James Orlowsky 12.31.25MI AMI(BE
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: JAMES ORLOWSKY
BOARD/COMMITTEE: QUALITY EDUCATION
DATE OF APPOINTMENT. 01/16/2024
Appointed by: COMM. FERNANDEZ
FOR SCANNER
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FOR CLERK STAFF , / ( I
o Letter of Appointment TERM END: [3I '2{ TERM LIMIT. ll3'2]
o Letter of Reappointment /
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on t[_[/]
o Board and Committee Application (Completed on - ' •
o R~sum~/Curriculum Vitae
o Diversity statistics Reporting (completed on. L[2L
o Oath
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK pEE!VE?l} " 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
JAN Ii,s amended through December 2010)
✓Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
CITY OF M_IAMI 8P.)!.f}tl/, ~ Highlights of the Miami-Dade County Ethics Code
OFFIC
E or-THE. CITY CLt.1- ,\{ ✓Sunshine Law and Public Records - Frequently Asked Questions
Memorandum - Solicitation by City Board and Committee Members
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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 Statement
o Board and Committees Liaison Responsibilities
o Diversity Statistics Reporting
l I acknowledge that pursuant to Sec. 2-22(9) of the Miami Beach Code of Ordinances, I will be removed
from my board/committee upon failure to attend 33% of the regularly scheduled meetings.
Se0. 2-22(9) I any member of an agency, board or committee fails to attend 33 percent of the regularly scheduled
meetings per calendar year, such member shall be automatically removed. To calculate the number of absences
under the 33 percent formula, .4 or less rounds down to the next whole number and .5 or more rounds up to the
next whole number.
Received on:
Scanned on:
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11
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_:-:-~-----Signed by~. oc Committee Member
res»soon 'h/@[1 reores. J
Date City Clerk's Office Staff Initials 1//l2 a . )
Date City Clerk's Office Staff Initials
We ate committed to providing excellent public service and salety to all who live, work, and play in our vibrant, tropical, historic communily.
M IA M I BEACH
City of Miami Beach, I/OO Convention Co nler Drive, Mia mi Boach, Florida 33 139 yNyyyy_miaIibga chll_gov
OFFICE OF THE CITY CIERK, Rafaol E. Granado, City Clerk
Tel: 305 .673.7411, Fox:. 305.673.7254
Email: CilyClerk@miamibeach fl.gov
January 16, 2024
Mr. James Orlowsky
9 ISLAND AVENUE APT 1414
MIAMI BEACH, United States 33139
SUBJECT: Committee for Qual ity Education in Miami Beach
Congratulations! You have been reappointed by Commissioner Alex Fernandez to the above
referenced, board or committee named above, 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 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: Decembe r 31 of the year the appointing City Commissioner leaves office or
upon the appoi ntm ent/election of the successor City Commission member."
If you are unable to accept this appointment, or have any questions, please call the Of fice of the City
Clerk at 305.673.7411. Please read the enclosed materials carefully.
Congratulations and good luck.
Regards,
Ra~do
City Clerk
cc: Monica Beltran, Parking Director
Dr. Leslie Rosenfeld, City Liaison
ATTACHMENTS:
Letter of Appointment
Oath
City Code/Ordinance section applicable to agency, board or committee
City Code Section 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 - Con flict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
City of Miami Beach, 1ZOO Con vention Cantor Drive, Miami Boach, Florida 33139 ya.miamibcachll.gay
OFFICE OF THE CITY CLERK, Ralaal E. Granado, City Clerk
Tel: 305.673.7411, Fox: 305.673.7254
Email: C ilyCl erk @mi am i bacch f.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. James Orlowsky
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: 12/31/2025.
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 /o r Committee, I must comply wi th the financial disclosure" requirements of Miami-Dade County or the
State o f 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.
Sworn to and subscribed before me this / '.:)-- jj..J,;:::_
K e ila M e n a Caceres
D e p u ty C ler k
*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.
M IA M I B E A C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florido 33139
OFFICE OF THE CITY CLERK
Em ail: B C @m iami b each fl_g ov
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: 9 IS LA N D A V E N U E A P T 14 14 M IA M I B E A C H , FL 33139
[E} tam the parent/guardian of a student attending a Miami Beach school for ++ Z3-2+ pool
year.
School: NAUTILUS MIDDLE SCHOOL, MIAMI BEACH SENIOR HIGH SCHOOL
Under penalties of perjury, I declare that I have read the foregoing document and that the facts
tated in it are true.
'
Signat re
JAt /ES ORLOWSKY
JANUARY 12, 2024
Date
Printed Name
MI A\0 /
City of Miam i Beach
1700 Convention Center Drive
Miam i Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
JAN 17 2024
CITY OF MIAMI BEACH
OFFICE OF /HF CITY CLERk
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):
}/{1 am a resident of the City of Miami Beach for six months or lon ger .
Horne Address: 9 ISLAND AVENUE APT 1414 MIAMI BEACH, FL 33139
[/] 1have 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).
Name of Business: JAMES ORLOWSKY CPA
Business Address: 4014 CHASE AVENUE SUITE 214 MIAMI BEACH, FL 33140
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).
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 declare that I have read the foregoing document and that the facts
stated in it are true.
]7/o Y
Date
0aw~y
Printed Name
M IAM I 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 REP ORI
ORLOWSKY JAMES s
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:
[0Male
[ remate
Joher
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
D Asian or Pacific Islander
El Caucasian/white
J Naive American/American Indian D Other- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Jves
No
D I prefer not to answer.
Do you consider yourself Physically Disabled?
Ives zn o
D I prefer not to answer this question.
Page 6 of 6
F:\CLERISALL\REGIBOARO AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL. docx
Updated: June 2020
1I A!
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: 305.673.7411
ORLOWSKY
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
JAMES s
Last Name First Name Middle Initial
Acknowl edgment of fines/suspension for Board/Committee Mem bers for failure to com ply 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 ye ar 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)';" or
3. A Copy of your latest Federal Income Tax Return.
Failure to fil e 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.
Ackn owl edgment to Compl y with Miami Beach Code of Ordinanc es 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 a tender of resignation from the City agency, board, or committee
~ .- 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:ACLERISALL'BOARD AND COMMIT TEES DATABASE\Board and Committee Application\BOARD ANDO COMMITTEE APPLICATION OCT 2023.d0cx
Updated: January 9, 2023
MIAMI
EIII 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
2023 ORLOWSKY JAMES STEVEN
Mailing Address - Street Number, Street Name, or P.O. Box
9 ISLAND AVENUE APT 1414
City, State, Zip
MIAMI BEACH, FL 33139
lf 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. []
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 [] Municipal: MIAMI BEACH
(Municipality)
Board where serving
COMMITTEE FOR QUALITY EDUCATION
Alternate address (if home address ls exempt) I Work telephone I Term began on/ended on
JANUARY 16, 2024
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 anothg
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
SELF-EMP LOYED CERTI FIED 4014 CHASE AVENUE STE 214 ACCOUNTING PRACTICE
PUBLIC ACCOUNTAN T MIAMI BEACH, FL 33140
ALLY BANK PO BOX 951 INTEREST
HORSHAM , PA 19044
I hereby swear (or affirm) that tho information above is a true and correct statement.
~..... .___ . ..__ ~-
-~son Disclosing
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
Jar«co»RECEIVED
I ]Electronic Copy
JAN 17 2024
CITY OF MIAMI BEACH
OFFICE USE ONY Accepted: Y { N Deficiency. Processed Date/initials: Scanned Date/Initials:-
130,_SP-14 COE 2016
//\/A\/\\//BE, cwIDE {CW) BOARD & COMMITTEES
cwy of tan»i es«d, PARKING DARrtNr PAR KING PP[[CAT[ON
1755 Meridian Avenue, Soito 200/Miami Boch, FL 33139/Ph: (305) 673-7505 or (305) 673.7000 ex4. 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 lo 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: 91/17/2024
Applicant Name: JAMES ORLOWSKY
Board/Comm ittee Name: COMMITTEE FOR QUALITY EDUCATION
Address: 9 ISLAND AVENUE APT 1414 MIAM I BEACH, FL 33139
E-Moil Address: JSOCPA@GMAIL.COM
Work Phone: 305-534-0005 Hom e Phone
Cell Phone: 305-588-9129 Preferred Contact Method: CELL
Vehicle Inform ation
Tag: 1AM89EJ Color: GREY
State: FL Year: 12021
Make: BUICK Model: ENCLAVE
Applicant Si@nature: e
Please provide signed form t« th~ Parking Department located at 1755 Meridian Avenue, 2" floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@m iamibeachfl.gov
e-m ail sub iet: BOARD & COMMITTE E PARKING APPLICATION - APPLICANT NAME
Parking Department Section -~----~
PERMIT SYSTEM GARAGE ACCESS
Expiration Dote: ID Cord Serial #:
Issued By Print Name: Print Name:
Signature; Signature:
Dote Issued: Dote Completed:
om u, i