Merle Shama 12.31.25Ml 1\
#
RECEIVED
JUN 26 2024
CARD AND COMMITTEE CHECKLIST.9"2%,£,%49g!
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BOARD/coMMr re. /4( l/one 6 ommi3ion Aoointea by! tog7oner at
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i HF #JAM!T INF( ER {TIA FOR BOARD AND COMMITTEE MEMBERS BOOK
+Codee rs use Section applicable to the agency, board or committee
3iCde he ti ns221,2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
cunt; CG &clioni 2-11.1-- Conflict of Interest and Code of Ethics Ordinance (as
unended o th December 2010)
rardmeIts o he Code of Ethics Ordinance (September 2009 through July 2012)
livglight « 1 s· Miami-Dade County Ethics Code
3n1shine zw. dPuolic Records - Frequently Asked Questions
emoran ta · Solicitation by City Board and Committee Members
C yde Fermi: \ppiiation (Parking Department Form)
B 0lat-Guida o iv shire Amendment & Code of Ethics for Public Officers and Employees
S ugcflrcone la.erent
kcwledgmer ! ci F nancial Disclosure Requirement
• E dad Corr rit. ass liaison Responsibilities
,J' I WE&lTY STAT#TICS REPORTING Keep COPY in file and ORIGINAL for Annual Report.
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! 1:1!1 ~mmittee Member
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COMA AJE)EI: 3 RESIGNATION LETTERS
Term Expired Letter Ere "rocessod
Resignation Letter Ere ocessod
-· ·-•-·-···-·•·-·····- --·· .. .. ·--·-··•··••-···--
Removal Letter due to abser es Ewe ocesed
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F:CLER\BOARD AND COM MAI TIE EA J-\CZ4 T MASTER\B&C Checklist 2015 MASTER.docx
MIAMI BEACH
City of Miami Beach, 1/00 Convention Canter Drive, Miami Boach, Florida 33 139 yNw_miamibgachll_gov
OFFICE OF THE CITY CIERK, Ralaol E. Granado, Cy Clo«k
Tl: 305.673.7411, Fa: 305.673.7254
Email: CiNyClerk@miamibeachfl.gov
November 29, 2023
Ms. Merle Shama
11 Island Avenue, #911
Miami Beach, Florida 33139
SUBJECT: Miami Beach Commission For Women
Congratulations! You have been reappointed by Commissioner Laura Dominguez to the above
referenced, board or committee named above, 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 305.673.7411. Please read the enclosed materials carefully.
Congratulations and good luck. ,/
..2!
City Clerk
cc: Monica Beltran, Parking Director
Monica Matteo-Salinas, City Liaison
ATTACHMENTS:
Letter of Appointment
Oath
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 Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees
OFFICE OE HE T' IEE, all E. Granai,Ti», k
Tel: 305.673./411,Er. A8 673./254
Emall: City.Clerk t@waribo hii.qcs
Oath of Office
hath of Civility
and
Acknowledgements
TO: Ms. Merle tan a
RE: Miami Ee@chi Cc nrission For: !'corn
I do solernnly svoa o affirm to bear tr.ae faith, loyalty and allegiance to the Government of the United
States, the State of 'lrid, and th iy of Miami Beach, and to perform all the duties of a member of the
above-mentioned b:ad or corrillr f the City of Miami Beach to which I have been appointed for a
term ending: 2/1/ 1025.
To my colleagues ad to all oi thcg ! represent and serve, I pledge fairness, integrity and civility, in all
actions taken and al orrnunications nade by me as a public servant.
I have been issued a copy of sec/ir 2-11.1 of the Miami-Dade County Code (Conflict of Interest and
Code of Ethics rdi ance), as wei as Florida Commission on Ethics Guide to the Sunshine Amendment
and Code of Ethics I Fuolic Ofl.er and understand that as a member of a City of Miami Beach Board
and/or Commnitlea, I mist comply wih the financial disclosure requirements of Miami-Dade County or the
State of Florida deperding on the houri or committee on which I serve) on July 1st, following the closing
of the calendar yaar or which ! have served.
0#&er==
r ., .. , ,, ,o ano subscribed before me this 'Jb ~ay 01~201/
--±..S eputy lerk
please visit I Ci y of Miami Ewan website at www.miamibeachfl.gov under City Clerk/Board and
Committees for ddi:ioal informavo a;arding the Financial Disclosure Requirements.
MI , I \
City of Mari Eacl
1700 Convention! Orive
Miami Bech, ila 3139
RECEIVED
JUN 26 2024
CITY OF MIAMI BE- OFfir r iii s;35ACH +. CLERK
OFFICE OF THE CT "Y IEE
Email: BC@mini] a hill gov
Telephone: 305.37 1.7 1
A FE DA[I {E_LEE/L,IAIN_ y/ITH THE CITy OF MIAMI BEACH
l am in compliance wil the afi tin requirement of Miami Beach City Code Sections 2-22 (4),
as (check ()al tl at piy)
GZ]' 1 am a rn:,.ir: ar I cf the City o: I1/ii,mii BEiach for six months or longer.
one.a. / 1Ghana /tr qt,MB3 Fl 33137 -· , ,,_ 5 )
E [1have a wr rsli nlaret (r a minimum of six months) in a business established in the
City of Mia i "ea;± (fora ririmum of six months).
E_[1am a fll-im employoe b.siness (for a minimum of six months) and l am based in an
office or a hie lo:attn of the business that is physically located in Miami Beach (for a
minimum l sis rrths,).
Name o B si ass: -
Business hdd &: ea -«au
"Ownersti /nras! means tve ownership of ten percent (10%) or more (including the
ownership c' 1% or are o"the outsranding capital stock) in a business.
"Business'r en ary sole proprietorsnip, sponsorship, corporation, limited liability company,
or other crdry sr musirvss asscation.
Under penal!is of 2rjury, I declare that l have read the foregoing document and that the facts
stated jn it are e ______ &~-----·--- .. -··-··--·--
rare , Ml,le hanu4 Date 1
City of Miami Ee& +
1700 Convention enter rive
Miami Beach, Florida33 3
www,miamibeachtl.g
OFFICE OF THE CITY IE ?K
Email: BC@miamhea. i Ac
Telephone: 305.673.71
EERIIT L.STATISTICS REPORT
Last Name First Name Middle Initial
The following inform atmn s voluntary av! has no bearing on your consideration for appointment. It is being
asked to comply with iy diversity eorir j requirements.
Gender:
~
. le
Female
Other
EH prefer not to .awe..
Race/Ethnic Caterie:
What is your raci
[]African Amer«car/3tact
E)Asian or Pacif: 1a d
[ Caucasian/tee
El Native American:/m ricer India
0 Other - Print R'.i':( ,:·,: - ··-·---
EM prefer not to vve.
Do you consider to rs ll :ch Spanish, Hispanic, or Latino/a?
Les
[ o
El prefer not to we.
De»
LA No
El refer not to a we ts cqustis
'. ,,_., _,.,,,. ~
Page 6 of 6
F:CLER\$ALL\REG\BOARD MI' TEES FFLI AH: INL DAE TS\BOARD AND COMMIT TEE APPLICATION REG FINAL.docx
Updated: June 2020
City of Miami le +
1700 Convention en ri
Miami Beach, Florida 33 3%
www.miamibeachll gc
OFFICE OF THE CITY CIERK
Email: BC@miamibea.ht 1c
Telephone: 305.673.71I
JO F) , CMMMMI! TEE ACKNOWLEDGEMENT STATEMENTS c5hamq ... ,, ,, ... __ lY.eL~~----
Last Name First Name Middle Initial
Acknowledgment s in@s'suspensiww pr Eloard/Committee Members for failure to comply with Miami-
Dade arty Financial Ji «closure Cole Provision Code Section 2-11.1(i) (2)
I understand that no lat r ran guy.1,of pug/g year all members of Boards and Committees of the City of Miami
Beach, including those of a ouriy ucwisory nature, are required to comply with Miami-Dade County Financial
Disclosure Requirer t (s.
Qne of the following Imm ±±s he fit gg wth the City Clerk of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florid, o at than 12: 0on o/ July 1, of each year:
1. A "Source of lncmns 4arrant," ct
2. A "Statement of "ir an interests tF st. 1)'; or
3. A Copy of your latest} aaral Incorss Return.
Failure to file one cc ti ess lorrs, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $500, i0 ay3 in jail, or th.
Acknowledgrts it opiy with liarri E3each Code of Ordinances Division 1 Sec. 2-22 (23)
l understand that corer irg wilh terrs heginning on or after January 1, 2024, and as a condition of applying
for appointment to a iy agency, board, at committee, I voluntarily agree that in the event l file with the City
Clerk a Statement oi Canida:e formally ouncing candidacy for City elective office, such filing with the City
Clerk shall be deemed tnler of resi@a on from the City agency, board, or committee
s~-(J~ .... -··-- pa 7
'Members of the Faining Ear and Erd of Adjustment will be notified directly by the State of Florida,
pursuant to F.S. S11.214()a), to file zit±tement of Financial Interests (Form 1) with the Miami-Dade County
Supervisor of Electicrs Doy 12:0) con, huh I. Planning Board and Board of Adjustment members who file their
Form 1 with the C nty Supervisor of Elections automatically satisfy the County's financial disclosure
requirement as a iem Beach City 3oah emittee member and need not file an additional form with the Office
of the City Clerk. ovevr rnpliare with the County disclosure requirement does not satisfy the State
requirement.
Page 6 of 6
F:\CLER\I$ALL\BOARD AND OMMTE S D)0AB3ASEE\ rd sud ormittee Application\BOARD AND COMMIT TEE APPLICATION OCT 2023.d0cx
Updated: January 9, 2023
MIAMl·DADE. EME7 SOURCE OF INCOME STATEMENT
Section 2-11.1(i) of the County Ethics Code requires that certain employees, public officials and consultants tile a financial disclosure Statement on a yearly
basis by July 1st of every year. For the last year of service, file SOI-F.
--·---·-···---··-·····---------~ pg"e« ans""WI
Mailing Address - Street Number, Street Name, or P.O. Box
5 0. # } n "held-ldfe{th.h d ml·-------- City, State, Zip
"an' O l1mt1le er eet t fl .--o- l
Middle Name/initial
lf 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 D Public Health Trust D Municipal:
(Municipality) 1-------------------------- ------·--·-·---"·--------------i Department
Position or Title Employee ID Number
~W-o-rk-ad_d_re_s_s ~I w_ork telephone ---~-~-~~~- ------ Employment began on/ended on
Filing as (check one)
[] County Board [] Municipal Board: []Consultant for County or Municipal Agency
(Municipality)
Board where serving or name of County or Municipal Agency Consultant is providing professional services lo
[)~mi p)eh lQowen's Cati3ion
Alternate address (if home address is exempt) Work telephone I Term began on/ended on
o l-850- 10[
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 another
person for your benefit. However, the income of your spouse or any business partner need not be disclosed. It continued on a separate sheet, check here.[]
Descri lion of the Principal Business Activity Name of Source of Income Address
@bowe>
a
Mich«el Bex49 , me 6
[Su6e, ..
J J
--- ---·----
···-···""""'-
I hereby swear (or affirm) that the information above is a true and correct statement
,(1(/!1!.~ ... ···~· ...
6/31a/
Date signed'
coo or ntcnos. f/%% oroeo»RECElV
Electronic Copy
JUN 2 6 2024
CITY OF MIAMI BEAGOH
OFFICE OF TIE CIIV CLERK
OFFICE USE ONLY Accepted: Y I N Deficiency: Process@i Date/Initials.
138_SP-14 COE 2024
Scanned Date/initials.