Darin Feldman 12.31.24MIAMIBEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Darin Feldman
BOARD/COMMITTEE: Animal Welfare Committee
1AMI BEACH
DATE OF APPOINTMENT: _Lu II illE CITY CLERK
Appointed by: Commisioner Magazine
FOR SCANNER
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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 0/@V??+_
o Board and Committee Application (Completed on 12/20/2021 )
o R~sum~/Curriculum Vitae
o Diversity Statistics Reporting (Completed on 5/23/2024
o Oath
TERM END. 12/31/2024 TERM LIMIT: 12/31/2031 -------
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓City Code Ordinance Section applicable to the agency, board or committee
Y 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 Ordinan e (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
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o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Emplovees
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 re oved
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 sch iduled
meetings per calendar year, such member shall be automatically removed. To calculate the number of abs nces
under the 33 percent formula, .4 or less rounds down to the next whole number and .5 or more rounds up o the
next whole number.
NOTE: Members of the Land Use Boards will be removed upon failure lo attend three of the regularly sch duled
meetings per calendar year; or upon abstaining from voting due to a conflict of interest on four di erent
applications within a calendar year. A member who is removed shall not be reappointed to membership n the
board for at least one year from the date of removal.
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Date
[rossed on. [3y mp[0y@e, l
Date City Clerk's Office Staff Initials
We are commuted to povding ocellont public sorwce and salty o al who live, work, and play in our vibvant, tropical, historic community
MIAMI BEACH
City of Miami Beach, 1/OO Convention Conler Drive, Miami Boach, Horida 33 139 yNyy_miamibgachllgoy
OFFICE OF THE CITY CIERK, Rafool E. Granado, Cy Clerk
Tl: 305.673.7411, Fax. 305.673.7254
Email: CilyClerk@miamiboachfl.gov
May 22, 2024
Mr. Darin Feldman
1662 Lincoln Court #404
Miami Beach, Florida 33139
RE: Animal Welfare Committee
Dear Mr. Darin Feldman:
Congratulations! You have been appointed by Commissioner Joseph Magazine to the above-
referenced Board or Committee, for a term ending: 12/31/2024.
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 305.673.7411.
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.
a ..2.
City Clerk
cc: Jose Gonzalez, Parking Director
Aron Soriano, 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, /OO Convention Center Drive, Miami Beach, Honda 33 139 yaw_miamlbccbll.gov
OFFICE OF IHE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.741I, Fa€ 305.673.7254
Emall: CiyClerk@miamtbeachfl. gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Darin Feldman
RE: Animal Welfare 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: 12/31/2024.
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 e) on ily 1st, followj e closing
of the calendar year on which I have served.
f~2024
do
Deputy Clerk
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
1 700 Convention Center Drive
Miami Beach, Florida 33139
ECEIVED
M4NY 24 2024
CITY O M orrice '],// EACH
CITY CLEPR
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl,gov
Telephone: 305.673.7 411
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.
or- Ao Ga3 LI0col e9# ·401_() [13213
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).
[am9 (f [,yg[res,S,
P/Jg]moss, l(}]fos,S,
t 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).
[[ammo (T Jg]PeSS,
b1g[pg,g flt(rags,
"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 associatjn.
that I have read the foregoing document and that the facts
Printed Name
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Fmail: RC@miamiheachfl_gov
Telephone: 305.673.741 l
DIVERSITY STATISTICS REPORT
Fallo
Last Name 42vs wane Middle Ir itial
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:
tale fee oner
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
[l African American/Black D Asian or Pacific Islander
tj caucasa/white Ll Native American/American Indian D Other- Print Race: _
D I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Tes
No
prefer not to answer.
Do you consider yourself Physically Disabled?
a,
No
prefer not to answer this question.
Page 6 of6
FCLER\SALL,REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL .docx
Updated: June 2020
MIAMI BEACH
Cit of Miami Beach
170 Convention Center Drive
Miami Beach, Florida 33139
.miamibeachfl.aov
OFF CE OF THE CITY CLERK
Em ii: BC@miamibeachfl.gov
Tele hone: 305.673.7411
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
To First Name Middle Initial
Ac nowledgment of fines/suspension for Board/Committee Members for failure to comply with Miami- i Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2)
I un erstand that no later than July 1, of each year all members of Boards and Committees of the City of Miami
Bea h, including those of a purely advisory nature, are required to comply with Miami-Dade County Financial
Dis osure Requirements.
On of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive,
Mia i Beach, Florida, no later than 12:00 noon of July 1, of each year:
1.
2.
"Source of Income Statement;" or
Copy of your latest Federal Income Tax Return.
Me bers of the Planning Board and the Board of Adjustment must electronically file a "Statement of Financial
Inter sts (Form 1)" directly with the Florida Commission on Ethics.
re to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
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 un erstand that commencing with terms beginning on or after January 1, 2024, and as a condition of applying
for aj ·ittee, I voluntarily agree that in the event I file with the City
Cler g candidacy for City elective office, such filing with the City
Cl the City agency, board, or committee
Date
' Me bers of the Planning Board and Board of Adjustment will be notified directly by the State of Florida,
purs ant to F.S. $112.3145(1)(a), to electronically file a Statement of Financial Interests (Form 1) with the Florida
Com ission on Ethics by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their
Forr 1with the Florida Commission on Ethics automatically satisfy the County's financial disclosure requirement ~~e~l iami Beach City Board/Committee member and need not file an additional form with the Office of the City
Page 6 of 6
F:CLEF \SALL\BOARD AND COMMIT TEES DATABASE\Board and Committee Application\BOARD AND COMMIT TEE APPLICATION FEB 2024.d0cx
Update : February 22, 2024
MIAMl·DADE- Em 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
Middle Name/Initial -----
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. 0
Filing as an Employee (check one)
D County D Public Health Trust [] Municipat:
(Municipality)
Department
Position or Title Employee ID Number
Work address Work telephone Employment began on/ended on
Filing as a Board Wember (check one)
D County ] Municiat:
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 trom business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. Also, include any source of income received by inothgr
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.[]
ss Activity
a true and correct statement.
Date signed
RECEIVED BY LEC
[ ] Hardcopy
remoniv24 20724
CITY OF MIAMI BEAC
OFFICE O +r CIT
OFFICE USE ONLY Accepted: Y N Deficiency: Processed Date/initials: Scanned Date/initials:l
138_SP-14 COE 2016
MIAMI BEACH
City ot Miami Beach, PARKING DEPARTMENT
1755 Meridian Avenue, Suite 200 Miami Beach, FL 33139/Ph: (305) 673-7505 0r (305) 673-7000 ext. 6200
BOARD & COMMITTEES
PARKING APPLICATION aiiiiG
As a Board/Committee member you are entitled to a Citywide Parking Permit, which includes Cit 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:
Applicant Name:
Work Phone:
cel Phone:< Preferred Contact Method:
Please Choose One 1 0 tion:
Citywide Parking Perrnit/G7 Access Card O Citi Bike/Deco Bike Membership
State: FL Year:
Make: OU Model:
A citywide (CW) parking permit is honored at metered parking spaces and restricted residential z nes
parking spaces. A CW parking permit IS NOT honored in prohibited areas. An Access Card wi I 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 nd
accurate information regarding your vehicle license plate. Inaccurate and/or outdated ver iicle
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 Iay
need to try the other side of the card. Please ensure you hold the entire surface of the card ag inst
the reader until the gate opens.
ACKNOWLEDGEMENT·
responsible to pay a
ess card be lost, stolen or damage, I wil be
A
ocated at 1755 Meridian Avenue, 2d fl or,
Working hours or ii to: ParkingReception@mlamibeachfl.gov
e-mails MITTEE PARKING APPLICATION -- APPLICANT NAME
f;\ping\$manor\forms\cw boords&committees porkingform.doc form updated 1/18/2024