David Nguah 12.31.24MIA M I BEACH
BOARD AND COMM ITTEE CHECKLIST
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DATE OF APPOINTMENT: 1_/13/4
Appointed by. or0/1&gr-r Ml 4L2A (o
FOR SCANNER
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RECEIVED
JAN 18 2074
FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o Copy of Letter of AppointmenUReappointment e-mailed to Committee Liaison on
o Board and Committee Application (Completed on • _)
o R~sum~/Curriculum Vitae [ )
o Diversity Statistics Reporting (Completed on4 ld {
o Oath a
TERM END: 12-[3/l24 TERM LuMrr:.n[3t/2
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IMPORTANT INFORMATION FOR BOARD AND COMMITT EE 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
BEACH IT OF MIMI !, O Citywide Permit Application (Parking Department Form)
o r r us (I CLER FFIE' O Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
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o Source of Income Statement
o Acknowledgment Statement
o Board and Committees Liaison Responsibilities
o Diversity Statistics Reporting
□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.
Sec. 2-22(9) If 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: /114 Signed by X a 9g
Date Board or Committee Member
Processed on: 'f6la By Employee: K/
Date City ~ce Staff Initials
Scanned on: [1«]14 By Employee:
Date City Clerk's Office Staff Initials
WVe are committed to providing excellent public service and salety to all who live, work, and play in our vibrant, tropical, historic community.
M IAM I BEACH
City of Miami Beach, 1/OO Convention Con lor Drive, Miami Boach, Florida 33 139 yyyy_Iiamibachllgoy
OFFICE OF THE CITY CLERK, Rafaol E. Gran ado, Ciy Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CiNyClerk@miamiboachll.gov
January 17, 2024
Mr. David Nguah
1200 14th Street #4B
Miami Beach, FL 33139
RE: Parks and Recreational Facilities Board
Dear Mr. David Nguah:
Congratulations! You have been appointed by Commissioner Joseph Magazine to the above-
referenced Board or Committee, for a term ending: 12/31/2024.
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:
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. Regja
Raz~ranado
City Clerk
cc: Monica Beltran, Parking Director
Vianca Peron-Sellan , City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
City Code/Ordinance section applicable to agency, board or committee
City Code Section s 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2-459
Ordinance No. 2006-3543 - Am en dmen t 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 - (Pa rking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
M IA M I BEACH
City o f M iam i Beach , I/OO Convention Contor Drive, Miami Boa ch, Florida 33 139 yyw._miaIibeach[l go
OFFICE OF THE CITY CLERK, Rafael E. Gran ado, Cy Clerk
Tol: 305.673.7411, Fax. 305.673.7254
Emal l: City Clerk@miamibeachll.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. David Nguah
RE: Parks and Recreational Facilities Board
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.
Mr. Daw&Nguen
Sworn to and subscribed before me this_ 18 __ day
*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 EA C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
JAN 18 2024
CITY O MIAMI BEA!
Flc.F f'IF ':\\.: (J f'( CL.ERK OFT A:. 1 -
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 com pliance with the affiliation requirem ent of Miam i Beach City Code Section s 2-22 (4),
as ( check ( ✓) all that apply):
[/1am a resident of th e City of Miami Beach for six months or long er.
Home A ddress: 1308 Drexel Ave # 207, M iam i Beach FL 33139
D I have an ow nership interest (fo r a minim um of six months) in a business established in the
C ity of M iam i Beach (fo r a minim um of six months).
[]9r e f [JS[res,S,
[JS]n sS (]]reSS,
l✓l I am a full-tim e em ployee of a business (fo r a minim um of six months) and I am based in an
office or other location of the business that is physically located in Miam i Beach (for a
m inim um of six months).
Nam e of Business: Douglas El lim an - Real Estate A gent
Business Address: 1111 Li ncoln R oad# 805, M iam i Beach FL 33139
"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 fo regoing docum ent and that the facts
stated in it are true.
a.ega 11%t
Signature Date
D avid Nguah
Printed Nam e
M IAM I
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
E m ail: BC@miamibeachfl.gov
Telephone: 305.673.7 411
DIVERSITY STATISTICS REPORT
Nguah David
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
Ll remale
0 Other Dl prefer not to answer.
Race/Ethnic Categories:
What is your race?
DI African American/Black
Ll Asta or Pacific Islander
D Caucasian/White
01 Native American/American Indian D Other- Print Race: _
,'431'1 prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
LT ves
LJo Dl prefer not to answer.
Do you consider yourself Physically Disabled?
[Ives no
.~I prefer not to answer this question.
Page 6 of 6
F:\C LE R \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A FT S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N R E G FIN A L.do cx
Updated: June 2020
M IAM I BEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7 411
Nguah
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
David p
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 a tender of resignation from the City agency, board, or committee
1/18/2024
Signature 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 of6
F:ICLER\$ALLIBOARD AND COMMITT EES DATABASE\Board and Committee Application\BOARD AND COMMITT EE APPLICATION 0CT 2023.d0cx
Updated: January 9, 2023
M IA M l·DAD E- EEM7 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
20 2 3 Nguah David p
Mailing Address - Street Number, Street Name, or P.O. Box
12 0 0 14 Street # 48
City, State, Zip
Miami Beach FL 33139
If your hom e address is your m ailing addre ss, and your hom e addre ss is exem pt fro m public records pursuant to Fla. Stat. $119.07, read
instructions on the follow ing 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)
[] county E] Municipal: Miami Beach
(Municipality)
Board where serving
0 S 3 ~ V
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
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
Douglas Elliman 1111Lincoln Rd # 805 Real Estate
I here by sw ear (or affi rm ) that the info rm ation above is a true and correct statem ent.
Signature of Person Disclosing
_l/18/24
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
toraeoECEIVED
[ ] Electronic Copy
JAN 18 2024
CITY OF MIAM I BE A CH
OFFICE C THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/Initials: Scanned Date/initials:
138_SP-14 COE 2016
/\/\IAMI CITYWIDE {CW) BOARD & COMMITTEES
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 M eridian Avenue, Suite 200/Miami Beach, 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 to avoid
any unnecessary enlorcement 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.
B o a rd M e m b e r In fo rm a tio n
Date of Application:
Applicant Name: David Nguah
Board/Com mittee Name: Parks and Rec Facilities
Address: 6/t Re, Or i t
E-Mail Address: tt
Work Phone: I Home Phone
Cell Phone: II Preferred Contact Method:
V e h icl e In fo rm a tio n
Tag: S9
State:
Make:
Applicant Si+nature: e
---
Color: l
Year: I l
Model: l
Please provide signed form folIhd Parkif gDepartm en t located at 1755 Meridian Avenue, 2d floor. Working
hours are 8:30 to 5:00 p.m. or il td: Pa rkingR eception@miami beach fl.gov
e-mail subject: BOAR & 'OMMITTE E PARK ING APPLICATION - APPLICANT NAM E
p. ·ki D S ar Ina enartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: e Signature:
Date Issued: Date Completed:
.ping man ra torms cw oatdscommutees par+ugtorm.doc