Katie Luddy 12.31.24DocuSign Envelope ID: 6509347D-F 169-4626-B798-094A9F680E C7
MIA M I BEACH
BO ARD AND COMM ITTEE CHECKLIST
APPOINTEE: CG"""& """
soARrcowmrreEe: """"" """"""""" Aoitea y. _"""" """""
DATE OF APPOINTMENT: 8/28/2023
FOR SCANNER
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R E C E IV ED
SEP 05 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to
9 12[23
o Board and Committee Application (Completed on 8l22]23
o R~sum~/Curriculum Vitae [
o Diversity Statistics Reporting (Completed on <1 L]3
o Oath
TERM END: 2[2 1]1-{ TERM Lu MI r: 2/ l30
Committee Liaison on
CITY OF MI AMI BEA CH
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, 2-26, 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
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Scan o
Received on:
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
o Board and Committees Liaison Responsibilities
. ·db ·
O DIVERSITY STATISTICS REPORTII 'ai ORIGINAL for An n ual Report.
9/2/023 X __________ Signed by
Scanned on:
Date ber
4112s 16c... KA) Processed on. _' By Employee.
al5 crease onces y0
__________ By Employee: _
City Clerk's Office Staff Initials Date
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 COMMITT IES 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 play in our vibran t, tropical, historic community
MI MI
City of Miami Beach, I/OO Convonlion Conlar Drive, Miami Boach, Horida 33 139 y yy y_m iaI ibc achf]_go
OF FICE OF THE CIT Y CL ERK, Rafael E. Gran ad o, City Clerk
Tel : 305.673.7411, Fox. 305.673.7254
Emai l: Ci#yCl erk@m iam i beach fl.g ov
August 25, 2023
M s. Katie Luddy
2001 M eridian Ave #529
M iam i Beach, FL 33139
RE: Sustainability Committee
Dear M s. Katie Luddy:
C ongratulations! You have been appointed by Commissioner David Richardson to the above-
re ferenced Board or Comm ittee, fo r a term ending: 12/31/2024.
Pursuant to City of M iami Beach Code Section 2-22 (5)a:
Notwithstanding any other pro vision of the City Code or of any Resolution, commencing with
terms beginning on or after Jan uary 1, 2007, the term of every board m ember who is directly
appointed by a member of the City Comm ission shall automatically expire upon the latter of:
D ecem ber 31 of the year the appointing City Comm issioner leaves office or upon the
appointment/election of the successor City Comm ission m ember.
If you are unable to accept this appointm ent, or have any questions, please call the Office of the City
C lerk at 305.673.7411.
Please read the encl osed materials carefully as they concern your duties, responsibilities, and
requirem ents as a board or comm ittee m em ber.
C ongratulations again and good luck. %4
la.I Granado
City C lerk
cc: M onica Beltran, Parking D irector
Juanita Ballestero s, C ity Li aison
ENCLOSURES:
O ath of O ffice/Oath of C ivility/Acknow ledgements
City C ode/Ordinance section applicable to agency, board or committee
City Code Section s 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
O rdinance No. 2006-3543 - Am en dm en t to City Code Section 2-22
M iam i-Dade C ounty C ode Section 2-11.1 - Conflict of Interest and Code of Ethics
C ity Wi de Perm it Application - (P arking Department Form)
Booklet - G ui de to the Sunshine Amendm ent and Code of Ethics for Public Officers and Employees
D o c u S ig n E n v e lo p e ID : C E B 9 3 5 1C -9 9 6 9 -4 9 17 -8 3 5 8 -E 7 D 6 A 5 2 E 2 A 9 E
MIAMI BEACH
City of Miami Beach, 1/O0 Convention Conler Drive, Miami Boa ch, Horida 33 139 yaw._Iiamnibachll.gov
OFFICE OF THE CITY CLERK, Rafool E. Granado, Cy Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: Ci#yClerk@miamibeachll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Katie Luddy
RE: Sustainability Committee
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 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.
DocuSigned by:
~uddy
E39F7C61 E11246C...
Sworn to and subscribed before me this Q day of Sept., 2023
L
Keila Mena Caceres
Deputy Clerk
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.
DocuSign Envelope ID: 6509347D-F 169-4626-B798-094A9F680EC7
MIAM I BEACH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
SEP 05 2073
CITY OF MIAMI EEEACH
OFFICE OF THE CITY CLERK
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 7411
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):
~ I am a resident of the City of Miami Beach for six months or longer.
Home Address: 2001 Meri di an Ave #529 Miami Beach, Fl ordi a 33139
D I have an ownership interest (for a minimum of six months) in a business established in the
C ity of M iam i Beach (fo r a m inim um of six months).
Nam e of Business: -------------------------
B usiness Address: ------------------------- □I am a full-tim e em ployee of a business (fo r a m inim um of six m onths) and I am based in an
office or other location of the business that is physically located in M iam i Beach (fo r a
m inim um of six m onths).
Nam e of B usiness: -------------------------
B usiness 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.
Undi~- e~~ltie~rul ~rjury , I declare that I have read the fo regoing docum ent and that the facts
:K ~ ~- 9_1_2_12_0_2_3 _
re77 at e
E 39F7C 61E 11246C ... Katie Luddy
P rinted Nam e
D o c u S ig n E n v e lo p e ID: 6509347D-F 169-4626-798-094A9F680EC7
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Luddy Katherine A
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:
LJ at e
El remale
0 Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
D Asian or Pacific Islander
El Caucasian/white
0 Native American/American Indian
D Other - Print Race: ------------- □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Tves
EJNo
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
vs
h o
D I prefer not to answer this question.
Page 6 of 6
F:\CLER\$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
DocuSign Envelope ID: 6509347D-F 169-4626-B798-094A9F680EC7
MIAMI BEACH
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: 305.673.7 411
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)
Luddy Katherine A
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.
Failurg_to file one Qf these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
H8fl'i "g8B!6o days in jail, or both.
·_ ~ __ 9_1_21_2_0_2_3 _
ature'7 y° Date
E39F7C61 E112460...
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 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:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
DocuSign Envelope ID: 6509347D0-F169-4626-B798-094A49F680EC7 pg@O D souRCE OF INCOME STATEMENT EIII
Section 2-11.1(@) 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 Luddy Katherine A
Mailing Address - Street Number, Street Name, or P.O. Box
2001 Meridian Ave #529
City, State, Zip
Miami Beach, Florida 33139
If your hom e addre ss is your m ailing address, and your hom e addre ss is exem pt fro m public re cords pursuant to Fla. Stat. $119.0 7, read
instru ctions on the follow ing page an d check here. D
Filing as an Employee (check one)
□County □Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[] county E] Municipal: Miami Beach
(Municipality)
Board where serving
sustainability committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
8/28/2023
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 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 Address Description of the Principal Business Activity
spearmint Energy 2916 N. Miami Ave Suite 910 Executive Assistant Miami, Florida 33127
KTL, LLC. 2001 Meridian Ave #529 Model/Actress Miami Beach, Florida
I hereby swgar (or affirm) that the information above is a true and correct statemen t.
Do~uSign~d by:
sits
97 51E11246C...
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
tJ aracohECEIVED
[] Electronic Copy
SEP 05 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CI Er
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials:
138_SP-14 COE 2016
D o c u S ig n E n v e lo p e ID: 6 5 0 9 3 4 7 D -F 16 9 -4 6 2 6 -B 7 9 8 -0 9 4 A4 9F 6 8 0E C 7
±%4 9£4.417 422 ± LO
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 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 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
Date of Application: 9/2/2023
Applicant Name: Katherine Luddy
Board/Committee Name: sustainability committee
Address: 2001 Meridian Ave #529 Miami Beach, Florida 33139
E-Mail Address: k@katieluddy.com
Work Phone: N/A Home Phone N/A
Cell Phone: (585) 350-8727 Preferred Contact Method: Cell phone
Vehicle Information
Tag: ONT A77 Color: white
State: Florida Year: 2020
Make: Jeep Model: Grand Cherokee
Applicant Simnature: e
Please provide signed folm to th Pr+ing le; irtment located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5.00 p.m. 1kE@9fr@6444l4@ception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
P ·d D S ar mna epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: Signature: e
Date Issued: Date Completed:
.'«p0mg man ar torms cw oaris «committees pat mngtorm.doc