Rosary Falero 12.31.24BOARD AND COMMITTEE CHECKLIST
APPOINT@e."osay Plana Falero DATE OF APPOINTMENr."
Hispanic Affairs Mayor Meiner
BORD/COMMITTEE:Appointed by.
FOR SCANNER
Scan o
Scan o
Scan o
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FOR CLERK STAFF \-o Letter o Appointment TERM END:1Q.\._2SK TERMLuMIr:9.3\.26
o Letter of Reappointment <
o Copy of Letter of Appointmen11Reappo intme nt e-mailed l°Crmittee Liaison on _•\,'.J..'--\
o Board and Committee Application (Completed on \Lo 22o)
o Resume/Curriculum Vitae
o Diversity Statistics Reporting (Completed on ?_[.2])
o Oath
RECEIVED
JUL 1'72024
CITY OF MIAMI BEACHOFFICEOFTHECITYCLERK
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 Ordinance (as
amended through December 2010)
V 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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Scan o
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 removedfrommyboard/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 ofthe 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 loss 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 ofthe 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.member who is removed shall not{be rea inted to membership on the
board for at least one year from the date ofremoval.'
Received on:
Date
ssessroe.1[a\z9¥
Date
3.1.24 X
o ]][]])lfl
i .
By Employee:_---,,,..,,,_d---~L~·-·------------City Clerk's Office Staff Initials
MIAMI BEACH
City of Miami Beach,1/OO ConvonfionContor Drivo,Miami Boach,Florida 33 139 yyyy_miamibeachll.gov
OFFICE OF THE CITY CIERK,Rafael E.Granado,City Clork
Tel:305.673.7411,Fax:.305.673.7254
Email:CiyClerk@miamibeachfl.gov
February 29,2024
Ms.Rosary Falero
4550 Pine Tree Drive
Miami Beach,Fl 33140
SUBJECT:HispanicAffairs Committee
Congratulations!You have been reappointed by Mayor Steven Meiner to the above referenced,board or
committee named above,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.
Congratulations and good luck.
Regards,
~do
City Clerk
cc:Monica Beltran,Parking Director
Leonor Hernandez,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
City of Miami Beach,:/G Convcnon Center Drive,Mami t«ah,Morda 33I39 ygw_migrribggcht]_gov
HK'±k iH AiY C(ERK,Rolool E.Gronodo,Ciy Clo«k
1ol.305.673.741I,faxc 305.673.7254
Email:.CityCloukmiomibooc.hl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO:Ms.Rosary Falero
RE:Hispanic 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:12/31/2024.
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 Mia 'ade County or the
State of Florida (depending on the board or committee on which serve)on u y 1s llowing the closing
of the calendar year on which I have served.
st inSwomtoandsubscribedbeforemethis_[day ot ]\/\''2024Al&la...SDeputyclerktie lad
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.
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:BC@miamibeachfl.gov
Telephone:305.673.7411
RECEIVED
JUL 112024
CITY OF MIAMI BEACOH
OFFICE OF THE CITY CLERK
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):
[]1am a resident of the City of Miami Beach for six months or longer.
4550 Pine Tree Drive,Miami Beach,Fl 33140h}[l\](foe5,-
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).
[[4re f [[IS[[]gSj,-
[]/[gSS ([][PSS,
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.
erjlry,I declare that I have read the foregoing document and that the facts
3.1.24
Date
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
www.miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email:BC@miamibeachf.0y
Telephone:305.673.7411
Plana Falero
Last Name
DIVERSITY STATS.IICS REPORT
Mk±gaFirstName 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:
LateLAFemaleomerEl1reter not to answer.
Race/Ethnic Categories:
What is your race?D African American/BlackEIAsianorPacificIslander
LL#Caucasian/white[I Native American/American IndianElother--Print Race:-------------□I prefer not to answer.
Do you consider yourself to be Spanish,Hispanic,or Latino/a?•JoElprefer not to answer.
Do you consider yourself Physically Disabled?
ee
0
l prefer not to answer this question.
Page 6 of 6
F:CLER\$ALLREGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSBOARD AND COMMITTEE APPLICATION REG FINAL.do0x
Updated:June 2020
City of Miami Beach
l 700 Convention Center Drive
Miami Beach,Florida 33139
www .miamibeachfl.gov
OFFICE OF THE CITY CLERK
Email:BC@miamibeachfl.gov
Telephone:305.673.7411
Plana Falero
Last Name
BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS
Rosary
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 tater 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 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 a ency,board,or committee,I voluntarily agree that in the event I file with the City
Clerk_a Statemey..of Candidate formally announcing candidacy for City elective office,such filing with the City
Clerk sl [[be d4er ied a tinc r of resignation from the City agency,board,or committeeI
3.1.24
Date
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 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 0f6
F:\CLERISALLB8OARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION FEB 2024.d00x
Updated:February 22,2024
MIAMI-.&TI SOURCE OF INCOME STATEMENT
Section 2-11,1(i)of the County Ethics Gode requiresthat certain employees and public officials file a financial disclosure Statement on a ycarly basis by July 1stofeveryyear.
Disclosure for Tax Year Ending
I
LastName First Name Middle Mame/initial
2023 Plana Falero Rosary
Mailing Address -Street Number,Street Name,or P.0.Box
4550 Pine Tree Drive
City,State,Zip
Miami Beach,FI.33140
If your home address is your mailing address,and your home address is exemptfrom public records pursuant to Fla.Stat.$119.07,read
instructions on the following page and check here.D
Fling as an Employee (checkone)
□County □Public Health Trust D Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address IWork telephone Employment began on/ended on
Fling as a Board Member (oleokone)
I]county E]Municipal:Miami Beach
(Municipality)
Board where serving
Hispanic Affairs Committee
Alternate address (if home address is exempt)IWorktelephone I Term began on/ended on
List below every source of incomeyou received,along with the address and the principal activity of each source.Include your public salary.Place the sources ofincomeindescendingorder,with the largest source first.Examples of sources of income include:compensation for services,income from business,gains frompropertydealings,interest,rents,dividends,pensions,IRA distributions,and social security payments.Also,include any source of income received by anotherpersonforyourbenefit.However,the income of your spouse or any business partner need not be disclosed.If continued on a separate sheet,check here.l_]
Mame of Source of Income Address Description of the Principal Business Activity
Wells Fargo 333 SE 2nd Avenue,Miami,Fl.Banker
33131
-r,
itt~e information above is a true and correct statement.I hereby sWea(or affihr tt "g#CERT"Lr_N -I/D Hardco)4/[]Electronic;Copy_/JUL1 2024Sinature/of I erson Di tclo
Date signed
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
REMEMBER TO PRINT,SIGN,AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY
A14AA/p,/A't;!\1 ,·,•\,•'t'"e \,~,~'5 ±{i;ft!+"Ssh}t,ix/'i id k.'{Cily of 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 LaPARKING
As a Board/Committee member you ore 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:3.1.24
Applicant Name:Rosary Plana Falero
Board/Committee Name:Hispanic Affairs Committee
Address:4550 Pine Tree Drive,Miami Beach,Fl.33140
E-Mail Address:rosaryfalero@yahoo.com
Work Phone:305.329.6835 Home Phone:786.414.6455
Cell Phone:786.414.6455 Preferred Contact Method:Cell
Please Choose One 1 0 Hon:
;Citywide Parking Permit/G7 Access Card Citi Bike/Deco Bike Membership
Vehicle Information (For Citywide Parking Permit/Access Card Only)
Tag:54DAYW Color:blue
State:Fl Year:2022
Make:Ford Model:Bronco
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
the reader until the gate opens.
ACKNOWLEDGEMEI •
responsible to pay
A licant Si nature:as '
my access card be lost,stolen or damage,I wlll be
Please provide signed for ilg epartment located at 1755 Meridian Avenue,2nd floor.
Working hours are 8:30 to 500 p..1.or email to:ParkingReception@migmibeachfl.gov
e-mail sublect:BOARD &COMMITTEE PARKING APPLICATION --APPLICANT NAME
f;\plng\$man\rot\toms\cwboards&comm/tleesparklngtom.doc fom undated 1/18/2024