Scott Needelman 09.01.24RECEIVED
JUN 6 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
BOARD AND COMMITTEE CHECKLIST
APPOINTEE: Scott Needelman DATE OF APPOINTMENT, 5/15/2024
BOARD/COMMITTEE: Ad-Hoc HP Ordinance Review /1 Appointed by: City Commission
FOR SCANNER
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FOR CLERK STAFF n.\ .\ l r, 011,..,' I
o tater or Ao»ointment rRMeN:'[\l{ eRMumr:1[]2{
o Letter of Reappointment cl\od
o Copy of Letter of Appointment/Reappointment e-mai_l to Committee Liaison on ~
o Board and Committee Application (Completed on L,[C2073 )
o Resume/Curriculum Vitae ~
o Diversity Statistics Reporting (Completed on _o[6\2{
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
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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
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 /east one yea, from the date of ,emoval.. (): l.~
Received on: June 5, 2024 Signed by X__.~'-<-~o---"'=--+--~~-..,~-------------
Date pard or Committee Member
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MIAMI BEACH
City of Miami Beach, I/OO Convontion Coner Drivo, Miami Boach, Florida 33 139 wNyyw._miaInibcachll.gov
OFFICE OF IHE CITY CIERK, Rafael E. Granado, City Clerk
Tol: 305.673.7411, Fax 305.673.7254
Emal: Ci#yClerk@miamibeachll.gov
May 15, 2024
Mr. Scott Needelman
1455 Drexel Avenue #1
Miami Beach, Florida 33139
RE: Ad Hoc Historic Preservation Ordinance Review Advisory Committee
Dear Mr. Scott Needelman:
Congratulations! You have been appointed by the City Commission to the agency, board or committee
named above for a term ending: 09/01/2024.
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.
t
2 City Clerk
cc: Monica Beltran, Parking Director
Deborah Tackett, 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
4 4,
City of Miami Beach, 1/OU Conenln Cont hive Mui Esah. Hord+ '3139 yy_Lui_u_LIL_L_Lg_[_l]_yes
OFFKCF Of THE CITY CIEK, Ralaol E. Granado, iy Clerk
lel. 305.673./4l1.fox 305 673 724
F mil City lrktmiamihcachfl gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Scott Needelman
RE: Ad Hoc Historic Preservation Ordinance Review 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: 09/01/2024.
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 0f 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 ha,e ,e.,ed. -~ u
Mr. Scott Ne'kdelman
¢ ( -- Sworn to and subscribed before me this _O day of )00e2024
"es..
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.
RECEIVED
JUN 7g74 UL
City of Miami Beach
1700 Convention Contor Drivo
Miami Beach, Florido 33 139
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
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):
l[lam a resident of the City of Miami Beach for six months or longer.
Home Address: 1455 Drexel Avenue ##1
lf] 4have 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.SAN Development, Inc.
Business Address: 1455 Drexel Avenue #1
l] 1am 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: York Towers Apartments
Business Address: 1463 Drexel Avenue
"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.
erjury, I declare that I have read the foregoing document and that the facts
June 5, 2024
Date
Printed Name
City of Miami Beach
I/00 Convention Center Drive
Miami Bech, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.741 l
DIVERSITY STATISTICS REPORT
Needelman Scott A
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:
[l Male
Ll remate
0 Other
Ll prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
D Asian or Pacific Islander
El Caucasian/white
L]Native American/American Indian
[l other --Print Race: ------------- □J I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
LJves
Jo
O; I prefer not to answer.
Do you consider yourself Physically Disabled?
LJv.
GJ
Ll prefer not to answer this question.
Page 6 of 6
F CLERISALLIRE GOARD AND COMMIT TEE APPLICATIONS FINAL RAF TS\BOARD AND COMMIT TEE APPLICATION REG FINAL.doc
Updated: June 2020
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Fonda 33139
ww_miamibegchf]_goy
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7 411
Needelman
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
Scott A
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 July1, 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 , all bed emed tender of resignation from the City agency, board, or committee
June 5, 2024
Sig 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 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\SALL\BOARD AND COMMIT TEES DATABASE\Board and Committee Application\BOARD AND COMMIT TEE APPLICATION FEB 2024.doc
Updated: February 22, 2024
MIAMl·DADE,. EEI SOURCE OF INCOME STATEMENT
Saction 2-11.1() of the County Ethics ode requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July Isl
of every year.
Disclosure for Tax Year Ending !Last Name First Name Middle Name/Initial
2023 Needelman Scott A
Mailing Addrcss - Strcct Number, Stract Name, or P.0. Box
1455 Drexel venue Apt 1
City, State, Zip
Miami Beach, Florida 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)
[] county D 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 [] Municipal: City of Miami Beach
(Municipality)
Board where serving
Ad-Hoc Historc Preservation Ordinance Review Advisory Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
(305) 710-5584 May 2024-Sept 2024
List below very source of income you received, along with the address and the principal activity of each source. Include your public salary. Place the sources ot
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 anothgr
person tor 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
York Towers Apartments 1463 Drexel Avenue Property Owner / Manager
Miami Beach, FL
Merrill Lynch / TD Ameritrade/ Charles Mutual Funds & Stocks/
Schwab / Northwestern Mutual Dividends / Capital Gains
Bank of America / Capital One Interest
I
Signature of Person Disclosing
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RECEIVED BY
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