Adam Kravitz 12.31.25M IA M I BE ACH
BOARD AND COMMITTEE CHECKLIST
APPonNrEee.._-AZ_ AT OF APowrNr: _l!/2i[a_A yh{
BOARD/COMMITTEE. {p l7 Co-@-41 Apointed by:. __[A_(Ao _
FOR SCANNER
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FOR CLERK STAFF
o Letter of A ppo intm ent
o Letter of R eappointm ent
o C opy ~f Letter of Ap pointm ent/R eappo intm ent e-m ailed
4/30\23
o Biard an C om m itt ee Ap pl ication (C om ple ted on
o R ~sum ~/C urri cul um Vitae {2,]
o Di v ersi ty Sta tistic s R epor ti n g (C omp l et ed on llJ _9 )
o O ath
rRw No. nll [2S TERM LIMIT: _
to C om m ittee Liaiso n on
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RECEIVED
DEC 01 2023
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓C ity C od e O rdinance Sect ion applica ble to the agency, bo ard or com m itt ee
Ci ty C od e S ection s 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 24 58 and 2-4 59
C ounty C od e Secti on 2-11.1 - C on fli ct of Interest and C od e of Ethics O rdinance (as
am ended through D ece mb er 2010)
Am en d m ents to the C od e of Ethics O rdinance (Sept emb er 2009 thro ugh July 2012)
H igh ligh t s of the M iam i-D ade County Ethics C od e
S unshin e Law and Public R ecor d s - Freq uently A sked Questions
✓M em or an d um - Sol icitation by C ity Boa rd and Co m m ittee M em bers
CITY OF MIAMI BEACH
OFFICE O IE o - CITY C LER #O C itywi d e Permit Ap p lication (Parking D epartm en t Form )
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o Bookl e t - G uid e to Sunshine A m endm ent & C od e of Ethics for Public O ffi ce rs and Em ployee s
o So urce of Inco m e Statem ent
o A ck now led gm ent of Financial Di sc lo sure R eq uireme nt
o Boa rd and C om m itt ee s Li aison Responsibilities
o DIVERSITYSTATISTICSREPOR[ING -•jPf!--"':!:'G""'Ll<w~~
L/o/2 sore»X t
r oate Boa rd or C om m ittee M em be r
o rs4 on 'h'B? re»rs '1
71 "7- ...l lmmDl/,
R ece ived on:
Sca nned on:
D ate C ity Cl e rk's Offi ce Staff Initials
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter D ate Proc essed Initials Scan o
R esignatio n Letter D ate Proc essed Initials Scan o
R em oval Lette r due to absences D ate pro cessed Initials Scan o
F:CLER\BOARD AND COMMITTIES DATABAS E\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are com mitted to providing excellent public serice and solely to al! who live, work, ond play in our vibrant, tropical, historic com munity.
MI A MI BEAC H
C ity o f M ia m i B e a ch , 1Z OO Con ven tion Con lor Dr ive, Miam i Beach, Horida 33139 yyew._miaIibeachf]gov
OFFICE OF THE CITY CLERK, Rafael E. Gran ado, City Clerk
Tel: 305.6 73.7411, Fax. 305.673.7254
Emai l: C iNyClerk @miamibeachfl.gov
November 30, 2023
Mr. Adam Kravitz
2982 Alton Road
Miami Beach, FL 33140
RE: Audi t Committee
Dear Mr. Adam Kravitz:
Congratulations! You have been appointed by Commissioner Alex Fernandez to the above-referenced
Board or Committee, for a term ending: 12/31/2025.
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 Jan uary 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. #d
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Mark Coolidge, 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 - Am endmen t to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics
City W ide Permit Application - (Par king Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
M IA M I BEACH
C ity o f M ia m i Bea ch , I/00 Convention Center Drive, Miami Boach, Florida 33 139 yyy_miamnibcachllgo
OF F ICE OF THE CI TY CL ER K , Rafael E. Gr an ado, City Clerk
Tel: 305.673.7411, Fax 305.673.7254
Email: CiyClerk @miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
T O : M r. A da m K ravitz
R E: A udit C om m itt ee
I do so lem n ly sw ea r or affirm to bear true faith, loyalty and allegiance to the Govern m ent of the United
States, the State of Florida, and the C ity of M iam i Beach, and to perform all the duties of a m em ber of the
ab ove-m entio ned board or com m ittee of the C ity of M iam i Beach to w hich I have been appointed fo r a
term ending : 12/31/2025.
T o m y co lle a gu es and to all of those I represent and serv e, I pledge fairn ess, 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 en issued a copy of section 2-11.1 of the M ia m i-D ade C ounty C ode (Conflict of Interest and
C o de of Ethics O rdinance), as w ell as Florida C om m ission on Ethics G uide to the Sunshine Am endm ent
and C od e of Ethics fo r Public O ffi cers and understand that as a m em ber of a C ity of M iam i Beach Board
and/or C o m m itt ee , I m ust com ply w ith the financial disclosure* requirem ents of M iam i-Dade C ounty or the
State of F lo rid a (d e pending on the board or com m ittee on w hich I serv e) on July 1st, fo llow ing the cl osing
of the cale ndar yea r on w hich I have serv ed.
M r. A dam Kravitz
Sw orn to an d subs cribe d before m e thi s_· day or [0en{o3
Keil~
Deputy Clerk
*P lease visit the C ity of M iam i Beach w ebsite at ww w .m iam ibeachfl.gov under City Clerk/Board and
C o m m itt ee s for ad ditional info rm ation regarding the Financial D isclosure R equirem ents.
MIA MIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florido 33139
RECEIVED
DEC 01 223
CITY OF M One 6.}]/SM BEACH
HE CITY CLERk
OFFICE OF THE CITY CLERK
Email: C@mnamibeachf_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):
&_am a resident of the City of Miami Beach for six months or longer.
Home Address._2'+62 Aoo >,_4-vu&o8,R33(0
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).
[q[ f P1JS,][@S,-
Py[es,S (Sf,S,
D 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).
[]9mP (T PA1mes,S,
P1]]f)es,, (]SfeSSS,
"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 pen "
stated i
eclare that I have read the foregoing document and that the facts
Signa ure
/
/0/23
Date
Printed Name
MIAMI BEA CH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florido 33139
www.miamibeachfl, gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 673.7411
DIVERSITY STATISTICS REP ORI
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:
ale
D Female
loner
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
0 Asian or Pacific Islander
Caucasian/white
0 Native American/American Indian 0 Other - Print Race: _
D I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
v es o 0 I prefer not to answer.
Do you consider yourself Physically Disabled?
bl;
Lltrefer not to answer this question.
Page 6 of 6
F CLER\SALL REG\BOARD AND COMMIT TEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL docx
Updated: June 2020
WIAMIBEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeacht!_gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone. 305.673.7411
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
[ fA
Last Name First Name Middle Initial
Acknowledgment 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)
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 more than $500, 60 days in jail, or both.
Acknowledgment to Comply with Miami Beach Code of Ordinances Division 1 Sec. 2-22 (23)
I understand that commencing with terms beginning on or after January 1, 2024, and as a condition of applying
for appointment to a City agency, board, or committee, I voluntarily agree that in the event I file with the City
Clerk a Statement of Candidate formally announcing candidacy for City elective office, such filing with the City
Clerk shall be deemed ender of resignation from the City agency, board, or committee
/ > 1/8ol2
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 6 of 6
F \CLER\SALL BOARD ANDO COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION OCT 2023.d0cx
Updated: January 9. 2023
/[AM[PEA,ycIw E (Cw OAR& & coMEeEs -
or+ --« ·vino oi»ii PARKING APPLICATION Ag#Egel
1755 Mer idian Aven ue, Soi#e 200/M iami Besch, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 e4. 6200 {A
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, l will be responsible to pay a $10.00 replacement fee.
Board Member inform"
Date of Application:
Applicant Name:
Address:
E-Mail Address:
Work Phone: Home Phone
col Pone: ?o, 350 20 Preferred Contact Method: C-
Vehicle In! -
Tag: Color:
State: Year:
Make: Model:
A_
Ap plicant Si+nature: a
Please provide signed form to the Parking Departm ent located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email to: Parking~Reception@miamibeachfl.gov
e-mail subiect: BOARD & COMM ITTEE PARK ING APPLICATION - AP PLICANT NA ME
Parki na Depa rtme nt Sect ion
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #.
lssued By Print Name: Print Nome:
Signature: a Signature:
Date Issued: Dote Com pleted :