John Novak 03.13.28M IAM I BEACH
B O A R D A N D C O M M IT T EE C H E C K L IST
APPOINTEE: _JO Hn _]Joyo DATE OF APPOINTMENT: 3/13/2{
OARDcoMMrrre. lo92 Ahr ta, Appointed y. Mr ref [gyp$on
FOR SCANNER FOR CLE RK STAF F ,JJ] a
scan o o Letter of Appointment TERM EN D: 3] O TERM LIMIT: Pl
Scan o o Letter of Reappointment I /
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on 3)}{/24
o Board and Committee Application (Completed on - )
o R~sum~/Curriculum Vitae ,J ]
o Diversity Statistics Reporting (Completed on >]1l24
o Oath
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RECE IVED
AR 14 2024
cm OF MI AMI BE A !j -pE up CIC!ER! OF' I-
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
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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
D 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 y_ear from the date of removal.
_3~J_l~L}----t-'-f-i_Lj~_ Signed by X ~~--=-------
Date Board or C
Processea on. -l_)4]ZR yEmployee'
Date City Clerk's Office Staff Initials
Received on:
WVe 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
City of Miami Beach, 1/0O C on ven tion Cen ter Dri ve, Miami Booch, Florida 33 139 yyy_miamibeachll_gov
OFFICE OF THE CITY CLERK, Rofool E. Gran ado, CHy Clerk
Tel: 305.673.74 11, Fax€ 305 .673.7254
Email: CiNyClerk@miamibeachfl.gov
March 13, 2024
Mr. John Novak
150 Alton Road Apt 306
Miami Beach, FL 33139
RE: Housing Authority
Dear Mr. John Novak:
Congratulations! You have been appointed by Mayor Steven Meinerto the above-referenced Board or
Committee, for a term ending: 03/13/2028.
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.
Re~
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Alba Tarre, 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 - 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
M IAM I BEACH
C ity o f M ia m i B e a ch , 1/0O Con vonl ion Center Dr ive, Miami Beach, Florida 33 139 yyyy_miamnibeachllgov
OFF ICE OF THE CITY CLERK, Rofool E. Granado, Ciy Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: CiNyClerk@miamibeachfl.gov
Oath of Offi ce
Oath of Civility
and
Acknow ledgem ents
TO: Mr. John Novak
RE: Housing Authority
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: 03/13/2028.
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.
Sworn to and subscribed before me this ]
Keil
*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 BEA C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
RECEIVED
M4AR 14 2024
CITY OF MIAM I BEA CH
OFFICE O I ITC 1E RK
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 (/) al l that apply):
~ I am a resident of the City of Miami Beach for six months or longer.
ore Aw»15 0 £)1Io) oftD
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 tru
Signature flu
Printed Name
Date
M IA M I B EA CH
City of Miami Beach
l 700 Convention Center Drive
Miami Beach, Florida 33139
www .miamibeach!l.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305. 673 .7 4 l l
DIVE RSITY STATISTICS REPOR I
O A K_ et
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:
fate
[lremale
0 Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
J Asta or Pacific Islander
0 Caucasian/Wh ite o
ge e Arn»ra rer.""_LL_ _p uetcU
[goner-Print Race: pl I.44 )A 7
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Lves
Li o
0 I prefer not to answer.
Do you consider yourself Physically Disabled?
ves
No
Ed~refer not to answer this question.
Page 6 of 6
F:\CLER\$ALL\REG \BO ARD AND CO M M ITT EE APPLI CATIO NS FINAL DRAFT S\BOARD AND CO MMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
M IA M I B E A C H
City of M iam i 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
- ~~ BO RO & COMMITTEE ACKNOWLEDGEMENT
6Q.off.
L~st Name First Name
TATEMENTS £
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)" 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 Candi e ormally announcing candidacy for City elective office, such filing with the City
Clerk shall be deemed at der f resignation from the City agency, board, or committee
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 of6
F :IC LE R \$A L L\B O A R D A N D C O M M ITT E E S D A T A B A S E IB o ard and C o m m itt ee A p p licatio n\B O A R D A N D C O M M ITT E E A P P LI C A T IO N FE B 20 24 .d0 cx
Updated: Febr uary 22, 2024