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Mark Brill 12.31.25BOARD AND COMMITTEE CHECKLIST APPOINTEE.MARK BRILL DATE OF APPOINTMENr:'1"Qt BOARD/COMMITTEE:POLICE/CITIZEN RELATIONS Appointed by:COMISSIONER BHATT FOR SCANNER Scan o Scan o Scan o Scan o Scan o FOR CLERK STAFF o Letter ofAppointment o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on o Board and Committee Application (Completed on]•Q}_23 ) o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on _].33Q.2] o Oath TERM END.12/2025 rRM uwn.\2.31.30 s.1.24 RECEIVED JUL 31 2024 CITY OF MIAMI BEACH OFFICE OE THE CITY CLERK Scan o Scan o IMPORTANT INFORMATION FOR BOARD ANO 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 [/]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)Ifany member of an agency,board or committee fails to attend 33 percent of the regularly scheduledmeetingspercalendaryear,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 yearfrom the date of removal. Received on: tc2 _71_30_12_4 Signed by X.__1_\.{,.__,/{'--\__,.,.(_ftyJ__,-<.Li_y{:...__.•_✓-·+(i _ Board or Committee MemberDate Processed on:__7,__.l_~_\....,\....,2_':\--+--By Employee:_..;.Ac....:.,__·L_·--=-·_ Date CiycleWes office Staff initials MIAMI BEACH City of Miami Beach,I/0O Convention Contort Drive,Miami Boach,Florida 33 139 yyNyy_miamibeachllgov OFFICE OFTHE CITYCLERK,RafaelE.Granado,Ciwy Clerk Tel:305.673.7411,Fax:305.673.7254 Email:Ci/Clerk@miomibeachfl.gov March 01,2024 Mr.Mark Brill 1095 North Shore Drive Miami Beach,Florida 33141 SUBJECT:Police/Citizens Relations Committee Congratulations!You have been reappointed by Commissioner Tanya Bhatt 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. Reifa Rafael Granado City Clerk cc:Monica Beltran,Parking Director Cilia Maria Ruiz-Paz,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,1Z00 Convention Conker Drivo,Miami [each,Florida 33139 ye_miaIIibcachll.gay OFFICE OFTHE CITYCIERK,Rofool E.Granado,City Clerk Tl:305.673.7411,Fax 305.673.7254 Email:CiyClerk@miamibeachf.gov Oath of Office Oath of Civility and Acknowledgements TO:Mr.Mark Brill RE:Police/Citizens Relations 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 th,clo ing of the calendar year on which I have served.IJ ~~~,l 1 ~,r,.,- rk Brill -<TSworntoandsubscribedbeforemethis3\day of3'~~-2024"ts±.ssir##bees as u.Deputy Clerk oodO *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 JUL 31 2024 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK City of Miami Beach 1700 Convention Center Drive Miami Beach,Florido 33139 OFFICE OF THE CITY CLERK Email:BC@miamibeachfl._gov Telephone:305.673.741 l 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. Home Address:1095 NORTH SHORE DRIVE,MIAMI BEACH,FL 33141 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). Name of Business:_ PIS[m@gs,J(HJ[es,S, 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 perju7,I d ~lare that I have read the foregoing document and that the facts stated in it are true I I I ~,•;'·,,~~,--Ff-_rL_[i_u_o_/_2,t._j _ @in@ore-[te Printed Name Ml1BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach,Florido 33139 www.miamibeachtl.gov OFFICE OF THE CITY CLERK Email:.BC@miamibeachfl_gov Telephone:305.673.7411 DIVERSITY STATISTICS REP.ORI BRILL Last Name MARK First Name A 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: [Zl alelemalelonerDIprefer not to answer. Race/Ethnic Categories: What is your race?D African American/BlackDAsianorPacificIslanderElCaucasian/whiteDNativeAmerican/American IndianDOther-Print Race:_0 I prefer not to answer. Do you consider yourself to be Spanish,Hispanic,or Latino/a? lves(loElprefer not to answer. Do you consider yourself Physically Disabled? veJo l1refer not to answer this question. Page 6 of 6 F:CLERISALLIREGBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated:June 2020 City of Miami Beach 1700 Convention Center Drive Miami Beach,Florida 33139 www.migmibeachf].goy OFFICE OF THE CITY CLERKEmail:BC@miamibeachfl.gov Telephone:305.673.7411 BRILL Last Name BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS MARK First Name A 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 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 shall be deemedat der of resignation from the City agency,board,or committee •#,+ll'7 1[/0rtpkt '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:ACLERISALLBOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION FEB 2024.d0cx Updated:February 22,2024 MIAMHlADE.EI SOURCE OF INCOME STATEMENT Section 2-11.1(@)of the County Ethics Code requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July 1stofeveryyear. Disclosure for Tax Year Ending ! Last Name First Name Middle Name/initial 2023 BRILL MARK Mailing Address -Street Number,Street Name,or P.O.Box 1095 NORTH SHORE DRIVE City,State,Zip MIAMI BEACH,FLORIDA 33141 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 0 Public Health Trust []Municipal:(Municipality) Department Position or Title Employee ID Number Work address IWork telephone Employment began on/ended on Filing as a Board Member (check one) D County E]Municipal:MIAMI BEACH (Municipality) Board where serving Alternate address (If home address Is exempt)I Work telephone rerm began on/ended on 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 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 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 MKRS,LLC.993-995 BAY DRIVE RENTS-MULTIFAMILY RAND R APARTMENTS,INC.1135-1145 MARSEILLE DR 9/I hereby swear (or affirm)th ibove is a true and correct statement. t·/ RENTS -MULTI FAMILY cvo sYME9SIP%RMN- [Hardcopy 1 aeetvonf%3 1 2024 CITY OF MIAMr!4 OFE1or - OFFICE USE ONLY Accepted:Y {N Deficiency.Processed Date/initials:Scanned Date/initials: 136_SP-14 COE2016 MIA/BE ACHiflIt}ho»sl t 'i +City of Miami Beach,PARKING DEPARTMENT 1755 Meridian Avenue,Suite 200 Miami Beach,FL 33139/Ph:(305)673-7505 or (305)673-7000ex1.6200 BOARD &COMMITTEES PARKING APPLICATION aPARKING 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:7/31/24 Applicant Name:MARK BRILL Board/Committee Name:POLICE/CITIZEN RELATIONS Address:1095 NORTH SHORE DRIVE,MIAMI BEACH,FL 33141 E-Mail Address:markbrill4@yahoo.com Work Phone:7863466950 Home Phone:same Cell Phone:7863466950 Preferred Contact Method:cell phone Please Choose One 1 0 tion: Citywide Parking Permit/G7 Access Card '(Citi Bike/Deco Bike Membership Vehicle Information (For Citywide Parking Permit/Access Card Only) Tag:81AAYG Color:WHITE State:FLORIDA Year:2018 Make:TOYOTA Model:TUNDRA 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. 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 A Please provide signed form ""ig Depart ent located at 1755 Meridian Avenue,2nd floor. Working hours are 8:30 to 500 p.m.or email to:ParkingReception@miamibeachfl,gov e-mail sub ect:BOARD &COMMITTEE PARKING APPLICATION -APPLICANT NAME f:\og\$man\var\forms\cw boords&committeesparkingform.doc torm updated 118/2024