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Dennis Scholl 12.31.25 MIAMIBEACH BOARD AND COMMITTEE CHECKLIST APPOINTEE: bem n i S cS o ) 1 DATE OF APPOINTMENT: 141- BOARD/COMMITTEE: of 6rte Q0-�jS 1-too omm Appointed by: CA V COrYl rrn t,S lfin FOR SCANNER FOR CLERK STAFF Scan o Letter of Appointment TERM END: Il/IN IZC- TERM LIMIT: 11(3) I J Scan o Letter of Reappointment Z�L3 L�F o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on Scan > o Board and Committee Application (Completed on ) Scan n o Resume/Curriculum Vitae ' ` o Diversity Statistics Reporting (Completed on Z�'1�ti`'t ) Scan o o Oath IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK ✓ City Code Ordinance Section applicable to the agency, board or committee �. q_ ✓ City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 Rai ��I V County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance (as amended through December 2010) FEES%44(124 V Amendments to the Code of Ethics Ordinance (September 2009 through July 2012) ✓ Highlights of the Miami-Dade County Ethics Code CI V Sunshine Law and Public Records- Frequently Asked Questions OF �i ✓ 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 o 0 Source of Income Statement Scan 0 0 Acknowledgment Statement o Board and Committees Liaison Responsibilities o Diversity Statistics Reporting aI 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 memberrship on the board for at least one year from the date of removal. Received on: 15 02,I 02.3, ,02 t,2� Signed by /� Date / rr Board Cor,�Committee M r Processed on: Z`-c By Employee: 1 `�" 1 Date City Clerk's Office Staff Initials We are committed to providing excellent public service and safety to all who live,work,and play in our vibrant, tropical,historic community. MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Hooch, Florida 33139 www.miamibeachfl.gw OFFICE Of THE CITY CLERK,Rafael E.Granada,City Clerk Tel:305.673.741 I,Fax: 305.673J25d Email:CityClerk@miamibeachll.gov February 23, 2024 Mr. Dennis Scholl 2001 meridian ave, #301 miami beach, FL 33139 SUBJECT: General Obligation (G.O.) Bond Oversight Committee Dear Mr. Dennis Scholl : Congratulations! You have been reappointed by the City Commission to the above referenced board or committee, 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. Congratulations and good luck. Respectfully, Rafael Granado City Clerk cc: Monica Beltran, Parking Director Maria Hernandez, 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 - Conflict 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 MIAMI BEAC H City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139 www.miamibeachfl.gov OFFKI Of THE CITY CLERK,Rafael E.Granada,City Clerk Tel:305.673.741 1, Fox:305.673.7254 Email:CifyClerk@miomibeochfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Dennis Scholl RE: General Obligation (G.O.) Bond Oversight 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: 12/31/2026. 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. Dennis S( 1ol2tQ' Sworn to and subscribed before me this day of , 2024 Keila Men 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. MIAMI BEACH City of Miami Beach RECEIVED 1700 Convention Center Drive Miami Beach, Florida 33139 FEB 2 8 2024 OFFICE OF THE CITY CLERK CITY OF MIAMI BEACH Email: BCamiamibeachfl.gov OFFICE Or_1HE CITY CLERK 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 (I) all that apply): I am a resident of the City of Miami Beach for six months or longer. Home Address: 02bO1 ffl iipl/ a_r-A a&) in Is&nii €C.J IJQ— 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 I 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 d ar tha ave read the foregoing document and that the facts stated in it a true. &02-)026)09002.4 Signature Date n o 1 ) Printed Name MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Email: BC c�D.miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORT -coll o ) 1 Last Name First ame 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: ® Male ❑ Female ❑ Other El 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 No I prefer not to answer. Do you consider yourself Physically Disabled? El Yes No El I prefer not to answer this question. Page 6 of 6 F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Email: BCc miamibeachfl.gov Telephone: 305.673.741 1 BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS &,41o ) 1 Pnr1iS Last Name Firs 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 Copy of your latest Federal Income Tax Return. Members of the Planning Board and the Board of Adjustment must electronically file a "Statement of Financial Interests (Form 1)1" directly with the Florida Commission on Ethics. 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 for Ily annou cir{g candidacy for City elective office, such filing with the City Clerk shall be deemed a tender of sig ation f he City agency, board, or committee (/11 0.1-) 09, -?0.7,6,1-4 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 electronically file a Statement of Financial Interests (Form 1)with the Florida Commission on Ethics by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the Florida Commission on Ethics 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. Page 6 of 6 F:\CLER\$ALL\BOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION FEB 2024,docx Updated: February 22, 2024 Clear From Print Form MIACOUNTY NI•t]ADE SOURCE OF INCOME STATEMENT COUNTY 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 Last NamelI st Name Middle Name/Initial S 2023 Gk D l ` e 1)2�i')is Mailing Address—Street Number,Street Name,or P.O.Box .2 o o a )'Y)e..r I.ct"0-c' ( J 4.410L. $k 3 0 ) City,State,Zip M; Qom; P o_c k, 1-115---ri of A 3a-13 q r-i. 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 ❑ Public Health Trust ❑ Municipal: (Municipality) Department Position or Title Employee ID Number Work address Work telephone Employment began on/ended on Filing as a Board Member(check one) ❑ County Municipal: 1 Y )I'Ain I "eP az-41 (Municipality) Board where serving ty- nti(a,! ©b)i q 0 -f0 n o n d Q ✓-e r L�q,4- Co m,n Hzp Alternate address(if home addr is exempt) Work telepho Term began on/ended on 36S- 458'-41,'-1. 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 c) 1‘ fe 1)(livii lq t_iiu6ocAiRdlt 4,1i g Alm, . I hereby wear(or affirm)that the information above is.a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ''' ) - 47 Electronic Copy Signature f Person Disclosing 2 8 p��( ���, — CITY OF E�MIAMI2O24 BEACH OFFICE OP,HE CITY CLERK Date signed FRINteMela-TO PRINT mod,AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA AIL Oft HAR COPY. M I AM I BEACH BOARD & COMMITTEES 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 P• RKING 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: 0,2)02 6 .1-4 Applicant Name: P,nn.t 0 l Board/Committee Name: 0-e..nr-rti,P D L; �-i o n o not D ve r� ti�- Cornmihrk4fibipi Address: 0200 ) Me-6()Ut,..'1 3/envL- , 2 t ) ►minirive& I41e to d 0 3 3la 9 E-Mail Address: U ti n IS 0_01 0 I i • Co m Work Phone: Home Phone: Cell Phone: S_46 r- 41. Preferred Contact Method: Please Choose One (1) Option: Citywide Parking Permit/G7 Access Card © Citi Bike/Deco Bike Membership MDC Monthly Transit Pass Credit Vehicle Information (For Citywide Parking Permit/Access Card Only) Tag: c-b $ / Color: State: 16--r(c16._ Year: a d Make: m Ce_des Model: 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 b ost, stolen or damage, I will be responsible to pay a $10.00 replacement fee. Applicant Signature: ,es 6-j Please provide signed form to the Parking Department loca e• at 1755 Meridian Avenue, 2nd floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkinaReceptio @miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME f:\ping\$man\rar\forms\cw boards8.commitfeesparkingform.doc form updated I/18/2024