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HomeMy WebLinkAboutSubmittal-Adam W. Old-Form 4ASubmitted into the public record for item(s) RE.1% on 07-23-2020. City Clerk FORM 4A DISCLOSURE OF BUSINESS TRANSACTION, RELATIONSHIP OR INTEREST LAST NAME - FIRST NAME - MIDDLE INITIAL Old, Adam W. OFFICE / POSITION HELD Board Member MAILING ADDRESS AGENCY OR ADVISORY BOARD 140 NE 86 St. Miami 21 Ad Hoc Task Force CITY ZIP COUNTY ADDRESS OF AGENCY El Portal 33138 Miami -Dade 3500 Pan American Dr., Miami, FL 33133 HOW TO COMPLETE AND FILE THIS FORM: s A and B of this form serve two different purposes. Part A is for advisory board members who wish to use an exemption in thi :s laws that is applicable only to advisory board members. Part B is for public officers and employees who wish to use a sepa- exemption that is applicable when the business entity involved is the sole source of supply within the political subdivision. In r to complete and file this form: • Fill out Part A or Part B, as applicable. • Sign and date the form on the reverse side. • File Part A with the appointing body or person that will be waiving the restrictions of 112.313(3) or (7), Fla. Stat., prior to the waiver. • File Part B with the governing body of the political subdivision in which the reporting person is serving, prior to the transaction. PART A - DISCLOSURE OF TRANSACTION OR RELATIONSHIP CONCERNING ADVISORY BOARD MEMBER Sections 112.313(3) and 112.313(7), Florida Statutes, prohibit certain business relationships on the part of public officers and employees, including persons serving on advisory boards. See Part III, Chapter 112, Florida Statutes, and/or the brochure entitled 'A Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees' for more details on these prohibitions. However, Section 112.313(12), Florida Statutes, permits the appointing official or body to waive these requirements in a particular instance provided: (a) waiver by the appointing body must be upon a two-thirds affirmative vote of that body; or (b) waiver by the appointing person must be effected after a public hearing; and (c) in either case the advisory board member must fully disclose the transaction or relationship which would otherwise be prohibited by Subsections (3) of (7) of Section 112.313, Florida Statutes. This Part of Form 4A has been prescribed by the Commission on Ethics for such disclosure, if and when applicable to an advisory board member. 4SE COMPLETE THE FOLLOWING: M ,_, 1. The partnership, directorship, proprietorship, ownership of a material interest, position of officer, emplo" tnerltr contractual relationship which would otherwise violate Subsection (3) or (7) of Section 112.313, Florida Statutes, itifieldf[Py [pl%e check applicable space(s)]:�; r rn (x) The reporting person; C�rnw rn ( ) The spouse of the reporting person, whose name is Ate' � � or ( ) A child of the reporting person, whose name is _ �n CD 2. The particular transaction or relationship for which this waiver is sought involves [check applicable spa (x) Supplying the following realty, goods, and/or services: Redevelopment of CRA neighborhoods ( ) Regulation of the business entity by the governmental agency served by the advisory board member. 3. The following business entity is doing business with or regulated by the governmental agency: Omni Community Redevelopment Agency 4. The relationship of the undersigned advisory board member, or spouse or child of the advisory board member, to the busi- ness entity transacting this business is [check applicable spaces]: ( ) Officer, ( ) Partner; ( ) Associate; ( ) Sole proprietor; ( ) Stockholder; ( ) Director; ( ) Owner of in excess of 5% of the assets of capital stock in such business entity; (x) Employee; ( ) Contractual relationship with the business entity; ( ) Other, please describe: OF FORM 4A - REV. 1-98 [CONTINUED ON REVERSE SIDE] —76 & 4 i h rvi 1 "a 1— A 412 A A W . 1 )1 /1 - 1;1 V rvi 4,4 Submitted into the public record for item(s) RE.1% on 07-23-2020, City Clerk PART B - DISCLOSURE OF INTEREST IN SOLE SOURCE OF SUPPLY MUST COMPLETE THIS PART: Sections 112.313(3) and 112.313(7), Florida Statutes, prohibit certain employment and business relationships on the part of pub- lic officers and employees. See Part III, Chapter 112, Florida Statutes, and/or the brochure entitled "A Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees" for more details on these prohibitions. However, Section 112.313(12)(e), Florida Statutes, provides an exemption from the above -mentioned restrictions in the event that the business entity involved is the only source of supply within the political subdivision of the officer or employee. In such cases the officers or employee's interest in the business entity must be fully disclosed to the governing body Of the political subdivision. This Part of Form 4A has been prescribed by the Commission on Ethics for such disclosure, if and when applicable. PLEASE COMPLETE THE FOLLOWING: 1. The partnership, directorship, proprietorship, ownership of a material interest, position of officer, employment, or contractual relationship which would otherwise violate Subsection (3) or (7) of Section 112.313, Florida Statutes, is held by [please check applicable space(s)]: ( ) The reporting person; ( ) The spouse of the reporting person, whose name is : or ( ) A child of the reporting person, whose name is 2. The following are the goods, realty, or services being supplied by a business entity with which the public officer or employee, or spouse or child of such officer or employee, is involved is: 3. The business entity which is the only source of supply of the goods, realty, or services within the political subdivision is: (NAME OF ENTITY) (ADDRESS OF ENTITY) 4. The relationship of the undersigned public officer or employee, or spouse or child of such officer or employee, to the busi- ness entity named in Item 3 above is [check applicable spaces]: ( ) Officer; ( ) Partner; ( ) Associate; ( ) Sole proprietor; ( ) Stockholder; ( ) Director; ( ) Owneanf inccess of 5% of the assets or capital stock in such business entity; ( ) Employee; ( ) Contractual relationship with Q burl ss entity; ( ) Other, please describe: Cn G mac' r n n�,= w - ram; N o r .. VM CD A 0% SIGNATURE SIGNATURE DATE SIGNED DATE FILED 7-23-2020 NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES a. 112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $10.000. CE FORM 4A — REV.1-99 [CONTINUED FROM FIRST SIDE] Submitted into the public record for item(s) RE.19, on 07-23-2020, City Clerk Ewan, Nicole From: Ketterer, Amber L. Sent: Thursday, July 23, 2020 1:46 PM To: Hannon, Todd Cc: Ewan, Nicole; Min, Barnaby; Wysong, George Subject: FW: Miami 21 Task Force Ethics Issue Update - Important Time -Sensitive Reminder Attachments: Form4a_signed.pdf Amber L. Ketterer, Assistant City Attorney V_ City of Miami Cn Cad r' -------- Original message -------- From: "Old, Adam" <AOld@miamigov.com> Date: 7/23/20 1:33 PM (GMT-05:00) To: "Ketterer, Amber L." <AKetterer@miamigov.com> Cc: "Eisenberg, Joseph" <1Eisenberg@miamigov.com>, "Keirn, Jacob" <1Keirn@miamigov.com>, "Garcia, Anastassia" <ANGARCIA@miamigov.com>, "Wysong, George" <GWysong@miami-police.org> Subject: Re: Miami 21 Task Force Ethics Issue Update - Important Time -Sensitive Reminder Here is the signed conflict form. I checked Employee for #4 since I am employed by the CRA. Thanks, Adam Old. From: "Ketterer, Amber L." <AKetterer@miamigov.com> Date: Thursday, July 23, 2020 at 11:50 AM To: "Old, Adam" <AOld@miamigov.com> Cc: Joseph Eisenberg <1Eisenberg@miamigov.com>, "Keirn, Jacob" <1Keirn@miamigov.com>, "Garcia, Anastassia" <ANGARCIA@miamigov.com>, "Wysong, George" <GWysong@miami-police.org> Subject: RE: Miami 21 Task Force Ethics Issue Update - Important Time -Sensitive Reminder Hi Adam, Thank you for your email. You should fill out the form and check off the first box in #2 since you provide services to the City by way of the Omni CRA. You would list the Omni CRA in #3. As for #4, you would have a contractual relationship. I copied George Wysong from my office should he have additional insight. Thank you. Amber L. Ketterer, Assistant City Attorney General Government Division City of Miami Office of the City Attorney Telephone: 305-416-1859 (KI Facsimile: 305-416-1801 aketterer o,miamigov.com Assistant: Stephanie Fernandez: (305) 416-1833 Submitted into the public record for item(s) RE.19, on 07-23-2020, City Clerk Disclaimer: This e-mail is intended only for the individual(s) or entity(s) named within the message. This e-mail might contain legally privileged and confidential information. If you properly received this e-mail as a client or retained expert, please hold it in confidence to protect the attomey-client or work product privileges. Should the intended recipient forward or disclose this message to another person or party, that action could constitute a waiver of the attorney -client privilege. If the reader of this message is not the intended recipient, or the agent responsible to deliver it to the intended recipient, you are hereby notified that any review, dissemination, distribution or copying of this communication is prohibited by the sender and to do so might constitute a violation of the Electronic Communications Privacy Act, 18 U.S.C. section 2510-2521. If this communication was received in error we apologize for the intrusion. Please notify us by reply e-mail and delete the original message. Nothing in this e-mail message shall, in and of itself, create an attorney -client relationship with the sender. Under Florida law, e-mail addresses are public records. If you do not want your e- mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. VA sa Please consider the environment before printing this a -mail. From: Old, Adam <AOld@miamigov.com> Sent: Thursday, July 23, 202011:24 AM To: Ketterer, Amber L. <AKetterer@miamigov.com> Cc: Eisenberg, Joseph <J Eisenberg@ miam igov.com >; Keirn, Jacob <JKeirn@miamigov.com>; Garcia, Anastassia <ANGARCIA@miamigov.com> Subject: Re: Miami 21 Task Force Ethics Issue Update - Important Time -Sensitive Reminder Hi Amber, sorry I missed your call just now --your caller ID is blocked. I don't believe I have any conflicts. The only entity I represent is the Omni CRA, which is a City Agency (sort of). If you think I should fill out a conflict report for my work there I am happy to do this. Let me know. Adam Old Director of Planning & Policy Omni Community Redevelopment Agency 305-815-5100 From: "Ketterer, Amber L." <AKetterer@miamigov.com> Date: Wednesday, July 22, 2020 at 3:29 PM Cc: Joseph Eisenberg <JEisenberg@miamigov.com>, "Keirn, Jacob" <JKeirn@miamigov.com>, "Garcia, Anastassia" <ANGARCIA@miamigov.com> Subject: RE: Miami 21 Task Force Ethics Issue Update - Important Time -Sensitive Reminder Dear Miami 21 Task Force Members: As a reminder, the City Commission will be considering tomorrow a Resolution to waive any conflicts of interest of the task force members upon proof of a member's full disclosure of his or her conflicting transactions or relationships provided on the attached Form 4A. Any Task Force member who has a conflict pursuant to the draft opinion and my below email sent last week, namely those that represent third -party clients before various boards and committees of the City, must complete the attached Form 4A before the City Commission votes on the item. Please complete the form and email it to me and the City Clerk at thannon@miamigov.com by the end of today. Please advise if you have any questions. Thank you. i 3 U1 V C Amber L. Ketterer, Assistant City Attorney CC > General Government Division o City of Miami Eo c + eq o Office of the City Attorney o N -=� Telephone: 305-416-1859 N Facsimile: 305-416-1801 E o 0 aketterergmiamigov.com cn 2 o Assistant: Stephanie Fernandez: (305) 416-1833 Disclaimer: This e-mail is intended only for the individual(s) or entity(s) named within the message. This e-mail might contain legally privileged and confidential information. If you properly received this e-mail as a client or retained expert, please hold it in confidence to protect the attorney -client or work product privileges. Should the intended recipient forward or disclose this message to another person or party, that action could constitute a waiver of the attorney -client privilege. If the reader of this message is not the intended recipient, or the agent responsible to deliver it to the intended recipient, you are hereby notified that any review, dissemination, distribution or copying of this communication is prohibited by the sender and to do so might constitute a violation of the Electronic Communications Privacy Act, 18 U.S.C. section 2510-2521. If this communication was received in error we apologize for the intrusion. Please notify us by reply e-mail and delete the original message. Nothing in this e-mail message shall, in and of itself, create an attorney -client relationship with the sender. Under Florida law, e-mail addresses are public records. If you do not want your e- mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. Please consider the environment before printing this e-mail. From: Ketterer, Amber L. Sent: Friday, July 17, 202010:05 AM Cc: Eisenberg, Joseph <lEisenberg@miamigov.com>; Keirn, Jacob <JKeirn@miamigov.com>; Garcia, Anastassia <ANGARCIA@miamieov.com> Subject: Miami 21 Task Force Ethics Issue Update Dear Miami 21 Task Force Members: I hope this email finds you all well. As you know, our office has been working to resolve an ethics issue regarding this task force and its members. Please review the attached draft opinion that is posted on the Florida Commission on Ethics website. Here is the link to the opinion on the website as well: http•//ethics state fl us/Documents/Ethics/MeetingAgendas/Jul20%20Materials/2763.pdf. Please note that this is only a draft and has not yet been officially adopted. It is set to be heard by the Florida Commission on Ethics on July 24, 2020. As we expect the adoption of the attached opinion on July 24, 2020, we anticipate a Resolution will be heard by the City Commission at the July 23, 2020 City Commission meeting to waive any conflict of interest upon proof of a member's full disclosure of his or her conflicting transactions or relationships on the attached State of Florida Commission on Ethics Form 4A pursuant to Section 112.313, Florida Statutes, in accordance with the anticipated opinion from the Florida Commission on Ethics. Please note that this opinion could affect several members of this task force, namely those that represent third -party clients before various boards and committees of the City, including the City Commission. If the City Commission approves the waiver of the conflict of interest, those members will have to complete the attached Form 4A. Thank you. _u Y Cn L W Amber L. Ketterer, Assistant City Attorney s h u General Government Division o E N E+=o City of Miami a L N Office of the City Attorney W N ^y Telephone: 305-416-1859 E Lo •� o Facsimile: 305-416-1801 N o aketterer@miamigov.com Assistant: Stephanie Fernandez: (305) 416-1833 Disclaimer: This e-mail is intended only for the individual(s) or entity(s) named within the message. This e-mail might contain legally privileged and confidential information. If you properly received this e-mail as a client or retained expert, please hold it in confidence to protect the attorney -client or work product privileges. Should the intended recipient forward or disclose this message to another person or party, that action could constitute a waiver of the attorney -client privilege. If the reader of this message is not the intended recipient, or the agent responsible to deliver it to the intended recipient, you are hereby notified that any review, dissemination, distribution or copying of this communication is prohibited by the sender and to do so might constitute a violation of the Electronic Communications Privacy Act, 18 U.S.C. section 2510-2521. If this communication was received in error we apologize for the intrusion. Please notify us by reply e-mail and delete the original message. Nothing in this e-mail message shall, in and of itself, create an attorney -client relationship with the sender. Under Florida law, e-mail addresses are public records. If you do not want your e- mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. .01" Please consider the environment before printing this e-mail.