Janis Good 12.31.25B OA R D AN D COMM ITTE E CH ECK LIST
80ARD.Q@TT. Cormss«n Ff o Worn Auotines ansya tsae:
: i...,..1t,t,,,ae;,,.._11•wc.~••11t :.ai· ~1'iflWJi:1Wf,..,I. 18"~,a.•Jf,111_..,_ ~ ~- ·n··...._.,,.~., ~-,1~,, ..,:,.,,.o:-; •. ~ .. ·,.,,. ,,i>'llk-.•-t.~r,,.-j, ,., . ..,.._,,
ow o '317% r«... Fo sAMtR
$.a
fe an
¥Q LERA $AF¥
I.etor t Appwntvrveet
t ethe ot RR¢sap pwtent
'Ci.J\lf' ()I t·..., fl -~;-\!ti'!ll'l\fl¥#\t,;~~ll# --~ ffl, (:~-~ /21v~
ti@uie.2 arr ,48Py9ft@ kg pi" ggo {(CU'pomp iggad q '
" Pe " " /NA,o - %\" {' +4"I " WO"f ow»ow»woos «eo w+ +no oirsos.
Wesuwe "arr'oi.um W'tao
worsy sututs» Reportwg «Crews on_l]I//12)
Oat
RECEIVED
EC 19 2023
CITY OF MIAM I BEA CH
OFFICE O HAE CITY CLERK
can 6
can %
PO TANT NF ORMA TION FOR OARD ANDO COMMITTEE ME,MR£RS OON
• Chy Cote Odra we Sect»on Mp0cabwe ta the ager«.y bow} cw cow#tee
• .' &,u4 4 »4 $ 49 4. $g 9 Mg M A 9 ..pg a4 $,go¢24 Cry (kb! Stows".'.sag l, « ski. 2di a? @4.
• Countv Cote Sect0n 2-tt t • Co/tut ot trtwest arg Cote t Zeis «.kw
rented through Qecertes 2Qt0
« AewNets tu the Code ot ~ thus Our.w (ee4tweet w 2th? wrap" A4.%y "
• ghvophvs ot ttw» Marnw-Dwte Cuny t tha.s Coke
v stw Law rd Paw #wonts ..Fr»quwry As4 wt kes. Nn
• MevrsM4a Mkqn· Sobctaw tw Cy P%sot$ rs 'orweevttee Mew""»es
Citywide Per Appca ton (Per tang Depar tr F wow)
book it - Guide to Sa shwn e Arner@mvent & C ote t iw s tw Put# Mt awwt e
• Sq«utce ! lone 3atenet
• Acknowtgrrent gt f wa cial Mo«closure R equ»revert
t or$ an C' wwrwrte»es t ale«own Resp vs.bvet#tnos
· DOVE.RBI STAI@IC3 Ero Io Kee tr Mn two 4 Ool. tw Meo
12/18v2023 snan Khans Good y #, o » "v " ow v c 6 ..,"---Me
K
12/1420 23
(Mate
3 fen ( »jirw«+ Le tt «et
i
' i , .. \·. ) ' t ..... , .y •· • ···'
, Me»wpwan et4et
l. , , . ' ~• • ,. •I•' l ;, ~- ., , ••. ,, •,., ,. , ' .• • •
, feravl l ott «ho@ to at)onweo
\
City CNA (Otte» Stu wvat»
I<N\
City C w w Otte e / Mwat
C O N C LU D E D & R E SI GN A TI O N L ETT E R S
{ (Mate Pr»cowed
l .. .
, Mate Wu«wet
,bi «or»s
..... 1 ... , .,., , .. ·<
'
{ tw#th
' # 1ow
I
I MIAMI BEACH
City of Miami Beach, ZOO Convonlion Conlor Drivo, Miami Boach, Florida 33 139 yyy._Iiamnibachll_gov
OFFICE OF THE CITY CLERK, Rafael E. Gr an ado, Cy Clerk
Tel: 305.6 73.7 411, Fax. 305.6 73.7 25 4
Email: CiyCl erk@miamibeachfl.gov
D ecem be r 11, 20 2 3
M s . Ja nis G ood
10 0 Li ncoln R oad , #742
M ia m i Beach, F L 33 13 9
S UBJE CT : Miam i Beach Com m ission For W om en
C o ng ratulatio ns! Y o u ha ve be e n rea p po inted by Co m m issioner Tanya Bhatt to the abo ve refe renced,
b oard or com m itt ee na m e d above , for a term ending : 12/31/2025.
P ursua nt to C ity of M ia m i Be a ch C o de Se ction 2-2 2 (5 ) a, "N o tw ithsta nding any other provision of the
C ity C o de or of any reso lutio n , co m m e ncing w ith term s beginning on or aft e r Ja n ua ry 1, 2007 , the term of
e ve ry b o a rd m e m b e r w ho is dire ctly appo in ted by a m em b e r of the C ity C om m issio n shall auto m atically
exp ire u p o n the la tt e r of: D e cem b e r 31 of the ye a r the appo in tin g C ity C om m issio ne r le a ve s offi ce or
upo n the appointm e nt/ele ctio n of the successor C ity C o m m issio n m e m be r."
If yo u are un a b le to acce pt this ap p o intm e nt, or ha ve any que stions, please ca ll the O ffi ce of the C ity
C le rk at 305 .6 73 .7 4 11. Ple ase rea d the encl o sed m ate ria ls carefully.
C ongra tu latio ns and go od luck.
%
R afa e l G ranado
C ity C le rk
cc: M o n ica Be ltra n, Pa rking Di recto r
M o nica M att eo-S a lina s, C ity Li a ison
ATT A CHM ENT S:
Letter of A ppointm e nt
O ath
C ity C o de/O rdina nce sectio n ap plicable to ag e ncy, boa rd or com m itt ee
Ci ty C o de Section 2-2 2 , 2-23 , 2-24 , 2-25, 2-26, 2-45 8 an d 2-4 59
O rdina nce N o . 20 06-3543 - Am endm e nt to C ity C ode Se ction 2-22
M ia m i-D ade C o unty C ode Se ction 2-11.1 - C on flic t of Interest and C o de of Ethics O rdina nce
C ity W id e Pe rm it Ap p lic ation - (Parking D e pa rt m e nt F o rm )
B ook l e t - G ui d e to the S unshine A m endm ent and C o de of Ethics fo r Public O ffi cers and Em ployees
++M /BEACH l '• ,. ' !' , 1 l· , , ,.f [,,..., ,.,..,.,, , ,
City wt Aini sh, /4± +wt «.t «4a tows a #oat is t #tuna.#ttk.4ai%#.l# ii.#
wt «s he rite tall i tnawed,, Ca a
l 49 4/' /it tw 4Ms 4$/4
wet to4.kteewel we.Ml.gee
Oath ot 0#fi e
Oath ot City
and
¢tnowlodgement
f) Mus Janis (Good
+ do 4otrnly 6war t tfum to boar true tarth, loyalty an4 allg@no to the Governor of the {/rrtd
tats the State of Fonda and the City o/ Miarw ct, and to portrrn tl the 0ts of s remoter ot #we
above·mentood board ot committee of the Caty ot Mierw (oh to wt wh l hv en op«rd e
er endi ng 12/31/202$.
Io ray colleague and to all of those N tptesent ard servo, I pledge fats tguty ard avitty i a%
Ac'tons ts«en and all corr unctions rnde ty rre as a pt., or vart
t tave tee 444ui0 copy of section 21t I t tine Mi»rw-Dad County ,ode ((.onfit t interest 4rd
.0M ot ~tmwcs Ordnance), t wet as F londa Conrns 4on on f ttw {ude to the 'untwne Arnerdrrer
rd f'ode ot Ettwcs to Pubic Ottcers no understand that as a merbet t a City o Marra feat No d
rd/or Corrmntte I must cornpl y with the hnancal dloure" requit errents of Marr» Dade County or the
State ot F lorda (dponding on the board or cornuttee on wuch l serve) on Judy 1st fowrg tte korog
of tre clrdt yoat on wwch ) have served
f.f,
t
Ciy et Aini no«eh
k' roe i, we {% e
Msgwe MM.h Pg i3' 3¢
RECEIVED
DEC 19 2023
CITY OF MIAMI BEACH
OFFICE OW THE CITY CLERK
Ar/IDA IL Or A/IILATON HIIH THE. CIIY Qr MIAML BEACH
l amn in cornplanco with the a/ttaton req uirem ent of Mam peach City Code Sections 222 {4).
as (check t) all that opp'y)
[]1am a res»dent ot the City ot Mam» Beach tor sx months or longer
Home Address· 100 Lincoln Rd.4742, Miami Beach Florida 33139
«tu#err.it.tao at.ti«tie a at oat art al»tao lo «oon,ii ¢ma_a.a.
[ [4tave an ownership interest (tot a minimum ot six months) in a business established mn the
City ot Mari Beach (tor a mnimnum ot s months)
Name ot Bull n-..·_ ,- .,. .. ~----- _ -·-------·-·•··-•· - _, __ . , ----·---•-· ,, , ,- ,., ..
Boline&<& Addro&.o.· -" .. ., .,,, ., ,, ,---., ,. , •.. , .•.
[ ]tam a full-tmne employee of a business (tot a mnnimnum ot six months) and I am based m an
o/tice or other locaton ot the business that is physically located in Mam Beach (tor a
mmum of sun months)
'Ownershup Interest" means the ownerstup ot ton percent (10%) or more (includin g tte
owners hip of 10% o more ol the ou tstanding cnpita/ stock) in a business
Business" means any sole pruprietorshp, sponsorship. corporation, limitod leability company.
or other entity or business assoc iation.
Under penalties ot porury I declare that ! have road tho tor@going document and that tto tacts
stated n it are true
u fk 8ign« tu
12/18/2023
Janis Good
~#RG Na,"
Cly ol Mlem Bed
!t'w t on &,elev (Otte
M9. Hren ·kw«ta 3.3139
www trgr&ea.t".guy
wt ¥ wt TALK
t mt , fmvm9!! ggy
I«tpho 30$ 6/3 74l1
DIVERSITY STATISTICS REPOI
Good Janis E
vat nee oar otoo et, o •
last Name frst Name
The following intormation is voluntary and has no bearing on your consideration for appointment. tt is boi
asked to comply with City diversity reporting requirements
Gender:
(Jae
[) remae
Jomor
L} prefer not to answer.
Race/Ethnlc Categories:
W at is your race?
[)Atncan Amencan/Black
[Asian or Pactc Islander
() Caucasarwhnte
[kNatvoe Amnoncar//morican Indian
[} Otter • Frint Ra~! -
Li peter not to answer.
Do you consider yoursot to be Spanish, Mlopa nlc, or Latino/a?
8
L} t potet not to answer
Do you conslder youreeMt Ptyelcally DOlseb»led?
0 FE '0
' l No
LJpetor not to answer ttws question
- Pwjo bot 6
+ st+'4aa. Wrists» A2 ,4 2 Hf4t kt,AN Mi + #4. f»At 1k4 'Mt+ M .t.et tf# 4#4k.Alt tt w t 14t de»
#Meed vs4 8040
---------------- ----
·A ' EA CH ·.·+-A \'} · · 4 ,
C ity of Miami eo h
Jarvertr rver [,ve
'a ms a 'Hodo ?3139
w w raoohht.gov
EFCE CF THE CTY CERK
col BC@nwambeacnf ! gov
Telep/on 30$ 673 74ll
G ood
8OAR D A COMMITTEE ACKNOWL EDGE MENT STATEME NTS
Ja nis E
to
Last Name F rst Name
Acknowledgment ot fines/suspension for Board/Committee embers for tallure to comply with iemt-
Oade County Finance! Disclosure Code Provision Code Sec tion 2-81.1(l) (2)
l understand that no later than duh 1, 0f @8 ch year all members of Boards and Committees of the City of M iam»
each including those of a purely advisory nature, are required to comply wth Mam-Dade County Financial
Disclosure Requirements
gng of the followng forms pu.be filed with the City Clerk of Miami Beach, 1700 Coventon Center Drove.
Mam Beach. Fonda, no later than 12 00 noon of July 1, ot each year
1 A'Source of Income Statement." or
2 A"Statement ot Financial Interests (Form 1)'." or
3 A Copy ot your latest Federal Income Tax Return. E;le} 21 3
Faure to file one ot these torms, pursuant to the Mam-Dade County Code. may subject the person to a fine
of no more than $500, 60 days in jail, or both.
Acknowledgment to C om ply with Mam beach Code ot Ordnances DOl vt lon 1 $ec. 2-22 {23)
l understand that commencing with terms beginning on or after January 1, 2024, and as a condition ot applymg
tot appoi ntmen t to a City agency, board, or committee. I voluntanty agree that in the eve nt l file wth tte City
Clerk a Statement of Candidate formally announcing candidacy fo City elective office, such hing wth tte City
Clerk shail be deemed a tender of resignation from the City agency, board. or committee
Sionaui' D ate
.e
'Members of the P ann ing Boar d and Board of Adjustment wl be notified directly by the State ot Florida,
pursuant to F.S $112.3145(1)(a), to file a Statement of Financial Interests (f orm t) wth the Miamy·ado County
Super vis ol Flections ty 12 00 noon. July t. Planning Board and Board of Adjustinnt meters wo hte ttet
Form 1 wth the C ount y Supersor of Elections automatically satis fy the County's financial disclosure
requirement as a Miam» Beach City Board/Committee member and need not file an additional trm w th tte Office
ot the City Clerk Mowever, compliance wth the County disclosure requirement does not satisfy the State tequlrerent
SOURCE OF INCOME STATEMENT
} tars$ # e%at ·cw. ta. b»
M M» Wt $tag
r e a0tress es your mwing a4dross. ant war he adt: es M erempt tram putw. vocar ts pvemt to +» Su $19 07 res
rsractww on the totewong page end tech here.[]
Vig es an febey qtee e)
w , i er «too ioie_ii a
era loo- a tot t..-. .hi a -· -- r,.;.·m·..._ ------·-----·-· ·
}
1
'
[ Emglorpyenet began envented en
ting as eo beard iesner @etest one)
a m e te to « e # te modi «o
\
[county []Municipal: Marv «on
·tear@ where serving'"
MAwr» fa.ct C van F t Worn
t 4 a t a tr +a o e aa a a
Alter ei eddvees it boon edrees le eaeneg9Q
l
4 • t •.»
» tow awr y s ari y rgore yo two vet avg wet? tw at mas and the prcog» c tvty ot eh s ate Mc'Mute you! puts' star¥ Pe»w the eow ore ol
awcm des. en0 etg o gt. w th tte as ge st Mur e hot f an ,es wl sour ces ot on ore in.de 'or4al w lo» evA es More 'yr b»rt 4ww 4 P
tw.'y e at g4 rl r t . rt4. whee9s., penaor4. IR A ds tr tuts., 0 sol cont paynea ts Aso woke aw sure w wees» +we: ts "i!
~*~ -~-Y'OI • ~ .. ,_ ~-~~~'! ~~ ~.:-?!f~-!-~:Y-~~.~1,_~-~-~• -~ ~:'~r ~- ~-- ~ • ..,.\9 __ ..... ~ ... - ·,
' - -- .• - ~-..:.~:;;; ... ····- I. - . ---··-~--- - •. '" . r~" .. "'-"'°'.■."c- ~-1
' - . p~;~~i ;,,:.;;;;;;~~-;;;.;;·· · r-· ··- . - .... ··- . . .. - . .. r . ····· . . . . ... . .. . . .. . . . )
· .... -- _,, -- - .. · .. ·· .. - · -- r r w · --- 1
. ' ,, ' ',, . ' 1 ., . ~ ,,, ' ,, ,.,, , , ~- ., , , t ', J
a o .ao i o ta «i i
+ter eby seas a trm } that the ntorma tion above ts a tu» and corr ect ta torrent
~~/'-v:~k- .. ---- ----- ---- ---- ----
1 +8la423
Me ind
ia ucis win- z 4s o
0EC 19 2023
CIT Y OF MI AM I BEA CH
-----le.OI- Ilk IL.EB ..-
j be tile tote io i i /tot ointr oit ,t o e tee toii o t t e r t o o iotot otee.woo ow t ea
.-----.·rs»or N AN")/#8M,T TO »£ #FIE OW TF CI CFRK A FMAI OR MARCO"Y
"wr w
«wywide [. W} poking permit honed ot metered pa rking spac es and restricted residen tial zones
pot+iq 4po0» A CW parking petmnt l$ po honored n prohibited areas. An Access Cord will be
rodeo«d to you lor Ciy Hall Goroge [G/) access
AN@ti NQf Your vehicle license plate serves as your "parking permit" In order to avoid
any uc«»»Mty enforcement oclions, it is important tho! our tocods reflect the most current and
wrote information toothing your vohtcle license ploto. lnoccurate and/or outdated vohwcle
mnksv motor may lead to the issuance of parking citation[s) and/or the towing ol your vehicle
f'tease note that this new a.o»s card Rt be hole punched ot perforated in any manner lo use
tho nsw cord please hold the cord ot close proximity to the reader until the gate opens, You may need
to try the other do o/ the cord Please ensure you hold the entire surface ot the card against the reader
ontul the goto opens
ACKNOWLDO@MNT N acknowledge that should my access cord be lost, stolen or
damage, N wi ll be responsible to pay o $10.0 replace me nt foe .