Dany Raffoul 12.31.24M IA M I BEACH
BOARD AND COMMITTEE CHECKLIST
Dany Raffoul
APPOINTEE: _
August 2023
DATE OF APPOINTMENT:
Next Generation Council Laura Dominguez
BOARD/COMMITTEE: Appointed by: _
roe. 12l31/3 ,a l 3 h4 FOR SCANNER
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RECEIVED
AUG 25 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment 6$@"3,3"J'{" o Aooenveaomrent en9yes o
o oar@ a@'committee Application (completea [[
Resume/curriculum Vitae [a133
o Diversity Statistics Reporting (Completed on ) l>l y
o Oath
Committee Liaison on
IMPORT ANT 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
✓Memorandum - Solicitation by City Board and Committee Members
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK o Citywide Permit Application (Parking Department Form)
Scan o
Scan o
Received on:
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
o Board and Committees Liaison Responsibilities
O DIVERSITY STATISTICS REPORTING Kee COP
08.25.23
_________ Signed by
Scanned on:
Date
08.28.23 A
Processed on. By Employee. l/"
Date Ciµt'lty Cler 's Office Staff Initials
08.28.23
[\y l[Pl\/@}, l
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 \CLER\BOARD AND COMMITTIES DATABASEICHECKLIST MASTERIB&C Checklist 2015 MASTER.docx
WVe are committed to provding excellent public service and safety to all wh o live work, and play in our vibrant, topical, historic community
MI BE
City of Mi ami Beach, I/OO Convention Con er Drive, Miami Beach, Florida 33139 ywy._iaIibgachl]go
OFFICE OF THE CITY CLERK, Rafaal E. Granado, Cay Clerk
Tl 305.673.7411, Fax: 305.673.7254
Email: Cit/Clerk@miamiboochfl.gov
August22,2023
Mr. Dany Raffoul
1800 Purdy Ave. #2207
Miami Beach, FL 33139
RE: Next Generation Council
Dear Mr. Dany Raffoul:
Congratulations! You have been appointed by Commissioner Laura Dominguez to the above-
referenced Board or Committee, for a term ending: 12/31/2023.
Pursuant to City of Miami Beach Code Section 2-22 (5)a:
Notwithstanding any other provision of the City Code or of any Resolution, commencing with
terms beginning on or after January 1, 2007, the term of every board member who is directly
appointed by a member of the City Commission shall automatically expire upon the latter of:
December 31 of the year the appointing City Commissioner leaves office or upon the
appointment/election of the successor City Commission member.
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.
u .2#.
City Clerk
cc: Monica Beltran, Parking Director
Ambar Herrera Gonzalez, 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
MIAMI BEACH
City of Miami Beach, LOO Convonlion Conlor Dr ivo, Miami Boach , Horida 33 1 39 www.maribxeachfl.gay
OHH CE OF TH CITY CLER K, Rolal E. Granado, CMy Clerk
Tel : 305.673.74H, Fax 305.6 73.72 54
Email: CiNyClerk@miamtboochfl. gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M r. D an y Raffou l
R E : N e xt G e ne ration C o uncil
I do so le m n ly sw ea r or affi rm to bea r true faith, lo yalty and alleg ia nce to the G overn m ent of the United
States, the S tate of F lo rid a , and the C ity of M ia m i Beach, and to perform all the duties of a m em ber of the
ab o ve-m e ntio ne d bo a rd or com m itt ee of the C ity of M ia m i Beach to w hich I have been appointed fo r a
term en di n g : 12/31/2023.
T o m y co lle a g ue s and to all of tho se I represe nt and serv e, I pledge fairn e ss, integrity and civility, in all
actio ns taken and all com m unications m ade by m e as a public serv ant.
I ha ve be e n issu e d a co p y of section 2-11 .1 of the M ia m i-D ade C o unty C ode (C onflict of Interest and
C od e of E th ics O rd ina nce), as w ell as Florida Co m m issio n on Ethics G uide to the Sunshine A m endm ent
and C o de of E thics fo r P u b lic O ffi cers and understand that as a m e m ber of a City of M iam i Beach Board
and/o r C o m m ittee , I m u st co m ply w ith the financi al dis cl osure" require m en ts of M iam i-D ade County or the
S tate of F lo rid a (de pe nd in g on the board or com m ittee on w hich I serv e) on July 1st, follow ing the closing
of the calendar year on which I have sen,ed IA
f- st..-
S w orn to and subs crib ed before m e tu 4
p le a se vi si t th e C ity of M ia m i Be a ch w e b site at w w w .m iam ib ea chfl.g o v under C ity C lerk/B oard and
C o m m ittee s fo r add itio na l info rm ation regarding the Financial Discl osure Requirem ents.
M IA M I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email:. BC@)m1am1beachfl.gov
Telephone: 305 .673 7411
RECEIVED
AUG 25 2023
g!TY or Mi»Ml eEAc
FICE OF THE CI TY CL ER -. 1k
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):
[/E1am a resident of the City of Miami Beach for six months or longer.
1800 Purdy Avenue #2207 Miami Beach FL 33139
b{ff ]f,j,
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).
[]are (f [4g[PS,S,+
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 clare that I have read the foregoing document and that the facts
stated in it are true
7y 21 08.25.23
Signature
Dany Raffoul
Date
Printed Name
M IA MI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Flor ida 33139
w ww.mi am i bea chll.go v
O FFI CE O F THE C ITY CLERK
Emal: B C @m I am I De ACIII.GOV
Telephone: 305.673.7411
Raffoul
DIVERSITY STATISTICS REP ORI
Dany M
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
Ll remale
D Other
[Id t prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
Asta or Pacific Islander
0 Caucasian/White
LJ Nawve American/American Indian
0 Other - Print Race: ------------ Ek 1 prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Tves
Jo
EM t prefer not to answer.
Do you consider yourself Physically Disabled?
v oe
Jo
l+prefer not to answer this question.
Page 6 of 6
F:ICLER\$ALLIREGIBOARD AND COMMITT EE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMI BEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Flor ida 33139
www ,miamibeachfl,gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl gov
Telephone: 305.673.741I
BO A R D & CO M M IT T EE FIN AN CIA L A CKNO W LED G EM EN T STA T EM 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)
Raffoul Dany M
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 for s, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, 1day; 'iy jail.or btt°
Signature
08.25.23
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 5 of 6
F.ICLER\$ALL\REG\BOARO ANO COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DAD E-
&EI SOURCE OF INCOME STATEMENT
Section 2-11.1 (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 Raffoul Dany M
Mailing Address -- Street Number, Street Name, or P.O. Box
1800 Purdy Ave. #2207
City, State, Zip
Miami Beach, FL 33139
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. D
Filing as an Employee (check one)
[] county □Public Health Trust [] Municipal:
(Municipality)
Department
Position or 1itle Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
□County E] Municipal: City of Miami Beach
(Municipality)
Board where serving
Next Generation Council
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
Ends 12/31/23
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 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.E]
Name of Source of Income Address Description of the Principal Business Activity
Real Estate Sales 2875 NE 191st St Suite 200, Real Estate Sales
Aventura, FL 33180
Business Management 3951 S Ocean Dr. Suite 1402 Parking Rental Business
Hollywood, FL 33019
08.25.22
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
or e»RECEIVED
D Electronic Copy
AUG 25 2023
CITY OF MIAMI BEACH
OFFICE O THE CITY CLERK
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
±e Alu "+Ee: fl
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph:. (305) 673-7505 or (305) 673-7000 ext. 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 importanl thal 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 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
Dote of Application: 08.25.23
Applicant Nome: Dany Raffoul
Board/Committee Name: Next Generation Council
Address: 1800 Purdy Ave. #2207 Miami Beach FL 33139
E-Mail Address: danyraffoul@gmail.com
Work Phone: Home Phone
Cell Phone: 7869425423 Preferred Contact Method:
Vehicle Information
Tog: NPKU99 Color: White
State: FL
Make:
Year: I2019
eep Model: Grand Cherokee
Applicant St+nature: e
Please provide signed form to the Pfrking Department located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingR eception@m iamibeachfl.gov
e-mail subiect: BOARD 8 COMMITTEE PARKING APPLICATION - APPLICANT NAME
ar' mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Dote: ID Cord Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature: 6
Date Issued: Date Completed:
P ·ki D S ·