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Ronald Starkman 12.31.25MI A M I BEACH Scan o B O ARD AN D C OM MITTEE C HE CKLIST APore./oval Shaeka/ A r or APP o r e r. /a / 2/ o ARo cowo wwrreee l@kntf pp4/gycd oointeay. Co . recuAI FOR SCANNER FOR cERksra,· )·~1 . ,Jo / ,,j ,[ scan o Letter of Appointment TERM END: /e/ // TERMLuMr. I43\J3l Scan o o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on _ o Board and Committee Application (Completed on I o R~sum~/Curriculum Vitae L o Di v ersi ty Statistics Reporting (Completed on 2 _){ \l ) o Oath Scan o Scan o ED r{Cy v MM44R 20 2024 CITY OE MIAMI BEACH OFEF AE CITY CLERK 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 Scan o Scan o 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 [] 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. 2-229) 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: 5/rt sis,X7a =- I / Date ••.. 3/2l2 Date Hy [rp[0/ee. lo MIAMI BEACH City of Miami Beach, 1/OO Convention Center Drivo, Miami Beach, Florida 33 139 yyy_miamibcachllgoy OFFICE OF THE CITY CLERK, Rafael E. Granado, Ciy Clerk Tel: 305.673.7411, Fax. 305.673.7254 Email: CiNyClerk@miamibeach~fl.gov February 09, 2024 Mr. Ronald Starkman 300 S. Pointe Dr Apt 2602 Miami Beach, Florida 33139 RE: Neighborhood Resiliency Projects Advisory Com mittee Dear Mr. Ronald Starkman: Congratulations! You have been appointed by Commissioner Alex Fernandez to 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 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. 7 411. 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. R~ RaL Granado City Clerk cc: Monica Beltran, Parking Director Amy Knowles, 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 City of Miami Beach, 1ZOO Convention Conlar Drive, Miami Bach, Horida 33139 ygyywy_migrribog chf]_go OFFICE OF THE CITY CLERK, Rofol E. Gran ado, City Clerk Tel. 305.673.7411, Fax. 305.673.7254 Email: Cit Clerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Ronald Starkman RE: Neighborhood Resiliency Projects Advisory Committee 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. sworn to and subscented etore me » _a/ Ga CHARLES D'AGOSTIN *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 RECE I VED City of Miami Beach 1 700 Convention Center Drive Miami Beach, Florida 33139 MAR 26 2024 CI!Or MIAMI BEACH OFFICE TOI OEk 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): ~ I am a resident of the City of Miami Beach for six months or longer. ome Address _300 Sfo,,E D. I,I 2oz □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 "",p - I /_h52oz/ 72" cu... printed Name MIAMAIBEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov OFFICE OF THE CITY CL ERK Email: BC@miamibeachfl_gov Telephon e: 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: Gae D Female 0 Other 0 I prefer not to answer. Race/Ethnic Categories: What is your race? []African American/Black L Asta or Pacific Islander DJ Caucasian/white 0 Native American/American Indian 0 Other- Print Race: _ 0 I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? Jves mno El prefer not to answer. Do you consider yourself Physically Disabled? vee go D I prefer not to answer this question. Page 6 of 6 F:\CLER\$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated: June 2020 MIA\MIBEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 ww w_migmibeachf._gov OFFICE OF THE CITY CLERK Em ai l: BC@m iamibeachfl_gov Telephone: 305.673.74 l l BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS ~SAL., Ks L~st 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 0 a,= Signature Date ' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. $112.3145(1)a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 6 of 6 F:\C L E R l$A L LIB O A R D A N D C O M M ITT E E S D A TA B A S E \B oard and C om m ittee A pplication\BO A R D AN D CO M M ITT EE APPLI C A TIO N O C T 2023.docx Updated: January 9, 2023 MIAMl·DADE- EIII 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 2023 Last Name Sh-E, Mid,iz'ame/lnitial Mailing Address - Street Number, Street Name, or P.O. Box 3.> S e.o City, State, Zip 1 2602 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 [] 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) D County Jntote_/a, le.b (Municipality) Alternate address f home address is exempt) Term began on/ended on 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 Ta veser Ta eyf 7A Kl co{ l4v Err I hereby swear (or affirm) that the information above is a true and correct statement. Signature of Person Disclosing /257/2/ Date signed RECEIVED BY ELECTIONS DEPARTMENT: [ Hardcopy tJ Electronic copy ECEIVED M4AR 25 2024 OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/Initials: Scanned Date/Initials: _ 138_SP-14 COE 2016