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Eufemia Plimpton 12.31.25M IA M I BEACH B O A R D A N D C O M M IT T E E C H E C K L IST APPOINTEE: Eufemia Plimpton BOARD/COMMITTEE: Disabililty Action Committee FOR SCANNER Scan o Scan o Scan o Scan o Scan o DATE OF APPOINTMENT. 4/15/2024 Appointed by: Commissioner Fernandez 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 ) • esorecuncon vae kpp4 o Diversity Statistics Reporting (Completed on ]LlD) o Oath reRMu No:_Q[3/\ rRM uwnr. l31l3) /r]14 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 ✓ ✓ CITY F 'AAMI BEACH o e E Fuery ~ER O:Ft )l tilt o Citywi de Permit 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 ) I acknowl edge 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. ..xl(4a%t. ____ D_a_t_e_____ ~.~--"tr'-a_r_d-or-r-C11-o-m_m_i_tt-ee_M_e_m_b_e_r _ Processed on: <-//l01., 1,,L{_ By Employee: __ ._l;;__wJ__;_ _ ____;_ _ Date City Clerk's Office Staff Initials Received on: 4/15/2024 We ore 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 Convonlion Contor Drive, Mia mi Boach, Florida 33 139 yaw_miamibogchf]_gov OFFICE OF THE CITY CIERK, Rafael E. Granado, City Clerk Tel: 305.673.7411, Fax. 305.673.7254 Ema ll: CiNyClerk @miamibeachll.gov April 15, 2024 Ms. Eufemia Plimpton 817 Meridian Ave Miami Beach, FL 33139 RE: Disability Access Committee Dear Ms. Eufemia Plimpton: 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 app ointm ent/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. Regards, Rafae~o City Clerk cc: Monica Beltran, Parking Director Valeria Mejia, 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 and 2-459 Ordinance No. 2006-3543 - Am endment to City Code Section 2-22 Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics City Wide Permit Ap plication - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees M IAMI BEACH City of Miami Beach, 17OO Convention Conte Drive, Miami Beach, Horida 33139 yNywy_miamibgachfl_gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.7411, Fax 305.673.7254 Email: CiyClerk@miamtbeachll.gov Oath of Office Oath of Civility and Acknowledgements TO: Ms. Eufemia Plimpton RE: Disability Access 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 subscribed before me this _/'6 __ da of \ , 2024 pl ease 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 APR 18 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 (/) al l that apply): l/Elam a resident of the City of Miami Beach for six months or longer. Home Address: 736 13th Street, Apt. 210, Miami Beach, FL 33139 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 stat in it are true. 4/15/2024 Signatu Eufemia Plimpton Date Printed Name M IA M I B EA CH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www._miamibeach[]_gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORI Plimpton Eufemia R 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 [l Female D Other D I prefer not to answer. Race/Ethnic Categories: What is your race? D African American/Black A sta or Pacific Islander [l Caucasian/wh ite LJ Native American/American Indian D Other - Print Race: ------------- □I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? ves No Ll1 prefer not to answer. Do you consider yourself Physically Disabled? v, G o D I prefer not to answer this question. Page 6 of 6 F:\C LER\$ALL\REG\BO ARD AND CO M M ITT EE APPLI CATIO NS FINAL DRA FTS\BOARD AND COMMITT EE 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._miamibeacht].gov OFFICE OF THE CITY CLERK Email: BC@miamibeachfl.gov Tel ep ho ne: 305.673.7411 Plimpton BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS Eufemia R Last Nam e First Nam e 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 mem bers of Boards and Com m ittees of the City of Miami Beach, including those of a purely advisory nature, are required to com ply with Miam i-Dade County Financial D isclosure Requirem ents. One of the follow ing fo rm s must be filed with the City Clerk of Miam i Beach, 17 00 Convention Center Drive, Miam i Beach, Florida, no later than 12:00 noon of July 1, of each year: 1. A "Source of Incom e Statem ent;" or 2. A "S tatement 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 Miam i-Dade County Code, may subject the person to a fine of no m ore 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 com m encing with terms beginning on or after Jan uary 1, 2024, and as a condition of applying for appointm ent to a C ity agency, board, or com m ittee, I voluntarily agree that in the event I file with the City Clerk a Statement of C andidate formally announcing candidacy fo r City elect ive office, such filing with the City Cle shall be deem ed a tender of resignation fro m the City agency, board, or com m ittee 4-15-2024 Date ' M em bers of the Planning Board and Board of Adjustm ent will be notified directly by the State of Florida, pursuant to F.S . §112.3145(1)(a), to file a Statem ent of Financial Interests (Form 1) with the Miami-Dade County S uperv isor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustm ent mem bers who file their Form 1 with the County Superv isor of Elections autom atically satisfy the County's financial disclosure requirem ent as a Miam i Beach City Board/Com m ittee mem ber and need not file an additional form with the Office of the City Clerk. How ever, com pliance with the County disclosure requirem ent does not satisfy the State requirem ent. Page 6 of 6 F:IC LER\$ALLIBO ARD AND CO M M ITTEES DATABASE\Board and Com mittee Applica tion\BOARD AND COMMITT EE APPLICATION OCT 2023.docx Updated: January 9, 2023 M IA M I B E A C H City o f Miami Beach, PARKING DEPARTMENT BOARD & COMMITTEES PARKING APPLICATION 1755 Meridian Avenue, Suite 200 Miami Beach, FL 33139 /Ph: (305) 673-7505 or (305) 673-7000 ext. 6200 a PARKING As a Boar d/C om m ittee m em ber you ar e entitled to a Ci tyw ide Par king Permit, which includes City Hall gar age (G 7) par king access (A ccess Car d), QI a com plimentary Citi Bike/Deco Bike Mem bership, or a discounted M DC M onthly Transit Pass throughout your term . Board Member Information Date of A pplication: 4/15/24 Ap plicant Nam e: Eufem ia Plim pton Boar d/C om m ittee Na m e: Disability Action Comm ittee A ddress: 736 13th Stre et Apt. 210, Mi am i Beach, FL 33139 E-M ai l A ddre ss: erplim pton@ gm ail.com W ork Phone: 305-798-7813 Hom e Phone: 305-798-7813 C ell Phone: 305-798-7813 Preferred Contact M ethod: C ell Please Choose One 1 O tion: • Cityw ide Parking Permit/G7 Access Card Citi Bike/Deco Bike Membership MDC Monthly Transit Pass Vehicle Information (For Citywide Parking Permit/ Access Card Only) Tag : KDKR91 Color : W hite State: Flo rid a Year : 2018 M ake: A u d i M odel: Q 5 A cityw ide (C W ) par king perm it is honored at m etered par king spaces and restricted residential zones par king spaces. A CW par king perm it IS NOT honor ed in pro hibited ar eas. An Access Car d will be pro vided to you for City Hall G ar age (G 7) access. IMPORTANT NOTE: Your vehicl e license plate serves as your "par king permit". To avoid any unnecessary enfor cem ent act ions, it is im portant that our recor ds reflect the most current and accurate infor m ation regar ding your vehicl e license plate. Inaccurate and/or outdated vehicle info rm ation m ay lead to the issuance of parking citation(s) and/or the tow ing of your vehicle. Pleas e note that this new access car d CANNOT be hole-punched or perforated in any manner. To use the new car d pleas e hold the car d at cl ose proximity to the reader until the gate opens. You may ne ed to try the other side of the car d. Pleas e ensure you hold the entire surface of the car d 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 $10.00r lacement fee. A, lican t Si nature : es Ple ase pro vid e sign e d for m to e Pa in Dep ar tm en t located at 1755 M eridian Aven ue, 2nd floor. W o rking hours ar e 8:30 to 5:00 p.m. or em ail to: ParkingReception@miamibeachfl.gov e-mail subiect: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME f:\ping\$man\rar\forms\cw b o a rd s&c o m m itte e s p a rkin g torm .d o c form updated 1/18/2024