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Saul Gross 02.28.25MIA MIBEA CH BOARD AND COMMITTEE CHECKLIST APPOINTEE: Saul Gross ----------------- DATE OF APPOINTMENT.02,[2]2} 8OARD/COMMITTEE: Ad Hoc Permitting Process I9 Appointed by:. Co""sS"OD FOR SCANNER Scan o Scan o Scan o Scan o Scan o RECEIVED 4AR 212024 FOR CLERK STAFF .... J I o Letter of Appointment TERMEND. ?-28-25 TERM LIMIT. 4O Q o Letter of Reappointment I , I ) • 11 o copy ot teter ot AppointmenReappointment e-map,9?F787Ee liaison on 2]\{)y1 o Board and Committee Application (Completed on Sl[2]; ) o R~sum~/Curriculum Vitae ]){ o Diversity statistics Reporting (Completed on ]2)b o Oath 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 OF MIAMI EE$OH3, <!'iii: o crywide Pert Application (Parking Department Form» o Booklet -- Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees Scan o Scan o o Source of Income Statement o Acknowledgment Statement o Board and Committees Liaison Responsibilities o Diversity Statistics Reporting [/] 1acknowledge that pursuant to Sec. 2-22(9) of the Miami Beach Code of Ordinances, ! will be removed from my board/committee upon failure to attend 33% of the regularly scheduled meetings. Sec. 2-22(9) lf 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 fess 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. _3_-2_0_-2_4 Signed by X ~_aj_........,._~---------- Board or cohmittee Member Processed on: -~3 ........... \1-0~ ........ ),_L-_'j~ __ By Employee: \(j\/l--=--------------- Date City Clerk's Office Staff Initials Received on: Date We are committed to providing excellent public service and safely to all who live, work, and play in our vibrant, tropical, historic community M IA M I BEACH City of Miami Beach, 1/OO C on ven tion Center Dri ve, Mia mi Boach , Florida 33 139 yyy _m iam ni bea chllgo OFF ICE OF THE CITY CLERK, Rafael E. Gran ado, City Clerk Tl: 305.673.74 11, Fax. 305.673.7 254 Emai l: CiN Clerk @mi amibeachfl .gov March 13, 2024 Mr. Saul Gross 2900 Flamingo Dr Miami Beach, Florida 33140 RE: Ad Hoc Permitti ng Process Improvement Advi sor y Committee Dear Mr. Saul Gross: Congratulations! You have been appointed by the City Com m ission to the agency, board or committee named above for a term ending: 02/28/2025. 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. # Rafael Granado City Clerk cc: Monica Beltran, Parking Director Eric Carpenter, City Liaison ENC LO SUR ES: 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 MIAMIB EA CH City of Miami Beach, ZOO Con ven tion Center Die, Mia m i Beach, Florido 33 139 yyNy_miamibeach]]go OFFICE OF THE C ITY CLERK , Rafael E. Granado, C ity Clark Tel: 305.673.7411, Fax. 305.673.7254 Email: CiNyClerk@miamtbeachfl.gov Oath of Office Oath of Civility and Acknow ledgem ents T O : M r. Saul G ross R E : A d H o c Pe rm itt ing Pro cess Im provem ent A dvisory C om m ittee ! do solem n ly sw ear or aff irm to bear true faith, loyalty and allegiance to the G overn m ent of the United State s, the State of Florida , and the C ity of M iam i Beach, and to perform all the duties of a m em ber of the ab o ve -m ention ed bo ard or com m itt ee of the C ity of M iam i Be ach to w hich I have been appointed for a term end ing : 02/28/2025. T o m y colleagues and to all of those I represent and serve, I pledge fairn ess, integrity and civility, in all actio ns ta ken and all com m unications m ade by m e as a public servant. I ha ve bee n issu e d a copy of sectio n 2-11.1 of the M iam i-D ade C ounty Code (C onflict of Interest and C o d e of Ethic s Or d inan ce), as w ell as Florida C om m ission on Ethics G uide to the Sunshine Am endm ent an d C o d e of Ethics for P ublic O ffi cers and understand that as a m em ber of a C ity of M iam i Beach Board an d /or C o mm i tt e e, I m ust com ply w ith the financi al discl osure requirem ent s of M iam i-Dade County or the State of Flo rid a (d e p ending on the board or com m ittee on w hich I serv e) on July 1st, follo wi ng the closing of the calenda r ye a r on w hich I have serv ed. M r. Saul G ross Sw orn to and subscribed before m e this Keila ena Caceres Dep uty Cler k *P le a se visit th e C ity of M iam i Be ach w ebsite at ww w .mi a m ib each fl.gov under City Clerk/Board and C om m itt ees for add itional inform ation regarding the Financial D isclosure Requirem ents. M IA M I BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 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 (/) all that apply): {/]1am a resident of the City of Miami Beach for six months or longer. Home Address· 2900 Flamingo Drive, Miami Beach, FL 33140 l✓l 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: Streamline Properties, Inc. Business Address: 1125 Washington Avenue, Miami Beach, FL 33139 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). [Jar7· of P{JS]ReS, [[IS]me,S (][eS, "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 true. Sal lo ·sos <:: -------------- Signature Date Saul Gross Printed Name M IA M I BEACH City o f Miami Beach 1700 Convention Center Drive Miami Beach, Florida 331 39 www.miamibeachfl.gov O FFI CE O F THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPOR T Gross Saul 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: [J M a e [l remale om her 0 I prefer not to answer. Race/Ethnic Categories: What is your race? D African American/Black [l Asian or Pacific Islander El Caucasian/white 0 Native American/American Indian 0 Other- Print Race: _ D I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latinola? Ives Jo 0 I prefer not to answer. Do you consider yourself Physically Disabled? v e zo , prefer not to answer this question. Page 6 of 6 F:ICLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx U pd ated : June 202 0 MIAMIBEACH City of M iam i Beach 1 700 Convention Center Drive Miami Beach, Florida 33139 wyyy_migmibegchflgoy O FF IC E O F TH E C ITY C LER K Email: BC@miamibeachfl.gov Telephone: 305.673.7411 Gross BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS Saul 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 Jul y_ 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 $500, 60 days in jail, or both. Acknowledgment to Comply with Miami Beach Code of Ordinances Division 1 Sec. 2-22 (23) I understand that commencing with terms beginning on or after January 1, 2024, and as a condition of applying for appointment to a City agency, board, or committee, I voluntarily agree that in the event I file with the City Clerk a Statement of Candidate formally announcing candidacy for City elective office, such filing with the City Clerk shall be deemed a tender of resignation from the City agency, board, or committee S aul G ross Digitally signed by Saul Gross Date: 2024.03.20 10:12:28 -04 00' 3-20-24 Signature Date 1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. S112.3145(1)(a), to electronically file a Statement of Financial Interests (Form 1) with the Florida Commission on Ethics by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the Florida Commission on Ethics automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. Page 6 of6 F:\C L E R l$A L LIB O A R D A N D C O M M IT T E E S D A T A B A S E\Bo ard and C om m ittee A p p lica tion\B O A R D A N D C O M M ITT E E A P P LI C A T IO N FEB 2024.d0cx Updated: Febru ary 22, 2024 MIAMI-DAD E- EI SOURCE OF INCOME STATEMENT Section 2-11.1(i) of the County Et hics Code re quires that certain em ployees and public off icials file a financial disclosure S tatem ent on a yearly basis by July 1st of every year. Disclosure for Tax Year Ending I Last Name First Name Middle Name/Initial 2023 Gross Saul Mailing Address - Street Number, Street Name, or P.O. Box 2900 Flamingo Drive City, State, Zip Miami Beach, Florida 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 ch eck here.DJ Filing as an Employee (check one) [] count y [] P ub l ic Health Tr ust [] M unici pal : (M unici pal ity) Department Position or Ti tle Employee ID Number W ork addre ss I Work te lephon e Em ploym ent be gan on/end ed on Fil ing as a Board Member (check one) D] count y E] Municipal: Miami Beach (Municipality) Board where serving Miami Beach Alternate address {if home address is exempt) I Work telephone I Term began on/ended on (305) 532-7368 3/13/24 Li st below every source of incom e you received, along w ith the addre ss and th e prin cipa l activi ty of each source. Include your public salary. Place the sources of incom e in descending order, w ith the largest source first. Exam ples of sources of incom e include: com pensation fo r serv ices, incom e fro m business, gains fr om pro pert y deal ings, int ere st, ren ts , di vid en ds, pensi on s, IRA dis tribu tion s , an d soci al security paym en ts. Al so, in clu de an y sourc e of in com e recei ved by an ot her person fo r your benefit. How ever, the incom e of your spouse or any business part ner need not be disclosed. If continued on a separate sheet, check here.LJ Name of Source of Income Address Description of the Principal Business Activity See attached schedule I hereby swear (or affirm) that the information above is a true and correct statement. Sal Ge.a sionatire rersnotsctosing ..2 RECEIVED BY ELECTION S DEPARTMENT: []H ard cop y [ Elec tronic Copy OFFICE USE ONLY Accepted: Y I N Deficiency: Processed Date/initials: Scan ned Date/initials: 138_SP-14 COE 2016 Source of Income Statement 2023 Saul Gross Ad Hoc Permitting Process Improvement Advisory Comm ittee City of Miam i Beach Name of Source of Income Address Description of Principal Business Activity Streamline Properties Inc 1125 Washington Avenue, MB, FL Washington Center Ltd Partnership National Financial Services c/o Commonwealth Financial Network Goldman Sachs Bank USA American Express National Bank Tikva Partners LLC City of Miami Beach Chestnut Street Ventures State of Israel 1121-1141 Washington Ave, MB, FL 29 Sawyer Rd, Waltham, MA Real estate Owner of retail stores Mutual funds, stocks, bonds Cranberry TWP, PA Salt Lake City, UT White Plains NY Miami Beach, FL New York, NY c/o Bank of NY Money Market Interest Money Market Interest Loan interest Pension fund Venture Capital Fund Bond interest and dividends 6 £ tt r ...%