Harvey Burstein 12.31.25MIAMI BEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Harvey J. Burstein DATE OF APPOINTMENT. 1/17/24 -------
BOARD/COMMITTEE. Transportation, Parking and bl} Appointed by: Commissioner Fernandez
FOR SCANNER FOR CLERK STAFF 1t,/~}ffe 0
Scan o o Letter of Appointment TERM END. 12/31/25 TERM LIMIT: ?I
Scan o o Letter of Reappointment / J
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on._]_/l[Ly
Scan o o Board and Committee Application (Completed on _,
o R~sum~/Curriculum Vitae / / Lf
o Diversity Statistics Reporting (Completed on ) ])/2'%y
o Oath
Scan o
Scan o
RECEIVED
JAN 18 2024
0·1:: MIAMI BEACH 9ID,,a rite crcii FFIr ur ' •
Scan o
Scan o
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
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
) 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. 2-229) 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:
Scanned on:
1/1"? sonea », Xarvey J. Burstein
Date Board qr Committee Member
Processed on: _l {_{_'6_1_1..-,_v( By Employee: 4-JV) _
Date City Clerk's Office Staff Initials
(llil rsres £1
Date City Clerk's Office Staff Initials
We are committed to providing excellent public service and salety to all who live, work, and play in our vibrant, tropical, historic community.
M IA M I BEACH
C ity of Miami Beach, 1/00 Convention Conlor Drivo, Miami Boach, Florida 33 139 yyyy._Iiamnibeachllgo
OF FICE OF THE CITY CI ERK, Rafaol E. Granado, Ciy Cl erk
Tel: 305.6 73.7411, Fax: 305.6 73.725 4
Email: CilyClerk@miamibeachfl.gov
Jan uary 16 , 2024
M r. H a rv ey Burstein
177 5 W ashington A ve PH 2
M iam i Beach, Florida 3313 9
S U B J E C T ; T ransp o rt ati on , Pa rk in g and B icy cle -P edestr ian Facili ties C om m itte e
C o ng ra tula tio ns! Y o u ha v e be e n reap po in ted by C o m m iss ione r A le x Fe rn a nd e z to th e abo ve
referenced, bo ard or com m itt ee na m ed above, fo r a term ending: 12/31/2025.
Pu rsua nt to C ity of M iam i B e a ch C o d e Sectio n 2-22 (5) a, "N otw ithstanding any othe r pro vision of the
C ity C o de or of any reso lution, co m m e ncing w ith term s beginning on or aft er Jan uary 1, 2007, the term of
eve ry bo a rd m e m ber w ho is directly ap pointed by a m em ber of the C ity C om m ission shall autom atically
exp ire up o n the la tt e r of: D ecem be r 31 of the year the appointing C ity C om m issio ne r leaves offi ce or
upo n the app oi ntm en t/el ectio n of the successor C ity C om m ission m em ber."
If you are un a b le to acce p t this ap p ointm ent, or have any questions, ple ase call the Offi ce of the C ity
C le rk at 30 5 .6 7 3 .74 11. Plea se read the encl osed m aterials carefully.
C ongratulatio ns and good luck. R egji
Rafjanado
C ity C le rk
cc: M o nica Be ltran, Parking D irecto r
M o nica Be ltra n, C ity Li a iso n
A TT A C H M E N T S :
Letter of A ppointm e nt
O ath
C ity C ode/O rdinance section app licable to agency, board or com m itt ee
C ity C ode Se ction 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
O rdina nce N o . 20 06-354 3 - Am endmen t to C ity C ode Section 2-22
M ia m i-D ade C o unty C ode Se ction 2-11.1 - C on fl ict of Interest and C ode of Ethics O rdinance
C ity W ide Pe rm it Ap plic atio n - (P arking D epart m ent Form )
Bo ok l et - G uid e to the S unshine A m e ndm ent and C ode of Ethics fo r Public O ffi cers and Em ployees
or o s «av tuns..
t ')15 /3a14 fa Ml 03?t
tat Cw«Ced he#amt sos hi go
Oath ot ottice
oath ot Ci4tity
and
Acknowledgements
TO Mr Harvey durstee
RE: transportation, Parking ard Bicycle- Pedestrian F acidities Committee
t do solemnly swear or affirm to tear true 1aith, loyalty and altoganco to the Government ot tte urutod
States, the State of F#orida, and the City of Miami Beach, and to perform all the duties of a member of the
abo ve -men tioned board or co mtnwttee of the City of Miami Be ach to which l have be@n appointed for a
term eroding 12/31/2025.
To my colleagues and to all of ttose I represent and servo, I pledge fairness, integrity and eivbty, in ail
action s taken and all commu nica tions m ade ty me as a public servan t
1 have been issued a copy of section 2.11 t of the Miami Dade County Code (Conflict of interest and
Code of Ethics Ordinance}, a welt as Florida Commission on Ethics Guide to the Sunshine #rend@rent
ad Cade of fthc s tor Public Officers and under stand that as a member ot a of Miami Beach Board
ad/or Corrittee, I rust compy with the financial disclosure" requirements of Miami-DOade County or the
State ol Florida {depending on tte board or committee on which ! serve) on.July 1st, fotowing the closing
f the calendar year on whwch l have served. »
Pease visit the City of Miami Beach website at www miaribeach/l gov under City CMerk/Board and
Committees for additional in ormna ton regarding the Financiat Disclosure Requirement
M IA M I BEACH
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
JAN 18 2024
CITY OF MIAMI BEA CH
OFFICE Or !E ITV ER R
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 compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check(✓) all that apply):
[/Elam a resident of the City of Miami Beach for six months or longer.
Home Address: 1775 Washington Ave Miami Beach Florida 33139 United States
D I have 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: _
Business Address: _
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.
Harvey J. Burstein 1/17/24
Signature
Harvey J.Burstein
Date
Printed Name
A1 BEA CH
City of Miami Beach
1700 Convention Center Dive
Miami Beach , Florida 33139
www.ramtbgachll gov
OFFICE OF THE CITY CIERK
Email:. BC@}myarutgacht gov
Telephono: 305.673.7411
Bur stein
BOARD & COMMIT T EE ACKNOWL EDGEMENT STATE MENT S
Harvey
First Name
J.
Last 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,_ot each year all members of Boa rds and Com mittees of the City of Miami
Beach, including those of a purely advisory nature, are required to comply wth Miami-Dade County Financial
Disclosure Requirements
One of the following torms 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 ASource of Income Statement," or
2. A"Statement of Financial Interests (Form 1)'," or
3. A Copy ot 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)
understand that commencing with terms beginning on or after January 1, 2024, and as a condition of applying
tor appointment to a City agency, board, or committee, I voluntarly 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
t' n)# ~·Tft ..... _, __ 'ef edi...- so.o
sionaie '?:'! Date
' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Fonda,
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 nee d not file an additional form with tho Office
of the City Clerk However compliance with the County disclosure requirement does not satisfy the State
requirement
Paae 6 of6
1774 WASHINGTON AVE, PH2 - MAMI HE.AH, FL 3319-1544 - phone 0-$35-244 - fax 305535-6541- email om iam ite vol.com
M IA M 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 REPORT
Burstein Harvey
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:
[ZJ ate
D Female
0 Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
Ll Asta or Pacific Islander
GZl Caucasian/White
D Native American/American Indian
D Other - Print Race: ------------- El l prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
ves
No
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
ve»
0Ro
t prefer not to answer this question.
Page 6 of 6
F:\CLER \$ALL\REG\BOARD AND COMMITT EE APPLICATIONS FINAL DRAFTS \BOARD AND COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
Sect ion 2-11 1i) of the County Ethics Code requi res tat certain employees and pubic officials fie a financ ial dscl osur e Statement on a yearly basis ty July 1st
of owory year.
0isclosure for Tax Year Ending [Last Name Frat iame
2023 Bur stein Harvey woo Mailing Address - Street Number, Stret Name, or P.0. Box
177 5 Washington Ave. PH 2
Middle Mame/ initial
J.
city, State, zi»
Miami Beach FL 33139 '------------------------ -
ll your home address is your mailing address, and your home address is exempt from public records purs uant to Fla. Stat. $119.07, read
instructions on the toto wing page and check here.L]
Filing as an Employee (etct oe) ---------- .......-
[ county [] Public Health trust [] Municipal:
Dep artm ent
Position or nie
Work addres s
I/IS5 Washington Ave Mam teach F lonkda 33 139 Unto States
[ work telephone
[+17863019667 --------------
. rEiiplOytl!ll l(l lt!J!J\tler
_ r ~tn l>eQaA 0Cll&\lldecl1 OIi
[] county [] Munici pal: Miami Be ach
(Municipality)
Board where serving
Tran sp ortation , Parking and Bicycle -Pede strian Facilities Com mittee
Alternate address it home addreuis ••emilJ l WOdl tllilep.llOOO ~ f'IIIIII llega11 ~ed OA
List below every source at inc.omne you received, atong with the address and the principal activity of each source. include your pubic salary Place the sources of
income in descending order, with the largest source first Examples ot sources ot income inciude. compensation tor senvios, income from business, gains from
property dealings, interest, rents, dvi dends., pensions, IA distrib utions, and social security payments. Also, incl ude any source ot income recered by ano thgy
porson tor your benet t. However, the income ot your spous e or any busin ess partner nee d not be disclosed. tt continued on a separate sheet, check here.L]
Mame of Source of income Address Description of the Principal Business Acti vity
1----
Real Estate Income 3950 N. Lake Shore Drive.
Chicago, IL
Trust Income & Miami Beach
arts Trust Income
Social Security
1775 Washington Ave Miami
Beach Florida 33 139
1775 Washington Ave Miami
Beach Florida 33 139 United
I hereby swear (or at firm) that the inform alin above is a true and correc t statement
':<fas
Si9nature ot Pors«on bi.hi
l -n7-2y
ate signed
Director
HECHrvE BY
I / Har dcopy
'tu tectonic / 18 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
2\9£4 .±1 2. LO
17 55 Meridian Avenue, Suite 200/Miam i Beach, FL 33 13 9/P h : (305) 673-7505 or (305) 673-7 000 e4 . 6200 PAR KIN G
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 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
D ate of A pplication: 1117124
A pplicant Nam e: Harvey B urstein
Board/Com m ittee Nam e:Tran spor tation , P arking and B icyclePedestrian Facilities Com m ittee
Address: 1775 W ashington Ave M iam i Beach Florida 33139 U nited States
E-M ail A ddress: Harvey.B urstein@ gm ail.com
W ork Phone: Hom e Phone
C ell Phone: +17 863019667 Preferred Contact M ethod: em ail
Vehicle Information
Ta g: xsob e x C olor: W hite
State: FL Year : 2021
M ake: Lexus M odel: ES 300h
Applicant s. Har v ey J. B ur st ei n ianature:
Pl ease provide signe d form to th e Parking Depa rtm ent located at 17 55 M eridian Aven ue, 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
p, ·d D ar ma epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature:
Date Issued: Date Completed:
s
ng ·m an or torm s w aris com m »tees par' ngrorm , toc orm up(ate