Marilia Kamil 6.30.24M IA M I B E A CH
B O ARD AN D C OM M ITTE E C HECKLIST
APPOINTEE: Marilia Kami! ----------------- DATE OF APPOINTMENT. 12/3/2023
BOARD/COMMITTEE. Commi ttee.far Quality.Educa"8 Appointed by. Treasure Island Elementary
FOR SCANNER
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REC E IV ED
0EC 04 2023
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment hf%4 p$5$" " Anon«onveavomwont, e-mesa
o Board and Committee Application (Completed on ti }-o / lD
o R~sum~/Curriculum Vitae p[1J/),2
o Diversity Statistics Reporting (Completed on_!"_,'1,'
o Oath
rRw N o. el/4 TERM uwnr. 6 l0/4
to Committee Liaison on
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 CITY OF MIAMI BEACH
OFFICE OF THE CITY C!ERK
o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o o Source of Income Statement
Scan o o Acknowledgment of Financial Disclosure Requirement
o Board and Committees Liaison Responsibilities
O DIVERSITY STATISTICS REPORTING Keep COPY in file and ORIGINAL for Annual Report.
Received on. 12/03/2023 Signed by /
Date
Processed on. 1?/0l0° By Employee:t !
Date
Board or Committee Member
ice Staff Initials
Scanned on: 12/0/20° yEmployee:
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 COMMITT IES DATABASE\CHECKLIST MASTER\B&C Checklist 2015 MASTER.docx
We are com mitted to providing excellent public service and safety to all who live, work, and play in our vibrant, tropical, historic community.
M IA M I BEACH
City o f M ia m i B e a ch, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl gov
OF FIC E O F THE C ITY CLERK , Rafael E. G ranado, City Clerk
Tel: 30 5 .673.7 4 11, Fax: 30 5.67 3.7 25 4
Em a il: C ity C lerk@ rn iam ibeachfl.gov
November 7, 2023
Marilia Kamil
193 N Shore Dr., 193-5
Miami Beach, FL 33141
RE: Committee for Quality Education in Miami Beach
Dear Ms. Kamil,
Congratulations! You have been appointed to the above-referenced Board or Committee as a
representative for the Treasure Island Elementary 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 305.673.7411.
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.
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.
M IA M I BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33 139 yyyw_miamibeachll_gov
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: City Clerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Marilia Kamil
RE: Committee for Quality Education in Miami Beach
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: 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 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.
~amil
Sworn to and subscribed before me this~ ~3
Keila Mina cares
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.
MIA\MIBEACH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH AND THE COMMITTEE
FOR QUALITY EDUCATION IN MIAMI 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:
~ I am a City of Miami Beach resident for six months or longer.
Home Address:"""""
~ I am the parent/guardian of a student attending a Miami Beach school for the _2_nd __ school
year.
School: Treasure Island Elementary
Under penalties of perjury, I declare that I have read the foregoing document and that the facts
"% ~ 11/02/2023
Signature Date
Marilia Kamil
Printed Name
MIAMI BEACH
City of Miami Beach
l 70 0 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 REPORT
Kamil Marilia
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 Mate
[Zl Female oner
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
D Asian or Pacific Islander
El Caucasian/white
El Native American/American Indian
D Other - Print Race: ------------- □I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Ives
(o
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
ave>
0o
D I prefer not to answer this question.
Page 6 of 6
F:IC LE R\$A LL\R E G \BOA RD A ND C O M M ITT E E A P P LI C A TIO N S FINA L DRA FTS \BOA R D A N D C O M M ITT E E A PP LI CA TIO N R E G FINA L.docx
U p d a ted : Ju n e 202 0
M IAM I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibegchfl,gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.741 l
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
Kamil Marilia
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 al be d ed a end f resignation from the City agency, board, or committee
12/03/2023
Date
1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
pursuant to F.S. $112.3145(1)a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County
Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their
Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure
requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office
of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State
requirement.
Page 6 of 6
F:\CLER1$ALLIBOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION OCT 2023.docx
Updated: January 9, 2023
' in3a t
MIAMl·DAD E- EI
Clear From Print Form
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 Kamil Marilia
Mailing Address - Street Number, Street Name, or P.O. Box
193 N Shore dr, 193-5
City, State, Zip
Miami Beach - FL, 33141
lf your hom e addre ss is your mailing address, an d your hom e address is exempt from public records pursuan t 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 Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[] count y (] M unicipat : Miami Beach
(Municipality)
Board where serving
Committee for Quality education Miami Beach
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
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.D]
# Name of Source of Income Address Description of the Principal Business Activity
11300 NE 2ND AVE, Miami Adjunct Professor
Barry University Shores, FL 33168
I hereby swear (or affirm) that the information above is a true and correct statement.
ill
Signature of Person Disclosing
12/03/2023
Date signed
cEe sv 4ens DF NRTNNT: □Hardcopy
Electronic @@ y 04 2023
CITY O F M IAMI BEACH
OFFICE OF THE CITY CLERK
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY.
M IA M I BEA C H CITYWIDE {CW) BOARD & COMMITTEES Ia City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 PARKING
A ci-tyw ide (C W ) par king perm it is honored at metered par king spaces and restricted residential zones
par king spaces. A CW par king perm it IS NOT honored in prohibited ar eas. An Access Car d will be
provided to you fo r C ity Hall G ara ge (G 7) access.
IMPORTANT NOTE: Your vehicle license plate serves as your "parking per mit". In order to avoid
any unnecessar y enfo rcem ent act ions, it is im portant that our re cords reflect the most curre nt and
accura te info rm ation regar ding your vehicle license plate. Inaccurate and/or outdated vehicle
info rmation m ay lead to the issuance of park ing citation(s) and/or the towing of your vehicle.
Pl ease note that th is new access card CANNOT be hol e-p unched or perforat ed in any man ner . To use
the new car d please hold the car d at close proxim ity to the reader until the gate opens. You may need
to fry th e other side of th e card. Please ensure you hold the entire surfa ce 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: 1210312023
Applicant Nam e: Marilia Kami!
Board/C om mittee Nam e: Committee for Quality Education Miami Beach
Address: 193 N Shore
E-M ail Address: mariliakamil@gmail.com
W ork Phone: Home Phone
Cell Phone: 3476056738 Preferred Contact M ethod: phone
Vehicle Information
Tag: 41AGDS Color: w hite
State: Florida Year: 2021
M ake: Tescla M odel: 3
-· ,, .. Q .k. Applican t Sianature : es
Please pro vide signed form td th e Park ing Department located at 1755 Meridian Avenue, 2d floor . W orking
hours are 8:30 to 5:00 p.m . or em ail to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
Parkina Department Section
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature: 6
Date Issued: Date Completed:
-fpttg \m an var \Orms Cw Doarddcommittees parking/orm.doc orm updated rt or tut