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Karen Rivo 12.31.24 MIAMIBFACH • BOARD AND COMMITTEE CHECKLIST APPOINTEE: Karen Rivo DATE OF APPOINTMENT: 01/01/2024 • BOARD/COMMITTEE: GO Bond Oversight Committee Appointed by: Mayor Meiner FOR SCANNER FOR CLERK STAFF Scan o o Letter of Appointment TERM END: 12/31/2024 TERM LIMIT: 12/31/2026 Scan o o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on 02/29/2024 Scan c o Board and Committee Application (Completed on 2023 Scan o o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on 03/01/2024 ) Scan o o Oath _ IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK RECEIVED ✓ 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 MAR 05 2024 amended through December 2010) I Amendments to the Code of Ethics Ordinance (September 2009 through July 2012) CITY OF • IIA I BEACH ✓ Highlights of the Miami-Dade County Ethics Code CLERK ✓ Sunshine Law and Public Records— Frequently Asked Questions OFFICE OF THE CITY 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 o 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. 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: 02/29/2024 Signed by XKaren Rivo Date Q ��rd Board or Committee Member Processed on: 31 5- 1 1 �\ By Employee: 4 V Date City Clerk's Office Staff Initials MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33 139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK,Rafael E.Granada,City Clerk Tel:305.673.7411,Fax:305.673.7254 Email:CityClerk@miomibeachfl.gov February 29, 2024 Ms. Karen Rivo 4566 Prairie Ave. Miami Beach, Florida 33140 SUBJECT: General Obligation (G.O,) Bond Oversight Committee Congratulations! You have been reappointed by Mayor Steven Meiner to the above referenced, board or committee named above, fora 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. Congratulations and good luck. Regards, 11 Rafa- - .do 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 MIAMIBEACH City of Miami Beach, 1/00 Convention Center Drive, Miami Beach, Florida 33139 www.mlamibeachfl.gav OFFICE Of THE CITY CLERK,Rafael E.Granada,CiIy Clerk Tel:305.673.7411,Fax:305.673.7254 Email:CityClerkemiomibeochfl.gov Oath of Office • Oath of Civility and Acknowledgements TO: Ms. Karen Rivo 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: 12/31/2024. 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. iCit-J-40102 - Ms. Karen Ftivo Sworn to and subscribed before me this ti day of;f!C ', 2024 K: a ena 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. • Pr' Y, amp MI AMI BEACH 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 BCCa�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:4566 Prairie Avenue Miami Beach Fl 33140 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 penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are ))/ 1.(--t..- 03/01/2024 Signature Date Karen Rivo Printed Name MAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miomibeochfl.gov_ OFFICE OF THE CITY CLERK Email: BCmiamibeachfl.gov Telephone: 305.673.741 1 DIVERSITY STATISTICS REPORT Rivo Karen T 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: ❑ Male El Female Other I prefer not to answer. Race/Ethnic Categories: What is your race? ❑ African American/Black ❑ Asian or Pacific Islander 0 Caucasian/White ❑ Native American/American Indian [] Other— Print Race: [� 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? ❑ Yes 0 No 0 I prefer not to answer this question. Page 6 of 6 F\CLER\SALL\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 Rivo Karen T 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 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 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 Q/t Q-i T 03/01/2024 Signature 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 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. Pa e 6 of 6 F\CLER\SALL\BOARD AND COMMITTEES DATABASEtBoard and Committee Application it ca on BOARD AND COMMITTEE APPLICATION FEB 2024.docx Updated:February 22,2024 MIAME 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 Name First Name Middle Name/Initial 2023 Rivo Karen T Mailing Address—Street Number,Street Name,or P.O.Box 4566 Prairie Ave City,State,Zip Miami Beach FL 33140 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 0 Municipal: Miami Beach • (Municipality) Board where serving GO Bond Oversight Committee Alternate address(if home address is exempt) Work telephone Term bega on/ended on 3es 2 J .3g f 7 �O/A i 2Y--,d' , 1i 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 Social Security I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIOF 'tIIAf'1T*tENT: /� - ❑Hy ❑Electronctronl9Aopyij 5 9024 Signature Person Di closing O Z CITY OF 10IANiI BEACH OFFICE OF THE CITY CLERK • Date signed OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials:_ Scanned Date/Initials: 138 SP-14 COE 2016 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 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: 03/01/2024 Applicant Name: Karen Rivo Board/Committee Name: GO Bond Oversight Committee Address: 4566 Prairie Avenue Miami Beach Fl 33140 E-Mail Address: Karenrivo@gmail.com • Work Phone: na Home Phone: na Cell Phone: 3052833897 Preferred Contact Method: cell Please Choose One (1) Option: O Citywide Parking Permit/G7 Access Card O Citi Bike/Deco Bike Membership 01 MDC Monthly Transit Pass.. Credit Vehicle Information (For Citywide Parking Permit/Access Card Only) Tag: HMCJ82 Color: red State: FL Year: 2015 Make: Chevy Model: Volt 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 replacement fee. Applicant Signature: AS 0.A p,� I 72f-4.A:3-- Please provide signed form to t4 Parking Department 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 I:\ping\$mon\ro!Vorms\cw boards&committees pork nty, form updated 1/18/2024