Karen Fryd 12.31.25M IA M I BEACH
FOR SCANNER
BOARD AND COMMITTEE CHECKLIST
A TE or ArPon r wENr. 3,/\3]2
BOARD/COM MITTEE: Q0»or po[o Anoi nted oy. D\qr l\i nd
rERM ENo. [3th Scan o
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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 b+} p
o Diversity Statistics Reporting (Completed on 3 []
o Oath
rERM LuMrr. l3][3 ]
3l/4\24
RECEIVED
MAR 15 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
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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
t acknow ledge that pursuant to S ec. 2-22(9) of the M iam i Beach C ode of O rdinances, I w ill be rem oved
from m y board/com m itt ee upo n fa ilure to attend 33% of the regularly scheduled m eetings.
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.
Received on: 2/4/24 Signed by X -a.T yl
Date Board or Committee Member
Processed on: 3 l sh 4 By Employee:
City C~~ce Staff Initials Date
Scanned on: l15l By Employee: K
Date City Clerk's Office Staff Initials
We are committed to providing excellent public service and sale y to all who live, work, and play in cur vibrant, tropical, historic community.
M IA M I BEACH
City of Miami Beach, I/OO Convention Cantor Drivo, Mia mi Boach, Florida 33 139 yyyy.miaIibeachll.go
OF FIC E OF THE CITY CLERK, Rafael E. Gr an ad o, City Cl erk
Tl: 305.673.7411, Fax. 305.673.7254
Email: CityClerk@miamibeachfl.gov
March 13, 2024
Ms. Karen Fryd
1708 W 25th St.
Miami Beach, Florida 33140
RE: Com mittee for Qu ality Education in Miam i Beach
Dear Ms. Karen Fryd:
Congratulations! You have been appointed by Mayor Steven Meinerto the above-referenced Board or
Committee, for a term ending: 12/31/2025.
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 Jan uary 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.
cc: Monica Beltran, Parking Director
Dr. Leslie Rosenfeld, City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
City Code/Ordinance section applicable to agency, board or committee
City Code Section s 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2-459
Ordinance No. 2006-3543 - Am en dmen t 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 IBEA CH
City of M iam i Beach, 1/00 Con vonlion Conlor Drive, Miami Boach, Honda 33 139 yww.miamibaachll.gov
OFFICE OF THE CITY CIE RK , Rafael E. Granado, City Cl er k
Tel: 305.673.7411, Fox:. 305.673.7254
Email: CilyClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Karen Fryd
RE: Committee for Quality Education in Miami Beach
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: 12/31/2025.
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.
Ms. Karen Fly@
Swom to and subscribed before me this _,) day of !y ,
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 BEACH ·-p
City of M iam i Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephono: 305.673.7411
MAR 1» 67i
or or MAMleg},
OFFICE OF THE CITY CL ER
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH AND THE COMMITTEE
FOR QUALITY EDUCATION IN MIAMI BEACH
As a voting member of the Committee for Quality Education in Miami Beach, I am in
compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4) and
2-190.137 as:
~ am a City of Miami Beach resident for six months or longer.
L..
Home Address. '?b vr 26 [
□I am the parent/guardian of a student attending a Miami Beach school for the school
year.
School: ---------------------------
Under penalties of perjury, I declare that I have read the foregoing document and that the facts
stated in it are true.
#au. f4l
Signature
[en. Fl Date
Printed Name
M IA M I BEA C H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachf], gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
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:
LJae
I Female
0 Other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
Ll Amica American/Black
D Asian or Pacific Islander
0 Caucasian/White
D Native American/American Indian
0 Other - Print Race: ------------- [l1refer not to an swer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a? a.
(No
D I prefer not to answer.
Do you consider yourself Physically Disabled?
2vee
1No
D I prefer not to answer this question.
Page 6 of 6
F:IC LER 1$A LLIR EG IBO AR D AN D CO M M ITT EE APPLI C ATIO NS FINAL DRAFTSIBO AR D AND CO M M ITT EE APPLI CATIO N REG FINAL.docx
Updated: June 2020
M IA M I BEA C H
City of Miami Beach
1 700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl,gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl_gov
Telephone: 305.673.7411
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
l-At -!
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 $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
Signature 7 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 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 of6
F:ICLER\$ALLIBOARD AND COMMIT TEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION 0CT 2023.d0cx
Updated: Jan uary 9, 2023
MIAMl·DADE. EI
Clear From
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 Last Name
20 (c o
First Name
tz»l
Middle Name/Initial
Mailing Address - Street Number, Street Name, or P.O. Box
62 wc+ .A, Al6
City, State, Zip
L
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 D Public Health Tru st [] 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 [X ~unicial: cy o «Al c A al
(Municipality)
Board where serving
>)A ro)
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
% +243¢
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.[l
Name of Source of Income Address Description of the Principal Business Activity
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I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Person Disclosing
3/4 /2-4
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
t1arc» AECEIVED
[ ] El ectronic Copy
MAR 15 2024
CITY OF MIAMI BEACH
(r;: ( THI; (yy (y Ezri
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY
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 a ±
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: +//zo4
Applicant Name: A t} «44D
Board/Committee Name: ED) Ao, 0444,T CZ
Address: 62% +'ta Al<G
E-Mail Address: HA 0<» @ #y4.
Work Phone: 6, I Home Phone: 44 2«4% ,,-
Cell Phone: Preferred Contact Method: ,--
Please Choose One 1 0 tion:
Citywide Par king Permit/G7 Access Car d O Citi Bike/Deco Bike Membership O MDC Monthly Transit Pass
Vehicle Information (For Citywide Parking Permit/ Access Card Only)
Tag: €CLo G,5% Color: 0
State: [o+ D Year: o2t
Make: a A4+6G o4€ Model: 6000e
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:s { Ft d
Please provide signed form to the Parking Department 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 & COMMITTE E PARKING APPLICATION -- APPLICANT NAME
f;\ping\$man\var\forms\cw boards&committees parkingform.doc form updated 1/18/2024