Yechiel Ciment 12.31.25MIAMI BEACH
BOARD AND COMMITTEE CHECKLIST
APPOINTEE:. lll,, Cavel, DATE OF APPOINTMENT:
sow«orcoworree. la. .t///oooea» Cit4
FOR SCANNER
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FOR CLERK STAFF
o teter ot Appointment TERM END: \2.3\.9S TERMLurr: L2..31-2.5
o tater of Reanointment, ,2\ [2\
o Copy of Letter of Appointment/Reappointment e-mailed \o ~mittee Liaison on '() ~
o Board and Committee Application (Completed on \\'2A!2\ )
o R~sum~/Curriculum Vitae <],'
o Diversity Statistics Reporting (Completed on ]\1\2\ )
o Oath t
RECEIVED
JUL 02 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
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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
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. 2-229) 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.
NO TE: 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 tor at least one year from the date at removal.
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Date Board or Committee Member
Processed or: \z.\2:\ sytmovoe fr •
bate T City Clerk's Office Staff Initials
We are committed to providing excellent public service and solely lo all who live, work, and ploy in our vibrant, tropical, historic community.
MIAMI BEACH
City of Miami Beach, I/0O Convonlion Contort Drivo, Miami Boach, Florida 33139 yw_miaIibachllgoy
OFFICE OF THE CITY CIERK, Rafool E. Granado, City Clerk
Tol: 305.673.7411, Fax: 305.673.7254
Email: CiNyClerk@miamibeachfl.gov
February 07, 2024
Mr. Yechiel Ciment
4101 Pine Tree Drive, Apt. 1414
Miami Beach, Florida 33140
SUBJECT: Planning Board
Dear Mr. Yechiel Ciment:
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.
Res12Sr
Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Rogelio Madan, 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
MIAMIBEACH
City of Miami Beach, 1/00 Convention Canter Drivo, Muaml Beach, Florida 33139 gNywy.mlamlhaachll.gov
OFFICE OF IHE CITY CIERK, Rafael E. Granado, Cliy Clark
Tl: 305.673.7411, Fax. 305.673.7254
Emall: CiyClerk@mlamtbeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Yechiel Ciment
RE: Planning Board
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 l "y_,2024
*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 02 2024
CITY OF MIAMI BEACH
OFFICE CF 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): t am a resident of the City of Miami Beach for six months or longer.
Home Addres. Vo) & M(( 5yo
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).
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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).
[pa/] (Of /][[gs,-
PA,[[es,S J(HF9SS,-
"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 Er', ~ -D-a-te_.__.__ _
fl& ca.k
Printed Name
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
<
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:
Lg ae
Ll remale
D Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
0 Asian or Pacific Islander
E2} Caucasian/white
0 Native American/American Indian 0 Other- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Jves
o D I prefer not to answer.
Do you consider yourself Physically Disabled?
ves z
D I prefer not to answer this question.
Page 6 of 6
F:ICLER\$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
cd al s
Last Name First Name
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/4 deemed a tender of resignation from the City agency_,'J_b_o_//_,,:_•';J.,/_o_r _co_m_m-it-te_e _
Sign Date
Middle Initial
1 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 of 6
F:ICLER\$ALL\BOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION 0CT 2023.d0cx
Updated: January 9, 2023
MIAMl•DADE- EE SOURCE OF INCOME STATEMENT
Section 2-11.1(l) 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 I Last Name ( , 4" Ea Middle Name/Initial < 2023
Mailing Address - Street Number, Street Name, or P,0. Box
4 33 4040 t- «%
City, State, Zip
rh6, 22//0
If your home address is your malling 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.[l
Filing as an Employee (check one)
D 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 [77 Municipal: kw, eoq
(Municipality)
Board where serving
Obos.ow &)/qr's. c6'\I~
Alternate address (if home address'is exempt) 'Work telephone I Term began on/ended on
0f-914(07»
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.[]
Name of Source of Income Address Description of the Principal Business Activity
Q6 29) 4'7 5). Mai z al
I hereby swear (or affirm) that the Information above is a true and correct statement.
"'"''~''"'&---
Date signed
nEcED s, Ytitir □Hardcopy
J Electronic g9y 02 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
OFFICE USE ONLY Accepted: Y / N Deficiency. Processed Date/initials:Scanned Date/initials:
138_SP-14 COE 2016
MIAMI BEACH City of Miami Beach, PARKING DEPARTMENT
l 755 Meridian Avenue, Suite 200 Miami Beach, FL 33139/Ph: (305) 673-7505 or (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
Date of Application: 9/\/4
Applicant Name: kl,\ Cc.
Board/Committee Name: 9lo 0-. [41! }- «-,
Address: 233, 9A» A M, 231lo
E-Mail Address: [&oak.b qd.to
Work Phone: 358-17 e7, Home Phone: /
Cell Phone: 3s5- 4»8332 Preferred Contact Method: e
Please Choose One 1 0 tion:
Citywide Parking Permit/G7 Access Card [} Cii Bike/Deco Bike Membership O MDC Monthly Transit Pass
Vehicle Info de Parking Permit/ Access Card
Tag:
State:
Make:
Color:
Year:
Model:
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 card 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
lhe reader unlil 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 replac t fee.
A, licant Si mnature: es
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2d floor.
Working hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov
e-mail sub'ect: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
f\ping\man\roar\forms\cw boards&committees parkinglorm.doc form updated 118/2024