Loading...
Haskel Mayer 12.31.25 MIAM BEACH BOARD AND COMMITTEE CHECKLIST APPOINTEE: 1( V-e1 r r A (/Y DATE OF APPOINTMENT: 1 )3 1/ 24 BOARD/COMMITTEE: .14%.S (, prc,rLrvaUfil Appointed by: ( -k COY1- -CI-W) FOR SCANNER FOR CLERK STAFF 13)l,y� Scan o Letter of Appointment TERM END: tz1 3 I)LC— TERM LIMIT: t I /" 1 Scan o Letter of Reappointment / o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on Z (/L4-( Scan o Board and Committee Application (Completed on 1)'4/) L� ) Scan o o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on Zh 1I) )i-1 ) Scan o o Oath IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK ✓ City Code Ordinance Section applicable to the agency, board or committee RECEIVED ✓ 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) FEB 12 2024 ✓ Amendments to the Code of Ethics Ordinance(September 2009 through July 2012) ✓ Highlights of the Miami-Dade County Ethics Code CITY OF MIAMI BEACH ✓ Sunshine Law and Public Records—Frequently Asked Questions OFFICE OF THE CITY CLERK ✓ 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 Scan 0 0 Source of Income Statement Scan 0 0 Acknowledgment Statement o Board and Committees Liaison Responsibilities o Diversity Statistics Reporting FM 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. NOTE: Members of the Land Use Boards will be removed upon failure to attend three of the regularly scheduled meetings per calendar year; or upon abstaining from voting due to a conflict of interest on four different applications within a calendar year. A member who is removed shall not be reappointed to membership on the board for at least one year from the date of removal. Received on: f I Lq Signed by _> Date j3aa r Comm. ember "21 13) A KMl Processed on: By Employee: Date City Clerk's Office Staff Initials We ore corrurwted to providing excellent public service and safety to all who live,work,and ploy in our vibrant,tropical, historic community. MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gw OFFICE OF TF(CITY CLERK,Rafael E.Granada,City Clerk Tel: 305.673.7411, Fax:305.673.7254 Email:CityClewk@miamibeachfl.gov February 05, 2024 Mr. Haskel Mayer 4455 Adams Ave Miami Beach, Florida 33140 RE: Historic Preservation Board Dear Mr. Haskel Mayer: Congratulations!You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2025. 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. Regards, Rafaer Granado City Clerk cc: Monica Beltran, Parking Director Deborah Tackett, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements 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 - 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 MIAMI BEACH City of Miami Beach, i/00 Convention Confer Ikivo,Miami Hooch, Florida 33139 www,miamibeach4Lgov Off ICE Of THE CFTY CLERK,Rafael E.Granado,City Clerk Tel:305.673.7411,Fax:305.673.7254 Email:CUyCierk@mianibeacfdl.gov Oath of Office Oath of Civility and Acknowledgements TO:Mr. Haskel Mayer RE: Historic Preservation 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: 12/31/2026. 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. skel Mayer Sworn to and subscribed before this Iv day of T , 2024 eila Mena Caceres Deputy Clerk *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. RECEIVED MIAMI BEACH FEB 12 2024 City of Miami Beach CITY OF MIAMI BEACH 1700 Convention Center Drive OFFICE OF THE CITY CLERK Miami Beach, Florida 33139 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): I am a resident of the City of Miami Beach for six months or longer. Home Address: 0 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: ❑ 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 penalti er , I declare that I have read the foregoing document and that the facts stated i // ignat Dat Pi- Printed Name MAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl gav OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.741 1 BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS 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 S500, 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 deem esignation from the City agency, board, or committee „2-/i/2-4— 'gnature Date 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\CLER\SALL\BOAR D AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION OCT 2023.docx Updated January 9,2023 MIAM BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Email: BC rc miamibeachfl.gov Telephone: 305.673.741 1 DIVERSITY STATISTICS REPORT A-(tM -- Mom% 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: IELMale Cl Female ❑ Other ❑ I prefer not to answer. Race/Ethnic Categories: What is your race? ❑ African American/Black ❑ Asian or Pacific Islander ,Caucasian/White ❑ Native American/American Indian ❑ Other— Print Race. El I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? ❑ Yes 1E21, No ❑ I prefer not to answer. i Do you consider yourself Physically Disabled? ❑ Yes HNo ❑ I prefer not to answer this question. Page 6of6 F\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated June 2020 MIAMI BEACH BOARD & COMMITTEES P City of Miami Beach,PARKING DEPARTMENT PARKING APPLICATION 1755 Meridian Avenue,Suite 200 Miami Beach,FL 33139/Ph:(305) 673-7505 or(305) 673-7000 ext.6200 PARKING As a Board/Committee member you are entitled to a Citywide Parking Permit, which includes City Hall garage (G7) parking access (Access Card), or a complimentary Citi Bike/Deco Bike Membership, or a discounted MDC Monthly Transit Pass throughout your term. Board Member Information Date of Application: tz:7 _////71_.-- �/ Applicant Name: 7z _ M >it: Board/Committee Name: 'gyp, Address: 4 -7 -- �3 )4 E-Mail Address: ( 15 RRA---, 40"y Work Phone: S-- 2� c?"3 Home Phone: ?j z S 3 f 3©993 Cell Phone: 5-- �S-- .'3 Preferred Contact Method: / XI ase Choose One (1) Option: li Citywide Parking Permit/G7 Access Card 0 Citi Bike/Deco Bike Membership O MDC Monthly Transit Pass Veh le Information (For Citywide Parking Permit/Access Card Only) Tag: I MT (-15c7 I Color: G��--- / State: i -e...-- Year: 202-0 Make: .4L - J2 Model: �1.�vj0 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". 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 rep!. f Applicant Signature:As <—�� Please provide signe.orm —- -: .'•• it -•artment located at 1755 Meridian Avenue, 2nd floor. Working hours are 8:30 to 5.00 p.m. or email to: ParkinaReception@miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME f-\ping\$mon\rar\forms\c v board;&comet ttees porkfngtorm.doc form updated I 18/2024