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Daniel Ciraldo 11.01.24MIAMI BEACH BOARD AND COMMITTEE CHECKLIST DATE OF APPOINTMENn."day 15,2024 Ad Hoc Historic Preservation Ordinance City CommissionBOARD/COMMITTEE:Appointed by:_ Daniel GiraldoAPPOINTEE:_ FOR SCANNER Scan o Scan o Scan o Scan o Scan o RECEIVED SEP 1 8 2024 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK Scan o Scan o FOR CLERK STAFF o Letter of Appointment TERMEND:ll.\.2-A TERM LuMrr:([.[.2] o Letter of Reappointment r o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on >.\),2 o Board and Committee Application (Completed on S.LA.2 ) o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on 4.l.2} o Oath 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.2-22(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. _q-_,:J --_J-'-/_Signedbyx_...__f2_~~-c-~-~--Received on: Date B::Committee Member Processed on_L.1?t rtemtree zt·Uc Date City Clerk's Office Staff Initials WVe are committed to providing excellent public service and sale»y to all who live,work,and play in our vibrant,tropical,historic community. MIAMI BEACH City of Miami Beach,I/0O Convonlion Conler Drivo,Miami Boach,Horida 33 139 yywy._miaImibgachll.go OFFICE OF THE CITY CLERK,Rafool E.Granado,Cy Clerk Tel:305.673.7411,Fax:.305.673.7254 Email:CiyClerk@miamibeachll.gov May 15,2024 Mr.Daniel Giraldo 730 10th Street #102 Miami Beach,Florida 33139 RE:Ad Hoc Historic Preservation Ordinance Review Advisory Committee Dear Mr.Daniel Giraldo: Congratulations!You have been appointed by the City Commission to the agency,board or committee named above for a term ending:09/01/2024. 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. Regards, Ra~o City Clerk cc:Monica Beltran,Parking Director Deborah Tackett,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 MIAMIBEACH City of Miami Beach,1/OO Convention Canter Drivo,Miami Beach,Florida 33 139 yywy.Iiamnibgachll_gov OFFICE OF THE CITY CLERK,Rofoal E.Granado,City ClerkTl:305.673.7411,Fox.305.673.7254 Email:CilyClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO:Mr.Daniel Ciraldo RE:Ad Hoc Historic Preservation Ordinance Review Advisory 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:09/01/2024. 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 of Miami-Dade County or the State of Florida (depending on the board or committee on which I serve)on July 1st,fol:::ing ,cl:sing of the calenda,yea,on which I have se,ved.µ~ ---------------Mr.Daniel Ciraldo Sworn to and subscribed before me this {f day of~.2024.de.. 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 OFFICE OF THE CITY CLERK Email:BC@miamibeachfl_gov Telephone:305 .673 .7411 RECEIVED SEP 1 8 2024 CITY OF MIAMI BEACHOFFICEOrTHECITYCLERK 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): I II'I I am a resident of the City of Miami Beach for six months or longer. 730 10 Street #102,Miami Beach,FL 33139HomeAddress:---------------------------□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:_ ]1am a full-time employee of a business (for a minimum of six months)and l am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months). Miami Design Preservation LeagueNameofBusiness:--------------------------1001 Ocean Drive,Miami Beach,FL 33139BusinessAddress:-------------------------- "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 ego«res 7//){ Date Printed Name MIAMI BEACH City of Miami Beach l 700 Convention Center Drive Miami Beach,Florida 33139 www.miamibeachll,gov OFFICE OF THE CITY CLERK Email:BC@miamibeachfl.gov Telephone:305.673.7411 DIVERSITY STATISTICS REPORT Ciraldo Last Name Daniel First Name G 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 MaeLlremaeDOther0Iprefer not to answer. Race/Ethnic Categories: What is your race?D African American/BlackLAstanorPacificIslanderElCaucasian/whiteDNativeAmerican/American IndianDOther-Print Race:_D I prefer not to answer. Do you consider yourself to be Spanish,Hispanic,or Latino/a? lves[loDIprefer not to answer. Do you consider yourself Physically Disabled? Ive,Rotprefer not to answer this question. Page 6 of 6 F:ICLER\$ALLIREGIBOARDAND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD 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:305.673.7 411 Ciraldo BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS Daniel G 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) l 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 Clerks all be d emed ender o re ignation from the City agency,board,or committee7-[7-24•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 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:ICLER\$ALLIBOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION FEB 2024.docxUpdated:February 22,2024 MIAMl·DADE-EI SOURCE OF INCOME STATEMENT Clear From Print Form 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 I Last Name First Name Middle Name/Initial 2023 Ciraldo Daniel G Mailing Address -Street Number,Street Name,or P.O.Box 730 10 Street 102 City,State,Zip Miami Beach,FL 33139 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 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) []county E]Municipal:Ad Hoc Historic Preservation Ordinance Review Advisory Committee (Municipality) Board where serving City of Miami Beach Alternate address (if home address is exempt)I Work telephone I Term 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 anotherpersonforyourbenefit.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 Miami Design Preservation 1001 Ocean Drive Executive Director/Art Deco League,Inc.Musuem and Visitor Center I hpr affirm)that the i Signature of Person Disclosingt.-77 RECEIVED BY ELECTIONS DEPARTMENT: Jara«co RECEIVED D Electronic Copy SEP 18 2024 CITY OF MIAMI BEACHOFFICEOrTHAECITYCLERK REMEMBER TO PRINT,SIGN,AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARDCOPY. MIAMI BEACH City of Miami Beach,PARKING DEPARTMENT 1755 Meridian Avenue,Suite 200 Miami Beach,FL 33139/Ph:(305)673-7505 or (305)673-7000 ext.6200 BOARD &COMMITTEES PARKING APPLICATION LaPARKING As a Board/Committee member you are entitled to a Citywide Parking Permit,which includes City Hall garage (G7)parking a ess (Access Card),or a complimentary Citi Bike/Deco Bike Membership,or a discounted MDC Monthly nsit Pass throughout your term. Board Member Information Date of Application: Applicant Name: Board/Committee Name: Address: E-Mail Address: Work Phone: Cell Phone: Please Choose One 1)0 tion: Citywide Parking Permit/G7 Access Card [)Citi Bi Vehicle Information (For Citywide Parking Permit/A cess Card Only) Tag:Color: State: Make: Year: Model: A citywide (CW)parking permit is honored at etered parking spaces and restricted residential zones parking spaces.A CW parking permit IS N honored in prohibited areas.An Access Card will be provided to you for City Hall Garage (G7)ac ess. IMPORTANT NOTE: unnecessary enforcement actions,it is accurate information regarding your v information may lead to the issuance of Please note that this new access card the new card please hold the card need to try the other side of the car the reader until the gate opens. late serves as your "parking permit".To avoid any portant that our records reflect the most current and icle license plate.Inaccurate and/or outdated vehicle arking citation(s)and/or the towing of your vehicle. ANNOT be hole-punched or perforated in any manner.To use close proximity to the reader until the gate opens.You may Please ensure you hold the entire surface of the card against ACKNOWLEDGEMENT:I acknowl ge that should my access card be lost,stolen or damage,I will be responsible to pay a $10.00 repl cement fee. A Please provide igne 'orm 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 subiect:BOARD &COMMITTEE PARKING APPLICATION -APPLICANT NAME f;\ping\$man\rar\forms\cw boards&committees parkingform.doc form updated 1/18/2024