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Seth Guttenberg 6.30.24MIA M I BEACH C ity o f M ia m i B e a ch , 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov August 17, 2023 Seth Guttenberg 4307 Alton Rd Miami Beach, FL 33140 RE: Committee for Quality Education in Miami Beach Dear Mr. Guttenberg, Congratulations! You have been appointed to the above-referenced Board or Committee as a representative for the Mechina of South Florida PTA, for a term ending on 06/30/2024. If you are unable to accept this appointment or have any questions, please call the Office of the City Clerk at 305.673. 7 411. 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~ Rafael Granado City Clerk cc: Monica Beltran, Parking Director Dr. Leslie Rosenfeld, 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 We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. MIAMI BEACH City of Miami Beach, 1/OO Cowvonton Conto Dwvo, Mamt ~ooh, I laida 33 139 www,marl2oz.hl.gzr OFICE OF TH CITY CI(RK, Rall E. Gronodo, Cy Clerl l. 305.673 7H1, fa 305 673 7254 Emal. CAN/Cler l @m loatbsoch~l go Oath of Off1 ca Oath of Cllllty and Acknowledgements T O : M r. S et h G ut t enb er g RE: Committee for Quality Education in Mlami Beach N do solemnly swear or affirm to bear tru e faith, loyalty and al legl an c e to the Government of the United States, the State ot Florida, and the City of Miaml 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 en ding: 06/30/2024. 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 ot 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 Publlc Officers and understand that as a member of a City of Mlaml 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 whi ch I have served. Mr. Seth Guttenberg Swor to and sub s crib e d before mo this _l5 K o "Please visit the Ci ty of Miami Beach website at www.miamibeachfl.gov under Cily Clerk/Board and Committees for additional inf or m at ion regarding the Financial Disclosure Requirements. M IA M I BEACH City of Miami lea ch 1700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: BC@mlamibeachfl_gov Telephone: 305.673.7411 A FFIDA VIT O F A FFILIATIO N W ITH THE CITY O F MIA MI BEA CH AND THE CO MMITT EE FO R Q UA LITY EDUCATIO N IN MIAM I BEACH As a voting member of the Committee for Quality Education in Miami Beach, I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4) and 2-190.137 as: [ am a City of Miami Beach resident for six months or longer. Jome A dar a . 4307 Alton Rd. Miami Beach, FL 33140 [tam the parent/guardian of a student attending a Mi am i Beach school tor » 3-+ ga ol year. school: Mechina of South Florida Under penalties of perjury, I declare that I have read the foregoing document and that the facts «""""E l ensaozs . al/dk - Signature Date Seth Guttenberg Printed Name MIAMI BEACH City of Miami Beach 700 Convenlion Center Drive Miami Bech, Florida 33139 www.miambeachfl,gov OFFICE OF THE CITY CLERK Email' BC@mlambeachf] gov Telephne: 305.673.741 DIVERSITY STATISTICS REPORT Guttenberg Seth N Last Name First Name Middle Initial Th e 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: [] Mae D Female loner D I prefer not to answer. Race/Ethnic Categories: What is your race? 0 African American/Black D Asian or Pacific Islander [) Caucasian/whi te D Native American/American Indian D Other- Print Race: _ D I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latinola? Jes No D I prefer not to answer. Do you consider yourself Physically Disabled? v es Jo 0 I prefer not to answer this question. Page 6 of6 F CLERISALLREGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFT SIBOARD AND COMMIT TEE APPLICATION REG FINAL docx Updated June 2020 M IA M I BEACH City of Miami Beach 17 0 0 C onvention Center Drive Mi ami Bea ch , Florida 33139 ww,miamibeachll,gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl_gov Telephone: 30 5.6 7 3 .7 4 11 B O AR D & COMMITTE E FINAN CI AL ACKN OW L EDGEMENT 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) Guttenberg Seth N Last Name First Name Middle Initial I understand that no later than July1, of each year all mem bers of Boards and Comm ittees 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 form s must be filed with the City Clerk of Miam i Beach , 1700 Conventi on Center Drive, Miami Beach, Florida, no later than 12:00 noon of July 1, of each year: 1. A "Source of Income Statemen t;" 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 more than $500, 60 days in jail, or both. > ===4 ~ =4 /--,-2 _4 1_2 0_2_3 _ Signature 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. Page 5of6 F \CLER\SALLREGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS1BOARD AND COMMITTEE APPLICATION REG FINAL docx Updated June 2020 n .» EIII SOURCE OF INCOME STATEMENT Section 2-11.1(@) of the County Ethics Code requlres that certain employees and publlc officlals file a financial disclosure Statement on a yearly basis by July 1st of every year. Disclosure for Tax Year Ending I Last Namo . First Name Middle Name/Initial 2022 \Guttenberg S eth N Malling Address - Street Number, Street Nam0, or P.0. Box 43 0 7 A lton R d City, State, Zip M ia m i Be ach , FL 33 14 0 If your home address is your mailing address, and your home address is exempt from public records pursuant to Fla. Stat. $119.07, read instructions on the following page and check here. [l Filing as an Employee (check one) â–¡County D Public Health Trust [] Municipal: (Municipality) Departm ent Position or Title Employee ID Number Work address I Work telephone Employment began on/ended on Fi lin g as a Board Member (check one) D County E] Municipal: Mi ami Beach (Municipality) Board where serving M ia m i Bea ch Alternate address (it home address is exempt) I Work telephone I Term began on/ended on 43 0 7 A lto n R d April 2023/June 2023 List below every source of income you received, along with the address and the principal activity of each source. Include your public salary. Place the sources ol income in descending ord er, w th the largest source first. Examples of sources ot 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 Address Description of the Principal Business Activity Hebrew Academy 2400 Pine Tree Dr. Miami Severance Beach, FL hereby swear (or affirm) that the information above is a true and correct statem ent. - s/it Signature of Person Disclosing /la Date signed RECEIVED BY ELEC TI ONS DEPARTMENT; LJ Hardcovpqgg{g4 MEI.r L] Electronie' di/"et.tr APR R 4 2023 CI(Or4MIAMI BEA;H iG± #flak O F FI C E U S E O N LY Acc ep ted: Y I N Deficiency. Processe d Date/l ntials: Scan ned Date/i nitials: 139_SP.-14 COE 2016 .----------......;.'r"\ i-11---------"-"'.""-, l£±%\9£4.1#2".ET IO PARKING 1755 Meridian Avenue, Suite 200/Miami Boch, FL 33139/Ph. (305) 673-7505 or (305) 673.7000 et. 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 Cily 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 citolion(s) and/or the towing of 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 readbr until the gate opens. ACKNOW LEDGEMENT: 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: 4/24/2023 Applicant Name: Seth Guttenberg Board/Committee Name: Quality Education Address: 4307 Alton Rd Miami Beach, FL 33140 E-Mail Address: shayeguttenberg@gmail.com Work Phone: Home Phone Cell Phone: 415-378-4680 Preferred Contact Method: Cell Vehicle Information Tag: RMR306 Color: Gold State: Florida Year: 2006 Make: Lexus Model: GX470 Applicant Sianature: e ad J5EI 7 I 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@miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME p, k' D rt ar' Ina epa men ec 1on PERMIT SYSTEM GARAGE ACCESS Expiration Dote: ID Card Serial #: lssued By Print Name: Print Nome: Signature: Signature: Date Issued: Date Completed: