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Laura Lewin 12.31.25M IA M I BEACH BOARD AND COMMITTEE CHECKLIST APPOINTEE: La u ra Le w in ----------------- 8O ARD/COMM ITT EE: D e sig n R e vie w Bo a rd DATE OF APPOINTMENT. March 14 , 2024 Appointed by: C ity C o m m issio n FOR SCANNER S c a n o S c a n o T E R M E N D : 12 .31.25 rRwun. 1/3l_ha Scan o Scan o Scan o FOR CLERK STAFF o Le tte r of A p p o in tm e nt o Le tt e r of R e a p p o in tm e n t o C o p y of Le tt e r o f Ap p o in tm ent/R e app oi ntm en t e-m aile d to C o m m itt e e Li a iso n on _ o Bo a rd a n d C o m m itt e e A p p lica tion (C om p le te d on ) o R ~sum ~/C u rricul um Vi ta e o D ive rsity S tatistics R e p o rt in g (C o m p le te d o n _ o O a th REC EI VED MAR 1 8 2024 CI TY O F MIAMI BEA CH OFFICE OF THE CITY CLERK Scan o Scan O IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK ✓C ity C o d e O rd in a n ce S e ction ap p lica b le to th e ag en cy, bo ard o r co m m ittee ✓C ity C o d e S e ct ion s 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2-459 ✓C o u n ty C o d e S e ct ion 2-11.1 -- C on fl ict of In te rest a nd C od e of E th ics O rd in a n ce (as am e nd e d th ro ug h D e ce m be r 2010) ✓A m e n d m e nts to th e C od e o f E th ics O rdin a n ce (S ep tem b e r 2009 thro ug h Ju ly 2012) ✓H ig h lig h ts o f the M ia m i-D a d e C ou nty Eth ics C o d e ✓S u n sh in e La w an d P u blic R e cord s - Fr e q u e n tly A ske d Q u estio ns ✓M e m or a n d u m - S o licita tion by C ity B o a rd an d C om m itt e e M em b e rs o C ityw id e P e rm it A p p lica tio n (P arkin g D e p artm ent F or m ) o Bo o kl e t - G uid e to S u n sh in e A m en d m en t & C o d e o f E th ics fo r P ub lic O ff ice rs and E m p loye e s o S o u rce of In co m e S ta te m e n t o A ckn o w le d g m e n t S ta te m e n t o B o a rd a n d C o m m itt e e s Li aiso n R e sp o n sib ilitie s o D ive rsity S ta tistics R e p o rtin g 0 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. R e ce ive d o n : March 1@20?4 sone@oy%, } D a te } oa r~m itte e M em ber Pr o ce sse d o n .2,1''L y t r o ve s: D a te C ity C le rk's O ffi ce S ta ff Initia ls We are committed lo 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/OO Convention Contor Drive, Miami Boach, Florida 33139 yyw_miamnibeachll_gov OFFICE OF THE CITY CLERK, Rafael E. Gran ado, City Clerk Tel: 305.673.7411, Fax. 305.673.7254 Email: CityClerk @miamibeach fl.gov March 13, 2024 Ms. Laura Lewin 650 West Ave., Apt. 1709 Miami Beach, Florida 33139 RE: Desi gn Revi ew Board Dear Ms. Laura Lewin: Congratulations! You have been appointed by the City Commission to the agency, board or committee named above 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 as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations again and good luck. Rega1{/ Rafael Granado City Clerk cc: Monica Beltran, Parking Director Michael Belush, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements 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 City Wide Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees M IA M I B EAC H City of Miami Beach, 1ZOO Convention Coner Drive, Miami Beach, Flor ida 33 139 yyw.miamibcachll.gov OFF ICE OF THE CITY CLERK , Rafael E. Granado, Ciiy Clerk Tel: 305.673.7411, Fax: 305.673.7254 Emal: Ci/Clerk@miamibeochll.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Laura Lewin RE: Design Review Board 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. Lewin Sworn to and subscribed before me this~ day o,f, ,___..,.,.._, 2024 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. MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: BC@miamibeachf_gov Telephone: 305.673.7411 RECE I FD MR 18 024 CI T Y Ok i1AMI BEA CH OFFICE OF THE CITY CLERK AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH I am in co m p liance w ith the affil iation requirem ent of M iam i Beach City C ode Section s 2-22 (4), as (ch e ck (/) all that apply): l/1 am a resid en t of th e Ci ty of M iami Beach for six m onth s or lon ger. H o m e A dd ress: 6 5 0 W est A ve. A pt. 1709 , M ia m i Beach, FL 33139 D I ha ve an ow nership interest (fo r a m inim um of six m onths) in a business established in the C ity of M ia m i Beach (fo r a m inim um of six m onths). N a m e of Business: _ Busin e ss A d dress: _ D I am a full-tim e em ployee of a business (fo r a m inim um of six m onths) and I am based in an offi ce or other location of the business that is physically located in M iam i Beach (fo r a m in im um of six m onths). N a m e of B usiness: _ Busin ess A ddress: _ "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. altie s of perjury , I decl are that I have read the fo regoing docum ent and that the facts t are true. M ar ch 18, 2024 D ate La u ra Lew in Printed N am e M IA M I B E A C H 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: 305.673.7411 DIVE RSI TY STA TISTICS REPO RT Lewin Laura M 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 Mae El remate loner D I prefer not to answer. Race/Ethnic Categories: What is your race? D African American/Black D Asian or Pacific Islander Ezl Caucasian/white 0 Native American/American Indian D Other - Print Race: _ 0 I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? Ives Io 0 I prefer not to answer. Do you consider yourself Physically Disabled? v e» no 0 I prefer not to answer this question. Page 6 of6 F:ICLERISALLIREGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx 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: 305.673.7411 Lewin BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS Laura M 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)" 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 sh e deemed a tender of resignation from the City agency, board, or committee March 18, 2024 Date ' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. S112.3145(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 Applicallon\BOARD AND COMMITTEE APPLICATION FEB 2024.d0cx Updated: February 22, 2024 MIAMl·llADE- 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 Lewin Laura M Mailing Address - Street Number, Street Name, or P.O. Box 650 West Ave. Apt. 1709 City, State, Zip Miami Beach, FL 33139 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) D County □Public Health Trust I] 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, FL 33139 (Municipality) Board where serving Design Review Board Alternate address (if home address is exempt) I Work telephone I Term began on/ended on (305) 373-9423 /12.31.25 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 Nelson Mullins RIiey & 2 S Biscayne Blvd, 21st Floor, Salary income for attorney Scarborough LLP Miami, FL 33131 position Hanuman Yoga Studio LLC 736 6th Street, Miami Beach, FL Income substitute yoga teaching 33131 Fifth Third Bank; Wells Fargo Savings and checking account Bank; USAA Bank interest I hereby swe (or affirm) that the information above is a true and correct statement. (sl I, w4 Date signed across9 ?7 %%%' D Hardcopy J Electronic %PY AR 1 8 2024 CITY OF MIAM I BEA CH OFFICE OF THE CITY CL ER K OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: _ 138_SP-14 COE 2016 MIAMI BE A C H City of Miami Beach, PARKING DEPARTMENT BO A RD & C O M M ITTEES PA RKIN G A PPLI C A TIO N 1755 Meridian Avenue, Suite 200 Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 a PAR KI N G 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. Bo ard M em ber Info rm ation Date of Application: March 18, 2024 Applicant Name: Laura Lewin Board/Committee Name: Design Review Board Address: 650 West Ave. Apt. 1709, Miami Beach, FL 33139 E-Mail Address: laura.lewin@nelsonmullins.com Work Phone: 305.373.9423 Home Phone: n/a Cell Phone: 813.748.5391 Preferred Contact Method: cell phone Please C ho ose O ne 1 0 tion: 3 , Citywide Parking Permit/G7 Access Card [} Citi Bike/Deco Bike Membership ) MDC Monthly Transit Pass V ehicl e Inform atio n {For C ityw ide Parking Perm it/A ccess Card O nly) Tag: FGB030 Color: White State: Florida Year: 2011 Make: BMW Model: 328i A citywide (CW) parking permit is honored at metered parking spaces and restricted residential zones parking spaces. A CW parking permit IS N O T honored in prohibited areas. An Access Card will be provided to you for City Hall Garage (G7) access. IM PO RTA NT NO TE: 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 C A N NO T 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. A C K N O W LEDG EM EN T: I ackno w led ge that sho uld m y access card be lost, stolen or dam age, I w ill be responsible to pay a $10 .00 re ce m ent fee. A Please provide sign form the Parkin Department located at 1755 Meridian Avenue, 2d flo or. Working hours are 8:30 to 5:00 p.m. or email to: ParkingRece ption@ m iam ibeachfl.gov e-m ai l sub i e ct: BO A RD & C O M MI TTE E PA RK I N G AP PLIC A TION -- AP PLIC A NT NA M E f;\ping\man\var\forms\cw boards&committees parkingtorm.doc form updated 118/2024