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
CITY OF MIAMI BEACH ✓Memorandum - Solicitation by City Board and Committee Members
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
Scanned on:
o Board and Committees Liaison Responsibilities
o DIVERSITY STATISTICS REPORTIN Keep COPY in file and ORIGINAL for Annual Report.
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Date
e./2/23
Date
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Date
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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 MASTER\B&C Checklist 2015 MASTER.docx
We are committed to providing excellent public service and safety to all who live, work, and ploy in our vibrant, tropical, historic community
Ml M l
C ity of Miami Beach, I/OO Convontion Canter Drive, Miami Bea ch, Horida 33139 yxwy_miaIibaachllgo
OFFICE OF THE CITY CLERK, Rafaal E. Granado, Cly Clerk
Tol: 305.673.74 11, Fox: 305.673.7254
Email: Ci#yClerk@miamibooch fl.gov
February 02, 2023
Mr. Andres Asian
1000 S. Pointe Drive, Apt 2204
MIAMI BEACH, FL 33139
SUBJECT: Board of Adjustment
Dear Mr. Andres Asian:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, 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. Congratulations and good luck.
Rlc'y 4...
City Clerk
cc: Monica Beltran, Parking Director
Michael Belush, 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 IAM I BEACH
City of Miami Beach, I/OO Convention Conler Drive, Miami Boach, Florida 33139 yywy._miamibgachll.gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: CiyClerk@miamibeachll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Andres Asion
RE: Board of Adjustment
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 Ordinan ce), 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 requirem ents 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.
Mr. Andres Asion
Sworn to an d subscribe d before me this day or Ju, 2023
/'2 = $a6....
Deputy Clerk
please visit the City of Miami Beach website at www.miamibeachf. ov under City Clerk/Board and
Committees for additional information regarding the Financial Disclosure Requirements.
MIAMI BEACH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673 .7 411
RECEIVED
JUN 02 2023
CITY OF MIAMI BEACH
OFFICE OF TH E CITY CLERR
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as ( check ( ✓) all that apply):
/ f2I I am a resident of the City of Miami Beach for six months or longer.
Fore Address: lo S (ode e #220-4 pd a,Lt 33137
D 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: -------------------------
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 physically 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 are true.
Date I
Andres Asion
Printed Name
M IA M I B EA C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach[l.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REP ORI
Asion Andres
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 ae
[l Femal e
0 Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
LJAstan or Pacific Islander
D Caucasian/White
D Native American/American Indian
Ll Other - Print Race.
EJ l prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a? r.
(No
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
L y es -o D I prefer not to answer this question.
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U pda te d: Ju ne 20 20
MIAM I BEACH
City of Miami Beach
l 700 C onvention C enter Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: B C @ m iam ib eachfl.gov
Telephone: 305.673.7 411
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)
Asion Andres
Last Name 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
of no mre than :500, 60 days in jail, or both. =-~G~/--2--+.-(_-z.,_3 _
srarad Date
' 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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Updated: June 2020