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Janinha Piazzetta 12.31.26MIAMI BEACH BOA R D A ND COMMITTEE CHECKLIST APPOINTEE:Janinha Piazzetta BOARD/COMMITTEE:_SSCCG"cs Appointed by.:Commissioner Bhatt DATE OF APPOINTMENT.12•09•2024 FOR SCANNER Scan o Scan o Scan o Scan o Scan o FOR CLERK STAFF o Letter of Appointment o Letter of Reappointment o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on o Board and Committee Application (Completed on ' o Resume/Curriculum Vitae o Diversity Statistics Reporting (Completed on I o Oath TERM END:12.31.2026 TERM LIMIT:12.31.31------- 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 CITY OF MIAMI BEACH ✓Memorandum -Solicitation by City Board and Committee Members OFFICE OF THE CITY CLERK RECEIVED E C 11 2024 Scan o 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 M%18!:D I acknowledge that pursuant to Sec.2-22(9)of the Miami Beach Code of Ordinances,I will be removed from m y board/com m ittee 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 ro unds 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 fro m the date of removal. X vanuaoagettaReceivedon:_1_2_.0_9_.2_0_~-:-t-e Signed by /'~ee Member Processed on:__l_i_,_/-'-11____._l _v_'-{By Employee:-----~---------------- Date WVe are committed to providing excellent public service and salety lo all who live,work,and play in our vibrant,tropical,historic community. City Clerk's Office Staff Initials MIAMI BEACH City of Miami Beach,I/00 Convention Conler Drive,Mia mi Boach,Florida 33 139 yywy _miamibcachllgoy OFFICE OF IHE CITY CIERK,Rafool E.Granado,Cly Clerk Tel:305 .673.7411,Fax.305.673.7254 Ema il:CityCl erk@mi a mibeac hll.gov Oath of Office Oath of Civility and Acknowledgements TO:Ms.Janinha Piazzetta RE:Sister Cities Program 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:12/31/2026. 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. z±a.s#a%z.ct Sworn to and subscribed before me this _9__day of Dec ,2024 (or.Alice Lavado 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 DEC 11 2024 CIT Y OF MIAM I BEACH OFFICE OF THE CITY CLERR 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): D x I am a resident of the City of Miami Beach for six months or longer. Home Address:1935 Calais Dr apt 205 MB 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). [[are f [3ys[[eSS, D 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). []are f [[JS[[esS., Business Address: "O wnership Interest"meanstheownershiortenpercent(10%)ormore(includingth e ownership of 10%or m ore of the outstanding capital stock)in a business. "B usiness"m eans any sole pro prietorship,sponsorship,corporation,lim ited liability com pany, 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. •..d±a,4r=ea Printed Name 12.09.2024 Date MIAMI BEACH C ity of M ia m i Be a ch 1700 Convention Center Drive Miam i Beach,Florida 33139 w ww.m iam ibeachfl.gov OFFICE OF THE CITY CLERK Email:BC@miamibeachfl.gov Telephone:305.673.7411 Piazzetta Last Name BOARD &COMMITTEE ACKNOWLEDGEMENT STATEMENTS Jane First Name M 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. ...d±a,4,=e 12.09.2024 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 of6 F:\C LE R \$A LL\B O A R D A N D C O M M ITT E ES DA TA BA SE\Board and C om m ittee Application\BO A R D AN D CO M M ITT EE AP PLI C A TIO N JU LY 2024.docx Updated:July 2,2024 MIAMI BEACHCityofMiamiBeach,PARKING DEPARTMENT BOARD &COMMITTEES PARKING APPLICATION a PARKING1755MeridianAvenue,Suite 200 Miami Beach,FL 33139/Ph:(305)673-7505 or (305)673-7000 ext.6200 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 Mem ber Info rmation Date of Application:12.09.2024 Applicant Name:Jane Maria Piazzetta AKA Janinha Board/Committee Name:Commissioner Bhatt Address:1935 Calais Dr #205 Miami Beach Fl 33141 E-Mail Address:jpiazzetta@yahoo.com Work Phone:Home Phone: Cell Phone:786-37 4-9009 Preferred Contact Method:text or email Please Choose O ne 1 0 tion: Citywide Parking Permit/G7 Access Card O Citi Bike/Deco Bike Membership 0 Vehicle Info rm ation (For Cityw ide Parking Permit/Access Card Only) Tag:KGRP83 Color:Silver State:Florida Year:2006 Make:Honda Model:Accord 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. IM PO RTANT NO TE: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 CANNO T 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. AC KNO W LEDG EM ENT:I acknow ledge that should my access card be lost,stolen or dam age,I will be responsible to pay a $10.00 replacem ent fee. A,licant Si mature:es et'tao Please provide signed form to the Parkin Department located at 1755 Meridian Avenue,2d floor. Working hours are 8:30 to 5:00 p.m.or email to:ParkingReception@m iam ibeachfl.gov e-m ail subiect:BO ARD &CO M M ITT EE PARKING APPLICATION -APPLICANT NAM E f:\ping\$man\rar\forms\cw boards&committees parkingform.doc form updated I /18/2024