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Carolina Cuadros 12.31.25MIAMI BEACH RECEIVED JUL 01 2024 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK BOARD AND COMMITTEE CHECKLIST DATE OF APPOINTMENr:Q\3 \202O I BOARD/COMMITTEE. Senior Affairs Committee Appointed by. l4 \'f05i0 FOR SCANNER FORCLERKSTAFr _[-[. _[:\9 scan o o Letter of Appointment TERM END: (213l\2G TERM LIMIT: 2-_[\.'> Scan o o Letter of Reappointment 2\85/; J o Copy of Letter of Appointment/Reappointment e-mailed to E[a2l o Board and Committee Application (Completed on _hp2I'l o R~sum~/Curriculum Vitae [6,,[v[ o Diversity Statistics Reporting (Completed on o[Q[-} o Oath Crd«d> Scan o Scan o Scan o Scan o Scan o 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 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 {/] 1acknowledge that pursuant to Sec. 2-22(9) of the Miami Beach Code of Ordinances, I will be removed from my board/committee upon fallure 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. Received on. Processed on. Alt .s»-,x_ bod»so tvolo Date Board or Committee Member 'a[z[?d .y moves zt. Die T City Clerk's Office Staff initials le ae ommuted o proodug excellent public servce and soloty lo all who live, work, and play mn out vbrant, topical, hvstooc conmony MIAMI BEACH City of Miami Beach, I/OO Convonlion Conlor Drivo, Miami Boach, Florida 33 139 yw_miaImibgachf].go OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tol: 305.673.7411, Fax:. 305.673.7254 Email: CiNyClerk@miamibeachll.gov February 07, 2024 Mr. Carolina Cuadros 1902 SE 14th Cir Homestead, FL 33035 SUBJECT: Senior Affairs Committee Dear Mr. Carolina Cuadros: Congratulations! You have been reappointed by the City Commission to the above referenced board or committee, for a term ending: 12/31/2025. 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. Res12l Rafael Granado City Clerk cc: Monica Beltran, Parking Director AIba Tarre, 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 MIAMI BEACH City of Miami Beach, I/OO Convention Contor Dwo, Miami Booch, Hondo 33 1 39 www.mlam/beachll.go OHAE OF IH CITY CIERK, Rolool E. Granado, Cay Cdork 1l. 305.673.7411, fax. 305.673.7254 Emal. Ca/Clo«k omkomtbochfl gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Carolina Cuadros RE: Senior Affairs 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. Mr. Carolina Cuadros ~\ Sworn to and subscribed before me this_\ __ day of~ 2024 Ass 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 1700 Convention Center Drive Miami Beach, Florida 33139 RECEIVED JUL 01 2024 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK OFFICE OF THE CITY CLERK Email: BC@miamubeachf.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): 0 I am a resident of the City of Miami Beach for six months or longer. Home Address: 3800 Collins Ave, Miami Beach FL 33140 0 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). [qr?% (f P1Jg1/@Si, Py1mes,S, (]]feSsS, 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 stated in it are true. lbuuo (dun ooares ~------------ Signature Date Carolina Cuadros Printed Name MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 w.miamibeachfl.gov OFFICE OF THE CITY CLERK Email. BC@mamibeachf gov Telephone: 305.673.7411 DIVERSITY STATISTICS REPORT Cuadros Carolina 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: late Z remale l oner 0 I prefer not to answer. Race/Ethnic Categories: What is your race? [Amica American/Black Asta or Pacific Islander 0 Caucasian/White 2.es2"" [other -- Print Race: • □I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latinola? rf. ho D I prefer not to answer. Do you consider yourself Physically Disabled? ves g0 Llt refer not to answer this question. Page 6 of6 FCLERSALLREG OARD AN COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL doc Udateed June 2020 MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florido 33139 www.miamibeochll,gov OFFICE OF THE CITY CLERK Email: BC@miamibeachf qov Telephone: 305.673.7411 BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS Cuadros Carolina 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 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 $500, 60 days in jail, or both. Acknowledgment to Comply with Miami Beach Code of Ordinances Division 1 Sec. 2-22 (23) I understand that commencing with terms beginning on or after January 1, 2024, and as a condition of applying for appointment to a City agency, board, or committee, I voluntarily agree that in the event I file with the City Clerk a Statement of Candidate formally announcing candidacy for City elective office, such filing with the City Clerk shall be deemed a tender of resignation from the City agency, board, or committee Signature Date ' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. 112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 6 of6 F CLER$ALL BOARD AND COMMITTEES DATABASE Board and Committee Application\BOARD AND COMMITTEE APPLICATION OCT 2023 docx Updated January 9, 2023 MIAMl-~- Erm SOURCE OF INCOME STATEMENT I I Statement on a yearly basis by July 1st Section 2-11.1(@) ot the County Ethics Code requires that certain employees and public officials file a financial disclosure of every year Disclosure tor Tax Year Ending llastNamo First Name Middle Name/initial 2023 o Cuadros Carolina Mailing Address - Street Number, Street Name, or P.0. Box 10701 NW 75th Ln City, State, Ip Doral FL 33178 f bl. d rsuant to Fla Stat. $119.07, read If your home address is your mailing address, and your home address is exempt from put lic records pu ' instructions on the following page and check here.[] Filln E lo (check gas an :mpl yee one [] county D Public Health Trust [] Municipal: (Municipality) Department Position or Title Employee ID Number Employment began on/ended on Work address I Work telephone Filing as a Board Member (check one) [] county D Municipal: Miami Beach (Municipality) Board where serving Senior Affairs Committee Alternate address (if home address ls exempt) I Work telephone I Term began on/ended on 3800 Collins Ave, Miami Beach FL 33140 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.l] Name of Source of income Address Description of the Principal Business Activity Chen Senior Medical Center 401 Opalocka Blvd, Opalocka Senior Medical Center FL33054 I hereby swear (or affirm) that the information above ls a true and correct statement. Signature of Person Dlsclosing oel2els4 RECEIVED BY ELECTIONS DEPARTMENT: D Hardcopy RECEIVED 0 Electronic Copy JUL 01 2024 CITY OF MIAMI BEACH OFFICE rE CITY CLERK REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOP oat 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 a PARKING As a Board/Committee member you are entitled to a Citywide Parking Permit, which includes City 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 Dote of Application: 06/28/2024 Applicant Name: Carolina Cuadros Board/Committee Name: Seniors Affairs Committee Address: 3800 Collins Ave, Miami Beach, FL 33140 E-Mail Address: Carocuadros81@gmail.com Work Phone: 786 734 1606 Home Phone: Cell Phone: 305 305 1113 Preferred Contact Method: Cell Phone Please Choose One 1 O tlon: Citywide Parking Permit/G7 Access Card [ Citi Bike/Deco Bike Membership MDC Monthly Transit Pass Vehicle Information (For Citywide Parking Permit/Access Card Only) Tag: QsQD32 Color: Red State: FL Year: 2014 Make: Chevrolet Model: Cruise A citywide (CW) parking permit is honored at metered parking spaces and restricted residential zones parking spaces. A CW parking permit IS NOT honored in prohibited areas. An Access Card will 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 and accurate information regarding your vehicle license plate. Inaccurate and/or outdated vehicle 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 cord at close proximity to the reader until the gate opens. You may need to try the other side of the card. Please ensure you hold the entire surface of the card 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 $10.00 replacement fee. A, licant Si mnature:. as Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2" floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkingReception@mlamibeachfl.gov e-mall sublect: BOARD & COMMITTEE PARKING APPLICATION -- APPLICANT NAME var\forms \cw board&committees om doc