Jack Benveniste 12.31.25+IA N/B E A CH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Ja ck Benven iste ---------'---'----------- DATE OF APPOINTMENT: 01/ 18/2024
BOARD/COMMITTEE: Bu d get A dv iso ry Com m ittee Appointed by. Mayor Meiner
FOR SCANNER
Scan o
Scan o
Scan o
Scan o
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FOR CLERK STAFF
o Letter of Appointment
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on
o Board and Committee Application (Completed on - )
Resume/Curriculum Vitae ,]
o Diversity Statistics Reporting (Completed on I [b t
o Oath
TERM END: [al TE R M LuM r: 1/31[31
/1eh4
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
FECElWED County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance (as
amended through December 2010)
JAN 18 Z0Q Y 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
[T OF MIAMI BEACH / Memorandum - Solicitation by City Board and Committee Members
OFFICE OF TH E CITY CLERK
O Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
S ca n o
Scan o
o Source of Income Statement
o Acknowledgment Statement
o Board and Committees Liaison Responsibilities
o Diversity Statistics Reporting
( I a c k n o w le d g e th a t p u rs u a n t to Se c . 2-2 2(9 ) of th e M iam i B e a c h C o d e of O rd in a n ce s , I w ill be rem o ved
fro m m y bo a rd /co m m ittee up o n fai lu re to att e nd 33 % of th e reg u larly sc h e d u led m eetin g s.
S ec. 2-22(9) lf any m em ber of an agency, board or com mittee fails to atten d 33 perc en t of the regula rly schedule d
m eetings per cale ndar year, such m em ber shall be autom atically rem oved. To calculate the numb er of absences
under the 33 percent form ula, .4 or less ro unds down to the next wh ol e num ber and .5 or m ore roun ds up to the
next whole num ber.
Received on: t/re/vf Signed by X -z. A.g Date oard or Committee Member
Processed on t/all By Employee: la
Date City Clerk's Office Staff Initials
Scanned on: 1/a/4 By Employee: KA
Date City Clerk's Office Staff Initials
We ate cmnittd to provding excellen t pubhc service and saloNy to all who lvo, wonk, and play o ur vib rant, apical, huston communiy
--------- --- --- -------- --·
MAI Ml
City of Miami Beach, LOO Convention Cantor Drive, Mia mi Beach, Florida 33 139 yw._miariboachll.gov
OFFICE OF THE CITY CIERK, Raf0al E. Granado, Ciy Clerk
Tol: 305.673741, Fax: 305.673.7254
Email: CilyCl erk @m iam ibooch fl.g ov
January 17, 2024
Mr. Jack Benveniste
8075
Miami Beach, Florida 33141
RE: Budget Advisory Committee
Dear Mr. Jack Benveniste:
Congratulations! You have been appointed by Mayor Steven Meinerto 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 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.
l •• City Clerk
cc: Monica Beltran, Parking Director
Tameka Otto Stewart, 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
M IA M I BEACH
City of Miami Beach, I/OO Convention Conlor Drwvo, Miami Beach, Florido 33 139 www.mniambeachtl.gay
OHFHKCF OF TH CITY CIERK, Rolal E. Granado, Cay Clod
el: 305.6 73.7411, Fax. 305.673.7254
Emal. Cit/Ckorl @mil amt booch ll gov
Oath of Office
O ath of Civility
and
Acknowledgements
TO: Mr. Jack Benveniste
RE. Budget Advisory Committee
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 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.
3)gel, up..e
Mr. Jack Benveniste
Sworn to and subscribed before me this l 8 day 4,2024
'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.
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
RECEIVED
JAN 18 2024
CITY OF MIAMI BEAC orc or ii civ ct
A FFIDA VI T 9 F AFFILIATION yITH TH E ~Ir y QF MIAM I BEA CH
I am In compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4).
as (check (/) all that apply).
W I am a resident of the City of Miami Beach for six months or longer.
Home Address:. 8075 _Noremac Avenue ,MIami Beach, El 3314l
[]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. dun b)pot
Business Address lOl8- 7l >t, 1am1beach, Fl 321%l
E]lam 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).
[[am79 [ bu,/meSi,
1fe Hf9S,S,
"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
2. ±- gc , H?A,Et o/18/2024
lanaue ae
Jack Benveniste
Printed Name
I A 1 BEACH
City of Miami Beach
17 00 C on v en tion C en ter Drive
Miami Beach, Florida 33139
ww.miamibeachll.gov
OFFICE OF THE CITY CLERK
Em a il: BC@miamibeachfl.gov
Telep h on e: 30 5.6 73.74 11
DIVERSITY STATI STICS REPORI
Benveniste Jack
La st N a m e F irst N a m e M idd le In itia l
The fo llo w in g in fo rm a tio n is vo lu n ta ry an d ha s no be a rin g on yo ur co nsid e ratio n for ap po intm e nt. It is be in g
aske d to co m p ly w ith C ity div e rsity re p o rt in g req u ire m en ts.
Gender:
[3J Mae
lremale □O ther
0 I prefer no t to a n sw e r.
Race/Ethnic Categories:
What is your race?
D Afr ica n A m e ric a n /B la c k
0 A sia n or P a cific Is la n d e r
EI C a u ca si an /whi te
0 N a tive A m e ric a n /A m e ric a n In d ia n
]Other - Print Race.
El prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
v es
(Jo
El pr e fer not to answer
Do you consider yourself Physically Disabled?
voe 2o
D I pre fe r no t to answer th is question.
Page 6 of6
F \CLER\SALL'REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAF TS\BOARD AND COMMITTEE APPLICATION REG FINAL docx
Update d. June 2020
MIAM 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
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
Benveniste Jack
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
Sig
01/18/2024
Date
1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
pursuant to F.S. S112.3145(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 ND COMMITTEES DATABASE\Board and Committee plication\BOARD AND COMMITTEE APPLICATION OCT 2023 docx
Updated: January 9, 2023
Clear From Print Form
SOURCE OF INCOME STATEMENT
Section 2-11.1(i) of the Coun ty Ethics Code requires that certain em ployees and public officials file a financial disclosure Statement on a yearly basis by July 1st
f every year
Disclosure for Tax Year Ending 'Last Name
2023 Benveniste
First Name Middle Nam e/initial
Jack
Mailing Address - Street Number, Street Name, or P.0. Box
8075 Norem ac Avenue
City, State, Zip
MIami Beach, FI 33141
If 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 I] Pub lic 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 E] Municipal: City of MIami Beach
(Municipality)
Board where serving
Budget Advisory Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
(305) 538-2188 01/18/2024
List below every source of incom e you received, along with the address and the principal activity of each source. Include your public salary. Place the sources of
incom e in descen ding order, with the largest source first. Examples of sources of income include: compensation for services, Incom e from business, gains from
prop e rty dealings, interest, ren ts, divi den ds, pensions, IRA distributions, an d social security paym ents. Also, include any source of incom e received by an othgr
person for your benefit. However, the incom e of your sp ouse or any business partner need not be disclosed. If continued on a separate sheet, ch eck here.[]
Name of Source of Income Address Description ot the Principal Business Activity
Southeast Florida provider for Florida
Motorcycle Safety School 1018-B 71 St Department of Highway Safety Miam i Beach, Fl 33141 an Mt h{0lag
Gun DEpot 1018-B 71 St
Miam i Beach, F1 3314l retail gun store
- -- -
I hereb y swear (or affirm) that the information above is a true and correct statement.
2...2.g.st
~gnature ot Person Disclosing
01/18/2024
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
war4coy RECEIVED
[] Electronic Cop y
JAN 18 2024
CI TY O F M IAM I BE A CH
OFFICE OF THE CITY CLERK
H E M E M E R T O PR IN T , SI G N , A N D S U BM I T TO T H E OFFICE O F TH E CI T Y CL ER K VI A EM AI L OH HAR D C O P Y
- -·---- - -----------
M IA MI BEACH TT»DE (cw4 soAs & cowners G
« i i -i i wiwi6 siwwwii" PARKING APPLICATION Mg##egg
1755 Meridian Avenue, Suite 200/Miami Beach, FL 33139/Pb: (305) 673-7505 or (305) 673.7000 ext. 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 enforcement actions, it is important that our records reflect the most current and
accurate inform ation 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 en tire 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 information
Date of Application:
01/18/2024
Applicant Name: Jack Benveniste
Board/Committee Name' 4A, Adv1 Comm1 u.get 'visory ttee
Address:
Flor4d4 3314] 8075 NOremac Ave, Miami Beach.
E-Mail Address: jackbenveniste@gmail.com
Work Phone: (305) 430-99978 Home Phone
Cell Phone: Preferred Contact Method:
(305) 331-4000
Vehicle information
Tag: Color:
1ZTD 57 white
State: FL gs
Make: Honda Model: accord
Ap plicant Sianature:
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2" floor. working
hours are 8:30 to 5:00 p.m. or email to: Parking Recept ion@mi amibea chfl ,gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
parkina Depart nt ° .. --
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature. Signature:
Date Issued. Date Completed.