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Samuel P Latone 12.31.25\ BOARD AND COMMITTEE CHECKLIST APPOINTEE:Samuel P Latone DATE OF APPOINTMENT:l..Zs BOARD/COMMITTEE.NOBE CRA Advisory Committe Appointed by:_'H,nos'0 FOR SCANNER Scan oScano Scan o Scan o Scan o FOR CLERK STAFF o Letter of Appointment TERMEND:[2_.312S TERM LIMIT:[231·QA o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison om l\.}.Q\ o Board and Committee Application (Completed on •13.2k ) o Resume/Curriculum Vitae ,I o Diversity Statistics Reporting (Completed on ((-l\.Q\ o Oath RECEIVED NOV 11 2024 CITY OF MIAMI BEACHOFFICEOFTHECITYCLERK Scan o Scan o 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 )Iacknowledge thatpursuant to Sec.2-22(9)ofthe Miami Beach Codeof Ordinances,I will be removed from my board/committee upon failure to attend 33%oftheregularly scheduled meetings. Sec.2-22(9)lfany memberofan agency,board orcommittee failsto attend 33percent of the regularlyscheduled meetings percalendar year,such member shall beautomatically removed.Tocalculate the number of absencesunderthe33percentformula,.4 orlessrounds down to the nextwhole number and .5 or more rounds up to the next whole number.NOTE:Members of the Land UseBoards will be removed upon failure to attend three of the regularly scheduled meetings per calendaryear,or upon abstainingfrom voting due to a conflictof interest on four different applications within acalendar year.A member who is removed shall not be reappointed to membership on the board for at leastone year from the date ofremoval. 11-112024sons«oXSmetLoe Board or Committee Member Processed on:__\_\_-~rl_~\_,~~-~----By Employee:____,,A'---_._L__·_ Date City Clerk's Office Staff Initials Received on: Date We are committed to providing excellent public service and sale#y io all who live,work,and play in our vibrant,topical,histuic community. MIAMI BEACH City of Miami Beach,I/OO Convention Conler Drivo,Miami Boach,Florida 33139 way._miaIibcachll.go OFFICE OF THE CITY CLERK,Ralool E.Granado,CityClerkTel:305.673.741,Fax.305.673.7254Emall:CiyClerk@miamibeachll.gov November 07,2024 Mr.Samuel Latone 6515 Collins Ave #1702 Miami Beach,FL 33141 RE:North Beach CRA Advisory Committee Dear Mr.Samuel Latone: 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. Reg:;J Rafael Granado City Clerk cc:Jose Gonzalez,Parking Director Rickelle Williams,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 MIAMI BEACH City of Miami Beach,/OO Convention Conler Drive,Miami Boach,Florida 33 139 ywy_miamibachf]go OFFICE OF THE CITY CLERK,Rafael E.Granado,CyClerkTol:305.673.7411,Fax.305.673.7254 Email:CiyClerk@miamibeachfl.gov Oath of Office Oath of Civility and Acknowledgements TO:Mr.Samuel Latone RE:North Beach CRA 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: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. Mr.Samuel Latone Sworn to and subscribed before me this 15th day or Novemb@54#~vado 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. 1\/\041B 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 AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH RECEIVED NOV 112024 CITY OF MIAMI'BSEAOH OFFICE OF THE CITY'OLBRK I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check (/)all that apply): I✓I I am a resident of the City of Miami Beach for six months or longer. Home Address:6515 Collins Ave,Unit 1702,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). ]4[Pe of P/],][]gSS,- [/JS]Pe,S,(Fe,- 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). []3nP (9f HI[m]S,,- P[[[[S,,J}}[eSi, "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 stated in it are true. Samoa P?Latona,cf4 11-11-2024 Signature Samuel P Latone Printed Name Date MI/AM1B City of Miami Beach l 700 Convention Center Drive Miami Beach,Florida 33139 OFFICE OF THE CITY CLERK Email:BC@miamibeachfl._gov Telephone:305.673.7411 H RECEIVED NOV 11 2024 CITY OF MIAMI BEACHOFFICEOrTEIrvore-•'LERK NORTH BEACH CRA ADVISORY COMMITTEE AFFIDAVIT OF COMPLIANCE I am in compliance with the North Beach CRA Advisory Committee's Membership Composition requirements pursuant to Section 2-190.151 of the Miami Beach City Code as a: □Resident Member. a.Currently residing,for a minimum of five (5)years,within the North Beach area,generally considered as that portion of Miami Beach located north of 63""Street. l)[\]]F,, b.Currently residing,for a minimum of five (5)years within the geographic boundaries of the North Beach CRA or a 300-foot radius thereof. ]9[]]Fi,» □Business Member with ownership interest for a minimum of five (5)years in a business established within the geographic boundaries of the North Beach CRA. Name of Business:_ Business Address:_ □Real Estate Industry Member residing generally within the City of Miami Beach. [})[]J][,bi,- License Number:-------------------------- □Attorney Member with experience in land use,real estate,or other related practice area, residing generally within the City of Miami Beach or maintaining a full-time law practice and physical office located in North Beach. [{9f7 J}]F,3, Law Practice Address:_ [_]}[],[][[[}[, □Normandy Fountain Businesses Association Ex-Officio Member. ~The five (5)year minimum residency requirement for the Resident Member Category (1)a) has been waived by a 5/7ths vote of the City Commission. I have an interest in neighborhood leadership issues,including,without limitation, neighborhood business groups,homeowner or condominium associations and cooperatives, civic groups,and/or other similar qualifications. ~The five 300-foot residency requirement for the Resident Member Category (1)b)has been waived by a 5/7ths vote of the City Commission. I have an interest in neighborhood leadership issues,including,without limitation, neighborhood business groups,homeowner or condominium associations and cooperatives, civic groups,and/or other similar qualifications and I live within a reasonable distance from the 300-foot radius of the North Beach CRA geographical boundary. "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 stated in it are true. Signature Samuel P Latone Printed Name 11-11-2024 Date MIA#Al City of Miami Beach 1700 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 REPORI Latone Last Name Latone First Name p 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: [Zh Mae [l remateDOtherElprefer not to answer. Race/Ethnic Categories: What is your race?D African American/BlackLJAstaorPacificIslanderElCaucasian/white0NativeAmerican/American IndianDOther-Print Race:_0 I prefer not to answer. Do you consider yourself to be Spanish,Hispanic,or Latino/a? Jves (JoDIprefer not to answer. Do you consider yourself Physically Disabled? Ive»zhoLltprefer not to answer this question. Page 6 of 6 F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated:June 2020 MIAMIB 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 Samuel Last Name BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS Latone First Name p 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 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 deemed a tender of resignation from the City agency,board,or committee. Acknowledgment to Comply with Miami Beach Code of Ordinances Sec.2-22 (24) I understand that if I am engaged to provide services,for compensation,to either (1)a candidate for City elected office,or (2)a political committee or electioneering communications organization expending funds for or against candidates for City elected office,such engagement shall be deemed a tender of resignation from the City agency,board,or committee. Signature 11-11-2024 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\$ALL\BOARD AND COMMITTEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION JULY 2024.d0cx Updated:July 2,2024 MIAMI-DADE.EI SOURCE OF INCOME STATEMENT 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 2025 Latone Samuel p Mailing Address -Street Number,Street Name,or P.O.Box 6515 Collins Ave,Unit 1702 City,State,Zip Miami Beach,FL 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 □Public Health Trust □Municipal: (Municipality) Department Position orTitle Employee ID Number Work address I Work telephone Employment began on/ended on Filing as a Board Member (check one) []county E]Municipal:Miami Beach (Municipality) Board where serving North Beach CRA Advisory Committee Alternate address (if home address is exempt) I Work telephone I Term began on/ended on (404)219-2989 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 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 Salary,Bonus,Stock I am the CEO of a Shopping Center Investment and Brokerage company called TSCG Investments Varied I hereby swear (or affirm)that the information above is a true and correct statement. Signature of Person Disclosing Date signed RECEIVED BY ELECT []Hardcopy J Electronic cotV 11 2024 CITY OF MIAMI BEACH OFFICE OF THE CIT CLERK OFFICE USE ONLY Accepted:Y /N Deficiency Processed Date/initials:Scanned Date/initials. 138_8P-14 COE2016 MlCityofMiami 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 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:11-1-2024 Applicant Name:Samuel P Latone Board/Committee Name:NOBE CRA Advisory Committee Address:6516 Collins Ave,Unit 1702,Miami Beach,FL 33141 E-Mail Address:sam.latone@tscg.com Work Phone:Home Phone: Cell Phone:404-219-2989 Preferred Contact Method:cell Please Choose One 1 0 tion: s)Citywide Parking Permit/G7 Access Card Citi Bike/Deco Bike Membership Vehicle Information (For Citywide Parking Permit/Access Card Only) Tag:56ASCM Color:Black State:FL Year:2020 Make:Porche Model:Cayenne Hybrid 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. Applicant Signature:es Please provide signed form to the Parking Department located at 1755 Meridian Avenue,2nd floor. Working hours are 8:30 to 5:00 p.m.or email to:ParkinqReception@miamibeachfl.gov e-mail subject:BOARD &COMMITTEE PARKING APPLICATION -APPLICANT NAME f;\ping\$mar\var\forms\cw boards&committees akin9form.doc formupdated 118/2024