James Silvers 12.31.25MIAMI BEACH
BOARD AND COMMITTEE CHECKLIST
APronreEe..hps {gEe]oar or APPowrwENr:._32¥)
BOARDrcoMMrrrEeE:pvo a±Dus[M4/]Appointed by..(011ll5Si ,2
FOR SCANNER
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RECEIVED
AUG 06 2024
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
FOR CLERK STAFF
o Letter of Appointment TERM END:\2\.25 TERM LIMIT:\2.3\.2)
o Letter of Reappointment
o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on .>_.2·
o Board and Committee Application (Completed on _j]_y[2}__)
o Resume/Curriculum Vitae t
o Diversity Statistics Reporting (Completed on _a.]
o Oath
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)
Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓Highlights of the Miami-Dade County Ethics Code
t Sunshine Law and Public Records -Frequently Asked Questions
✓Memorandum -Solicitation by City Board and Committee Members
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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.2-22(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:][}sonea y In&el
Processed on:--~-·_lo_--~-~----By Employee:d---1~'...;:l___._
Date City Clerk's Office Staff Initials
I
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MIAMI BEACH
City of Miami Beach,I/OO Convention Conlor Drivo,Miami Boach,Florida 33 139 yNyy._miaInib_achll.go
OFFICE OF THE CITYCIERK,Rafaol E.Granado,City Clerk
Tel:305.673.7411,Fax:305.673.7254
Email:CityClerk@miamibeachfl.gov
February 02,2024
Mr.James Silvers
279 N.Hibiscus Drive
Miami Beach,Florida 33139
RE:Board of Adjustment
Dear Mr.James Silvers:
Congratulations!You have been appointed by the City Commission to the agency,board or committee
named above 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 as they concern your duties,responsibilities,and
requirements as a board or committee member.
Congratulations again and good luck.
cc:Monica Beltran,Parking Director
Michael Belush,City Liaison
ENCLOSURES:
Oath of Office/Oath of Civility/Acknowledgements
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
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,17OOConvention Canter Drivo,Miami Each,Florida 33 139 www.miamiboachfl.go
OFFICEOF THECITYCLERK,Rofaol E.Granado,Ciy ClerkTel:305.673.7411,Fax.305.673.7254Email:CIN/Clerk@miamtbeochl.gov
Oath ofOfi
thofciviliandwledg
~emnly swear or affirm tobear true ernment of the UnitedtheStateofFlorida,andthe City of ties of amemberofthe
inned board or committeeof th been appointed for a
\
tfairness,integrity and civility,in al
i
•I
untyCode (Conflict of Interest ar
Guide to the Sunshine Amendm
iami Beach Bo
deCounty or t
ing the closi
Please visit the City of Miami Beach under City Clerk/Board and
Committees for additional information regarding t quirements.
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
OFFICE OF THE CITY CLERK
Email:3CG@miamibeachfl gov
Telephone:305.673.7411
CITYOr ii/MI EACH
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):
~am a resident of the City of Miami Beach for six months or longer.
Home Aadress..97j I HI!sus Dk_
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:_
Business Address:_
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 rjury,I declare that I have read the foregoing document and that the facts
stated in i ar
Date
Printed
City of Miami Beach
I700 Convention Center Drive
Miami Beach,Florida 33139
ywwmiamibeach#]_goy
OFFICE Of THE CITY CLERK
Email:AC@ymiamnibeachi.oy
Telephone:305.673.7411
DIVERSITY STATISTICS REPORT
Last Name First Name Mie.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:EfDFemaleLJonerD:I prefer not to answer.
Race/Ethnic Categories:
What is your race?D African American/BlackDAsianorPacificIslanderEIcaucasianwnre
[]Native American/American IndianDOther-Print Race:-------------□I prefer not to answer.
Do you consider yourself to be Spanish,Hispanic,or Latino/a?
EsDIprefer not to answer.
Do you consider yourself Physically Disabled?
resEH0Iprefer not to answer this question.
Page 6 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated:June 2020
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
wwv miamiheachtl.gov
OFFICE OF THE CITY CLERK
Email:BG@namibeachfl.go
Telephone:305.673.7411
BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS
SQets ls
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 ndidate formally announcing candidacy for City elective office,such filing with the City
Clerk shall e e a ender of resignation from the City agency,board,or committee
Signature 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 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:CLERISALL\BOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION 0CT 2023.d0cxUpdated:January 9,2023
MIAMI·-~EI SOU,CE OF INCOME STATEMENN
Section 2-11.1(I)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
2023
L.ast NameutS First Name
It
Mlddle Name/lnltlal
Malling Address -Street Number,Street Name,or P,O.Box
f n,k
City,State,Zip
lf your home address is your mailing address,andyOU{ome address is exempt from public records pursuant to Fla.Stat.$119.07,read
instructions on the following page and check here)j[
Filing as an Employee (check one)
□County □Public Health Trust ~unicipal:M
Department
Position or Title Employee ID Number
Work address Work telephone Employment began on/ended on
Filing as a Board Mlember (check one)
[]county ~unicipal:M[I peal
(Municipality)
Board where serving
oARo p )UT4en/
Alternate address(If home address Is exempt)Work telephone Term began on/ended on30r1731¥8 1)2/
IListbeloweverysourceofincomeyoureceived,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 yourspouse or any business partner need not be disclosed.If continued on a separate sheet,check here.Ll
Name of Source of Income Address Description ofthe Prlnclpal Business Activity
277 1.1Iv>
tk){3€)j f,
he &rt,
tion above Is a true and correct statement.
Signature of Person Disclo
et»Date sioil@ T
RECEIVED BY ELECTIONS DEPARTMENT:□Hardcopy RECEIVED□Electronic CopyAUG 0 6 2024
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.
,I IBOARD&COMMITTtES
City of Miami Beach,PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue,Suite 200 Miami Beach,FL 33139/Ph:(305)673-7505 0r (305)673-7000 ext.6200
.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:
Applicant Name:
Board/Committee Name:
Address:s336
E-Mail Address:
Work Phone:
Cell Phone:Preferred Contact Method:aL
Please Choose One 1 Option:
Citywide Parking Permit/G7 Access Card O Citi Bike/Deco Bike Membership MDC Monthly Transit Pass
Vehicle Information For Cit ide Parkin Permit/Access Card Onl
Tag:CUZ-D83 color:i+1€
state:Pt
Make:
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
the reader until the gate opens.
ACKNOWLEDGEMENT:I acknowle
responsible to pay a $10.00 repla
that should my access card be lost,stolen or damage,I will be
A
Please provide signed form t the Parking Department located at 1755 Meridian Avenue,2d floor.
Working hours are 8:30 to 5:00 «m.or email to:irking ·piton@mi ue fl.gav
e-mail subiect:BOARD &COMMITTEE PARKING APPLICATION -APPLICANT NAME
f;\ping\man\rar\forms\cw boards&committees parkingform.doc form updated 1/18/2024