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Brittnie Bassant 12.31.24MIA M I BEACH B O A R D A N D C O M M IT T E E C H E C K LIST APPOINTEE: Brittnie Bassant BOARD/COMMITTEE: Next Generation Council DATE OF APPOINTMENT: 2/29/24 -------- FOR SCANNER Scan o Scan o Scan o Scan o Scan o Appointed by: Commissioner Alex Fernandez TERM N o. /3l \ reR M Lu n r, l31h 2l/29 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 ) o R~sum~/Curriculum Vitae Jo] o Diversity Statistics Reporting (Completed on 2l3\a- o Oath RE CEI VE D 4AR 07 2024 KAMI BEACH crTY O cr c En( OFFICE 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 [Z] 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: 37P2 sor«so»Xt car< Date Board or Committee Member roses4 or l3/4 »ore K] Date City Clerk's office Staff initials We are com mitted to providing excellent public service and salely to all who live, work, and play in our vibrant, tropical, historic community. M IA M I BEACH City of Miami Beach, 1/OO Con ven tion Con ler Dri ve, Miam i Boach, Horid a 33 139 yyywy_miamibgachll.go OFFICE OF THE CITY CIERK, Rafaol E. Granado, Cy Clerk Tl: 305.673.7411, Fax:. 305.673.7254 Email: Ci NyCl erk @mi am ibeach ll.gov February 29, 2024 Mr. Brittnie Bassant 5151 Collins Avenue Apartment #1126 Miami Beach, FL 33140 RE : Next Gen erati on Council Dear Mr. Brittnie Bassant: Congratulations! You have been appointed by Commissioner Alex Fernandez to the above-referenced Board or Committee, for a 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 as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations again and good luck. Regm Rafael Granado City Clerk cc: Monica Beltran, Parking Director Luis Atencio, 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 - Am endment 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 - (Par king 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, 1/OO Convention Con lor Drivo, Miami Boach, Horida 33 139 yaw._miaIibca chll.gov OFFICE OF THE CITY CIERK, Ralool E. Gran ado, City Clerk Tol: 305.673.7411, Fax. 305.673.7254 Email: CiyCl erk@mi amibeach ll.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Brittnie Bassant RE: Next Generation Council 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. Mr. Brittnie Bassant Sworn to and subscribed before me this 7 --- *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. M IA M I BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 RECEIVE.n MAR O7 224 CITY OE • OFF IA\A¢ CE Or7n o { 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 com pliance with the affiliation requirement of Miam i Beach City Code Sections 2-22 (4), as ( check ( ✓) all that apply): {/El am a resident of th e City of Miami Beach for six month s or long er. Hom e Address: 5151 Collins Avenue, Apartment 1126, Mi am i Beach FL 33140 D I have an ow nership interest (fo r a minim um of six months) in a business established in the C ity of Miam i Beach (fo r a minim um of six months). Nam e of Business: ------------------------- Business Address: ------------------------- 1 ✓I I am a full-tim e em ployee of a business (fo r a minim um of six months) and I am based in an office or other location of the business that is physically located in Miam i Beach (for a minim um of six months). Nam e of Business: M iam i Beach Chamber of Commerce Business A ddress: 1920 M eridian Avenue M iami Beach FL 33139 "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 fo regoing docum ent and that the facts stated in it are true. 3/7/24 S ignature B rittnie Bassant Date Printed Nam e MIAMI BEACH City of Miami Beach l 700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSI TY STATISTICS REP ORI Bassant Brittnie R 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: LJ Mate [l Female 0 Other D I prefer not to answer. Race/Ethnic Categories: What is your race? DI African American/Black IZli Asian or Pacific Islander 0 Caucasian/White 0 Native American/American Indian LO oher- Print Race: _ 0 I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? ves No D I prefer not to answer. Do you consider yourself Physically Disabled? v» zlo D I prefer not to answer this question. Page 6 of 6 F:IC LE R \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A FT S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N R E G FIN A L.d o cx Updated: June 2020 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: 305.673.7 411 Bassant BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS Brittnie R 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) l 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)" 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 3/7/24 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. Page 6 of 6 F:ICLER\$ALL\BOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION FEB 2024.docx Updated: February 22, 2024 MIAMl·DAD E- EI SOURCE OF INCOME STATEMENT 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 I Last Name First Name Middle Name/Initial 2023 Bassant Brittnie R Mailing Address - Street Number, Street Name, or P.O. Box 5151 Collins Avenue Apartment #1126 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. D Filing as an Employee (check one) [] county □Public 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) [] county E] Municipal: Miami Beach (Municipality) Board where serving Next General Council Alternate address (if home address is exempt) I Work telephone I Term began on/ended on 3/7/24 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 Miami Beach Chamber of 1920 Meridian Avenue Miami President & CEO Commerce Beach FL 33139 I hereby swear (or affirm) that the information above is a true and correct statement. Signature of Person Disclosing Date signed RECEIVED BY ELECTIONS DEPARTMENT: or ate CEIVED □Electronic Copy MAR 0'7 2024 CITY OF MIAMI BEACH OFFICE O F E CITY CLERK OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/initials: Scanned Date/initials: 138_SP-14 COE 2016 M IA M I BEACH City of Miami Beach, PARKING DEPARTMENT 1755 Meridian Avenue, Suite 200 Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 BOARD & COMMITTEES PARKING APPLICATION Lal PARKING As a Board/Committee member you are entitled to a Cityw ide 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: 3/7/24 Applicant Name: Brittnie Bassant Board/Committee Name: Next Generation Council Address: 5151 Collins Avenue #1126 Miami Beach FL 33140 E-Mail Address: brittnie@miamibeachchamber.com Work Phone: 305-674-1300 Home Phone: Cell Phone: 786-973-4868 Preferred Contact Method: Cell/Email • Citywide Par king Permit/G7 Access Car d Q Citi Bike/Deco Bike Membership O MDC_ Monthly Transit Pass Vehicle Information (For Citywide Parking Permit/ Access Card Only) Tag: 16DJWG Color: Grey State: FL Year: 2020 Make: Mercedes Benz Model: C300 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: ; utt aaaan Please provide signed form to the Parking Departme nt located at 1755 Meridian Avenue, 2d floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov e-mail subject: BOARD & COMMITTEE PARKING APPLICATION -- APPLICANT NAME f;\ping\$man\rar\forms\cw boards&committees parkingform.doc form updated 1/18/2024