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Submittal-City Clerk-Qualified Applicants
Submitted into the public record for item(s) SP.1, on 11-18-2Q2D, City Clerk QUALIFIED APPLICANTS FOR DISTRICT 5 CITY COMMISSIONER VACANCY Office of the City Clerk Miami City Hall 35M Pan American ©rive Miami, FL 33133 (305) 25MWI www.mlamigov.com/cityderk 6 � 3 -"'�obli'11 I I Ql- bfj CWk, -qUCc.G f-iecl n'I 1 UC(in Submitted into the public record for item(s) 5ti1, on 11-18-2020. City Clerk fir~ YI Q �1 �7 CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT r, p CITY OF MIAMI, FLORIDA Cn l 1 STATE OF FLORIDA j COUNTY OF MIAMI-DADE } Q CITY OF MIAMI j � x 1 w ��'r�. d c Q i "� �2 4 of Pi .. (hereinafter "affiant" ), being first duly sworn under penalty of perjury, deposes and says: 1. My name is oG'3 U f a\t Z. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I Must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. LA I presently r/e�side at t(h]e following address (must include z1ip code): which is my legal address, and I have resided continually at said address from the I day of vvo q *) -roc , --- 19 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbeiow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: 3-A'% For the Period: i Z'-L ne, ;?9, wwl' t �_\ e � rz LA YV Znd Ale KA, Page 1 OF Rev F1,2020 8, in addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: '� 1A 6. Affiant's spouse resides at the following address (must include city, state and zip code): 7. Affiant's minor children reside at the following address (must include city, state and zip code): iZ� ��' d� s���� r� ,ram►.,. :'� 3313�' 8. At the present time, affiant (is) (is not egistered to vote in any city, county or state other than as stipulated in subparagrap above. 9. Name and business address of affiant's employer: 10. Affiant's occupation: i^V Affiant's business telephone number(s): � — , 2 11, Affiant has been employed in the above -cited capacity for the following period of time: (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and addresses) of his/her +em*yer(s) and occupation(s) for the period of pne year prior to the date of this affidavit), Z9 c, r' o `-J 12. Affiant represents that he/she (is) (is no currently holding another elective �r a,�Ipointive office — whether city, county or m paf — the term of which or any part3lh of runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed, Submitted into the public Fine 2 oaf 3 record for items) Sp. on Zz`ZS-?t7Z ' City Clerk Submitted into the public record for item(s) SP.1, on 1-18-202Q, City Clerk SIGNED THIS l r " DAY OF ogcyo &2 AFFIANT BEFORE ME, the undersigned authority, by means of - / physical h sical or online presence appeared � ir][c7i s ,�� + �e='1LClCcjj V who, after first being duly sworn (or affirmed), deposes and states that _ e executed the foregoing to the best of IS knowledge and belief. Q, 1,N CIT RK, (SEAL) CITY OF MIAMI, FLORIDA Y Did take an oath Produced identification Type of identification produced: �L -nyu 1:Acen.c-e-- ;.� NvaryPut�-5�a�eofFlarida ' Commi&s�on#GG684618 4+� `'•�'�oc My Comm. Ex0es Agar 19.2021 €.�'. 61rdAt dr��yn Ns6xal Malay Wn C1 P'�' nil - ca =�r Q t r-- x tA3 Pipe 3 or3 Rev 1012020 FORM I STATEMENT OF 2019 Please print or typa you rnama, rnailfng FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position befaw: LAST NAME -- FIRST NAME — MIDDLE NAME: NAkiav-%() 4ter►CL4�° S MAILING ADDRESS c' V) ( r }ryt 1 C7 f G '?2i m l-C3to 1= C-u v t,irj CITY : ZIP : COUNTY' NAME OF AGENCY n NA OF OFFICE OR POSITION HELD OR SOUGHT, m CHECK ONLY IF ❑ CANDIDATE OR (rNEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBEIR 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF US]'NG REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (mustfAeck one): COMPARATIVE (PERCENTAGE) THRESHOLDS OR EY DOLLAR VALUE THRESHOLDS PART A •- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (if you have nothing to report, write "none" or "nla" ) NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY '' rr V r 5 LK�y ���+ ,' 'l.K'i✓ . '� E Y 1�� � a � LEI' �. ", PART B — SECONDARY SOURCES OF INCOME I VL1111A-' V���+� [Major eustamers, clients, and other sources of income to businesses owned by t e reporting person - See instructions] (If you have nothing to report write " none " or "nla") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVI OF SOURCE PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the (if you have nothing to repo , rite "none" or "Na") lines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill It out hanin nn nano R 1 1 1 CE FORM 7 - ENeclloe. Januare 1 n2a {Continua Submitted Into the public PAGE 1 lac"Orated by reference In Rule 34-8.20211 M. F.A.C. record for item(s) on 11-18-2020, City Clerk 5 k PART O —INTANGIBLE PERSONAL PROPERTY [Stocks, bonds. certificates of deposit, etc. - See instructions] Rif you have notating to report, write "none" or "n/a") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E — LIABILITIES [Major debts - See instructions] r (if you have nothing to report, write "none" or "nla") �;. rip. 0 NAME OF REDiTOR ADDRESS OF CREDfTORif `rr Cn 1'1 PART F —INTERESTS IN SPECIFIED BUSINESSES (Ownership or positions in certain types of businesses -See instructtgn ] —.- (If you have notating to report, wrfte "none" or "nia") m X- BUSINESS ENTITY 1 BU&lNES: 1fA, NAME OF BUSINESS ENTITY t Kvl mt� EN # c ADDRESS OF BUSINESS ENTITY �}[� PRINCIPAL BUSINESS ACTIVITY Y� � �} r� � U 'h, r7c POSITION HELD WITH ENTITY ' I OWN MORE THAN A Sin INTEREST IN THE BUSINESS ' . NATURE OF MY OW417RSHIP INTEREST Z �] PART G — TRAINING For elected municipal officers required to comoJete annual ethics training pursuant to secticri 112.3142, F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE I SIGNATURE OF FILER: Signature: Date Signed: FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure Filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside_ (If you do not permanently reside in Florida, 'file with the Supervisor of the county where your agency has its headquarters.) Form 1 fiiers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.Q. Drawer 15709. Tallahassee, FL 32317-5709; physical address; 325 Joan Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed farm and any attacftments as a pdf (do not use any other format), send it to CEForm1@leg.state.fl.us and retain a copy for your records. Do not fie by both mail and email. Choose only one. Fling method. Form 6s will not be accepted via email. CE FORM i-EHecbva Januety 1. 2020. Incoriwaled by reference in ROft 3".202t1). F.A.C. CPA Or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, , ,prepared the CE Form 1 in accordance with Section 112.3145. Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature - Date Signed: Candidates Fie this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they Fite their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form IF (Final Statement of Financial Interests) does nol relieve the filer of filing a CE Form 1 If the filer was in his or her position on December 31, 2019. Submitted into the public PAGE record for item(s) SPA, on 1111-18 2020, City Clerk CANDIDATE OATH — NONPARTISAN OFFICE RECEIVFD (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a 2820 NOV] 6 PM k 43 write-in candidate: iliE CITY GLERif Write-in candidate CITY OF MIAMI OFFICE USE ONLY Candidate Oath .021(1)(a), Florida Statutes) (Section 9�__L FR (Print name abbve as you wish it to appear on the ballot. if your last name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of quaiirying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of 4 e,, (Office) (district #) I am a qualified elector of County, Florida; {Circuit #) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the terns of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): �qL_ Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): (Not applicable to write-in candidates.] Si ature of Candidde Telephone Number Email Addre ' p� r/ 2, r Y( I r/Wl Address City State ZIP Code STATE OF FLORIDA Sign re 6f Notary Public OF 6 i Print, T p . or Stamp Commissioned Marne of Notary Public below COUNTY SANDRAFMES Sworn to (or affirmed) and subscrlbed before me by IA physical or HeraryNviC-StatedFWa ' Comn4sOn # GG U4618 ' My Comm. Enos Mar 19.2021 online presence this day of 20M. d�MF:m+�ruti:na�+ac+aryA�n. Personally Known: or Produced Identification: Type of Identification Produced: f V '� _ Submitted into the public DS-DE 302NP (Rev. 04120) record Tor nemts; 7r. ule jb-2.uuu1, t .►�.�. on 11-18-2020, City Clerk. LOYALTY OATH STATE OF FLORIDA COUNTY OF MIAMI-DADE Submitted into the public record for item(s) SP.1� on 11-18-2020 City Cleric I, F GainC�.i S V_ AWC"(,Wf First dame Middle Initial Last dame a citizen oj4he:8tate of Florida and of the United States of America, ... and a candidate for public office ... do hereby sole` hni; swear or affirm that I will support the Constitution of the Uni d States and of the State of Florida, ZJ tj LLJ >-X LLJ to wU Signature of Candidate _ CITY OF I1+tIIAMI OATH OF CANDIDATE Cj OFFICE OF(C)y n 41 ti'Ss) 0 V-1e,< 'd tS� 7 Before me, an officer authorized to administer oaths, personally appeared ate_ ya"46 (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of 6- v'w. w' r� j /t (� rC ID � S � �� , for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Address / Signature of Candidate e ?L�5t�l� City State ZIP Cod - The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by /physical or online presence, this till" day of 1�1�y►nn { , 24 20 — Q�r_q� Signatu a Ciffiter Administering Oath or Notary Public Personally Known: OR Produced Identification Type of Identification Produced: �Lr Dce U a a &,—, Name of Notary Typed, Printej or Stamped SANDRA FQRG'ES C.er+w i&s on t GG W818 My0 mm. Exp+ Mar 19, 2021 tknaawrw,yn wee rryAW. I R:2SPyG Fraii�ois J. Alexandre 122 NE 7V Street, Miami FL, 33138 (954) 543-2810 FalexatHl ll fd�gmail.cnm Date: March 2020 To Whom It May Concern: I graduated with a bachelor's degree in International Relations and a minor in Mass Communications at Florida International University. I wish to apply for the Commission Seat District 5 from the City of Miami Fl.. While researching opportunities in South Florida, both Private and non-profit sector, I found that the city of Miami municipality has been highly recommended for having an interest in the development of its representatives while simultaneously providing education the community needs to engage in combating and advocating for climate change/justice, environment justice, voter registration, racial, social, economic and political justice. For the past seven years, I've been building research and outreach in underserved Low -Income g to elected officials, community leaders, grassroots organizers communities in South Florida speakin around various local issues facing our people. In particular, a Climate gentrification issue our Ayisyen immigrant community dealt with where over 75% oiAyisyen Americans were being evicted out of their mobile homes without proper notice in the middle of the school year. We coordinated a campaign and implemented strategies that led to a significant victory. This was a coalition led by Legal Services of Greater Miami and concerned community leaders. We took the City and the new property owner to court and won a million dollars for the remaining 100 families. My work background has supplied me with many skills along with a wealth of knowledge and understanding when working with and for our communities in South Florida. I have been mobilizing local community rnetnbers around campaigns concerning Temporary Protective Status Gentrification, Climate Change, Affordable Housing, Civic Engagement and Political Campaigns.. I have been in charge of creating committees around campaigns as well as maintaining relationships with community members and influence leaders. Within the past six years, I have stepped into the space of educating and training organizers and local leaders to maximize their full self -empowered potential goals. These experiences have greatly improved my leadership, Training, communication and coalition -building skills. Above all, it helped me recognize the importance of teamwork in achieving campaign goals and objectives, qualities that I could use at your establishment. Being the committed and diligent person that I any, I assure you a great performance both as a team member and also at an individual level. Please find further details in my Curriculum Vitae enclosed for your perusal. Thanking you, Yours Respectfully, Francois J. Alexandre Submitted into the public record for item(s) 5P.1, on 11-1€?'-202- ] City Cleric Submitted into the public record for item(s) SP.I., on 11-18-2020, City Clerk: Franpis J. Alexandre 122 NE 78" Street, Miami FL, 33138 r; (954) 543-2810 n f4-1exa001 cagmaiLC0M Education: Z Florida international University Bachelor of Science in International Relations Minor in Mass Communications, December 2016 Employment Experience: Konscious Kontraktors Nliami FL September 2017- Current Position- )Founder, CEO • Konscious Kontractors with our Community in mind have created and developed 9 programs: Art Kreyol, Ti Ayiti News awareness, Ti Ayiti Kornmunity Kultural Konversations, Ti Ayiti Klimate & Kulture Art Science Initiative, Ti Ayiti Kommunity Awareness Preparation Initiative, Ti Ayiti Kommunity Organic Garden And Water Initiative, Ti Ayiti Beautification And Konstruction Initiative, Ti Ayiti Youth Art Kontest, Ti Ayiti Summer Environmental Youth Initiative. • Create community -based strategies and implement programs to mitigate the impact of "climate change gentrification" in Ti Ayiti/Little Haiti. • Create community -based strategies and implement programs to mitigate the socioeconomic impact of folks residing in Ti Ayiti/Little Haiti. • Organizes bi-monthly community beautification activities "K1ean Street Mean Mind Initiatives" in Ti Ayiti/Little Haiti as well as a monthly community dialogue called "Kominunity Kultural Konversations". • Organizes a weekly Drum Cirkle on Sundays at any location. ■ Supports low income homeowners efforts to remain in the neighborhood with Home renovation, repairs, and landscaping design services. • Provides at -risk youths with job -training skills, exposing them to kulture, arts and science initiatives. • Curating an annual "1804 Forever Youth Klimate Art Kontest Exhibition" reflecting climate change within the spirit of 1804. This is done in conjunction with local partners such as The city of Miami, Elected officials, Magic City, nonprofits organizations and the general community at large. • Curating, hosting, presenting "Art kreyol" a Multi -disciplinary artistic Platform created to represent and showcase the work of Black People within the Diaspora. • Since our inception in 2017 we have worked on a variety of Projects and initiatives. Our operational budget has grown to $50,000 plus including generating a list of volunteers to assist each particular project. • konscious Kontractors have developed leadership capacity in areas such as Landscaping, Tree Cutting, Homes/Commercial renovations, vocational training, event Coordinating and Staffing. • Konscious Kontractors have partnered and sponsored big events such as Sounds of Little Haiti, Konpa Festival, Griot Festival, Miami Dade and Broward Carnival, Madame Gougousse Haiti Cup. New Florida Majority, Miami FL July 2017- November 2017 Position Organizer: Democracy Lead Organizer • Created strategic plans on engaging marginalized and excluded communities around voter restoration, voter registration, Affordable Housing, Gentrification, Money & Politics and voter suppression. • Developed and fostered relationship growth with other Community Based Organizations (CBOs), faith leaders, community members, community leaders, business owners and other gatekeepers. • Coordinated events with CBOs aiding community members on voter registration, completing voter restoration petitions and the importance of civic engagement. ID • Found and developed volunteers, including training and providing Ieadership opportunities that increase the participation of marginalized communities. • Developed voter registration sites, keeping track of sites and relationships. • Followed quality control procedures for safeguarding sensitive information collected. Family Action Network Movement Miami, FL August 2015- April 2017 Position Held: Community Organizer • Developed and coordinated programs designed to promote the organization and its services to the community and the target population. • Identified other community issues happening in the Ti Ayiti/Little Haiti Communities. • Worked with leaders, staff and committees to engage, educate, agitate and motivate the community members to action. • Trained volunteers and staff on house calling, run successful neighborhood canvasses and phone banks while holding them accountable to goals and outcomes. • Designed and implemented training of volunteers/activists and staff, assisted in and/or coordinated work of other staff. • Guided integration of politics, community relationships and organizing support in the daily work of staff. • Maintained accurate and detailed information on community networks, relationships built, activists and volunteers recruited, assignments and assessments etc. • Contributed to the overall community and political strategy for campaign with staff • Promoted activities and services through various forms of media. The Dutch Miami, Miami Beach, FL Position Held: Food Runner December 2014-June 2015 • Delivered food to guests quickly and efficiently • Coordinated daily Front of the House and Back of the House restaurant operations • Delivered superior service and maximize customer satisfaction • Responded efficiently and accurately to customer complaints • Reviewed product quality and research new vendors • Organized and supervise shifts • Appraised staff performance and provide feedback to improve productivity • Ensured compliance with sanitation and safety regulations • Controlled operational costs and identified measures to cut waste. • Communicated clearly with the kitchen and front of house staff1`�'��„ h • Other duties as assigned .q Submitted into the public record for item(s) SPA, on 11-18-2420, City Clerk SLS hotel, Miami Beach August 2013- September 2014 Position Held: ServerlSecurityfFood Runner • Coordinated daily Front of the House and Back of the House restaurant operations • Delivered superior service and maximize customer satisfaction cs • Desponded efficiently and accurately to customer complaints , • Reviewed product quality and research new vendorsCD • Organized and supervise shifts ` Fri • Appraised staff performance and provide feedback to improve productivity • Ensured compliance with sanitation and safety regulations • Delivered food to guests quickly and efficiently • Communicated clearly with the kitchen and front of house staff r CD • Guarded against theft and maintain security of premises ; • Other duties as assigned Comcast, Miramar FL July 2007 — May 2011 Position Held: Retention Executive Assisted customers who want to cancel their services Sold the benefits and value of Comcast's products and services along with identifying customers unstated needs, selling any missing lines of business to the customer, and make account changes as necessary LANGUAGE AND COMPUTER SKILLS Fluent in Spoken and Written: English, French, and Kreyol. Certified Miami -Dade County Community Emergency Relief Team Certified Hvac Technician City of Miami Department of Human Resources, Customer Service - Business Etiquette Certification City of Miami Department of Human Resources, Conflict Management Certification City of Miami Department of Human Resources; Time Management Certification City of Miami Department ofHuman resources, Effective Communication For Success Certification Certified Climate change instructor via FEMA Computer Skills: Microsoft Word, MS Excel, MS Power Point, Safari, and type 40 words per minute. HOBBIES AND INTERESTS Skills: I'm a fast learner, eager to learn and i take the initiative. I'm a hard-working individual with a team working and managerial experience. I have been featured in local and national media platforms such as the New York Times, Sierra Club Magazine and Podcast, Npr, PBS, A1.lazeera Plus, Academic articles from various universities (MIT, UF, Cornell University, FIU, Barry University), Miami New Times, C. 1 Huffington Post, all of South Florida Local TV Stations, Uk. Daily Mailand and the Miami W +, Herald. I testified in front of the Council on Environmental Quality (CEQ) on the National a 6 Environmental Protection Act (NEPA). _ (U *' N o Interests: People, Family, Philanthropy, Making Money, Politics, Music, Sports, and Traveling. E' V r 7 of y, C 0 Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk VOLUNTEERING/ORGANIZATION AFFILIATES Co -Founder of Justice 4 Miami, 2020 President of Concerned Leaders of Ti Ayitillittle Haiti since, 2018 Poetic Lakay, 2016 Sounds of Little Haiti 2016 Miami -Dade County Millennial Task Force, 2020 Miami Climate Alliance, Active member, 2016 Dream Defenders, Active Member since, 2014 Roots Collective, Active Member since, 2014 Circle of Brotherhood, Active Member since, 2016 President of Tribe Kreyol, Active since, 2019 Appointed ambassador of Ti Ayiti We Derr Zoes Entertainment Group Muce305, Active since, 2017 References; Jan Mapou; 305-299-9918 Email; Janmapou@gmail.com Father Reginald: 786-704-4255 Email; Tiyogann@yahoo.coni Leonie Hermantin: 786-473-5889 Email; lhermantin@gmail.com Submitted into the public record for item(s) SPA, on 11-18-2020 City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) 5P.1 on 11-18-2020, City Clerk Tom% C= CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA am (mil -c n CP M, STATE OF FLORIDA COUNTY OF MIAMI-DADE `co 0 CITY OF MIAMI } n x sn Jacquetta (Jacqui) B. Colyer (hereinafter "afFiant"), being first duly sworn under penalty of perjury, deposes and says: 1. My name is Jacquetta (J'acqui) B. Colyer 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the distract for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 501 I presently reside at the following address (must include zip code): which is my legal address, and I have resided continually at said address from the 1 St day of June, 1, 2009 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: For the Period: 2 years 10 Page I OD Rev. 1012020 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: 6. Affiant's spouse resides at the following address (must include city, state and zip code): same as mine 7. Affiant's minor children reside at the following address (must include city, state and zip code): n/a S. At the present time, affiant (is) Pisnoregistered to vote in any city, county or state other than as stipulated in subparagraove. 9. 'Name and business address of affiant's employer: Colyer Consulting - Self Employed Colyer Consulting - Self Employed 10. Affiant's occupation: Affiant's business telephone number(s): -, C= CD=1 , 21, COFT1 I M M cn 11. Affiant has been employed in the above -cited capacity for the following period of time: 5 years (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 12. Affiant represents that he/she (is) is noty currently holding another elective or appointive office — whether city, county or maWCipal — the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.5,99.012 and/or the City of Miami Charter. j 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Pale Z oF3 Rev. liirZO?[} Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk Submitted into the public record for item(s) 5P•1, on 11-18-202�7 City Clerk ` -M SIGNED THIS 1 ) DAY OF �O'JCYA� BEFORE ME, the undersigned authority, by means of / physical or ' online presence appeared qU�Colwe-y ,who, after first being duly sworn (or affirmed), deposes and states that executed the foregoing to the 'best of lr- knowledge and belief. cys= �,�. CITY CL K, CITY'OP MIAMI, FLORIDA d Did take an oath Produced identification Type of identification produced s, N91ay �J�IIC —$fEfe d �A1fua •' Cem*wnAGGO !8 �rf Iffy ".arm. �zyres pia' t9. iD21 �`v'k"ocR .•'� �;�gYgy,�I1 Ya[GRal Npgrt.lss'� �-� N Ve rs u u o se - (SEAL) P;ige 3 of 3 Rev. 1012020 FORM 1 STATEMENT OF 2019 Please printortype your raame,Mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY; address, agency name, and position below; LAST NAME -- FIRST NAME -- MIDDLE NAME: Colyer, Jacguetta Bland MAILING ADDRESS ; ca r1�'r C::5 �-I Ct C lei CITY ZIP COUNTY rlF, Miami Miami Dade` �C I� NAME OF AGENCY : o City of Miami Commission,, �. NAME OF OFFICE OR POSITION HELD OR SOUGHT ; x City Commissioner - District 5 CHECK ONLY IF I] CANDIDATE OR NEW EMPLOYEE OR APPOINTEE ** THIS SECTION MUST BE COMPLETED "'** DISCLOSURE PERIOD; THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. (MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): 0 COMPARATIVE (PERCENTAGE) THRESHOLDS M Z DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME (Major sources of income to the reporting person - See instructions, (If you have nothing to report, write "none" or "n!a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Florida Retirement System 200 East Gaines St.; Tallahasdee FL 32.399 Retirement Services Social Security 8345 Biscayne Blvd, Miami FL 33138 Retirement Services Colyer Consulting Social Services Consulting PART B -- SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions) (if you have nothing to report, write "none" or "Na") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE NA PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See Instructions] You are not limited to the space on the (if you have nothing to report, write "none" or "nla") lines on this form. Attach additionat sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to Fill it out begin on page 3. Submitted into the nublic CE FORi i - ERecum; January 1. 20M Incorparated by reference In Rule 344202(5), F.A.C. record for or itl,'I'n(s) SP•1, on 11-18-2020 City Clerk I PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposd, etc. - See instructions) (if you have nothing to report, write "none" or "Wa") 111 TYPE OF INTANGIBLE I BUSINESS ENTITY TO WHICH THE PROPERTY RELATES )Financial Portfolio lAmeriprise, Inc. - 8353 SW 124th Street, 4104, Miami FL 33156 I PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF CREDITOR ADDRESS OF CREDITOR South Florida Educational FCU 1498 NE 2nd Avenue, Miami FL 33132 ,American Express 701 Bricicell Avenue, Miami FL 33131 PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses -See instructions] {If you have nothing to report, write "none" or "Inla") BUSINESSNTI# 2 BUSINESS ENTITY # 1 c� NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY NA � .e 171 PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY rn �n I OWN MORE THAN A 5°% 1NTEREST IN THE BUSINESS 3�-�4 M NATURE OF MY OWNERSHIP INTEREST C7 r !� PART G —TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S. 0 I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ 0 i; SIGNATURE OF FILER: 1 i i, / - CIXL1101.1 FILING INSTRUCTIONS: if you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local offfcerslemployees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by entail, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose oM na Him method. Form Bs will not be accepted via email. CE FORM 1 - Mown: 7aniary 1, 2020. I nmrpo [ed by raler9nrtn in ftIo 394 202(11. F.A.G CPA or ATTORNEY SIGNATURE ONLY If a ceriified public accountant licensed under Chapter 473. or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the fallowing slstement: I, prepared the CE Form 1 in accordance with Section 112.3145. Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPA/Attorney Signature: Date Signed: Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY. A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE; Initially, each local officerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate roust file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019. Submitted into the public , record for item(s) SPA, on 11-18-2020, City Clerk CANDIDATE OATH — NDNPARTISAN OFFICES `EtVD (Do not use this form if a Judicial or School Board Candidate) 202alloV 13 A4 Check fox only if you are seeking to qualify as a,� write-in candidate; �� � E OFI Y T "E 0TYCLEi?f MtAMt ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99,021(t){a), Florida Statutes) CD � V_10_� au Ut e*�� (Print name above as you wish it to appear on thel ballot. if your Iasi name consists of twd or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidates name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of City Commission 5 (office) (District #) I am a qualified elector of Miami -Dade County, Florida; (Circuit N (Group or Seat #) I am qualified under the Constitution and the taws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida, Candidate's Florida Voter Registration Number (located on your voter information card): 149039290 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] "N.0 al er14 � 0 cq @1 khoc C)finidate TeleRhone Number Email Address 4 dress City tote ZIP Code STATE of FLORIDA Signatu o N Lary Public COUNTY OF % Print, Ty r tam commissioned Name of Notary Public. below: SM Sworn to (or affirmed) and subscribed before me by physical or = '. V' , -Fq��s n HoYaryiraeib-5mleorFro • -Ky� ' • :.. _: Comrrrssaq # GG N461a Y online presence this day off air MyComm. Fries Mar 112021 3urn+ FlCtdygsr, W_ Personally Known: or Produced Identification. -- Type of Identification Produced:��y��`'-+�� ❑S-DE 302NP (Rev. 04120) SUbmittea into the puDiic Rule 1S•2.0001, F.A.C. record for item(s) SP.1, on 11-18-2020, City Clerk LOYALTY OATH STATE OF FLORIDA RECE ED COUNTY OF MIAMI-DADE Fist Name Middle nitial ub j" Y CLERK Atit a citizen of the State of Florida and of the United States of America, ... nd a candidate, for public office do hereby solemnly swear or affirm that I will support the Constitution of the U lted States dd/of the State of Florida. f yig ature of Can date r CITY OF MIAMI OATI4,OF CANDIDATE Submitted into the public _�- OFFICE OF 1i�11S 1 f' i i record for item(s) 5 Before me, an officer authorized to administer oaths, personally appeared on 11-1� City Clerk (PLEASt PRINT NAME}_ who, being sworn, says he/she is a candidate for the office of Umrn�61 [� t [:�' for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 9.012, Florid Mutes. Y Signature Candidate 1 , Address city State ZIP Code Loyalty Oath and Oath of Candidate are sworn to or affirmed and subscribed before me byZphysical car The y y � � online prese this _ 1 -day of h�PeJY� , 20 2-0 Sign ur of er Administering Oath or Notary Public Name of Notary Typed, Pr d or Stamped ,..�.,, �+o� ra>i�rs Personally Known: OR Produced Idenlifcation ;=:; �__ NatayPswNDRASrateal�fonda _ Camm�ssbn � GG 4E4G16 `:,4 sty Comm. &pres Mar 19.2921 Type of Identification Produced: JACQIJI B. COLYER LXPERIIENCE The Colyer Group Consultant rr1.' l- .. ape • Social Services consultant to the following organizations- St. John Community Development Corporation, The Obama Foundation f My Brother's Keeper, Florida Rights Restoration Coalition Illinois Department of Children and Family Services 1 Cook County Regional Administrator ■ The Administrator for Chicago's Child Welfare Programs - both Investigations and Child Welfare (Permanency) • Provided Executive Leadership for the Chicago Region, the largest county in Illinois. Introduced strategies to track data for both Investigations and Permanency, Significantly reduced pending investigations in Cook while continuing to provide optimal daily operations. The Children's Trust Director of Neighborhood and Community Services (-0N_I AC T 4 En colyer4109@yahoo.com 1.1)UC:ATI0N Doctoral Candida-e. University of Miami M.S.W- Social Work and Social Work Education. Barry University, Miami Shores, FL B.A.. Social Science Education and Social Work Winthrop University, Rock Hill. SC Executive responsibility for Program Development for children and youth living in at risk neighborhoods. • Developed strategy to use neighborhood hubs that provided mentoring, after school, and prevention services to seven neighborhoods. The goal: All children would be supported by caring adults who would work with them through various life situations. Florida Department of Children and Families Regional Director • Executive responsibility For the overall operations and budget management for programs that provide safety net assistance to vulnerable populations - Child Care Licensing, Substance Abuse and Mental Health. ACCESS - Food Stamps, Family Safety- Child and Adult Protective Services in Miami Dade County. • Under my leadership the Region won awards for Food Stamps accuracy and awarded a $3 million award for an innovative early child care initiative and $7 million for Prevention Programs in Early Learning (child care) settings throughout the community Budget of $150 million dollars and 1,400 employees. Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk Submitted into the public record for item(s) 5P 1 an 11-18-2420, city Clerk � z .cr '—ter of C� J Cti7 _ r+11 Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk our Kids, Inc. Director of Permanency and Prevention • Pesponsible for the operations of the Adoptions and Permanency initiatives.. ■ Developed innovative programs and strategies to reduce the number of chi dren removed from their homes through intensive diversion and prevention programs in child welfare ■ Authored grants to HHS and foundations. Policy Studies, Inc. Pegional Director of Workforce Operations • Co -wrote grants for Workforce in Florida (Palm Beach and Volus,a County), Nebraska (Omaha) and Arkansas (Little Pock) • Coordinated the opening of the offices from site selection, hiring, training and daily operations. • All sites achieved work force goals and contracts were increased by 20% during my tenure. Lockheed Martin IMS, Miami, FL Deputy Project Manager + Built the South Florida Workforce Development programs From start-up to maturity. Led up to 180 employees. Esther Project, Miami, FL Project Director • Provided senior level strategic direction and management for this $5- million federal faith based welfare to work (WtW) project For 120 hard to place women. BOARD MEME EIM-[IPS • AGAPE - Belen Jesuit Preparatory ;school - Secretary • Overtown Advisory Board - Vine President • Peace Education Foundation -Vice President ■ 4Ward Miami- Member AWAIZDS • Belen Jesuit Preparatory School (Founded the AGAPE Program) Program to provide scholarships for very bright disadvantaged teenagers. • Miami -Dade College outstanding Faculty Member • Truth and Hope Award - Human Services Coalition • Community Services and Leadership Award -League of Women Voters Leadership Award • Wom+en's Chamber of Commerce -Business Woman Service Award 2 Submitted into the public record for items) SJ on 1111-1City Clerk Submitted into the public record for item(s) SP on 11-18-2p2Q. City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) Lp, -' on I-18-2o2o City Clerk CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT"' CITY OF MIAMI, FLORIDA co �Tl STATE OF FLORIDA } COUNTY OF MIAMi-DA❑E } d CITY OF MIAMI } VI C' (A IJ ck to k � yA_s (hereinafter "affiant"), being first duly sworn un er penalty of perjury, deposes and says: 1. My name is M(A rluj t LLB ri 2. I am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3, 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No.f� I presently reside at the following address (must include zip code): 5 N ti�J 6DJ I-) &fy-'rc' f Q d Ct ut� , FL - 33 1-I which is my legal address, and I have resided continually at said address from the day of to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow ail addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: For the Period: Page t oi'3 Rev. 10/2020 5. In addition to the residence that 1 have fisted as my present address, I also reside at the foliowing listed addresses on a temporary basis as a secondary domicile or domiciles: Al /A- 6. Affiant's spouse resides at the following address (must include city, state and zip code): 7. Affiant's minor children reside at the following address (must include city, state and zip code). 8. At the present time, affiant (is) is not registered to vote in any city, county�pr Zte other than as stipulated in subparagraph above. : �• 9. Name and business address of affiant's employer: ` C7 CO M -4 CDL�7*7 r~ All 10. Affiant's occupation. Affiant's business telephone numbers): All' -i 1 . Affiant has been employed in the above -cited capacity for the following period of time: '41//_ (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, af'Fiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 1 Z Affiant represents that he/she (is (is note currently holding another elective or appointive office — whether city, county or municipal -- the term, of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter, 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Submitted into the public ��b� °r� record for items) Sip, 1, R��. tnfzoYn on 11-18-2024 City Clerk SIGNED THIS �_ DAYOF MOVCM hC' C I AFFIANT BEFORE ME, the undersigned authority, b means of physical or online � Y Y p Y presence appeared vt who, after first being duly sworn (or affirmed), deposes and states that executed the foregoing to the best of knowledge and belief. rz_— (SEAL) CIT LE K, CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced: EL-Y1Vey_ Ucxis,-- 5 hla+�ryFs�c-�se rlar�b r • iamm55�R # GG 084619 C CM''•.'F ;. Icy Ccmm. Fxp ies l lar 19, 202i as +c.` kapa+a{hcra�yk�+. ---I C C) C rn 3� rn W 51 :'D x Cn Page 3 of 3 Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk Rev.10/2020 FORM I STATEMENT OF 2019 Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position heiow: LAST NAME -- FIRST NAME -- MIDDLE NAME: bawk—i'ns, k/api cV MAILING ADDRESS' w 3125 N 0 5N-0 r-c(ft t� -t [ L� _D5 � Z, ili111 — G1� � 1 _I �� � � CITY : ZIP couNTY : , co � NAME OF AGEN�Y l UD C7 4 `I t NAME OF OFFICE OR POSITION HELD OR SOUGHT CHECK ONLY IF ❑ CANDIDATE OR 21 NEW EMPLOYEE OR APPOINTEE *** THIS SECTION MUST BE COMPLETED`'`#�` DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019, MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one). Ll COMPARATIVE (PERCENTAGE) THRESHOLDS OR ❑ DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or "nla"} NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (if you have nothing to report, write "none" or "n1a") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESSINCOME OF SOURCE ACTIVITY OF SOURCE PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the ]if you have nothing to report, write "none" or "nla"} Pines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are � j 1, 0 A/ located at the bottom of page 2. Submitted into the public INSTRUCTIONS on who must file record for item(s) SP.1, this form and how to fill it out begin an page 3. CEFCRM 1-Egactive: January 1, 2020 on 11-16-11LIZU, City Clerk PAGE 1 Incorporated by mler©nca in Rule 34-32G2I11, F A.C. PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, hands, certificates of deposit, etc. - See instructions] (If you have nothing to report, write "none" or "nia") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES Submitted into the public V /V %% record for item(s) SP_1, PART E -- LIABILITIES [Major debts - See instructions] on 11-18-2020, City Clerk 411` you have nothing to report, write "none" or "nia") NAME OF CREDITOR ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses -See instr tionw (If you have nothing to report, write "none" or'Wa") n v Q11CIAICCC CAITITV & i nr nn tom. rtr• NAME OF BUSINESS ENTITY IVO C7 /V ADDRESS OF BUSINESS ENTITY CD rq PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITYCD ?. I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST NLn X PART G TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S. ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. I IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signature: L Date Signed: J q_ r� b FILING INSTRUCTIONS: If you were mailed the farm by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 Filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not ernail your form to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to RO, Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1@feg.state.fl,us and retain a copy ror your records. Do not file by both mail and email. Choose only one 'ding method. Form 6s will not be accepted via email. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Ftorida Bar prepared this form for you, he or she must complete the following statement: 1, , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPAlAttomey Signature: Date Signed: Candidates file this form together with their filing papers MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finality, file a final disclosure form (Form IF) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019. CE FORM 1 - Efactive: January I.21320. PAGE i Immoratea� by reference in RWe 34-8.202fl ), F.A.C. CANDIDATE OATH -- NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: ❑ Write-in candidate RECEIVED 211a IDY 18 ABM 5= 55 �7710- 9; THE c! i Y CLIRK VTY cF f Ilr4yl Candidate Oath (Section 99_021(1)(a), Florida Statutes) i 1\,i u in Lill -Y. D o w k i n s ncrir� 11C'C nN1 Y Submitted into the public record for item(s) SP.I, on 3.I-18-_2 j2p City Clerk ----- -- - you, r,ui _ ..vriui u.0 — . _ — rrr ,c rrurrlc^a uur rraa rlv hyphen, check box []. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name most be printed above for oath purposes.) am a candidate for the nonpartisan office of � �i��1 ! r� Yrirnl 55 I C��le� (Office) (District1 I am a qualified elector of 1`Cl lj I — t. Acl County, Florida; (Circuit #) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which 1 desire to be nominated or elected, I have qualified for no other public office In the state, the term of which office or any part thereof runs concurrent with the office I seek. and I have resigned from any office From which 1 am required to resign pursuant to Section 99.012, Florida Statutes; and l will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): 1 as q 3.1 r— Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): )Not applicable to write-in candidates.] Signatuie of Candidate Telephone Number Email Address D-{-n 531cj 2-- Address City State ZIP Code STATE OF FLORIDA ,,,A Signat o Notary Public COUNTY OF I Y 4 Print, Type, or Stamp Commissioned Name of Notary Public below. Sworn to (or affirmed) and subscribed before me by physical or "r'o S�AWCAAFflRGES }Q M�""MNX-Stale ofNr0 aonline presence this � day of �� t 20 �..1�,1':�- ml iiomm. DOM start9, 2021 Personally Known: or Produced Identification; Type of Identification Produced; i ��✓� �Q DS-DE 302NP (Rev. 04120) Rule 1S-2.0001, F.A.C. STATE OF FLORIDA COUNTY OF MIAMI-DADE NO n c First M LOYALTY OATH ~<S . Middle Initial Submitted into the public record for item(s) 5P.1, on 11-18-2020. City Clerk Last Name a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do hereby so1L*nl wear or affirm that I will support the Constitution of the United States and of the State of Florida, i LLJ 'Signature of Candidate co La �� CITY OF MIAMI OATH OF CANDIDATE OFFICE OF 'CIO tfyl- Before me, an officer authorized to administer oaths, personally appeared Man co S. bowk_ikiS r (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office ofL , for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes, that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Signature of Candidate Address City State ZIP Code The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by ZPhysical or aonline presence, this U day of Oooem'vn- , 20_0'D . f Sig at re 6f tfficer Administering Oath or Notary Public Name of Notary Typed, Printed or tamped Personally Known.- OR Produced Identification: ;; ;: SAt ORA-GRGE5 NaarvPj c- Stale dNnda Co,vi syw 4 GG 31451 Type of Identification Produced: V'_ U 6� :t OF � "._ AIr Comm. t �� zs At�i 49. m 8"N ^cLIP NmWal tiMf kw. I0i20'U Submitted into the public record for item(s) SPA on 11-18-2020, City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) SPI on T1-IS-2[32o., City Clerk CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA STATE OF FLORIDA COUNTY OF MIAMI-DADE CITY OF MIAMI Zico Fremont first duly sworn under penalty of perjury, deposes and says: 1. My name is Zico Fremont (hereinafter "affiant"), being . 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3- f have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. i am presently registered to vote in Precinct No. 7 Qj I presently reside at the following address (must include zip code): 180 NW 49 Street. Miami FL 33137 which is my legal address, and I have resided continually at said address from the 4 day of October 10 2010 to the present.. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: Page I of 3 For the Period: e C3 x Rev.1012020 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: 0 0. Affiant's spouse resides at the following address (must include city, state and zip code): V\j 16 7. Affiant's minor children reside at the following address (must include city, state and zip code): N I (I 8. At the present time, affiant (is) is no registered to vote in any city, county or state other than as stipulated in subparagraph 3 above. 9. Name and business address of affiant's employer: RA Automative =<-"j i� 1 180 NW49 ST . Miami FL 33127 $� 10. Affiant's occupation: Owner Affiant's business telephone number(s); 7$6-7E8-3587 ; v 11. Affiant has been employed in the above -cited capacity for the following period of time: 3 years (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the names) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 12. Affiant represents that he/she (is) is not currently holding another elective or appointive office -- whether city, county or municipal — the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Palle 2 00 Submitted into the public Rcv. 10.,2020 record for item(s) SP,1, on 11-18-2020, City Clerk Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk SIGNED THIS 1_ DAY OF November FFIANT h BEFORE ME, the undersigned authority, by means of physical or online presence appeared 2ACC, Fre_evlc)� who, after first being duly sworn (or affirmed), deposes and states that �ne— executed the foregoing to the best of tS knowledge and belief. ei::— (SEAL) CITY RK, ° CITY OF MIAMI, FLORIDA V Did take an oath �I Produced identification Type of identification produced: . Nowy P&C - 5tabnf Fonda Comm sEio^. p GO 08018 _ =. My Comm. Was Ma, 1202 oF� xarsaQ"NW!avAgrfk 3 L- 0-N vE Y 5 U C CVL & — -rY -+nFi CD .. iy � N x hge 3 or3 Rev- 1012020 FORM I STATEMENT OF 2019 Please print or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position below: LAST NAME -- FIRST NAME -- MIDDLE NAME: Fremont zico MAILING ADDRESS. 180 NW 49 ST o 12=4 ry —►� rn CITY: ZIP: COUNTY: : +-- C Miami 3a 127 Miami - Dade NAME OF AGENCY' a City of Miami —C, f;? � NAME OF OFFICE OR POSITION HELD OR SOUGHT fo City Commissioner CHECK ONLY IF ❑ CANDIDATE OR ® NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one) ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR ❑J DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions) (If you have nothing to report, write "none" or "nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY RA Automotive 180 NW 49 5T Miami Fl. 33127 PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (If you have nothing to report, write "none" or'Wa") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE N/A PART C -• REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the (If you have nothing to report, write "none" or "nla") lines on this form. Attach additional N/A sheets, if necessary. Submitted into the public FILING INSTRUCTIONS for when record for item(s) SP.1, and where to file this form are located at the bottom of page 2. on 11-Z� 8-2020, City Clerk INSTRUCTIONS an who must file this form and how to fill it out begin on page 3. CE FORM 1 -Elfeel+ve: January 1, 2WJ {Continued on reverse sidel PAUL , krcorporaled by reference in Rule 34.8.2020I, F A.C- I PART 1)— INTANGIBLE PERSONAL PROPERTY IStocks, bonds, certificates of deposit, etc. - See instructions] Ij (If you have nothing to report, write "none" or "nla") TYKE OF INTANGIBLE I BUSINESS ENTITY TO WHICH THE PROPERTY RELATES Cash- Bank Account IBank OfArn rica, Dade Credit Union. Wells Fargo I PART E — LIABILITIES [Major debts - See instructions] elf you have nothing to report, write "none" or "nla"] NAME OF CREDITOR ADDRESS OF CREDITOR Goldman Sachs 1222 South Main Street Salt Lake City,11T PANT F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions In certain types of businesses - See instructtans v (if you have nothing to report, write "none" or"nla") -., e►� BUSINESS ENTITY # 1 BUSINESS E TY i# 2 NAME OF BUSINESS ENTITY r'Cn ADDRESS OF BUSINESS ENTITY N!A PRINCIPAL BUSINESS ACTIVITY X POSITION HELD WITH ENTITY' I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST PART G —TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S. © I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. l it ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE L] SIGNATURE OF FILER: Signature: Z Fremcvlt I, r Date Signed: 11/13/2020 FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officerslemployees rile with the Supervisor of Elections of the county in which they permanently reside. Of you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics it will be returned. State officers or specified state ernployees who file with the Commission on 'Ethics may fate by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303, To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm 1@1eg.state.fl,us and retain a copy for your records. Do not file bar bath mail and email. Choose only any fil in meth , Form Fs will not be accepters via email. CE FORM 1 - Effective: January I, 2020, Incorporated by reference in Rue 34.8.202(1), FAC. CPA or ATTORNEY SIGNATURE ONLY II a certified public accountant licensed under Chapter 473, or attorney In good standing with the Florida Bar prepared this form for you, he or she must compute the following statement: I prepared the CE Form 1 in accordance. with Section 112,3145, Florida Statutes, and the instructions to the farm- Upon my reasonable knowledge and belief, the disclosure herein is true and Correct. CPAIAttorney Signature? Date Signed: Candidates File this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form I with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO 'FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter,, file by July 1 following each calendar year In which they hold their positions. Finally, fife a final disclosure form (Form IF) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019. Submitted into the public record for item(s) SP.1, an 11-18-2020, City Clerk PAGE 2 CANDIDATE OATH — N©NPARTISAN OFFICE REC:EIV E 0 (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: r"";. ti ,r ilt CITY CLERK{ CITY OF MIAM Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99,021(1)(a), Florida Statutes) I Zico Fremont (Print name above as you wish it to appear on the ballot if your fast name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of City commissioner 5 (office) fDistrict #j I am a qualified elector of Miami -Dade County, Florida, {Circuit #) {Group or Seat #J I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99-012, Florida Statutes-, and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card). 110323493 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this farm) [Notapplicable to write-in candidates.] ziko frimnt '` Zico.fremont@ �_jvt,(786) X t 768-3567 gmailsm Sign a of Candidate Telephone Number Email Address 18NW 49 Street Miami Florida 33127 Address City State ZIP Code �j tl--- STATE OF FLORIDA Signalt if Notary Public COUNTY OF l - T1e, Print, Tyk,,br Stamp Commissioned Name of Notary Public below: SMRA tNGES Sworn to (or affirmed) and subscribed before me by L"_] physical yr : a= tktaypuk-Stale ofFbrda Cammi viNGGOEA618 M,� online resence thisda of ov zo .MYComm. WfesMar 19.M21 8okk naaanal wpry Wn. Personally Known: or Produced Identification r+ Type of identification Produced. 1.- '��� Submitted into the public _J r_.. �wi u +U► Remt5j �F�J, Rule 1S-2.0001, F.A.C. IDS -DE 302i�P (Rev. 04120j on 11_1-8-2020, City Clerk LOYALTY OATH STATE OF FLORIDA COUNTY OF MIAMI-DADE 2020 NOY 13 P14 Z: 28 u-1,wc IF First Narne Submitted into the public record for item(s) 5P•1 on 11-1� &2o2o City Clerk Last Name a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do hereby solemnly swear or affirm that I will support the Constitution of the United States and ot the State of Florida. S 4 Sigma ure of Candidate CITY OF MIAMI OATH OF CANDIDATE 0FF10E DF 0,54's r'c� Before me, an officer authorized to administer oaths, personally appeared (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of j),���. r .t �, � .,%, I �,,, , e,!e. t .r for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution„ the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from w h he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Signatudof Candidate Address City State ZIP Code The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by Zphysicall or F7online presence, this :] day of 11UJeM\7W ►r , 202,0 5igofffi,istering Oath or Notary Public Name of Notary Typed, PrinkAd or Stamped SMOROORGcS Personally Known: OR Produced Identiflcabon: ; IbraryF,At-sOG&d6f 461a Camrrusswan q G6 OB3 =_, T My Comm. Expires WF 14.2b21 Type of Identification Produced: C L— y We �` 5 �cxn&-e^ iur'_C,2r1 Submitted into the public record for item(s) on 11-18-020, City Clerk From: Zico Fremont To: Campaigns. Cite Subject: Zico Fremont Resume Date: Friday, November 13, 2020 3:53:46 FM Attachments: Federal Resume (1) Mzdr CAUTION, This is an email from an external source. Do not click links or open attachments unless you recognize the sender and knew the content is safe. Zico Fremont 786-768-3567 zico.fremontCq'gnaw Submitted into the public record for item(s) SP.1 on 1-18-2p2o City Cleric Zi cv Fremont 180 NW 49 ST, Miami, FL 33127 (786) 768-35671 zico.fremont@gmaill.com Date available to begin work: Immediately SUMMARY STATEMENT Honored Professional with eight years of managerial experience working in Government and nonprofit industry, Finance, Operations and Customer Relations. Strives to exceed professional and personal goals. Strong written and verbal communication skills. PROFESSIONAL SKILLS Education Professional Certificate in Global Financial Crisis and Financial Markets from Yale University Online . Bachelor of Science in International Relations from Florida International University. Associate in Science in Business Management and Music. Associate in Art in Liberal Arts from Miami Dade College. Employment My self -motivation, hard work and dedication all contribute to the continuing success of my employer, Technically competent, Natural leader and team player. Personal Strong work ethic with a positive approach. Expert in Multitasking, Decision making, and Effective communication. Continuously striving to achieve goals and exceed expectations. Organized and focused. Proficient in Mac and Windows platforms. Experienced in Python, html, css, C#, javascript program languages. Proficient in Quickbooks, Microsoft Office, including Word, Excel, and PowerPoint. Mastery in Business management, International Law, Business Law, Social Media Marketing, Financial management. Impeccable managerial and interpersonal skills. Competent in Creole, French and Spanish. PROFESSIONAL WORK EXPERIENCE Chief executive officer, January 2017 — Present RA Automotive, Miami FL, At RA Automotive, we make sure to offer our clients the best advice for vehicle and auto parts, as well as provide them with great customer service. Our staff works with our customers to rind the solutions they need for the right price_ We're here to help inform you about our products, so that you only buy what is necessary Submitted into the public record for item(s) 5P on 11-18-2020, City Clerk Treasurer, May 2019 — Present Miami Shores Village Lodge 315 F&AM, Miami Shores, FL Supervisor: Andrew Adams, (305) 967-3544 Managed and oversees financial affairs, cash flaws, preparers quarterly budget monitored and compared revenues and expenses. Organized financial reports and important financial ratios_ Translate financial concepts and information to ,hoard members. Managed checking, businessr and credit accounts for members, staff, and trustees. Prepared taxes quarterly and yearly on time, Certificate of Appreciation for May 2019, January 2020, and June 2020- OTHER WORK EXPERIENCE Financial Advisor, December 2013 — March 2020 Aegis Capital, Miami, FL Supervisor: Vijay Singh, (305) 965-8216 Ensured clients meet all tax obligations by advising, preparing, and submitting tax returns in accordance with the Internal Revenue service and United States Treasury Department. Reviewed financial records such as income statements and documentation of expenditures. Verified client's totals on recent forms for accuracy. Provided businesses and individuals with guidance in financial planning and adhering to tax laws. Library Administrative Assistant, December 2017 — March 2018 Miami Dade County Government, Miami, FL Supervisor: Janet Jean, (786) 285-4571 Typed and field administrative documents, forms, and budget sheets. Shelved government materials by the Library of Congress Classification System . Created and organized government programs for STEM. Answered directional questions and assisted patrons an web communication applications. Scheduler! appointments, Updated event calendars and arranged staff meetings. Managed databases and filing systems, whether electronic or paper. Answered incoming calls; directed calls to appropriate associates, mail distribution, flow of correspondence, requisition of supplies as well as additional clerical duties. Employee of the month of December. Supervisor II, December 2017 — March 2018 Community Outreach Group, Miami, FL Supervisor: Sonia Lopez, (786) 994-4571 Developed strategies team members will use to reach our foundation goal. Provided training for team members. Give team members clear instructions to perform tasks_ Monitored team members work to ensure satisfaction. Provided important health information to communities by going to each resident home, speak to occupants and inquire occupants contact information. Successfully managed and led a team of 72 members. Received distinction award for being Team leader. Director of Government Relations, October 2015 — March 2016 Manifezt Foundation, Miami, FL Supervisor: Kaven Jean Charles (305)906-6622 identified the primary demographics of the target region to rectify the rising social -economic issues Submitted into thepublic record for item(s) SP.-I, on 11-1_ 8-2� City Clerk involving diversification 0 specific industries. Prepai-ed mennos, invoices, or reports to local Government officials Chief of Staff Assistant, October 2014 — November 2016 City Of North Miami Government, Miami, FL Supervisor: Nicole Wiilarns Analyzed and reviewed materials on grant proposals; city code ordinance, and State statutes. Modified city financial models: prepared video media; performed due diligence on proposed funds. Arranged social media properties; assisted local officials in organizing events. Director of Government Relations Student Government, October 2014 — October 2015 Florida International University, Miami, FL Job Type: 15 hours per week, Part -Time Supervisor. Larissa Ada mes Participated on various university committees to plan and implement strategies to support the vision of F.1_ U_ Impacted and created advocacy for the student Body, faculty, and staff. Directed F.1. U policies and objectives to Local and State affairs. EDUCATION Bachelor of Science in International Relations, August 2015 Florida International University, Miami, FL GPA 3.0 Associate in Science in Business Management, August 2010 Miami Dade College, Miami, FL 33138 GPA 3.0 CERTIiFICATlONS1ACHIEVE MENTS Financial Market Certification, June 2020 Financial Crisis Certification, September 2019 FlU Dean's List, 2015 First Generation Scholarship Recipient, 2013 School Of International And Public Affairs Award, 2015 Treasurer Appreciation Award, 2020 Submitted into the public record for item(s) S- P.1,. on T1-7` 8-2a. 20, City Clerk City Of North Miami Appreciation Award, 2016 Team Leadership Appreciation Award, 2018 Miami Dade College Alumni Award, 2010 TRAINING LAUNCH CODE PREMIER ACCELERATED LEARNING WEB DEVELOPMENT, UXiUI, DIGITAL MARKETING & CORPORATE TRAINING May - November. 2018: 700 hours University of Miami Life Science & Technology Park, Miami„ FL VOLUNTEER EXPERIENCE ! COMMUNITY SERVICE Assistant Coach, August 2010 — June 2014 Little Haiti Optimist, Miami, FL Job Type. 13 hours per week, Part -Time Supervisor: Marie Pierre Monitored student athletes progress in academics in school and at home_ Oversaw the discipline, conduct and image of all student athletes. Assisted students in interest related activities. Submitted into the public record for item(s) SPA, on 11-18-2020, City Cleric INTENTIONALLY LEFT BLAND[ Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk L,61 ilF ,rf 7� CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA cl C Fri C3 STATE OF FLORIDA } , COUNTY OF MIAMI-DADE CITY OF MIAMI } � r� x Q' Michael A, Hepburn (hereinafter "affiant"), being first duly sworn under penalty of perjury, deposes and says: 1. My name is Michael A. Hepburn 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. l have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 504 I presently reside at the following address (must include zip code): 645 NE 77th Street #15, Miami, FL 33138 which is my legal address, and I have resided continually at said address from the 15t day of August , 2023 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbeCow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: A For t e Period: ' � 12G161 ° 91 8262 NEIstAvis. Miami, FL 331361 #2 2402 PM 12 Ave., Miami FL 33127 #1 JVL �02Q to I�1ov 2f119 j #2 ACT 2[}`19 to May 2419 to 154$ Nw 15th St RD. Miami. K 33125104 1911 N River ❑r, Mieml, FL 33125 #3 APR 2019 to SEP 2018 i #k4 AUG 2018 to ❑EC 2016 5494 North East Miami Piece Apartment 03, Mrdrtli, FlorWa 33137 A � � � 6toz k t -:rk A'J a r'r_4f6, FL 13:li13,& Page 1 00 � JUL 2001 to SEP 1982(MiamiRorniMiamiRaisedlMiamiMade) �-u k t\A Rey, i a,"n2a 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: NIA 6. Affiant's spouse resides at the following address (must include city, state and lip c�ie): NIA C '3 r 7. Affiant's minor children reside at the following address (must include citFkate ano ip code): ; n NIA � �` �• 8. At the present time, affiant (is)' is not)} registered to vote in any city, county or state other than as stipulated in subparagraphabove. 9. Name and business address of affiant"s employer: Miami Dade College - Institute for Civic Engagement and Democracy 11380 North West 27th Avenue, Room 4204 Miami, Florida 33167 10. Affiant's occupation: Coordinator (North Campus & Carrie P. Meek Entrepreneurial Education Center) Affiant's business telephone number(s): (305) 237-1820 11, Affiant has been employed in the above -cited capacity for the following period of time: September 2020 to Present (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). T,+i•.il f-i.:.0 I'Af,, ruM.7 Grree, &NSaid ]06 LMm�6RY, fL A tot rTeWonQr I UNY ILL.•^.C... Fc5 W3 rq IM�t.Vi4 Ivrwoi. tv i7fLcvzec. i 10,10o Cc ;'6t}hL'c �L P)I jd, Cvoer � Vl- �q 1 - Q �i�Gct �r 1 Loxi" v 1' d rwr.lr`., racI ro+ra w, yw sua`L6 c.uv aer:n •v aa,,,�ca•av:.loFn:eau is normmY.e wre.nYn+oevuivr*en-+sYrrb'+S'kseveei. seac x. s+.aa. €wv. n+�a1 acm.scc.m dEB xriramwzmn Ft�3�r1 =zn r� �rc�l ljnRyec�� :�-.. 5 �1�[�c.• �1' t3� 9 tce=- I I 1`�eh2oq 12. Affiant represents that he/she (is)is not)} currently holding another elective or appointive office -- whether city, county or municipal — the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter, 13• Affiant represents that, if appointed, he/she shall serve in the office so appointed. Page 2 ❑F3 Submitted into the public Hee� 1E0020 record for item(s) SP.1, on 11-18-202D City Clerk Submitted into the public record for items) SP.1 on 11-18-2020, City Clerk SIGNED THIS � lu OLNWi ❑AY OF X Y 7_ 7 AF {ANT BEFORE ME, the undersigned authority, by means of physical or online presence appeared T"l C. 6xcj A. �AePW�rv') , who, after first being duly sworn (or affirmed), deposes and states that \,)e— executed the foregoing to the best of S knowledge and belief. (SEAL) CI RK, CITY OF MIAMI, FLORIDA J Did take an oath V Produced identification Type of identification produced SMORA FGRGES tt" Pddiw - Swe ffodla Commiss3n 4 GG 084818 0" MiUmm Fx* Mar19,201 5MW EN gr, Nxaw kdoydesn. U iqC'2. Page 3 vF3 Rev. 10/2020 FORM 1 STATEMENT OF 2019 Please print or type your name. mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position below; LAST NAME -- FIRST NAME — MIDDLE NAME: Hepbuni Michael Antwan MAILING ADDRESS 645 NE 77th Street 416 !'1 C'-J C= r ] i CITY : ZIP : COUNTY- Miami 33138 Miami Dade = --`_ NAME OF AGENCY: City of Miami NAME OF OFFICE OR POSITION HELD OR SOUGHT : 11 N City of Miami Commissioner - District 5 x Cn CHECK ONLY IF 4 -F--'- OR QeNEW EMPLOYEE OR APPOINTEE THIS SECTION MUST BE COMPLETED k*** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE. INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIGNS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): El COMPARATIVE (PERCENTAGE) THRESHOLDS OR Q DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of Income to the reporting person - See instructions] {If you have nothing to report, write "none" or "n1a") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Florida International University 11200 SW S Street., Miami, Florida 33199 Public University )Mertz Local Edition 13205 SW 137 Ave, Miami, Florida 33186 Rental Car Company PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "Na") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OFSOURCE ACTIVITY OF SOURCE NIA PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the (if you have nothing to report, write "none" or "n1a"] lines on this form. Attach additional N/A sheets, if necessary. Submitted into the public FILING INSTRUCTIONS for when record for item(s) SP.1 and where to file this form are l located at the bottom of page 2. on 11-18-2t30 City Clerk INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. cE FoRm t - EI{ecuve: January T. 2020 (Contlnund on reverse sfdel PAGE r Incorporated by relerenee in Rule ail-&20211), FAC_ I PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] I (if you have nothing to report, write "none" or "nia") TYPE OF INTANGIBLE i BUSINESS ENTITY TO WHICH THE PROPERTY RELATES ISt Unit/ System Op Retirement(S U S ORP) I Personal Retirement Acount via VOYA PART E— LIABILITIES (Major debts- See instructions] (If you have nothing to report, write "none" or "nia") NAME OF CREDITOR IADDRESS OF CREDITOR Federal Student Loans I FedLoan Servicing, P.U. Box 69184, Harrisburg, PA 17106-9184 PART F —INTERESTS IN SPECIFIED BUSINESSES (ownership or positions in certain types of businesses -See instructions] (if you have nothing to report, write "none" or "nia") 6U5iNt_SS ENTITY # 1 t3U51NE55 ENTITY q 2 NAirtE OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY N/A N/A PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY c I OWN MORE THAN A 5% INTEREST IN THE BUSINESS c-, NATURE OF MY OWNERSHIP INTEREST PART G — TRAINING y t ill Far elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S._Cn - I CERTIFY THAT i HAVE COMPLETED THE REQUIRED TRAINiPQ iF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE SIGNATURE OF FILED: Signature_ Date Signed: tq/ 20y-, FILING INSTRUCTIONS: if you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Farm 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics, it will be return State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed farm to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox fed, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForml@leg.state.fl.us leg.state.fl.us and retain a copy for your records. Don t file by both mail and email. Ghoose only on filing method. Form 6s will not be accepted via email. CF FORM 1 - Ellecwe: January t. 202Q. lowparaled by reference in Rule 244202{1 1, FA.C. CPA or ATTORNEY SIGNATURE ONLY If a eerlified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, prepared the GE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPAIAttorney Signature: Date Signed: Candidates file this form together with their filing papers MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local officerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment_ Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 fallowing each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment, Filing a CE Form 1F (Final Statement of Financial Interests) does !fit relieve the filer of filing a CE Form 1 if ". - _ _ -- -.1 2019. Submitted into the public record for item(s) SPA, PAGE on 11-18-2020, City Clerk CANDIDATE OATH - NON°ARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) VIED Check box only if you are seeking to qualify as a 2920 NOV .13 PM 1: 25 write-in candidate: Lr-t ICE CF fiaE C I f Y CLEi i( ❑ Write-in candidate CITY OF MIAMI OFFICE USE ONLY Candidate Oath (Section 99.021(i )(a), Florida Statutes) A- He p b u r l (Print name above as you wish it to appear on the ballot. If your fast name consists of two or more names but has no hyphen, check box n. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of [ �.�- 4 K o, n s I] (Office) (District #) I am a qualified elector of Kam" D Lcle_ Q,- Lj1-1 County, Florida, (Circuit #) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number {located on your voter information card}. IC)gq Bs) 4 C IL -1 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to he pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] fY� --.Keh 1 Vf-C+ LlcrLN � � `)`�tC 0 r. rr„ rtge) rev burN Czirr Signature of Candidate Telephone Number Email Address Ls WE Mi ) C)-� s et.� 1 b ;� � 1 C'I Address city State ZIP Cede STATE OF FLORIDA Signa f Notary Public COUNTY OF A nawk—1 e, Print, Type, or stamp Commissioned Name of Notary Public below: is.af Sworn to {or affirmed} and subscribed before me by physical or 'r% IVo-jryrxe-ScartefF Ida ��r��? Ce^r-, sso^ �CrG Y�4G`i online presence this = day of VK.i�LN �1� , 20 . Personally Known; or Produced Identification: Type of Identification Produced: � L. Viwey- _L A CJe e1�1'� Submitted into the public Ds -DE 302NP (Rev. 04120) record for item(s) 5P._1 ture Is-2.0001. F.A.C. on 11-18-2020, City Cleric STATE OF FLORIDA COUNTY OF MIAMI-DADE First Name LOYALTY OATH A - Middle Initial Submitted into the public record for item(s) SPA, on 1111-182020, City Clerk L st Name a citizen c estate of Porida and of the United States of America, ... and a candidate for public office ... do here sole�mnlWswear or affirm that I will support the Constitution of the United States and of the State of Florida, Signature of Candidate CITY OF MIAl11'II OATH OF CANDIDATE OFFICE OF Before me, an officer authorized to administer oaths, personally appeared iE c�) &e- L ?r - HAep �uv o (PLEASE PRINT NME) who, 'being sworn, says he/she Is a candidate for the office of C_Z:�' , C.cn rn. m i 7;', +1e ; for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which 'he/she desires to be elected, that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/stye has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. J-OW Signature of Candidate Address city State ZIP Code The 'Loyalty Oath and Oath of Candidate are sworn to for affirmed) and subscribed before me by Zphysical or Flonline presence, this —� day of tlxembey 20jx—. _ ra)ivAes Signa of Officer Administering Oath or Notary Public Name of Notary Typed, Pri4ald or Stamped Personally Known: OR Produced Identification: �Aa Pdoic-S td-of r . „-n -. hps�ry Pic . Sit_ of Florida cammswn # GG 084t8 MyCcmm. Exyues Ma't9,iG2i Type of Identification Produced: eawrirra,�rwrmrkwti�ss:•. I N2020 Forges, Sandra Submitted into the public record for item(s) SS .1, vn 11-18-2020 City Clerk From: Michael Hepburn <michael.hepbum@ymail.com> Sent: Monday, November 9, 2020 4:19 PM To: Campaigns, City Subject- Michael A. Hepburn M.S.Ed. I Resume Packet Attachments: Michael A. Hepburn - City of Miami Commissioner from District 5 Resume.pdf CAUTION: This is an email from an external source. Do not click links or open attachments unless you recognize the sender and know the content is safe_ To City orMiami Commissioners 3500 Pais American Drive Miami. Florida 33133 Attached to this email, you will find my Resume Packet for your review. Respectfully, Michael A. Hepburn, M.S.Ed. Candidate for City of Miami Commissioner from District 5 Michael A. Hepburn, M.S.Ed. 645 NE 77'h Street, Ntiarni, Florida 33138 November 10'1'- 2020 To: City of Miami Commissioners 3500 fan American Drive Miami, Florida 33133 Dear City of Miami Commissioners, I am confident that my education credentials, strong professional work experience, and record of service in our communities — has precisely prepared me for this opportunity to serve. I have worked extremely hard to become a CN.-irVGE21f4 ER and champion For Affordable Housing: Safe & 'Secure Neighborhoods: Economic & Workforce Development, and Higlr-Duality Education for all of us. I am qualified and ready for this opl?nr iuni,*�'to serve: : Project Management. Effectively implemented my business acumen, and pro -active solution -based regimen to achieve objectives and targeted benchmarks. My extensive experience includes working with Fortune 500 Companies, Property Management Finns, Non -Profits. Labor Unions. Community Based Organizations. Non -governmental Organizations, Elected Officials. Professional Athletes (RIBA & NFL), community stakeholders, multicultural students, parents and our remarkable senior citizens. Higher Education Administration, Serving at three types of institutions (HBCU. Private, & Public) with mare than six combined years of experience. I understand the challenges and opportunities that our City of Miami children encounter from our Pre-K-through-12 schools and their assortment of post -secondary goals & dreams. Servant Leadership. Over the last ten years — developed- enhanced, and supported programs that Focused on community building and addressed the civic empowerment gap which exist in our communities. As a Miami Herald Silver Knight Award Recipient and Legacy Miami 40 Under 40 Honoree, service to others is in my blood. I'm a Co -Founder of Allapattah Neighborhood Association and Formerly served as a member of City of Miami Parks & Recreation Advisory Board: Citizen - on -Patrol with Miami Police Department, and currently serve as a (.Miami Workers Center) Health & Housing Liberty in the City Steering Committee Member. + Financial Budgeting. Despite limited budgets — I have used innovative, cost-effective techniques- and private -public partnerships to execute, recruit and foster transparent & strong financial concepts to achieve organizations strategic plans. + Advocacy, Attended in -person or virtually watched every City of Miami Commission Meeting held in 2020. to learn, process and disseminate vital information to my fellow district residents. During my time serving as Student Government Association Vice President at Florida Intertnational University and onward — I have utilized Parliamentary procedure (Robert's Rules of Order) rules and customs for goveming meetings and I'm familiar with Mason's Manual of Legislative Procedure'Municode. • Miami Made. Native son of Little Haiti, and 30+ year resident of City of Miami — I am Miami Born. Miami Raised, and Miami Made. As a graduate of Toussaint L'ouverture Elementary to attending and graduating from Miami Dade County Public Schools. From running to bus stops to catch the 49, #54. #bw Metro Buses and the Jitneys -- to playing football at Athalie Range park and basketball at Lennon City park — to now working for Carrie P. Meek Entrepreneurial Education Center (1VlEEQ and traveling home to Belle Meade — I know District 5. In all honesty, my preference would be for our Miami Commission to call for a special election, so my fellow residents can cast their ballots and vote for who we would like to represent us as the next Commissioner from District 5. However. I am ready to showcase my accomplished skill set that hopefully will set nee apart from the other applicants if you chose otherwise. Please feel free to contact me at 786-390-2068 or micliaelfainiichaell)e burrt.com if I can provide you with any additional information. Thank you for your kind consideration. Sincerely, Atirka.eIA. *Fep6rn, K-`;Z�. Submitted into the public record for itern(s) SP.1, are 11-18-2Y020, City Clerk MIC'HAEL A. HEPBURN, M.S.Ed. 645 NE 77ih Street, Miami, Florida 33 138 1 (78G) 390-2068 ( Michael cz+Michaell-1 burn.com SUMMARY DF UALIFICATIO S Project iVanageneent ■ Directly supers iced over [1231 professional staff members and experience managing up to S23 Million Dollars in budgeted revenues. • Project managed over [201 client Initiatives by planning and Implementing programs administrative and openational activities (including finance budgets, evaluations. event planning, curriculum design. recruitment strategy, and marketing initiatives). • Assisted with execution of logistical operations for [37] events (e.g. 513 XLVI, MEAC Championships, progressive Turnout Project). • $uecessfully enlisted teams, implemented strategies, and measured RDI of initiatives for all stakeholder groups. • Articulated report overviews to variotis administrators and community stakeholders —also interviewed prospective contractors. project managers, and vendors to determine completion dates and financial projections, • Produced bi-weekly observation reports, implemented performance -based Funding revicivs, and initiated quarterly Financial audits. Strategk Partnet-shi'ps Development & Engagement ■ Raised awareness of multiple assigned lx'ogram initiatives through cultivating relationships with targeted prospective participants. • Conducted presentations (PowerPoint;'Rvundtables) at high schools, CFBO's, university stakeholders/philanthropic donor events. • Networked and proactively researched new revenue opportunities and identified new partnerships S player appearance activations. ■ Traveled across the country to facilitate partnership meetings, onboarding trainings and activations of corporate sponsor events. • Focused on grass -tops advocacy and relationship-buildin- with pro'colIeeiate athletes, governmental officials, and corporate entities. • Served as primary point of contact For all emai Is, phone calls, and inquires related to execution of prograrn initiatives (SalesForce CRM}. Education Adminlsh•rttlon • Oversaw management of Florida International University Golden Scholars Bridge Program. Planned, implemented, and executed operational activities including program but{get, engagement, professional development curriculum design. and marketing initiatives. • Focused recruitment efforts on increasing higher education enrollment From City oFMiami Senior High Schools d Miami Northwestern, Miami Edition. Miami High, Miarni Jackson, and Booker T. Washington). • Utilized experiential le min,- opportunities; to develop my student -athletes knowledge. skills, and values through direct experiences. • Increased university brand awareness and expanded recruitment regions via marketing campaign to (1,500) public/private high schools. • Tau«ht Freshman Year Experience Serninar sections covering life skills, social justice, and financial literacy topics. Leadership & .Advocacr ■ Coordinated roundtable events for youth groups, collegiate students, government officials and community/Faith-based groups to collaborate and share different perspectives. • Co-fourided Allapattah Neighborhood Association. and formerly served as Citizen -On -Patrol with Miami Police Department, City of Miami Parks 3 Recreation Advisory Board member, and Catalyst Miami —Community Leadership on the Environment. Advocacy, and Resilience Fellow. • Co -executed 6,000,000 calls campaign and captured thousands ofcommitment-to-votes from voters as a part of Operations Directors team with [S] offices, and [138] employees statewide. • Successfully written legislation and city ordinances (Municotde), advocated for policy initiatives/constitution amendments and incorporated multicultural prograrnslservices to promote inclusion, encourage social responsibility, equality, and collective success. Submitted into the public record for item(s) SP on 11-18-2020, City Clerk 2 W'OP-K EXPERIENCE Miami Dade College September 2020 — Present Coordinator I Institute of Civic Engagement and Democracy lliami, FL Freelance Project Manager (Marketing & Public Affairs) May 2007 — Novetnber 2020 C url-ent TitlelC'lient: District Operations Director I Progressive Turnout Project Miami, FL Florida International University February _'019 — February 2020 Success Coach I Golden Scholars Brikge Program Miami, FL University of Nliand August 2016 — February 2018 Senior Advisor I Miami Business School Coral Gables, FL North Carolina A&T State University Lecturer & Academic Counselor I Student -Athlete Enhancement Program National Football League Players Association (AFL-CIO) Coordinator of Players Services I Players- [tic. July 2015 — July 2016 Greensboro, NC June 2011 — June 2012 Washington, DC EDUCATION FLORIDA INTEP"NATIONAL UNIVERSITY Miami, FL Master of Science in Higher Education Administration April 2014 Areas of Concentration: Student Aff7irs and Public Administration Bachelor oFScience April 2008 Physicai Education — Sports Management Track MIAMI DADE COLLEGE Miami, FL Associate Arts Au-ust 2006 NIIANIl CENTRAL SENIOR HIGH SCHOOL Miami, FL H.S. Diploma - Academy of Infonnation Technology Magnet dune 2001 TRANSFERABLE SHILLS Prplicient with Microsoft Nord, SharePoint„ Excel, PowerPoint I G-Suite Products I CRM I Robert's Rules of Order I Mason's Manual I Municode I Facebook, Twitter, Instagram I Public Sector Budgeting I Advocacy I Coalition Building I Public Relations I NeVtiation PROFESSIONAL AFFILIATIONS • The Omicron Chi Chapter of Kappa Alpha Psi Fraternity, Inc— Charter Member • The National Association of Academic and Student -Athlete Development Professionals (N 4A) Submitted into the public record for item s# SP.1, on 11-18-2020, City Clerk 3 Submitted into the public record for item(s) SP.1, on 11-18-2-020 City Clerk Michael A. Hepburn is Ready to Serve as your next City of Miami Commissioneir COMMUNITY/PROFESSIONAL PUBLIC SERVICE PROFESSIONAL • Operations Director— Miami Dade, Progressive Turnout Project. • Member, National Association for the Advancement of Colored People— Miami Dade Branch. • Graduate, Health and Housing Liberty in The City Leadership Training — Miami Workers Center & Partners. • Inaugural Mentor, DCS Mentoring Program, 2020 Honoree, Legacy Miami 40 Under AQ Awardee • Fellow, Community Leadership on the Environment Advocacy and Resilience Program —Catalyst Miami. • Co -Founder, Allapattah Neighborhood Association. • Citizen -On -Patrol, City of Miami Police Department • Board member, City of Miami Parks & Recreation Advisory Board. • State Senator, Florida Model Legislature. • Fellow, Lawton Chiles Leadership Corps. • Intern, National Football League Players Association. (AFL-CIO). • Charter Member, The Omicron Chi Chapter of Kappa Alpha Psi Fraternity, Inc. • Vice -President, Student Government Association, Florida International University. • Award Recipient, The Miami Herald Silver Knight • Coordinator, Institute of civic Engagement and Democracy, Miami Dade College, • Success Coach, Golden Scholars Bridge Program, Florida International University. • Senior Advisor, Herbert Business School, University of Miami. • Lecturer & Academic Counselor, North Carolina Agricultural and Technical State University. • Player Services Coordinator, National Football League Players Association (AFL-CIO). • Principal Project Manager, Freelance Consulting. • Executive Team Leader, Target Corporation - EDUCATION • Master of Science in Higher Education Administration, Florida International University. • Bachelor of Science in Sports Management, Florida International University. • Associate Arts Degree, Miami Dade College_ • Miami Central Senior High School. • South Miami Middle School, • Toussaint L'Ouverture Elementary School "Putting People First" PAID FOR B1 COMMITTEE PO EL Eck SR N BE L i IPPRUIL1 Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) SP.1, on 3.1-18-2020 City Clerk i1 1f' I 9 CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT{ M CITY OF MIAMI, FLORIDA .° t-TI STATE OF FLORIDA } COUNTY OF MIAMI-DADE } CITY OF MIAMI } (hereinafter "affiant"), being first duly sworn under penalty of perjury, deposes and says: 1. My name is 0-1 , - 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. I have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. � . I preset reside at the follow, nq address, (must include zip code): which is my legal address, and I have resided continually at said address from the f day of to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address). Prior Addresses: For the Period: page 1 4i Rr% . 1 [}I2020 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary 'basis as a secondary domicile or domiciles: ( (? 6. Affiant's spouse resides at the following address (must include city, state and zip code): 7. Affiant's minor children reside at the following address (must include city, state and zip code): W// 8, At the present time, affianTara notistered to vote in any city, coun,r s ete er than as stipulated in subpap above.; CO 9. blame and business address of affiant's employer: M 10. Affiant's occupation: S Z/ — �-f /� c , , Affiant's business telephone numbers): 11. Affiant has been employed in the above -cited capacity for the following period of time: (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 12. Affiant represents that he/she (is (i� urrently holding another elective or appointive office — whether city, county o mun al — the term of which or any part thereof runs concurrently with that of the offi e/she seeks, and that he/she has resigned from any office from -which l,.h s required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. �` 13. Affiant represents that, if appointed, he/she shall serve in the office so appointedP___ Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk Type of identification produced z+ =' CcmmSs DFORGES 6Wry PdblicGG MyCnn Ex 10114 SIGNED THIS IQ DAYOF Ie K W 20 Submitted into the public record for item(s) SPA on 11-18-2020, City Clerk AFFIANT BEFORE ME, the undersigned authority, by means of /physical or online presence appeared K-e n I HV ! rme , who, after first being duly sworn (or affirmed), deposes and states that executed the foregoing to the best of knowledge and bel' f. (SEAL) ItI/CITY CLE K, CITY OF MIAMI, FLORIDA Did take an oath Produced identification 'FL )N�Y%vey u ce ac'e Page 3 of 3 [tee. 10i-102b FORM 1 STATEMENT OF 2019 Please . agency address, agency name, and ffosiSian below: �7 yname, a name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: LAST NA E -- FIRST NAME -- Iv DLE NAME ; MAILI �c o f C=) CITY : ZIP : Q[}UNITY rr co 4� i7 tJ�' NAME OFAGENCY y l 1 EP NAME OF OFFICE OR POS ION EL OR SOUGHT CHECK ONLY IF 0P19RF70IE OR Wa-fZY EMPLOYEE OR APPOINTEE DISCLOSURE PERIOD: **** THIS SECTION MUST BE COMPLETED **** THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019, MANNER OF CALCULATING REPORTABLE INTERESTS. FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES. WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (m71too-LLAR e)• 11 COMPARATIVE (PERCENTAGE) THRESHOLDS OR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME (Major sources of income to the reporting person - See instructions] (if you have nothing to report, write "none" or "nfa") NAME OF SOURCE OF INCOME SCOURGE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY el er/ / PART 8 -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses awned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla"i NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE I PART C -- REAL. PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nythirgg to report, write "none" or "nla") CE F0RM t - Ertetliv i jailuary 1, 2G2p IflCO <ated by reference m Rufe 34-8.202(sl, F.AC Submitted into the public record for item(s) SP.1, on 11-18-2020. City Clerk (Continued on reverse sidel You are not limited to the space on the lines on this form. Attach additional sheets, If necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. PAGE i PART ❑ — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (if you have nothing to report, write "none" or "nla") TYPE OF INTANGIBL PART E — LIABILITIES [Major debts - See Instructions] (If you have nothing to report, write "none" or "nla") NAME OF CREDITOR BUSINESS ENTITY TO WHICH THE PRO . 1 n C 1 co i C ADDRESS OF CREDITOR e CD � � 7, PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses -See instructions] (If you have nothing to report, write "none" or "nla") BUSIN S ENTITY # 1 BUSINESS ENTITY # 2 NAME OF BUSINESS ENTITY/ ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY < POSITION HELD WITH ENTITY {'017L�, I OWN MORE THAN A S% INTEREST iN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST -� Sid PART G -- TRAINING ,f r For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F_S. ❑ I CERTIFY THAT i HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE 0 SIGNATURE DE FILER; Signature: Date Signed: FILI` C INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location, To determine what category your position falls under, see page 3 of instructions. Local offlcerslemployees file with the Supervisor of Elections of the county in which they permanently reside. (if you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters_) Form 1 filers who file with the Supervisor of Elections may fife by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not mail your form to the,Commission on Ethics, i b returned. State officers or specified state employees who fie with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P_O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303- To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForml@leg,state.tl.us and retain a copy for your records. Do not file by both mail and email Choose only one filing method. Form 6s will not be accepted via email. CE FORM 1 • Etfeclive: January 1, 2020. Incrgperaled by reference cn mule 34•11-M2Ely, F.A.G. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: T7___- , prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPAIAttorney Signature: Date Signed: Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections - WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must File within 30 clays of the date of his or her appointment or of the beginning of employment - Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, Fife by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does riot relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019, Submitted into the public record for item(s) 5PAP PAGE 2 on 1111-18 2020. City Clerk CANDIDATE OATH - NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: ❑ Write-in candidate ,andidate Oath 99,021(1)(a), Florida Statutes) 21"NOV 18 PH 3:07 W'F'tlf Ar THE CITY CLERK CITY OF MIAMI OFFICE USE ONLY (Print name above as you wish it to idppear an the ballot. if your last name consists of two or ,more names but has no hyphen, check box ❑, (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not pr%in�ted on the ballot, the name must be printed above for oath ppuu]rposes.) am a candidate for the nonpartisan office of , SJida+ 6 (Office) (Distract #) I am a qualified elector of �'f'7i r �� [ p'-� County, Florida; {Circuit #) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office i seek, and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the united States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): 69 _.Do /' Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] Signature of Candidate Telephone Number Address City STATE OF FLORIDA COUNTY OF 4am I — 4� Sworn to (or affirmed) and subscribed before me by LJ physical or ❑ online presence this ff day of fA]2i�I / 20 70, Personally Known; or Produced Identification- Type of Identification Produced: F "',Ler L' urtsoe� Email Address Late � ZIP Gffde Signature of ry Public Print. Type. tamp Commissioned Name of Notary Public below: :* "p SANDRA FORGES R Notary Nbllc -Seale dP.*a ' = COfrL11v£5 4 GG wait My con". Expires . ,. , fiat 19, 2021 9aaed m3,�lsl+�m�elhc�ykc�. DS-DE 342NP (Rev. 04120) Submitted into the public Rule 1s-2.0041, F.A.C. record for item(s) SP.1, on 1111-182020, City Clerk Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk STATE OF FLORIDA COUNTY OP'PIAMI-DADS First Name �ET % -AL67-11 111:. /A/w, Middle Initial f ' Last Name a citizen of the State of Florida and of the United States of America, .._ and a candidate for public office ... do hereby sow nlswear or affirm that I will support the Constitution of the United States and of the State of Florida. LLJ _ < �� Signature of Candidate CO CD wZO� CITY OF MIAMI OATH OF CANIZIPATE� n OFFICE OF Before me, an officer authorized to adminis r of H-7, aths, personally appeared 4 j L- rV , '7�i 1 U�-t �' (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of 00nq rn ( �� �,— l �� SC for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seems; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Fla rida Statutes. Address Signature of Candidate City State ZIP Coda The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me try FV_1 physical or line presen his _� day of f \� f(�1]� V� , 20 rl �1 Signs 1 of Offider Administering Oath or Notary Public Personally Known: OR Produced Identification: Type of Idenfification Produced' _�I . N\lf � U Cy r,SC_ S'Im(a fooe'<�' Name of Notary Typed, Pnnj or Stamped SPJ ORA FORGES ha!ay Rri>I c-Sate of Fba h Cammsiim 9 GG 664618 `<.y 'EaF 1 ,• My Comm. Exixfes Mar 19, 201 ... 9Or�'eCutt�p+kipxs+irwrylss,. IV _'0a0 Submitted into the public record for item(s), P. on 11-18-2020 City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) SPA, on 1.1-18-2020 City clerk f ` - REDFIVED • ii 14r 41ni. 2020 OCT 2 ! PM 1: 24 CITY COMMISSION VACANCY AFFIDAVIT OF APPOIWfMY 1AE CITY DLW IF MIAMI OF MIAMI, FLORIDA STATE OF FLORIDA } COUNTY OF MIAMI-DADE } CITY OF MIAMI } Grady E. Howard first duly sworn under penalty of perjury, deposes and says: 1 My name is Grady E. Howard (hereinafter "affiant"), being 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 505 presently reside at the following address (must include zip code): 7017 NW 5 Court, Rear Unit Miami, FL 33150 which is my legal address, and I have resided continually at said address from the 7 day of February 2020 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: 594 NW 67 St Miami, FL 33150 For the Period: April 10, 2015 untill Feb 7, 2020 Page I of3 Rev. 10/2020 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: N/A 6. Affiant's spouse resides at the following address (must include city, state and zip code): NIA 7. Affiant's minor children reside at the following address (must include city, A Qte d code): < ro C NIA "�' 8. At the present time, affiani s} s not registered to vote in any city, county aptaf& other than as stipulated in subpar grail a ove. 9. Name and business address of affiant's employer: 10. Affiant's occupation: Consultant Affiant's business telephone number(s): 305-834-3958 11. Affiant has been employed in the above -cited capacity for the following period of time: 2009 until present (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 1 / I P F 12. Affiant represents that�Iunty /shemmcEipal currently holding another elective or appointive office -- whether city, -- the term of which or any part thereof runs concurrently with that of the office e'she seeks, and that Ishe has resigned from any office /she is required to resign pursuant to�S.99.012om which(�S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Submitted into the public �t x �r3 record for item(s) 5P.1, on 11-1_ 8-202a City Clerk SIGNED THIS 27 DAY OF Oct. Submitted into the public record for item(s) S;_ .1. on 11-18-2020, City Clerk � J AFFIANT BEFORE ME, the undersigned authority, by means of / physical or online presence appeared who, after first being duly sworn (or affirmed), deposes and states that �1C- executed the foregoing to the best ofi �5 knowl dpe an ef. p1( CITY RK, CITY OF MIAMI, FLORiDA Did take an oath Produced identification (SEAL) Type of identification produced: F L We CGt-}-r. V, Cara FORM E �a ��". 6�d xen,�i final �rj Aaan Page 3 af3 Rev. 1012020 FORM 1 STATEMENT OF 2019 � oNLY: Please print or type yatir name, milling FINANCIAL INTERESTS FORK EMU address, agency name, and pesitlon below: LAST NAME — FIRST NAME -- MIDDLE NAME: 4119n [f14tf Howard Grady Eugene MAILING ADDRESS'{l 7017 NW 5 CT. Oar 21 p� ��6 ii'tC rr L4rY Fjjjx�lQL. aw Rear Unit CITY * ZIP: COUNTY: Miami.., FL 33150 33150 Miami -Dade NAME OF AGENCY: City of Miami Commission Submitted into the public NAME OF OFFICE OR POSITION HELD OR SOUGHT: record for item(s) $,1, City of Commissioner-, District 5 on 11-18-2020, City Clerk CHECK ONLY IF 0 CANDIDATE OR E3 NEW EMPLOYEE OR APPOINTEE THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS OR t' I DOLLAR VALUE THRESHOLDS PART A — PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (if you have nothing to report, write "none" or "nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY GMA, Inc. 594,W 67 St. Miami, FL 33150 Consulting PART B -- SECONDARY SOURCES OF INCOME (Major customers, clients, and other sources of income to businesses awned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE N/A PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (if you have nothing to report, write "none" or "nla'7 You are not limited to the space on the lines on this form. Attach additional N/A sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. CF FORM 1 • E6ee1ive. January 1,207.0 iCon4lnued on (averse side) PACF i Ir.mrparated by reference in Rae 34.820211), FA.O. PART 0 — INTANGIBLE PERSONAL PROPERTY [Stocks, bands, certificates of deposit, etc. - Sea instructions] (If you have nothing to report, write "none" or "nia") I�/J�i�f@IfIPCHt IRS N/A BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E — LIABILITIES (Major debts - See instructions] (If you have nothing to report, write "none" or "nla") Submitted into the public NAME OF CREDITOR ADDRESS record for item(s) Sp.1 NIA on 11-18-2020, City Clerk PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses -See instructions] (If you have nothing to report, write "none" or "nia") BUSINESS ENTITY # 1 BUSINFAS EMTY fP 2 -rt NAME OF BUSINESS ENTITY n e►>t ADDRESS OF BUSINESS ENTITY 7017 NW 5 Ct Miami, FL 33150 dv� PRINCIPAL BUSINESS ACTIVITY Consulting POSITION HELD WITH ENTITY CEO _1 I OWNMORE THAN J A 5% INTEREST IN THE BUSINESS Yes NATURE OF IVY OWNERSHIP INTEREST 100% CD PART G — TRAINING Q1 For elected municipal officers required to complete annual ethics [raining pursuant to section 112.3142, F.S. C) I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE a SIGNATURE OF FILER: III CPA or ATTORNEY SIGNATURE ONLY Signatur r Hate Signed: 10-27-2020 FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county In which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your f rm to the Commission on Ethics. it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scary your completed form and any attachments as a pdf (do not use any other format), send it to CEForrnl@leg.state.fi-us and retain a copy for your records. Do not File by both mail and email. Choose only one filing method. Form 5s will not be accepted via email. If a certified public accountant licensed under Chapter 473, or attorney in goad standing with the Florida Bar prepared this form for you, he or she must complete the following statement: I, . prepared the CE Form 1 in accordance with Section 112,3145, Florida Statutes, and the instructions to the farm. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPAIAttorney Signature: Date Signed: Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY. A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each focal officerlemployee, state; officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendaryear in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does n— ot relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019. GE FORM 1 - Effective: January 1, 2020. PAGE Z incwForated by Werance in Rude 3h-8.202i 1 y, E•A.C. CAN DI DATE OATH — NONPARTISAN OFFICE RECEIVED (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a 202D OCT 27 FM l: 25 write-in candidate- 0 r E Qf Tti� CITY Q1.:�{ CITY IF-MIAMI El Write-in candidate OFFICE USE: ONLY Candidate Oath (SecVon 99.021(1)(a), Florida IIItutes) (Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box ❑. {See page 2 - Compound fast Names). No change can be made after the end or qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.} am a candidate for the nonpartisan office of City of Miami Commissioner 5 9 �( y� (Office) (Distlict MS I am a qualified elector of Miami -Dade County, Florida, {Circuit #j (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes;. and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card)- 126643607 Phonetic spelling for audio ballot. Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form); [Not applicable to write-in candidates,] . ,/ j % �;1, F (305) 834-3968 realgradymuhammad@gmail.com Signature of Candidate Telephone Number Email Address 7017 NW 5 Ct. Rear Unit Miami FL 33150 Address city t to ZIP Code STATE OF FLORIDA g u4 of Notary Public COUNTY OF Prtn , Type, or Stamp Commissioned Name of Notary Public below- •SA JRAFGR:08018 Sworn to for affirmed) and subscribed before me by physical orraron*ssO P GG0 online presence this day of Y 20 2Q� �=. MY�m-Ex�4es� a Personally Known; or Produced Identification; + _ 5 Type of Identification Produced 1" L, 18 a (r l $ubfiljit2d into the public DS-DE 302NP (Rev. 04120) recora Tor item(s) � :l. on I1-I8-2020, City Clerk LOYALTY OATH Submitted into the public record for item(s) SP.1, on 11-18-2020, City Cleric STATE OF FLORIDA COUNTY OF MI Mi-DADE First Name Middle Initial Last Name a citizen of the State of Florida and of the United States of America, ... and a candidate for public office do hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida. Signature of Candidate CITY OF MIAM1 OATH OF CANDIDATE OFFICE CF C Before me, an officer authorized to administer oaths, personally appeared � I F n � pZ (PLEASE PRINT NAME) n who, being sworn, says he/she is a candidate for the office of (� Iti'PItL-I f <' t Y1 to /' `? for City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that,4767she ' � lifiod ur�nr the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which &I sires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/shras qualified for no tither public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that{ 8/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Signature of Candidate -2) n _ Address City State ZIP Code The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by / physical or online presence, this day of L V 2-y Sign ure of 10fAcer Administering Oath or Notary Public Name of Notary Typed, Printe r Stamped ;: WIORA FORGES Personally Known: OR Produced Identification' :, �kvaryFuJiic- Stateaf�Orida j� ' • ' cemnssien 8 GG484618 Type of Identification Produced: I{� �j� [q��1 a"Oed "° ""0O"�*` Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk INTENTIONALLY LEFT BLAND[ Submitted into the public record for item(s) LP on 11-18-2020, City Cleric CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA STATE OF FLORIDA ] COUNTY OF MIAMI-DADE j CITY OF MIAMI ) ANDRE D. JOYCE (hereinafter "affiant"), being first duly sworn under penalty of perjury, deposes and says: 1. My name is ANDRE D. J©YCE 2. 1 any offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. l have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 511 I presently reside at the following address (must include zip code): 1525 NW 58TH TERRACE MIAMI FL 33142 which is nay legal address, and I have resided continually at said address from the 8 day of JANUARY 2004 to the present. 4. Immediately prier to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: 1� A For the Period: a N Corn q rn _Q rage 1 o13 Rm WA2020 5. In addition to the residence that I have fisted as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: NA 6. Affiant's spouse resides a1 the following address (must include city, state and zip code): NA 7. Affiant's minor children reside at the following address (must include city, �ifate, yip code): c,r" CD 3 NA Sri � 3. At the present time, affiant (is) pis�not' registered to vote in any city, countyst o #r�rthan as stipulated in subparagraove. 9. Name and business address of affiant's employer: BRCWARQ PARTNERSHIP 920 NVV 7TH AVENUE FT LAUDERDALE FL 33311 BRCWARD PARTNERSHIP 920 NVV 7TH AVENUE FT LAUDERDALE FL 33311 10. Affiant's occupation: DIRECTOR OF RESIDENTIAL AND SAFETY Affiant's business telephone number(s): 9547793990 11. Affiant has been employed in the above -cited capacity for the following period of time: APRI L 19, 2019 (Vote. In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant small give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 12. Affiant represents that he/she (is) kis no currently holding another elective or appointive office — whether city, county or municipal — the term of which or any park thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she Is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Page 2 of 3 Submitted into the public record for item(s) SP.1, on 11-182020, City Clerk R(.Vr 1012070 Submitted into the public record for item(s) SP.1, on 1111-1� City Cleric. SIGNED THIS I3th DAY OF November 2020 AFFI , NT r BEFORE ME, the undersigned authority, by means of V physical or online presence appeared D. __ C ^, who, after first being duly sworn (or affirmed), deposes and states that �I+° executed the foregoing to the best of i 41_ knowledge and belief. 5,-rCITY C K, CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced: L -Dr'w,�r ljC-ev-�Se— (SEAL) r,t;�:'o ,; 5AAGnAF�iRuES NtoPO4-53!earE a CemmsSun i GG 0@dfi19 My Carom. Egwes Mai A9 2V c *a c� {ti3 Q 17\ ^i rj Im f'1 lY Page 3 00 km I Ql2029 FORM 1 ,STATEMENT OF 2019 Please print or type your name,malling FINANCIAL INTERESTS address, agency name, and pa%Wun belnw: FOR OFFICE USE ONLY: LAST NAME -- FIRST NAME --- MIDDLE NAME JOYCE ANDRE DEMERITTE MAILING ADDRESS: 1526 NW 58TH TERRACE c� MIAMI rr;m rT)I CITY: ZIP : COUNTY: cn r W FT1 MIAMI 33142 MIAMI-DADE NAME OF AGENCY < W C3 NAME OF OFFICE OR POSITION HELD OR SOUGHT: ran 1� F COMMISSIONER D5 CHECK ONLY IF 0 CANDIDATE OR ® NEIN EMPLOYEE OR APPOINTEE a1ScLosuRE PERIOD-.**** THIS SECTION MUST BE COMPLETED **** THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS-. FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATAREABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for Further details). CHECK THE ONE YOU ARE USING (must check one); ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS 9 0 DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (It you have nothing to report, write "none" or "nIa") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Broward Partnership 920 NW 7th Avenue Ft. Lauderdale FL Homeless Shelter PART B -- SECONDARY SOURCES OF INCOME [Major customers: clients, and other sources of income In businesses owned by the reporting person - See instructions) (If you have nothing to report, write "none" or "n!a'") NAME OF NAME OF MAJDR SOURCES ADDRESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE NA PART C -- REAL PROPERTY (Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nIa") NA CE FORM 1 - Elfeclive: January 1, 2020 lnwgmraredbyreference inRule3a-8.202(11.FAC. Submitted into the public record for item(s) SP.1, on 11-18-2020 City Cleric PRINCIPAL BUSINESS ACTIVITY OF SOURCE You are not limited to the space on the lines on this form. Attach additional sheets, If necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. PAGE 1 PART D — INTANGIBLE PERSONAL PROPERTY (Stocks, bonds. cerdificates of deposit, etc. - See instructions) (It you have nothing to report, write "none" or "nla•") TYPE OF INTANGIBLE n PART E — LIAB1LIT] ES [Major debts - See instructions] Qf you have nothing to report, write "none" or "nla") NAIVE OF CREDITOR NA BUSINESS ENTITY TO WHICH THE PROPERTY RELATES ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIES] BUSINESSES [ownership or positions in certain types of businesses -See instruciruins] (If you have nothing to report, write "none" or � �• BUSINESS ENTITY # 1 BUSINES EP9ztSTY #�33 NAME OF BUSINESS ENTITY j CD l AODRESS OF BUSINESS ENTITY W :1 PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY' d I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST je PART G — TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S Ll I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING 1F ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET; PLEASE CHECK HERE ❑ SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney Signature: in good standing with the Florida Bar prepared this form for you, he at she must complete the following statement. � Vv WL'I /tiJ prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. Date Sighed: November 13th, 2020 FILING INSTRUCTIONS: If you were mailed the form by the Commission an Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officerslemployees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, rile with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your farm to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1@ieg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose oni one filing method. Form 6s will not be accepted via email. c:t FUPiM i - t=lleetive: January 1. 2024, dncorpmled by WitMnSe in Rule 31-&2e2I1 I, FA.C- CPA/Atlomey Signature: Date Signed; Candidates file this farm together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local off icerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at (lie same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does D_o_l relieve the filer of filing a CE Form 1 If the filer was in his or her position on December 31, 2019, Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk CANDIDATE OATH — NONPARTISAN OFFICE PECENED (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a 2029 NOY 13 PM 3. 25 write-in candidate: ►.4TYlOF �i1AtiICLERK ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) 1, ANDRE D JOYCE (Print name above as you wish it to appear on the ,ballot. It your last name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot the name must be printed above for oath purposes) am a candidate for the nonpartisan office of COMMISSIONER 5 (oboe) (District #) I am a qualified elector of Miami -Dade County, Florida, (circuit N (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state. the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and i will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): 109212001 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form); [Not applicable to write-in candidates.] ANDRE D JOYCE X (786) 843-8820 ANDREDJOYCE@GMAIL.COM 5lgnature of Candl V e Telephone Number Email Address 1526 NW 58TH TERRACE MIAMI FL 33142 Address City to ZIP Cade STATE of FLORIDA Sig re of Notary Public 1 4 COUNTY OF Print, Type, or Stamp Commissioned Name of Notary Public below: SANORA FORM Sworn to (or affirmed) and subscribed before me by ❑ physical or ; T 1Vrs7aryPat-5retedfloeK!a ''f1+1 rammss� � GG 034St& ❑ this day of L ►r 20-0. '"��F. .. MuCa m FxpresAiat9.232I online presence , F vraq, �erora �aar Assn. ,V Personally Known: or Produced identification: Type of Identification Produced: & —b,6 k�- U ajj� DS-DE 302NP (Rev. 04/20) Subrnitted into the public Rule 1S-2,0001, F.A.C. record for items) SPA, on 11-18-2020, City Clerk LOYALTY OATH STATE OF FLORIDA COUNTY OF MIAMI-DADE ANDRE D JOYCE First Name Middle initial Last (Name U-7 a citizen c1N. he�ttate of Florida and of the United States of America, ... and a candidate for public office ... do hereo soles nly- ear or affirm that l will support the Constitution of the United fates and of the State of Florida. cam. is SignatuN of Candidate CITY OF MIAMI OATH OF CANDIDATE OFFICE OF COMMISSIONER bjtraerO Before me, an officer authorized to administer oaths, personally appeared ANDRE D JOYCE (PLEASE SPRINT NAME) who, being sworn, says he/she is a candidate for the office of COMMISSIONER 0- for the City of Miami, Florida; that helshe is a qualified elector of the City of Miami, Florida, that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. 1525 NW 58TH TERRACE Address 5ignatur Candidate MIAMI FL 33142 City State ZIP Code The Loyalty Oath and [bath of Candidate are sworn to (or affirmed) and subscribed before me by ] physical or online presence, this l�S day of 0\k C 2U 2-0 Sig t re a Officer Administering Oath or Notary Public Personally Known: OR Produced identification: Type of Identification Produced; 1r.Ye �, t [ Qyj � "%03ra Qracs Name of Notary Typed, P d n tqjor Starnped s; :'e .. SMDRA FORGES M1bayFul;c-Sta+ariFVta ' Ocmm�san x GG O��fit3 _ Icy Comm. bpro W tS. N21 •.'E �F z�i' Boned war, Hrn� w,�rYAn�a Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk jomao2ry ANQREJOYCE Miami, FL 33142 ,andredioyce@gmail.com 786-843-8820 RECEIVED 2020 HOY J 3 PM 3: 25 G • THc" U Y CLERK t:ITY OF MIAMI Social services professional with over twenty five years of experience in the area. The experience includes Children and Family Services, Forensic Mental Health, Mental Health Services, Dually Diagnosed Co-occurring Disorders, Substance Abuse, Medical Case Management, and Homeless. Fortunate to have had the experience to work in Administration as a Staff Development and Training, Human Resources, quality Assurance, and Ass(. Director and Director. WORK EXPERIENCE Director of Residential and Safety Broward Partnership For the Homeless, fMC - Fort Lauderdale, 1-L April 2019 to Present - Ft. Lauderdale, FL • Ensures the safety and welfare of all clients, employees and visitors through direct supervision of security • Provides leadership and direction to Residential Coordinators • Oversee the day to day client activities on the shelter and ensures sufficient staffing • Serves as a leader in emergency preparedness and response activities, including fire drills and hurricane • Conduct monthly Client Town Hall Meetings and may lead these meetings, • Develop, implement and manages Agency -wide safety training for staff and clients in conjunctions with HR. • Ensure that staff is aware of program expectations for clients. • Ensure that staff is familiar with the Low Barrier Model and Housing First Model • Implement Agency -wide policies and procedures for clients as it related to their stay in shelter • Investigate and resolve client issues in a caring and compassionate manner that encourages clients to be respectful to one another. Supervised Staff and Peer Specialist Mercy Behavioral Health Center, IHC - Hialeah, FL 2015 to 2019 Hialeah, F-L • Responsible for monitoring and coordinating program services and systems hosed under the Day Treatment Program, • Supervised staff and Peer Specialist. • Attended community meetings to share and network with area community partners. • Monitored the daily I weekly submission of progress notes for quality and integrity. • Monitored trilling for quality and timely submission. • Prepared day treatment curriculums for clients participating in services. • Assisted clients in obtaining medical, social and economic resources, including assistance: with housing, mental health Submitted into the public record for item(s) SPA, on 11-1� 8-2020 City Clerk Submitted into the public record for item(s) SP on 11-1� 8-2� City Clerk and subsrance abuse treatment. * Supervised case managers in the absence of coordinator • Provided training to case managers on the key components of Case Management Services Quality Assurance Specialist ! Human Resource Coordinator New Horizons Community Mental Health Center - Miami, FL September 2013 to July 2015 - Miami, FL • Responsible for all human resource activities to include employment, compensation, benefits, and training and development. • Interview job applicants; review application/resume; evaluate applicant skills and make recommendations regarding applicant's qualifications, • Design and conduct new employee orientations. • Administer and explain benefits to employees, serve as liaison between employees and insurance carriers. • Recommend, develop and schedule training and development courses. • Provide advice, assistance and fallow -up an company policies, procedures, and documentation, • Develup and recommend operating policy and procedural improvements. • Other duties as assigned Intake Coordinator Bayview Community Mental Health Center- fdonh Miami, FL 2006 to 2011 • Responsible for the initial intake of clients coming into the Crisis Stabilization Unit • Made sure clients met the requirements for admission (Baker Act, Court Order, Exparte) • Checked enrollment eligibility of clients coming into the center. • Coordinated the provisions of labs, x-rays ordered by the Behavioral Health Practitioner • Had detailed knowledge of the Florida Baker Act • Liaison to all departments and was the key communication between the various disciplines. • Spoke with insurance companies to look at the level of care in which client was receiving Sociology [ Criminal Justice Florida Memorial University 2012 MPA-Pendinig in Public Administration Barry University - Miami Shores, PL Crisis Intervention • Behavioral Health • Human Resources • Emergency Management EDUCATION C' N Q - c �. SKILL-S — - n{- _C T w r � N .`�. Cn Social Work Group Therapy Phi Beta Sigma Fraternity Inc Present Society For Human Resource Management - SHRM Present Advisory Board- City of Miami Police Department 2014 Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk Submitted into the public record for item(s) SPU on 11-18-2020, City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) 5P.1, on 31-7� City Clerk CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT, CITY OF MIAMI FLORIDA �'`'� w— STATE OF FLORIDA } 34�! -0 01 COUNTY OF MIAMI-DADE CITY OF MIAMI } Christine M. King first duly sworn under penalty of perjury, deposes and says: 1, My name is Christine M. King (hereinafter "affiant"), being 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No, 504 I presently reside at the following address (must include zip code). 720 NE 62 Street #505 Miami, FL 33135 which is my legal address, and I have resided continually at said address from the 15 day of August 2018 to the present. 4. Immediately prior to residing at the above -stated address, i have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: 1270 NW 131 Street For the Period: October 1994 - August 2018 Page 1 01-3 Rcv 1U12020 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: 12181 Water Poppy Ct. Orlando, FL 32828 E. Affiant's spouse resides at the following address (must include city, state and zip code): 2210 North 48th Avenue Hollywood, FL 33021 7. Affiant's minor children reside at the following address (must include city, state and zip code): N/A 8. At the present time, affiant (is) is no , registered to vote in any city, county or state other than as stipulated in subparagraph 3 above. 9. Name and business address of affiant's employer: Martin Luther King EDC, � h F6� 6114 NW 7th Avenue Miami, FL 33127rn President/CEO F 10. Affiant's occupation:. Affiant's business telephone number(s): 305-757-7627 0 11. Affiant has been employed in the above -cited capacity for the following period of time: 0 years (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). N/A N/A 12. Affiant represents that he/she (is) (is not) urrently holding another elective or appointive office -- whether city, county or �4v- opal — the term of which or any pail thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.5.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Pa,gc Z 00 Pcv 10/2020 Submitted into the public record for item(s) 5P.1, on 11-1$-2020, City Cleric Submitted into the public record for items) SP.1, on 11-18-2020, City Clerk SIGNED THIS 13 DAY OF Novo DE - aTTT� BEFORE ME, the undersigned authority, by means of V physical or online presence appeared :"�5 t�1��' who, after first being duly sworn (or affirmed), deposes and states that executed the foregoing to the best of he( - knowledge and belief. CITY CLERK, CITY OF MIAMI, FLORIDA TOOO 9 HANNON Nalary Pubtic - State of Florida Commission p GG 262274 My Comm. Expires Sep ?S, 20Zi Bonded throwgn National Notary Assn. aarrG°' yl/ Diu take an oath lsir Produced identification Type of identification produced: t £c a Ut.r s L c-e use, >v C= G { -n , I i rn 7tt � Pagc 3 of 3 Rev. 10)2020 FORM I STATEMENT OF Please print or type your name, mailing FINANCIAL INTERESTS address, agency name, and positfon below: LAST NAME -- FIRST NAME — MIDDLE NAME . King Christine Margaaret MAILING ADDRESS 6116 NW 7th Avenue CITY: ZIP: COUNTY Miami 33127 Miami -Dade NAME OF AGENCY NAfvIE OF OFFICE OR POSITION HELD OR SOUGHT City of Miami Commission, District 5 CHECK ONLY IF 9 CANDIDATE OR Lff NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED `* 2019 FOR OFFICE USE ONLY? DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL fNTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one)- ® COMPARATIVE (PERCENTAGE) THRESHOLDS _R, ❑ DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or fvwnnG U� Z UVUM t_ OF INCOME SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY Martin Luther King EDC 6114 NW 7th Avenue Miami, 33127 Non Profit Advocacy Law Office of Christine King, PA 6116 NW 7th Avenue Miami, 33127 Legal Representation Property *see Part C Rental Property PART 5 -- SECONDARY SOURCES OF INCOME [Major customers, eI eras, and other sources of income to businesses owned by the reporting parson - See lnstructionsl (If you have nothing to report, write "none" or "nla") NAME OF NAME OF MAJOR SOURCES ADDRESS BUSINESS ENTITY I OF BUSINESS` INCOME ] OF SOURCE PRINCIPAL BUSINESS ACTIVITY OF SOURCE Law Office C. King, PA Doctor United Group, Inc. 3215 NW 10th Teri, FL Lauc Health Care if tf Waste Management, Inc. 2600 Wiles Road, Pompano Waste Collection PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See insiructionsl You are not limited to the space on the (If you have nothing to report, write "none" or "nla"") lines on this form. Attach additional k 12690 NW 10th Avenue , North Miami, FL 33168 sheets, if necessary. * 1270 NW 131 Street, North Miami, FL 33167 CE FOWIl 1 - Eltccl,m January 1. 2020 Inc Pcmted by refemrtca -n RLh- 34-8.2024 1). F,A.0 Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3, PAGE PART D — INTANGIBLE PERSONAL PROPERTY [Stocks bonds, certificates of deposit, etc- - See instructions] (If you have nothing to report, write "none" or "nla") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES 457E Qualified Retirement Plan Miami -Dade County PART E — LIABILITIES (Major debts - See instructfonsl ('If you have nothing to report, write "none" or "nla") NAME OF CREDITOR ADDRESS OF CREDITOR Nelnet Student Loan Services PO Box 82561 Lincoln, NE 68501 PART F -- INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions] (If you have nothing to report, write "mane" or "nia") BUSINESS ENTITY it 1 BUSINE4&ENTITY 0 2 NAME OF BUSINESS ENTITY pi � 'V �1 � ADDRESS OF BUSINESS ENTITY I _ f'RENCIPAL BUSINESS ACTIVITY t� POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS r NATURE OF MY OWNERSHIP INTEREST PART G — TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 1113142. F.S. ❑ 1 CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY Signature: If a certified public accountant licensed under Chapter 473, or attorney In good standir^g with the Florida Bar prepared this form for you, he or she muss complete the 'allowing statement: 1, , prepared the CE Form 1 in accordance with Section 112.3145: Florda Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true ano correct, Date Signed: CPAIAttorney Signature: 13 November 2020 Date Signed - FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (if you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters,) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address at email address to use. Do not email your form to the Commission on Ethics. it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P.O. Drawer 15709. Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E. Ste 200, Tallahassee, FL 32301 To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1@Ieg.state.f1.us and retain a copy for your records. Do not file by bath (nail and email. Choose only one filing method. Form 6s will not be accepted via email. CE FORV " - Effamve January ' 2020. Inc000raiee by r4ference in ROn 1A-8.2I}2I I. F.A.C. Candidates file this form together with their filing papers MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local ofiicerlemployee. state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment_ Candidates must rile at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, File a final disclosure farm (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1F (Final Statement of Financial Interests) does not relieve the fifer of filing a CE Form 1 if the filer v— i- hic nr ihnr nncifinn nn nPr:Pmhar 31- 2419- Submitted into the public record for item jsy SP.1, PACI=2 on 11-18-2020, City Clerk CANDIDATE OATH — NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) RECEIVED Check box only if you are seeking to qualify as a 7020 NOV 13 FM 4122 write-in candidate: ❑ Write-in candidate Lrf,,'iCIT � F-MI,sY-Cl.£R�+ CITY fly` M#AMi OFFICE USE ONLY Candidate Oath (Section 99A21(1 )(a), Florida Statutes) I, Christine M. King (Print name above as you wish it to appear on the ballot, if your last name consists of two or more names but has no hyphen, check box ®. (See page 2 - Compound Last Names). No change can be made after the end of qualifying - Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of City of Miami COmmission 5 (Office) (Distdcl #) :I am a qualified elector of Miami -Dade County, Florida; (Circuit #) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office 1 seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located an your voter information card); 109230069 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be us d by persons with disabilities (see instructions on page 2 of this form): [Notapplicable to write-in candidates.] X (305 ? 917-5736 christinekingcampagin@gmaii.com d ate Telephone Number Emali Address SignatuV62 720 N Street #505 Miami FL 33138 Address City State ZIP Cade STATE OF FLORIDA ' Signature of Nota Pub c COUNTY OF M t ctl"`+ 1 r. bC)1 �,� Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by Wphysical or 'rG :. t'flUD B NAi1HOP4 Nour Public - State of Florida ❑ online presence this �� day of G`y'�k"'j ►�(�, 20 �.Q :1� 'dW y a: Cemmisuor. ■ GG 2h221d r41a * My Comm. Ekairrs Sep 2i, 2022 Personally Known: or Produced Identification: Banded through haleonol Notary Assn. C, � 1 _ Type of Identification Produced; - E L d' ,j L j C. wive_ Submitted into the public os-DE 302NP (Rev. 04l20) record for item(s) SPA, on 11-18-2020, City Clerk STATE OF FLORIDA COUNTY OF MIAMI-DADE Christine First Name Submitted into the public record for itern(s) SP.1, on 11-18-2020, City Clerk King, fi Last Name 'Wf o � :J y a citizen of the State of Florida and of the United States of America, and as c didate for pu�'Pffi c;y . do hereby solemnly swear or affirm that I will support the Constitution of the United St Les. gad of the Stated F Oda. Si ure /date M LOYALTY OATH Middle Initial CITY OF MIAMI OATH OF CAND�D OFFICE OF Commission, District Before me, an officer authorized to administer oaths, personally appeared Christine M. King (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of Commission , District 5 , for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to he elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from an office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Sig f C,"e 726 NE 62 Street #505 Miami FL 33138 Address City j State ZIP Code The Loyalty oath and oath of Candidate are sworn to (or affirmed) and subscribed before me by Q physical or F7online presence, this day of 20 0,10 r Signature of Officer Adrnit`itste ath or Notary Public Name of Notary Typed, Printed or Stamped �♦ ,ti�RM;u , TOOO Ei HANNON Personally Known, OR Produced Identification: lT_I 3°' fir'.• Notary Public - State of Florida Commission k GG 262214 t1 My Comm. Expires Sep 25, 2022 Type of Identification Produced: - t wi �� r f s�3 9an4ed through NatianaE Notary Assrc. 1 Sl: -)1020 ICHRISTINE M. FORDE-KING, ESQ. 720 NE 62 Street #505 Email: fordekingglive.com Miami, Florida 33138 OVERVIEW Christine King was born in Guyana and moved to Miami at the age of 5. She attended Allapattah Elementary School, Westview Middle School. and Miami Central Sr. High School. She has proudly served the community for many years and is known for her passion to serve. Before becoming an attorney, Christine worked as Chief of Constituent Services for a Miami - Dade County Commissioner and later as an executive with the Community Action Agency (CAA). Her career with the county spanned eighteen years. She is now President and CEO of the Martin Luther King Economic Development Corporation and a practicing attorney. Christine is married with three beautiful children. EDUCAT1(ON Juris Doctor Degree, 2007 Shepard Broad Law Ctrs, Nova Southeastern Univ_, Ft. Lauderdale, Fl, Achievements; Pro Bono Honors Program (Silver Level), Law Student Adviser: Black Law Student Association Member Bachelor of Arts Degree in Public Administration (B.P.A.), 1999 Barry University, Miami, Florida Associate in Arts Degree (AA), 1993 Miami -made Community College, Miami, Florida BAR AFFILIATIONS Florida Bar (Member in Good Standing) 2010 PROFESSIONAL EXPERIENCE 2010 — Present 2011 —Present 1993 — 2011 MIA-W-DADS COUNTY, Miami, Florida Law Office of Christine King Practicing Attorne MIMvIi-DADS COUNTY, Miami, Florida Martin Luther King Economic Development Corporation (MLKIDC) President and CEO M[Ami-UADE COtJNTY, Miami, Florida Community Action Agency (CAA) Special Assistant to Executive Director (07-11) CAA Contracts Officer (0 1 -07) CAA Public Information officer (97-01). M[Arvn-DADS COUTNTTY. Miami, Florida Miami -Dade Board of County Commissioners District 2 Coordinator (94-01 ). Aide to County Commissioner lames Burke (93-94) C-J n: m a x 0 C m CD Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk 2009 -- 20121 Barry University, Miami, Florid t Adiunct Professor / American Government COMMUNITY INVOLVEMENT *Bake House *Camillus House *Foundation of Community Assistance and Leadership -Law Offices of Carlos J. Martinez Equal Justice Initiative -Dade Legal Aid/Put Something Back Program Homeowners Association - President Guardian Ad Litem Program — Volunteer Guardian *Board of Directors Pro Bono Attorney Submitted into the public record for item(s) SP.1, ❑n 11-18-2� 4 City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) 5p.1, 'ol t,F�� ❑n 1L.-1$-202__0, City Clerk CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT = N x CITY OF MIAMI, FLORIDA S' C=� STATE OF FLORIDA � COUNTY OF MIAMI-DADE CITY OF MIAMIb jrn 2g:::_ yr m 4 //7 '� `� (hereinafter "affiant"), being fi st duly sworn under penalty of perjury, deposes and says: 1. My name is r_2 �_ 1 17 (_ a / 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 57 3 -� L, , 1 presently reside at the following address (must include zip code): which is my legal address, and I have resided continually at said address from the day C- Of to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: For the Period: G- 14 1 Page 1 of Rcn. lOY2020 5. In addition to the residence that I have listed as my present address, 1 also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: )V /,j 0. Affiant's spouse resides at the following address (must include city, state and zip code): r7 f A 7. Affiant's minor children reside at the following address (must include city, state and zip code): S. At the present time, affiant Os� i o `' registered to vote in any city, county �ir s2te other than as stipulated in subparagraph' above. E.Ir, o ;;7 1 c r rm-S 9. Name and business address of affiant's employer:, 40 ^' n f �n �o 10. Affiant's occupation. Affiant's business telephone number(s); 11. Affiant has been employed in the above -cited capacity for the fallowing period of time: (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 12. Affiant represents that he/she (is) (is not currently holding another elective or appointive office -- whether city, county or municipal the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Submitted into the public p��e i °e3 SRev. turzaza record for item(s) SP._1 on 11-1�8-2p2o, City Clerk ,v1.1 SIGNED THIS L DAY OF �u��'r BEFORE ME, the undersigned authority, by means of 7020 Submitted into the public record for item(s) SP.1, on 11.-18-2020, City Clerk AFFIANT / physical or online presence appeared Keviran M- tnco( rl , who, after first being duly sworn (or affirmed), deposes and states that 96-C executed the foregoing to the best ofIvey knowledge and belief. lei CITY CLERK, CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced: FL vbe46C � (SEAL) r'^� sar�w+Pc�c€s • tA]f��.•rYssan�Gaceasaa + � i my 4fWre8 mat 14, 2021 ,, orrt,.•'` ;lOM16Y�}f1Asl!Vsd7n91FWq[y,y41, C) wry 1V Q Q r) rt� r � CD 40, r-t = M c, o Page 3 Qr3 gee. 1012020 FORUM 1 Please print or type your name, mailing address, agency name, and position below: LAST NAME -- FIRST NAME -- MIDDLE R L14VCOt MAILING ADDRESS :y . STATEMENT OF FI.NANCIAL INTERESTS Ii f�f SAI CITY : ZIP COUNTY k4i c f NAME OF AGENCY: NAME OF OFFICE OR POSITION HELD OR SOUGHT r I rl e ,4,11f 1-J1 OVM10161t-k 1%1111F91 CHiECK ONLY IF Y-QA IDQATF---QRC.,I NEW EMPLOYEE OR APPOINTEE 2019 SE ONLY: -MG NOY r-2 AM !Q-- 19 iiF ic£ OF 3 1E CITY CLERK. CITY SF HIAM! Submitted into the public record for item(s) SP_1, on 11-18-2020 City Clerk **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE: THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must c ck one): El COMPARATIVE (PERCENTAGE) THRESHOLDS OR DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (if you have nothing to report, write "none" or "rila") NAME Ul- 5UILIF(E OF INCOME SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY O !`f`' PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See Instructions] (If you have nothing to report, write "none" or "nia") i FAAAC ()AIARAC nC ■AA 1r)D CrU 16rlLe AnnocCo nD1AtA+1nA1 nr in l�lrnn BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE 014 z PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or"nfa") r �f You are not limited to the space on the lines on this form, Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and flow to fill It out begin on page 3. CE FORM 1 • Effective: January 1, 2020 (Conllnued an ravarse side) PAGE } Inwrpwaled by reference in Rule 34420211), FA.C. PART n — INTANGIBLE PERSONAL PROPERTY [Stocks. bonds, certificates of deposit, etc. - See instructions] (if you have nothing to report, write "none" or "nla") TYPE OF INTANGIBLE BUSINESS E TITY TO WHICH THE PROPERTY RELATES Submitted into the public record for item(s) SPA, PART E — LIABILITIES (Major debts - See instructions] on 11-18-2020, City Cleric (If you have nothing to report, write "none" or "n1a") NAME OF CREDITOR ADC PART F —INTERESTS IN SPECIFIED BUSINESSES (Ownership or positions in certain types of businesses -See instr6itiorra (If you have nothing to report, write "none" or "nla") �% +" BUSINESS ENTITY # 1 BUUSESSITITY # 2 NAME OF BUSINESS ENTITY y =ate tz) ;;u ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS � NATURE OF MY OWNERSHIP INTEREST CD PART G — TRAINING For elected municipat officers required to complete annual ethics training pursuant to section 112.3142. F.S. I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER; Signature: Date Sighed: Z.0 2-9- C 0� ' a — FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections For your annual disclosure filing, return the Form to that location. To determine what category your position fails under, see page 3 of instructions. Local officerslemployees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 fliers who File with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form to the Commission on Ethics, it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed Form to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address; 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303, To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEFormi @leg-state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. Form 6s will not be accepted via email. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in gcod standing with the Florida Bar prepared this form for you, he or she must complete the following statement: 1, prepared the CE Form 1 In accordance with Section 112.3145, Florida Statutes, and :he instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. CPAfAttomey Signature: Date Signed: Candidates rife this farm together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Farm 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially, each local off icerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019. ICE FORM 1 - Erfe(Jw January 1, 21041. PAGE 2 ImarpnrateJ by rererence in Rune 34-B.292t71. F.A.C. CANDIDATE OATH — NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: ❑ Write-in candidate Candidate Oath {Section 99.021(l)(a), Florida Statutes) RECEIVE0 2020 NOV -2 AM 10* 20 of tZE11YOF 1Ii �iIAMIC ITYGLEAK OFFICE USE ONLY (Print dame above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box 0. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidates name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of (Dfff ce) (District #j I am a qualified elector of } County, Florida; (Circuit it) (Gaup or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have Qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): Z Zl Z�L ,12 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as maybe used by persons with disabilities (see instructions on page 2 of this form): [Notapplicable to write-in candidates.] Signature of Candidate Telephone Number ICI Al &YZ Address City STATE OF FLORIDA COUNTY OF MIArl tt Q>�I - Sworn to (or affirmed) and subscribed before me by ❑ physical or ❑ online presence this ! day of a t. l'_ 33113�6 State Cv Q !1 o 1 Email Address .} ZIP Code 5ig"rd'of Notary Public Print, Type, or Stamp Commissioned Name of Notary Public below: 20 ,.•`� ra�8.. FRANCFS t_LOP-NOY . r `t =Notary Publlc•5 Personally Known, or Produced Identification' _ ! Type of Identification Produced: Fk2c,-� I^�,- Commis race of Florid+ Commission N GG 9Q59d6 •V Commi Man Expia3 August 27. 2n23 Submitted into the Public record for nemts) SP.1, Rule 1S-2.0001, F.A.C. on 11-18-2020, City Clerk QS-DE 302NP (Rev. 04120) STATE OF FLORIDA COUNTY OF MIAMI-DADE K�Vrot 11 First Name Middle Initial L� Last Name a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida. Signature of Candidate G o CITY OF MIAMI OATH OF CANDIDATE OFFICE OF CITY OF MIAMI COMMISSIONER Before me, an officer authorized to administer oaths, personally appeared A/Y;� KI S. M - I�q (PLEASE PRINT NAME) Iq Fn n-' x M Q .- who, being sworn, says he/she is a candidate for the office of City of Miami Commissioner, District-__ for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs. concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Signature of Candidate "�jy1/11 1 Lai'',: fII(.Vr;,��l+ Address City State ZIP Code The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me this 711 day of i� , 20 Signature of C&6er Adminis! rntig Oath or Notary Public Personally Known: OR Produced Identification: X Type of Identification Produced: Rf Y1,161, R? „+•., FRANCES LLOP-NOY 4 Notary Public -State of Floridl •rk Commission N GG 905986 iY 76 My Commission Expires •,,,,«'' Auaust 2t. 2023 Ma Re of Notary i TpO, P rin led or Starnped Submitted into the public record for item(s) SPA on 11-18-2020, City Clerk October 26, 2020 RE: District 5 Dear Decision Making Professional: Submitted into the public record for items) SPA, on 11-18�-2020, City Clerk City of Miami Commissioner This letter is to express my strong interest in the City of Miami Commissioner District 5 Whether the issues are communication, equality, or productivity, I work effectively in finding solutions towards the desired results. The greatest satisfaction in my career is derived from the support, direction, and leadership that I provide. My experience has enabled me to deliver quantifiable results and build effective teams by providing excellent communications, encouraging involvement, and sharing responsibilities. I can add exceptionally good value by applying these skills to the City of Miami. I submit my resume for your consideration, from which you will see the successes I have experienced. l would be happy to become part of the continuing success of the City of Miami, Sincerely, Reveran Lincoln revlJncoln202OCgmail.com 305.763.0820 CP _ So C$ v Fri � r c Reveran Lincoln C3 ^r F►] p 210 Northwest 151h Street , = M Apartment #2 r''' i`�'f Miami, Florida 33136 s� Phone- 4305) 763-0820rn Email: revlincoln2020@gr-nail.com Objective: Seeking the position of City of Miami Commissioner district 5 Skills: Community Servant Strong Interpersonal Skills Strong Organizational Skills Community Activist Strong Leadership Career Overview • Reveran Lincoln was married for 54 years engaging in Import and Export business in British Guyana. Reveran Lincoln, her husband and her 8 children moved to Canada in 1952. • Reveran Lincoln started a clothing business in Toronto Canada in 1973 • Her business migrated to Montreal Quebec Canada in 1985 in the fashion clothing district. • She bought various buildings and continued in the real estate field and clothing business industry. • She became a teacher once the family moved to Quebec. • The family realized that they can make more money in the clothing business than real estate. The Family continued the business until the passing of her husband. • in 1998 Reveran Lincoln moved to Miami Beach • Reveran Lincoln stated taking a crash courses in ethics at Miami Dade College - Wolfson Campers • In 2000 Reveran Lincoln came to the OverTown community to help by starting a corporation called People Helping People Reliance in 2002. • Reveran Lincoln became an activist once her program People Helping People started • Reveran Lincoln engaged in real estate in OverTown district 5 ■ She is actively Involved with various political efforts and groups to help Overtown • Reveran Lincoln decided to register as a candidate for commissioner of District 5 • Reveran Lincoln is perfect candidate to make massive changes in for District 5 • She posses leadership skills that people can trust Education Fyrish- British Guyana Congregational School References Available Upon Request Submitted into the public record for items) 5P.1, on 11-18-2020, City Clerk Submitted into the public record for item(s) SP.1, on 11-18-2020, City CI'erk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) 5P.1, on 11-18-2020, City Clerk CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA STATE OF FLORIDA COUNTY OF MIAMI-DADE CITY OF MIAMI Robert Malone, Jr. first duly sworn under penalty of perjury, deposes and says: 1. My name is Robert Malone, Jr. (hereinafter "affiant"), being 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 512.0 I presently reside at the fallowing address (must include zip code) 1825 NW 47th Terrace Miami, FL 33142 which is my legal address, and I have resided continually at said address from the 1 day of January 2009 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: NIA For the Period: 1 v 70 w n C3 r w page I uf'3 Rev. 100-020 Submitted into the public record for item(s) Sp.1, on 11-18-2o2o, City Clerk 5. In addition to the residence that l have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: NIA 6. Affiant's spouse resides at the following address (must include city, state and zipp NIA - o 7. Affiant's minor children code): NIA reside at the following address (must include city, sta'_�Inpzip e 8. At the present time, affix than as stipulated in subp his not)registered to vote in any city, county or state other p -3ove. 9. Name and business address of affiant`s employer: Miami -Dade County Public Schools, 1450 NE 2nd Avenue, Miami, FL, 33132 US Dept. of Education, 400 Maryland Avenue, SW, Washington, DC, 20202 10. Affiant's occupation: Interventionist/instructor Affiant's business telephone number(s): (786) 512-1919 11. Affiant has been employed in the above -cited capacity for the following period of time: 02I201 3 (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prier to the date of this affidavit). 1 12. Afflant represents that he/she (is) is not} currently holding another elective or appointive office - whether city, county or m icipal - the terra of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. N 0 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed, Px t' 2 or3 [ley. I0/2020 Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk SIGNED THIS 32DAY CAE 0-CC 7 c- Zo2 AFF1 NT BEFORE ME, the undersigned authority, by means of / physical or online presence appeared <-"- ckkov'1e., �, r. , who, after first being duly sworn (or affirmed). deposes and states that Ie- executed the foregoing to the best of In knowledge and CITY(�LE�K! CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced SMDR:rORGES W,&7Foh.daCommissio76My Comm_ FxW1ht6li- L t-1 c.evn (SEAL) CJ f1 Q �_4 CJ .• CD Pagc 3 Of 3 fiev. 10!2020 FIRM 1 STATEMENT OF Please print or type your name, mailing FINANCIAL INTERESTS address, agency name, and positron below; LAST NAME -- FIRST NAME — MIDDLE NAME Robert, Jr. Malone MAILING ADDRESS P.O. Sax 371555 CITY: ZIP Miami 33137-1555 NAME OF AGENCY: City ofMiaini NAME OF OFFICE OR POSITION HELD OR SOUGHT Commissioner, District 5 2019 4 FUR-C+PFIC�66E ONLY: 20OOI 30 Ale 1O.4O OFF;CE CF 1-1.jE CITY CLEcAK CITY OF MIAMI COUNTY: Submitted into the public Miami -Dade record for item(s) SP,J, on 11-18-2020, City Clerk CHECK ONLY IF Q CANDIDATE OR ® NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions For further details), CHECK THE ONE YOU ARE USING (must check one): 0 COMPARATIVE (PERCENTAGE) THRESHOLDS M Q DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (if you have nothing to report, write "none" or "nfa") NAML Ur b(JUH E OF INCOME SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY Dade County Schools 1450 NE 2nd Ave, Miami, FL 33132 Interventionist/Instructor US Debt of Education 400 Maryland Ave SW, Washington, DC Peet- Rcviewer/Panel Monitor F'AK1 tS -- ZiLLAA4uAKr SULIKUtti Uf INL:UME [Major customers, clients, and other sources of income to businesses ovmed by the reporting person - See instructions) Ili you have nothing to report, write "none" or "nla") AIa M1A1= r1r AIAAAC nE 6AA inn 0— 1—n BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE n/a PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nfa") n/a You are not limited to the space on the lines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3, > L rune i , Mirms - is uury i zuzu (Contlnund an reverse sidel AhGE l lnegr)Mlad by ra%renca {n Rine V.S.242{1}, F_A.0 PART D —INTANGIBLE PERSONAL PROPERTY ISlocks, bonds, certificates of deposit_ etc. -See Instructions) (If you have nothing to report, write "none" or "nla") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES nla tlla PART E — LIABILITIES [Major debts - See Instructions] (If you have nothing to report, writs "none" or "wa") NAME OF CREDITOR ADDRESS OF CREDITOR nla nla PANT F —INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses -See instructions] (If you have nothing to report, write "none" or "nla") BUSINESS ENTITY # 1 BUSINESS ENTITY # 2 NAME OF BUSINESS ENTITY Q ADDRESS OF BUSINESS ENTITY 11/a rl/a PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS "tr" NATURE OF MY OWNERSHIP INTEREST 7" i Q PART G — TRAINING t For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F5. ❑ I CERTIFY THAT 1 HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY Signature, If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, lie or she must complete the fallowing statement: prepared the CE r Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the disclosure herein is true and correct. Date Signed: on 4■ yy L / (_.. � L 0 CPA/Attorney Signature, Date Signed: i ]LING INSTRUCTIONS. If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officerslemployees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the making address or email address to use. ❑o not email +our farm to the Commission on Ethics it will be returned. State officers or specified state employees who file with the Commission on Ethics may File by mail or email. To file by mail, send the completed form to P.O. Drawer 15709, Tallahassee, FL 32317-5709, physical address: 325 John Knox Rd, Bldg E. Ste 200. Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send It to CEFormi@leg.state.fl.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing methad. Farm 6s will not be accepted via email. CE FORM t - Eft&Trve. January 1 2625 lrw=Fated by Fafar ens in RiAe 34-8.202.f l! F.A.C. Candidates file this farm together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE: Initially. each local oC#icerlemployee= state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same tune they file their qualifying papers. Thereafter, file by July I fallowing each calendar year in which they hold their positions. Finally, file a final disclosure form (Form IF) within 60 days of leaving office or employment. Filing a CE Farm IF (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her, position on December 31, 2019. Submitted into the public PArF2 record for item(s) SP on 11-18-2020, City Clerk CANDIDATE OATH — NONPARTISAN OFFICE RECEIVED (Do not use this form if a .judicial or School Board Candidate) 2020 OCT 30 AM ia: 48 Check box only if you are seeking to qualify as a N f,cE OF ThE ciiy c m write-in candidate: 01TY OF MlAMj ❑ Write-in candidate OFFICE USE ONLY Candidate Oath {Section 99.021(i)(a), Florida Statutes) I, Robert Malone, Jr. (Pilaf name above as you wish it to appear on the ballot If your last name consists of two or more names but has no hyphen, check box D. (See page 2 - Compound Last Names). No change can be made after the end of qualifying Although a write-in candidate's narne is not printed on the ballot the name most be printed above foroath purposes.} am a candidate for the nonpartisan office of City of Miami Commission (office) 5 : 1 am a qualified elector of Miami -Dade iWrculr rt1 (Uroup or seat n) (District #) County, Florida; 1 am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office 1 seek; and l have resigned from any office From which I am required to resign pursuant to Section 99.012, Florida. Statutes; and l will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located an your voter inforrnation card): 105027640 Phonetic spelling for audio ballet: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] roe-BUHRT MAH-loen JUHR-NUR ,�`'� ,�� ( 786) 512-1919 dr.malonejr@gmail.com Signature of Candidate Telephone Number Email Address 1825 NW 47th Terrace Miami FL 33142 Address City State ZIP Code STATE of FLORIDA cz, Sign re Pf otary Public COUNTY aF 1 1>, Iffi1 - �e Print, Tue. or Stamp Commissioned Name of Notary Public below Sworn to (or affirmed) and subscribed before me by LJY physical or s ; ='W -• S `GRGES t.h f+Nil c State of Ruda gammsa�cn # GG D&SBiS ❑ online presence this 3T day of P+C 20 c7 . ';,! iffy mm.Sxarr;sI r19.2021 •., ocs. do^dedmru„onNaEa�H^�aryA�. Personally Known: or Produced identification: Type of identification Produced, i► TJ>r i I%;( � DS-DE 302NP (Rev. 04120) Submitted into the public record for item(s) SPA, on 1.1-18-2020, City Clerk ale 15-2.0001, F.A.C. STATE OF FLORIDA COUNTY OF MIAMI-DADE Robert Ffrst Name 2020OCT 30 AM 10= 48 elf I'.4 V /HIE CIfS LL"A CITY 6F MIAMI Middle Initial Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk r Malone Last Name a citizen of the State of Florida and of the United States of America, ... and a candidate for public office _ do hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida. 1I r f: 21-1-4 IL �M Signature of C ndidate CITY OF MIAMI OATH OF CANDIDATE OFFICE OF Commissioner, district 5 Before me, an officer authorized to administer oaths, personally appeared Robert Malone, Jr. (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of City of Miami Commissioner, District for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Signature of Candidate '1825 NVV 47th Terrace Address Miami FL 33142 L, ?V Stale ZIP Code Tine Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by Zphys ical or online presence this e day of ADbeIt• 20 2,0 Sign tus of ff er Administering Oath or Notary Public Name of Notary Typed, .led or Stamped SAN0:FVSPersonalNy Knawn: C]I; Produr�d Identi(ratian_y� aiftodda cam 0BWQ18idly Comm. Ee 10, M21Type of Identification Produced:Llf��cse'gprp�mu hyApn- tazo2o My Verizon - Profile Page l of 5 Corder online and get your device shipped directly to your hone. verizon`/ My Profile Quick links Security Contact & Billing Email address Provide the emall address that we should use to contact you. DR. MF,LMiEJR-1—d'GMAIL.COM contaratt+urnfier Pi ovide the prone nurnoer, were we can best reach you. 786.23 1.824! Billing address Let us know where to send your bill. Have a question about changing addresses? See FAQs Address* 1825 NW47TH TF Apt/Suite/Other Submitted into the public record for item(s) SP 1 on 1111-1� City Clerk 11�) n N c rrt�' 3 CO Cancel c r-2 C= {'. a -VL 7AV Chat with us littps:Ilmyvliostpay.verizoii,Lrniilttil�icctlseccii-c!profilcleotitiictbilliliglbllling.Acicli'ess 10/28/2020 My Verizoti - Profile Pa e 2 of 5 Submitted into the public record for item{sj SPCA tQrWnllne and get your device shipped directly to your home. on n-1� 8-2Q2o City Clerk MJAMI erlzoW State* Zip code* FL 33142 ServiceAddresse Tell us Where YOU Lf3L the ser'viCe SO 4Ve van calculate the right taxes and sufcharcres_ Have a quesOon abOUt chpinging 8ddiesses? See FAQS Same as hiiling address 783.423.33:35 [R©BERT" MAL ONEJ 786,512-1019 [ROBERT M©L[7N Q Payment settings Ctiange your AutO Pay. paper -free billing and preferred raayment nielhotl . CPayrli-mt Settings r Trip Device Brands Samsung Al7nle O 7i o r, p CsX-' CJ CDQ LG avz_ .7AV Chat with us Motorola littps:llliivvppostpliy.veriZ011.Colilluilsicc(/secizrc/ptY7Cle/LC wactbl11111i Ib11I117oArleiress 1 {]I?$1?U2{i My Verizon - Pro flie Page i of Submitted into the public record for itern(s) SP.1, Order online and get your device shipped directly to yrtur home- on 11-18-2020, City Clerk Ve.rizol'1/ Q �,') n My Profile r. LOA IrIVI 1 ^� Quick finks Security -� Contact & Billing car ��co Ernail address Provide the email address that we should use io contact you- Pa.finAL0NEha: @EMAIL G0I` t Contact nt, nbers Pt'ovide the laha17e OU(IloelS where we can Kest reach VOLu. 786.237.8247 ILI Biilliingaddres.3 SIM, ,:��a � _4 1-171 Lot u5 knew where to send yow hill Q ("Tj 1825 NW 47TH TE�� ate} �► Y ' � MIAMI. {.k_ 33142 G V- Service Addresses Tell us where you use the service so we can calculate the right taxes and surcharges. Have a question about changing addresses? See FAQs Same as Milling address 786.428.8335 [RORERT MALONE] - Gnat wi Line 7AV 786.512.1919 (ROBERT MOLONE] Fait Liiie https:llmyvPostpay-veri oai.et)mltiilacctlsecui-elprofilelcontaethillinglscrvieeAdclress 1{ll?f�12f1?0 Submitted into the public record for item(s) SP,1, on 11-18-2020, City Clerk Cin- of hliIQU Commission Attention: Todd Hannon, Cin• Clerk City ofAfiami City !-call 3500 Pan American Ave Miami, FI. 33133 Via Hand Delivery and Electronic Mail Dr. Robert illalotic, Jr. P.O. Box 371553 1lliami, Florida 33137-1555 cell ('786) 512-1919 email dr.maloneira!4mail.com October 27, 2020 Re: Citt° Go.,wXfJI(lwr l3r_oia 7 I Sao-,vi T Dear Conirnissioners and CM, Clerk: _ S a lifelong resident, civic leader and youth advocate of the Cin- of ilfia:ni District 5 Commission, I would like to enter me name in consideration to replace outgoing Cotnsnissioner 14eorr I lardemon. As the fortner president of the Hadley Purl: I Iomeowners Association working alongside such instrumental Figures in our commurrity such as Hershel Haynes, Henn- Goa and Nana• Datwkms, the founding, president of the local chapter of the A_. RP, there is a need for -someone,,vho represents the comrnurity to step tip and answer this call to seine. Please see my professional resume attached to tl-is letter which should demonstrate my deep ties and affection for this commur in' as well as my experience in government affairs. I am reads` to serve on Dav One should I be selected to jouh the cin- commission. I respectfully request an cappornttun- to meet with city commissioners before the November 18, 2020 special meeting. If you have any questions about my- application, please feel free to contact me directly. Thank you, 'G'M truly yours, Dr. Robert Malone, Jr. U CL a 0 Qr in DR. ROrBERT MALONE, JR., M.S., Ph.D. P.O. Box 371335 ■ lliami, Florida 33137-1333 • cell (786) 317-1919 ■ email. clr.m,doncy{ t?g,i-,:iil.cc)m PROFILE • Liberty City civic leader and past president of the I ladles Park Homeowners Association • Veteran educator and youth advocate working ti&ith Inner Ciw comr-nunities of Nliarrii Experienced peer rek-iewer for the United States Department of Education • Nledia personality and contributor to the Nliat i Herald and Kizu Times editorial pages • Former legislative aide and intergovernmcLntal consultant • Helped over 5,000 families of high achliffing students earn academic scholarships ■ Mentored thousands of at -risk youth youths from college to elementary school level • Former college lecturer in Criminology /Criminal Justice EDUCATION ■ Ph.D. in Educational Leadership, Florida 't&M C niversitt`, Tallahassee, Fl. April 2007 • plaster of Science in Criminology, Florida State Uruversit', fallahassee, FL December 1992 • Bachelor of Science ui Criminology, Florida State University, Tallahassee, FL April 1991 ■ .Associate of Arts, Univer:sit- of Florida, Gainesville, FL April 1989 PROFESSIONAL EXPERIENCE Consultant, Self -Proprietor, Miami, FL, 3/2017-Present Provides consulting services to non -pro kits, local, state and federal government agencies in the area of }youth advocacy, crime prevention and education. o Provide research and community outreach for film projects and media coverage. o Assessed the Teen Court division under the Miami -Dade Economic Advocacv Trust (1IDE .T) organization in the areas of personnel, budget, resources. and deliver- of services to develop improvement strategies through capacity building and process improvement. Trains educators, parents and students in retention strategies, classroom management and violence prevention techniques. Peer Reviewer/Panel Monitor. U.S, Department of Education, Washington DC, 3/2016-Present • Evaluates applications froth post-secondui, education programs to support low income and first generation students through federal programs such as Upward mound, Talent Search and Gear Up. L o ,Assesses the Techtrical Review, Forms (TRF) from each Peer Reviewer. '- o Ensures applications receive an objective, fair, and ecliaiuble evaluation. v�iil o Developed partnerships between corrununities and schools seeking funding. C3 rInterventionist/Instructor, Davie County Schools, NILuri. FL, 02/2013-Present .4- o a Served as a reading interventionist and substitute teacher for at -risk school student populations `' o Implement pleent reading inter•ention strategies to assist students in increasing performance level � N rn reading. o ri o Provide on -call academic instruction and guidance at schools From Nlianu Jackson and a) C Nliau-d Edison High Schools; and Shadowlawn Elementary. 0 o .Assist students with completing college applications, preparing essays, guiding financial aid applications, developing college preparedness, and reaclung out to parents or guardi,rns. Consultant, Broward County Schools, Ft. Lauderdale, FL, 12/201 1-2/2013 Provided training and resources for school in at -risk, economically -challenged con- mtlrtities. o Led classroom management activities with teachers. © Provided grant opportunities relating to tolerance, Wlyirig, violence prevention. Submitted into the public record for item(s) 5 on 11-18-202o, City Clerk ROBERT MALONE, JR., M.S., PH.D. o Trained for educators and students in secondat-_t` schools on violence prevention and conununica titan. ilniversit-v Representative/Recruiter, _ltnerican Inter -Continental University South Florida, Weston, FL, 5 /09-11 / 11) • Represented the college to piospeetive high school students and establishing relatinnslups with ,guidance counselors, teachers and school administrators. o Identified target school populations For recruitment and conunluuty ourreach_ o Advised students rcgarching schot)I career options dlrnugh education anti scholarshp oppominities. * Organized college visirations/presentations for potential students, * Surpassed 80110 of goals in submission of lush school saident lead generations. St. University Representative/Recruiter, Florida A&M L-niversitr, Tallahassee. FL, 8/00-5/08 • I-Ielped manage a multi -million dollar scholarship/recruitment program for Florida A&M Universiry cinder the Office of Student _affairs. o Provided group presentations for high school students in cities throughout the L.S. With approved u- iversin7 marketing materials. b .assisted in developing enrollment and recntitment strategies organized recruitment fairs for potential academic scholars in high school. o Maintained approximately 500 to 600 university student .cliotarsluip files, calculated scholarship awards, processed admission and scholarship applications, o Orgaluaed student activities for scholars, supervised utuversity student Workers and informed incoming students of enrollment and in -state status- * Counseled and advised Families and potential students on financial aid packaging, career planning and college. preparation. Criminal Justice Adjunct Instructor, Brown Mackie Career College, Miami, FL, 1/08-5/08 • Instiuctcd courses an the field of CrimnnnaI justice, * Provided a foundation for students interested %n the Arens of Iaw enforcement, corrections, and related areas in the expanding critnilnal justice su-steln. o Taught standards and principles of the legal held along rerun substantiveand procedural law; investigating facts; and research were also discussed. Supervisor/Counselor, Black Male College Explorers Program (B.NLC.E.P)-Pre-Collegiate Program, Tallahassee, IL, 6/00-7/00 - 6/03-7/03, 6/06-07/06 * Responsible For providing oversight and organizing activities addressing fine personal, athletic, academe, and leadership development needs of at -risk young men during the 8 week summer college program. ® Supervised 7-8 mentors during the length of the program. o Managed the program for a total of 60-m 0 participarim Criminal Justice Adjunct Instructor, Tallahassce Comnnunity College, Tallahassee, FI., 8/03-8/04 • Insrnicted courses in the field of C;riniiznal justice. o Provided a ftaundarion for students interested in the areas of dic law enforcement, corrections. and related areas in the expanding criminal justice systenn_ o DisClaSsed standards and principles of the legal Field along with substantive and procedural law; investigating facts; and research. Research Associate, Institfte of Health and I-[uman Services Research, Tallahassee, FL, 4/97-12/99 • Evaluated cormmuniii -based programs funded by the Florida Department of Community .Affairs Teaching Assistant and Class Instructor, Florida State Universin-, Tallahassee, FL, 8/96-12/98 • Conducted classroom instructions as a Teaching .Assistant at Florida State University, School of Social Work. Submitted into the public record for item(s) SPA, on 11-18-2020, City Cleric ROBERT MALONE, 9R., M.S., PH.D. Gtotrp Treatment Leader, Better Outlook Center Juvenile HARvay (louse, Ilia ni, FL, 9/94--10/95 • Supervised a group treatment program for 60-80 juvenile offenders. * Created and inaplemented treatment plans including individual counseling. o Coordinated group treatment activities. o Developed a re-entry- process for juveniles in consultation with parents. Legislative Assistant, :Mate Representative Larcenia Bullard, 11%ianv, FL, 8/93-9/94 • Responsible for the daily operations of the district office for State Senator l.arcenia Bullard when she was a State Representative :addressed co:astituetnt services to resolve! cotiUnunits' concerns. o Provided bookkeeping for the office budget. o attending conrtnunin• meetings to develop corrununit , relationships. SOFTWARE EXPERTISE Microsoft Office Suite (1N-ord, Po4kerPoint, Excel); Zoom (Video Conferencing) COXIMUNITY/UNIVERSITi1 SERVICE Comrnunin' Youths against Violence Volunteer judge, Speech Therapy Contest for Troubled Youth ffhe Links) Educational Excellence School .advison- Council (EESAC) Needs assessment Chair, Urban Partnership Drug Free Con munity Coalition IIadley Park I lomeowners Association, President N._LA.C.P., Executive Board Nlennber I iampton House Conununin- Trust, Ad%isor 5000 Kole vlodels of Excellence, Member Board Member, The Enterprise Zone Advison- Council Career Day Participant at Miami Edison Senior I Iigh School, Miami', F1 Principal for the Day at the School for applied Technology, Zvfiarni, Fl Liberty City Conimutain- Action Agencv Chaitpersozn of In -State Appeals Crntmtaittee (FAINlU), Tallahassee, F1 AWARDS/ ORGANIZATIONS 21119 2015-1 �) 2012 2012 2012-13 2010 2008 ?U08 2008-12 2008 2008 2008 2003-t)- Certificate of Participation, National Young Rcaders Day,• 2008 -kwardcd best counselor Slack NLale College Explorers Program 2006 Florida A&M LTrnivenity Job Performance Bonus Award 2002 Certificate of .appreciation for Participation in die Guide Right Reuesat 2002 Program for `bung -Men h-tppa Alpha Psi Fraternity, Inc. Awarded Best Counselor Award for the Black Male College Explorers 2000-03 Program (I3.1a.1.C.E.P.) Awarded Best Staff Role Model Award for the Black Male College 2042 Explorers Program (B.M.C.E.P.) Awarded the Delores Aurenne Doctoral Fellowship 1998-00 Florida State University's Seminole Torchbearers lxadership :award 1991 Nanonal Young Leader. Delegate for the Congressional Youth Leaderslup 1990 Conference (Georgetown University) Member of the Tallahassee alumni Chapter. of Kappa Alpha 11s1 Fraternity, Inc. 2002 Member of the New Providence 365 Prince Mall Affiliated, Free and Accepted 1993 1\lasonic I..odge (Miami, Fl.) Submitted into the public record for item(s) SP.1., on 11-1�8-2D2Q City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) on 11-18-2020 City Clerk RECEIVED 2020 NOY —2 AM 9. 57 UH',`E OF ir4LlTY@#E CITY O . MIAMI CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA STATE OF FLORIDA COUNTY OF MIAMI-DADE CITY OF MIAMI ,fT7Z1rC fC 0114 Ci pN 0 V-�eM - — (hereinafter "affiant" ), being first duly sworn under penalty of perjury, deposes and says: 1. My name is � 4 c k 0' ? W 45X) 6 I am offering myself as an appointee to fill the unexpired terra for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. . I presently reside at the following address (must include zip code): which is my legal address, and I have resided contlnually at said address from the / Vday of Hr, I'L 6 63 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list herelnbelow all addresses at which you have resided for the past five years, as well as the length of time at each address). Prior Addresses: )1.21 For the Period; Pave I of3 Rnn' 102020 Submitted into the public record for item(s) SPA, on 11-18-2020 City Clerk 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: 6. Affiant's spouse resides at the following address (must include city, state and zip code): /(-JX - 7. Affiant's minor children reside at the following address (must include city, state and zip code): 8. At the ,present time, affiant (is) pis no ]'registered to vote in any city, county or skate other than as stipulated in subparagraph 3 above. 9. Name and business address of affiant's employer: =) L r e /'1 /1l C� �-3� . !� 2 C C � ' ; ;ctiyf �c i Nt°.c,"5 Tc+ 10. Affiant's occupation: Affiant's business telephone number(s): - eZO 11. Affiant has been employed in the above -cited capacity for the following period of time: 3- I- e61-'j=4'4 rj-k;e•rrc� ;dj�4 �"� E�Li° �.t! L03461. - ; :3r�;c (Note. In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). M 12. Affiant represents that he/she its (is nat))currently holding another elective or appointive office — whether city, county or mu i ipal — the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. A€fiant represents that, if appointed, he/she shall serve in the office so appointed. Pom:2of3 Rev 101G20 iV c , C4 [J0 wC rFV r ZK. Ss Cn -4 Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk SIGNED THIS DAY ❑F �0"P-M\X - 7Q7- AFFIANT BEFORE ME, the undersigned authority, by means of physical or online presence appeared &[J`ri C IV— [a,_ QWCves, who, after first being duly sworn (or affirmed), deposes and states that 4 el executed the foregoing to the best of knowledge and b (SEAL) PCITY ULEV, CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced: �- L yJYyey' lit C_.e_4 sa� sa+os .p`:>ary Poi r - 5�1e pf Fa da iamm63o� 9 GG 084618 ': j �• My Cah n �xp yes Mar 19. V11 .`*��F'•�•' El+�7cd 7+p HMW1 h'NHry Awl r.: �3frt d 3 n yr U1 Page 3 of 3 Rev 10-2970 Submitted into the public record for item(s) 5P,1, on 11-18-2020, City Clerk FORM 1 STATEMEl'�TT-� OFF 2019 Please prim or type your name. mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address. agency name, and yasruan heroes. LAST NAME -- FIRST NAME — MIDDLE NAME P "lee-r wlc/j j T11 ' t 0 i MAILINGADDRESS�� r ,w � N Y CITY 21P COUNTYfri `'i� rPilA.Z LF�,� NAME OF AGENCY r •- NAME OF OFFICE OR POSITION FIELD OR SOUGHT. P 4' CHECK ONLY IF NDIOATE Oil NEW EMPLOYEE OR APPOINTEE ._ THIS SECTION MUST BE COMPLETED .... DISCLOSURE PERIOD. THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES. WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details)- CHECK THE ONE YOU ARE USING (must check one): [Sd COMPARATIVE (PERCENTAGE) THRESHOLDS QB ❑ DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCE& OF INCOME IAtajor sources of rncnme to the reporting person - See instruchons] (if you have nothing to report, write "none" or "nla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY :I 171 _r4:1 h7j Lr� x7i %Ll: !r C �r ►� / 11� L' ill r y1� 1 PART B — SECONDARY SOURCES OF INCOME IMe101' customers. Gients, and other sources of income to businesses owned by the reporting parson - See instructions] (if you have nothing to report, write "none" or "nia") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE a� PART C — REAL PROPERTY (Land, buildings Owned by the reparhng Parsna - 5ee Instrzrcbons] You are not limited to the space on the (if you have nothing} to report, Write "none" or "nla") tines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. _ INSTRUCTIONS on who must I[to INSTRUCTIONS form and how to fill it out begin on page 3. CE FORM 1- iCrlemre Janvwy �. 202ll I�annnucn an rererse uocr lnum ated hr rpserance n fiuFe 3d-8.Z11211 } F4C ri Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk PART D — INTANGIBLE PERSONAL PROPERTY [Slodts, bonds. cenificatas of deposit, etc -See instrucltonsl I (tf you have nothing to report, write "none" or "nfa") TYPE OF INTANGIUr_E I BUSINFSS ENTITY TO WHICH THE PROPERTY RELATES 46.6rC6— rt' TVA' �F� r �.rr` :E I I�c� Jw/r,` ,LtjI-j5,gP Ir,�-M >'1:ttri'C 17017 w i ' r ,�aL �a �rr,_F� i, -331q-7 1 PART E •— LIABILITIES [Major debts - See instructions) ilf you have nothing to report, write "none" or "rite") NAME OF CREDITOR ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of buslriesses - see instructions) IIf you have nothing to report, write "none" a "ala") eUSINE55 ENTITY & 1 BUSINESS ENTITY = 2 NAME OF BUSINESS ENTITY I WIA I ADDRESS OF BUSINESS ENTRY PRINCIPAL BUSINESS ACTIVITY ry I! P POSITION HELD WITH ENTITY I OWN MICRE THAN A 5% INTEREST IN THE BUSINESS A)IA NATURE OF MY OWNERSHIP INTEREST fit!IA A.%/4 PART G — TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112 3142, f.S ❑ I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE (,..] SIGNATURE OF FILER: CPA orATTCRNEY SIGNATURE ONLY If a carb5ad pcblrc accountant licensed under Chapter 473, or attorney Signature: In good standing vvrih the Florida Bar prepared this farm for you, he or she must complete the Following stale merd: I, prepared the CE N � 1_ - - Form 1 In accordance with Section 112.3145, Florida Slatules, and the nsiruchuris to the roan. Upon nay reasonable knowledge and belief, the disclosure herein is true and correct Date Signed: LING INSTRCrCTIONS: If you were mailed the form by the Commission an Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local offfcerslemployees fie with the Supervisor of Elections of the county in which they permanently reside. (It you do not parmanenity, reside In Florida, Pilo with the Supervisor of the county where your agency has ils headquarters) Form t filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Electrons for the mailing address or email address to Use, Do not email YGUr form Ifl the Commission on Ethics- it wiflbe r rued. Stare afflcers or specfffed stare employees who file with the Commission on Ethics may file by retail of email. To rile by mail, send the completed form to P.O. Drawer 15709, Tallahassee FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, fits i GU Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other formal), send it to CEFcrm1@IQ��.slata.fi.us and retain a copy for acords. Do not fife b both inail anrd email. Chaasd dot one fain your rmath d. Form S will not be accepted via email. -EFecirm. January 1 :lido.. ri nlerence In nulo 3s4.202(il- FA C GPA1Agorney Signature: Dale Signed: Canaidares file this form togethor with their filing papers - MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer Is not roquirod to fife with the Commissian or Supervisor of Elections. WHEN TO FILE: filrlaliy, each local off)cerlempioyee, state officer, and specified slate employee must file within 30 days of the date or his or her appointment of of Ilia beginning of emptaymsnl. Appointees who must be confirmed by the Senate must file prior to confirmation, even if Ihat is less than 30 days from the data of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which They hold their positions. Fr•nally, file a final disclosure form (Form 1F) within 00 da f leaving office or ampioyment. Filing a GE Form 1F (Flomlate tit of Financial Interests) does not relieve the flier of tiling aE Fri 1 if the filer was in his or her position on December 31, 2D1�; Z G� CD _, aA I, -.i h? 3-� —J Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk CANDIDATE OATH ��� �� ���� NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) �e [ri C i E Or.lt.' -CITY- �EM iW14M Check box only If you are seeking to qualify as a CITY write-in candidate: 0 Write -In candidate OFFICE USE ONLY Candidate Lath (Section 99,021(t)(a), Florida Sta(utes) pp (Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box [. (See page 2 - Compound Last !Names). No change can be made after the and of qualifying_ Although a wnte-in candidate's name is not printed on the ballot, the name must be printed above for Oath purposes.) am a candidate for the nonpartisan office of ('LIAV MX3� i 0A) SJ - (flfrce) (District #) I am a qualified elector of �.f, f},�{ar�r%.t"TtIM -014.0C County, Fonda. (Circuit #) {Gimp or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected. I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and i have resigned from any office from which I am required to resign pursuant to Section 99.012. Florida Statutes, - and I will support the Constitution of the United States and the Constitution of the State of Florida. c� Candidate's Florida Voter Registration Number (located on your voter information card): - 10 l � 0 � 1 0 7 _-- Phonetic spelling for audio 'ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities {see instructions an page 2 of this farm): iNot applicable to write-in candidates.] S Ignatu re at Ca n di� Teleph�-r Number Emati Address �� 1X �r�e e4;04 - 3 r Address city S ZIP Coda STATE OF FLORIDA Si t re 6f Notary Public C O ll N TY a F s 1, ype, or Starno Commissioned blame of Notary Public lioio :Sworn <PVslca to (or Worried) and sub abed before me by Ut'l or y,.� Y'p .,, SAFN3R:FCRGU ;� 3 '] tbtary of Fforlctaonline presence Ibis Y day fll 4�i'Y1�1�[ , 2Q LQ _ q t omsruss a84419l�ty Comm. frr 1S. M1Personally Known: or Prroduced Idenlificalion: •• °FF;,�ttpr�sjNrwjr,kAYyP�SSn Type at Identification Produced: i D"t ve yr Ut'JiiYlse, DS-135 302NP (Rev.64f20) Rule 1S-2.0001, F.A.C. Submitted into the public record for item(s) SPA, on 11-18-2020 City Clerk fL CE VED LOYALTY OATH 2029 NOY —Z: STATE OF FLORID COUNTY OF MIAMI-DADE b'FF ;� OF !hE ITy %E: A� , CITY V1 IAMI t [ First Name Middle Initial Last Name a citizen of the State of Florida and of the United States of America, ,.. and a candidate for public office ... do hereby solemnly swear or affirm that I will support the Constitution of the 11 United States and of the State of Florida. Signature of Candidate ^ CITY OF MIAMI OATH OF CANDIDATE DFFICE DF CT TT 0,S,4.147 4.5T 5 Before me, an of Fier authorized to administer oaths, personally appeared (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of CO-9 Ar51 '�_, for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Signature of Candidate — Address City State ZIP Code f The Loyalty Oath and Oath of Cayntqidate are sworn to (or affirmed) and subscribed before me by 7, physical or aonline presence, this day of yyl , 20 2-0 , Gtr6ca �Ar >a5 Siegn to e of OlMer Adminislwing Oath or Notary Pubic Name of Notary Typed, Printed or arnped Personally KPOVM7OR Produced Identification: 9ANDRAFMESiss j� �',� �=, ticiary?,h'w:-5raleofFkuica G 1J�1��V� j Cbermon4GG084613 Typo of Identification Produced: 1 �1 [ Q �7� My Comm. Fires Ma, IS, 2021 1010W Submitted into the public record for item(s) SPA on 11-18-2020, City Clerk Industry Bio. & Consulting Capacity 1, ederal License: FCC— Registration Number (FRN ): 002=4937187. M Call Sign: K.k14N,1TH. i Station Privi)e¢es: Primary. rjrr C r Operator Privileges: Technician .��-"� r' Effective Date: October 2, 2015, = It r� C [?�1 r Expiration Date: October 2, 2025, Florida Licenses: D 1227043: G 1206873: W 1264076. r CD (All Current-2017) Zj Federal Certifications: DHS/FEMA (:acquired in 2013): G557: Rapid Needs Assessment (FormerIv G250.7). 097-R1 SP: Mass Fatalities Incident Response (G 86), Florida Certifications: Florida Founda[ic+n Basic Emergency Management Academy (201 ;). FDLE Certification: Police Officer: 1.992-1999. ($LE 141 - PoIice Academy). Field: Director: FEMA 0557 Tactical S.A. Corp. (201 G--Current). Crisis Security Management & Operations In Fo.ir Earth Quake Haiti: (Task Begin Dare: January 14, 2010-Dominican Republic And Haiti): (Principak NBC Universal —including MSNBC). Police ❑fficcrlCiviIian Contractor: (1992-1999)/(?004-2016): (Undercai er Nur-coric:s,- llrfulli-Agetrcy Ault'-Thefi Task Farce: MiniaFi-DadeCcunh•)l (Tacrical Seffer), Consultant On pjg!.art_irjns & Prgq o q?I Irt Several Cities A Haiti): (Cities include: City Soled, Croix Des Bouquet, Petionville, Petit Goave, Thsamazeau). Office- Affiliated Advisor As Seen On: Member Natiun Security Council Facehook. Authored Code Enforcement Legislation: Ordinance 021-11, City of Gpa Locka, Florida. Vice Chair: Florida Governor's "Front Porch" Council — Opa Locka/Miansi Gardens: (Crime Preveinion Carr miflee Chair7r on: 2003-2008). Education: Florida Agricultural & Mechanical University: 1982-1935; (Undergraduate Major., ElcctronicEngineerbig &_Teclrnolo.gy-EET). Query: Local Jail Card Reveals ID Tltief Using My Narne & Info. On His Multiple ;arrests, Patrick ; FS51P9.RT:� MATTHEW Chapter 10; Verse 28. Submitted into the public record for item(s) 5P.1, on 11-18-2p2D City Clerk Voter Information card t Xiiarri-Uide Crum:%. FL Tarjeta de lnionnaci6n del Elector, ";rdadr, rld� ,11i ^ al-Cvt,"e. fry Kat Ertibmasyon Voti PatrlCk t3'Kejth OwensKopte Miami -Lade, FL 961 NW 43Rd St tsSUED Miami FL 33127 L%"711.,, 11] _ ENM;xtF Bring photo identification 08/10/15 when voting. g RL•4�'ISlFltl�n iw6. Para vota presen Pe una No— de Inscripcirin went*=="n cor.. €otn Niru, Enskripsyon Q 7-�r scs Ianpri POW Yon P-is idantiffUsyon 09307907 k Qen FOW w %OU 16 "r— it---� w`ap xin v3te. Yeating Location I Centro de 4ntac'ion I Lokal Riwo Viat Penelope 7o rnsley "1 Supervisor of Electionsj Supervls4ra de FJeaCi.,. i Sipeyize Eleksycin rw arcar„yye lu vrx.; arrine ream, r.:n.:s:4e i,; v. EI:umPr dm shire. 11 il'b Pau w rra;e peu:MFUar tan W nan dtsink ld 6n aqua to vs - Congress State Sena le State House Congreso Senado Eslatal Camara Estafal kon � Sena Eta a Lachanm Eta a 39 109 County Commission COnil sehoor Beard Community Council rnionda[ly Knm isyon Kan[e Junta bcDConseio Asanhle lar WiUsyon Cvntunitario Kvnscy ltominote 3 2 NIA MunicipaGIYMIAI4'IIIoI'dtinlsipaliie r Submitted into the public record for item(s) 5P.L on 11-18-2020 City Clerk C,O.P,&, C.O.P.S., and more C.O.P.S. Continuity Of Public Safety Continuity Of Public Service Continuity Of Public Stability A brief peek into [who is Pat.Owens]? Support expressed via vote: Twice for H.W. + Once for Dale_ • Twice for W. • Twice for Obama (999 dropped out of the 2012 contest, and I just couldn't do Mitt). • Jeb 3 times (including the lost to Chiles). • Attended Rick Scott's Inaugural Address & Invitational Dinner, • Fully support Governor DeSantis. Also, I'm in full support of electing a Sheriff for Miami -Dade county, and I believe the City of Miami's Civilian Investigative Panel (CIP) should sunset as soon as legally possible, as to not do so only indicates a lack of confidence in the competence of the Miami Police Department, The MP❑ is competent enough to NOT need a CIP. Quick tidbit; I created friendly individual nicknames for our wonderful Miami City Commissioners (see A. Barrera for further info). Note. I believe the primary long-term objective of a CRA should be to operate toward sunsetting. Patrick Owens, Chairman Community Relations Board City Of Miami, Florida Thank you. lam`. m � Submitted into the public ' record for items) Spj, on 11-1— , City Clerk OPER ETON: DUALITY OF LIFE Covenants P7H Code e;r, y t 0 ommercxa Residential } Private Sector Safety Protocols Partnering Secure Data Firewalling Technology Network Engineering I The Lave r f Community RoLmdtable vi Team Builder For Miami's Liberty Square HOUSING MIAMI-DARE COUNTY - EMERGENCY MANAGEMENT HOMELAND SECURITY Mayor's Office f I f f I AqA Local State Federal Government Bureaucratic Partnering Licensed Security Professionals Law Enforcement o Partnering a Ca t� te-er6o W.- V 1 I l 1 ���' ��'� � a� �,�0 c��,-R�C� w NERD �a3 .� fCS�-S, ��-�T�-'�, �+�� ��f�E �t►� ��rr� Submitted into the public record for items) SP.1, on 11-18-2020, City Clerk March 5, 2029. Arthur Noriega, City Manager. Attention: Mayer, Commission, City attorney. Re: Possible Solution To Wynwood Dispute- RECFIUED 2020 NOV -2 AM 9= 58 'i I° i i :e C i t Y G1.BRii wfTY aF MIAMI CONISILIATOR: Person or body acting as a Mediator between Tv.(o(2) disputing people or groups, and who provides a non -binding settlement proposal. PED TCAM: "Red. Tearnina' is the practice of rigorously challenging plans, policies, systems and assumptiops by adopting an adversarial approach in order to gain row perspective via creating scenarios of tangible risks. Please take note that the Miami Cade of Ordinances Chapter 2, Article X1, Code Section 2-481 & 2-335, Ordinances (11742, 11999, 12016, 12434, 12970 and 13626), Division 12, Section 2- 1151.(purpose, powers and duties), Subsection (4) specifically defineatas how the Community Relations Board shall be governed when acting as Conciliator. Th refore, and under Di. ision 12, SP-ction 2-1151 (4), it is rry intent to establish a Seven(7) member "Chairrnan's Red Team Task Force" (RTTF) as CR9 Chair. The intent is to assi n the CRZA's 3 Cflcers to serve as R i F Co-chairs, and that the remaining 4 RT F members would be representatives from Wynwood's disputing sides, i.e. 2 frori the. Wynvvocd Business Improvement District (BiD), and 2 from Moishe Mara. It is my hope that the RTrF can convene in the meeting room at City Half, upon authorization by the City Manager. CRB Officers: Patrick ©wens, Chairman Mason Manowitx, Vice Chairman Leslie Puzo, Esquire, Parliamentarian Respectfully, Patrick Owens, Chairman, y Community Relations Board Submitted into the pudic record for item(s) SP.1, on 11-118-2020, City Clerk �i MOR-NTNGSIDE PARK Today, Tomorrow, Together r' 3n y Covenants fri Code "` c & CD The Law *j R V Surrounding Neighborhoods Of The Park Access To Parking For General Public Department Partners Solid Waste; Parks Recreation ►1 Community Roundtable On Park Issues Com.-nunity Relations Board r OFFICE OF EMERGENCY I�.fANAGEM NT City Of Miami Mayor's Office [Police & Fire] Local - State Federal Government Partnering With Non -Profits .Licensed Security Professionals Law Enforcement Partnering -cam �� c�,c.r_ficl �aE o sc C CAET i riple T" Initiative Submitted into the public record for item(s) on -8 --2-C—)2 0 , City Clerk Volunteer Mobilization Facilitator State Ground Zero Red Tape Elimination (.' , ove rno r's Office Local P Duce/ P Pri V "a, to 'va Security Roundtable r' � e LLI Roundtable Of County Sheriff! Volunteers Police Chiefs --- Liaison County's Office Of Emergency Management Q-v-rYLjz4e- Z-,Urrr Miami -Dade V554 /4/107'.. Round :KQAjt&flYRtiQrIS Federal Red Tape Elimination DHSIFENIA Media Liaison M,�U M= 4 �. A rn FrI Cata,,trop Weath rW�.rnij 4.A1crcZ.&g�Ajftq.E Aid i]th�i,Envi(ol��nent�! l:i��acds Recurring r2ctio ...... . H-..0 ... ......... Ljft Command Chanel. ........ .......... .................. Safety Mobilization Active RounffTabfe Cn CD Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk CM CM CJ a S-IM.A.P.T...2 < r�--�1 ti + M Kno%vled;e ` c State Red 'Pape Elimination Liaison Governor's Office INIilitary Veterans Information Swap Clinic Identifiers Transfer Registration Center Military Vets Documented Irnmigrants Knowledge Transfer Paring Volunteer N1 .10bilization Facilitator Ground Zero *DNE COMMUNITY -- ONE GOAL* Federal Red Tape Elimination Liaison DHS/FEMA Documented Immigrants Identified Shills r Clinics by �I....... Veterans can iae liven atthe ]Qcal.i!iatianal Guard armory Y Skirls 5«:aps v {;irnisrants M!A faciIitafed.v„ia the Iucai Carpenter's Uniulr Safe—z.1Iingful Arrct riectProcal I rases S. M.A. R. IT. -2 PERSONAL DATA Full Dame: Address: Date of Birth: Passport Number: (if applicable) ErnaN: Submitted into the public record for item(s) SPA., on 11-18-2020. City Clerk M M m Ge!1d$r: Male ly Female SKILLSETS AVAILABLE FOR KNOWLEDGE SWAP Military Veterans cn co Li Urban Art.dlOr Jungle survival Methodologies _ Sell' Oefense i Cornmunicaticn Methodola les _ 9 F First Responder _ f 'ream Leader Protocols nrAPt1mP_ntL-d irnmiarants T" Outside Labor r Vehicle Qperatlons (Heavy Mechanics) Inside Labor Finishinas & other ❑etaliing) f Work Culture Insl ht F Plumbing (Irslde & Outside} C' Roofing r Electrical (Inside & Outside) r Windows IF Hand Machine Operations (Heavy or Small) r Paving (Cement/Concrete or Asphalt] I`T�EJOET'TI Submitted into the public record for item(s) SPA, on 11-18-2020. City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) SP.2,. on 11-18-2020 City Clerk r 0 , . CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA STATE OF FLORIDA } COUNTY OF MIAWDADE ) CITY OF MIAMI Ronald Page, MF}A , ' r' first duly sworn under ,penalty of perjury, deposes and says: 1. My name is Ronald Page, M-PA i-Z .-P c r (hereinafter "affiant"), being 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter d a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No.. I presently reside at the fallowing address (must include zip code): 1155 NW 2nd Ave APT 7 Miami, FL 33136 which is my legal address, and I have resided continually at said address from the 61 day of April 2010 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: 1744 NW 154st Miami, FL 33054 For the Period: 9410112415- {This is my malhers address, l sfil4r my lime among bath addressesy Page 1 ❑r3 [tcv. 1012020 5. In addition to the residence that I have listed as my present address, 1 also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: Listed in Q4. 6. Affiant's spouse resides at the following address (must include city, state and zip code): NIA 7. Affiant's minor children reside at the following address (must include city, state and zip code): 1155 NW 2nd Ave APT 7 Miami, FL 33136 (1/2 the tirne with me, the other 1/2 with my son's mother). 8. At the present time, affiant (is) (i ,tio-t egistered to vote in any city, county or state other than as stipulated in subparagraph 3 above. 9. Marne and business address of affiant's employer: SSA 8501 W Sunrise Blvd STE 100, Plantation, FL 33322 SSA 8501 W Sunrise Blvd STE 100, Plantation, FL 33322 10. Affiant's occupation: Contact Representative and Sales Represetative Affiant's business telephone numbers): 1-800-772-1213 11 _ Affiant has been employed in the above -cited capacity for the following period of time: 1. 09/15/2019 2. 12/16/2019 �,; �� '�. 1) {Nate: In the event the occupation of a iant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the names) and address(es) of his/her erne oyer(s) and occupation(s) for the period of one year prior to the date of this affidavit). o NIA =''T t NIA r t� 12. Affiant represents that he/she (is) is no currently holding another elective�r Vpoi `Gve office -- whether city, county or mun� l - the term of which or any paM thWeof �ns concurrently with that of the office he/she seeks, and that he/she has resignAofrom any office from which he/she is required to resign pursuant to F.S.99.912 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Submitted into the public rage a of record for item(s) SP.1, Rim r�izdaar� on 11-18-2020, City Clerk Submitted into the public record for itemjsj SPA, on 11-18-2020, City Clerk SIGNED THIS DAY OF N Lf- 2020 FIANT BEFORE ME, the undersigned authority, by means of V/ physical or online presence appeared Rc n'(�'A P(A,CyP_ who, after first being duly sworn (or affirmed), deposes and states that "e— executed the foregoing to the best of V)' 5 knowledge and belief. (SEAL) CITY CLERK, CITY OF MIAMI, FLORIDA L/ did take an oath Produced identification Type of identification produced: C vsu L t r-e . * ;x• :Ga,.. 70OC 3 HANNON 1 •''` � Notary Pub[Ic - State of Florida S s• aa; Cornmicsicy+ = GG 762274 My Comm. Ez;ires ieo 25. 2022 i Bonged through ha-,,or.al H.Itary Axs ,j � wr, na � H O .� [—S x to Page of Rev. r0r2020 FORM 1 STATEMENT OF 2019 Please sprint or type your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position below: LAST DAME -- FIRST NAME - MIDDLE NAME _ Page Ronald MAILING ADDRESS : 1155 NW 2nd Ave _ 4% r 4 APT 7 C,c C-5 CITY: ZIP : COUNTY: I Miami 33136 Miami -Dade Vic, NAME OF AGENCY: A 2 City of Miami ;? w NAME OF OFFICE OR POSITION HELL) OR SOUGHT District 5 Commissioner CHECK ONLY IF Q CANDIDATE OR NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THfS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019, MANNER OF CALCULATING REPORTABLE INTERESTS: FILLETS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH RE USUALLY BASED ON PERCENTAGE VALUES (See instructions for further details). CHECK THE ONE YOU ARE USING (mus check one): COMPARATIVE (PERCENTAGE) THRESHOLDS DES Q DOLLAR VALUE THRESHOLDS PART A µ PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or "rtla°"j NAML Ur bULIKUL OF INCOME SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY Social Security Administration 8501 W Sunrise Blvd Plantation, FL 33322 Federal Gov. Employee S L Realty and Property Manage 1 155 NW 2nd Ave APT7 Miami FL 33136 Sties Associate PART 6 -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF NAME OF MAJOR SOURCES ADDRESS BUSINESS ENTITY OF BUSINESS' INCOME 1 OF SOURCE NIA PART C REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla") NIA Submitted into the public record for itemtsj 5_. •1, an 11-1i 8-20 , City Clerk PRINCIPAL BUSINESS ACTIVITY OF SOURCE You are not limited to the space on the fines on this form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and haw to fill it out begin on page 3. CE FORM 1 - Efiecwe: J"Mary 1. 204 tCantinued an mverse side] PAGE r Incorprualed by Werence in Ruler 34-81W(1). F.A.G. PART D — INTANGIBLE PERSONAL PROPERTY IS -locks. bands, certificates of deposit, etc. - See instructions] (if you have nothing to report, write "none" or "nla") TYPE OF INTANGIBLE N/A PART E — LIABILITIES [Major debts - See instructions] (if you have nothing to report, write "none" or "nla") NAME OF CREDITOR BUSINESS ENTITY TO WHICH THE PROPERTY RELATES ADDRESS OF CREDITOR Navient (Student Loans) 1123 Justison St, Wilmington, DE 19801 PART F —INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses- See instrucVVsj n (if you have nothing to report, write "none" or'"nla") of rer►iceo r.r7rTv u NAME OF BUSINESS ENTITY uvvrr emu. err r r i r n r uu.,snr�caq .Lry i�r » c S� a �. ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN N10RE THAN A 5% INTEREST IN THE BUSINESS S� d NATURE OF MY OWNERSHIP INTEREST PART G — TRAINING For elected municipal officers required to Complete annual ethics training pursuant to section 112.3142. F.S. I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ SIGNATURE OF FILER: Signature: J' . 1 Date Signed: 10/30/2020 FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position Fails under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (Ir you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Form 1 filers who Fie with the Supervisor of Elections may file by mail or email_ Contact your Supervisor of Elections for the mailing address or email address to use. Do nerlem—ail your form to the Commission on Ethics. it will be returned. State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed farm to P.O. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 .John Knox Rd, Bldg E. Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed farm and any attachments as a pdf (do not use any other format), send it to CEForm1@1eg.state.11.us leg.state,fi.us and retain a copy for your records. Do not file by both mail and email. Choose only one filing method. Form 6s will not be accepted via email. CE FORM 1 - Effe fiva January 1. 2010. Incorporated by refnramc in Rolo 34•9.2W(i I, FAC. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473. or attorney in good standing with the Florida Bar prepared this Form for you, he or she must complete the following statement: I, prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, thy: disclosure herein is true and correct. CPA/Attorney Signature. - Date Signed: Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO FILE. Initially, each local officerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must fie at the same time they file their qualifying papers. Thereafter, file by ,July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of financial Interests) does not relieve the flier of filing a CE Form 1 if the Submitted into the public record for item(s) SP.1, on 11-T8-202D, City Clerk PAGE z CANDIDATE OATH -- NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: Write-in candidate Candidate Oath (Section 99.021(1 ){a}, Florida Statutes) RECEIVED 2020 Nov -4 PSI 3= 30 Uif{�Elei' ijjEClTyULErRK CITY OF MIAMI OFFICE USE ONLY I, Ronald Page, M-PA R. e (Pril7t name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of qualifying, Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of City of M j a M (Q(frce) ; I am a qualified elector of Miami -Dade (circuit N (Group or Seat #) 5 (District #) County, Florida; I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): 115984646 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as maybe used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates.] X `J _ _ �,e, 4 f 786 i 202-g589 -�:c `� _ rpage003 car. f u.e�iu _ Signat e of Candidl� Telephone Number Email Address 1155"NW 2nd Ave APT 7 Miami FL 33136 Address City Stare ZIP Code STATE OF FLORIDA COUNTYOF `Srgnature of Notar�_Palwic/ Print, Type, or Stamp Commissioned Name of Notary Public below. Sworn to (or affirmed) and subscribed before me by 1 physical or ❑ online presence this I—& day of C , 20 1- 9 Personally Known: or Produced Identification: Type of Identification Produced: FL U C r \J� 5 t I — i t ` TODD if HONQN Notary Public -State of Florida a` Commission A GG ZW74 'nF n' My Comm, Expires Sep I5, 2l?2t donsfed throu%h National Notary Assn. Submitted into the public df recur or ttemlls) SP.1. S-2.001, F.A.C. on 11-18-2020, City Cleric DS-CE 302NP (Rev. 04120) STATE of FLORIDA COUNTY OF MIAMI-DADE Ronald First Name LOYALTY OATH Middle Initial Submitted into the public record for item(s) SP.1, on 11-18-2020 city Clerk Page Last dame a citizen of the State of Florida and of the United States of America, ... and a candidate for public office ... do hereby solemnly swear or affirm that I will support the Constitution of th nited State,§ and the State of Florida. Signature of Cal f d idate CITY 9F MIAMI OATH OF CANDIDATE OFFICE of District S City Commissioner Before me, an officer authorized to administer Oaths personally appeared (PLEASE P I T NAME) L who, tieing sworn, says he/she is a candidate for the office of S ` t e_i �� �j tC: '�!for the City of Miami„ Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that helshe has taken the oath required by Section 99,021, Florida Statutes, that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.01 ', Florida Stat fes. Signature of Candidate 1155 NW 2nd Ave Apt 7 Address Miami FL 33136 City State ZIP Code The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by lzphysical or Flonline presence, this " ~ day of. r � �'-r�"1�-L_� . 24 'DC) ftr ature of Officer Adrn` istvin Oath or Notary Public Personally Known: OR Produced Identification: Type of Wentifiication Produced: �-- L C ( i V-P--r'-, L. C -R V] - � _ CAA f� . 0c)_V) V') 0 Name of Notary Typed, Panted or Stamped .,; * •r' TDCO d HANNION _. Notary?Ublic • State of rlonda Commission K GG 762274 My Comm. EADires Sep 25 Mill Banded through NdUORdl Noiary Asar, Iof"IYZO Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk RONALD "RON" PAGE, MPA Miami. Florida I RpageO03(cffiu.edu EDUCATION & CERTIFICATIONS Florida International University, (Miami. FL) Graduate School: MPA c/o 2019 Ph. D, EGD: 2024 Doctor of Philosophy in Public Affairs Horrors: Pi Alpha .4lphcr Horror Society o President Emeritus Masters o/.Ptiblic ,4tltntni.stration Progr ana Connnittee o Student Representative The International Public tl,fcrrrcrgcrrrent.4sscrciatiorr,lbi- Hrtina r Resources o Student Representative Goi-ernmenr Finance Officers Association (FIU Chapter) o Co -Founder Council, for Strtclent or garrLations o Rep►-cstrrtatii�e liar Goi,e)-nrrtcnt Fincrnce Officet:r Association (FIUClraplet) American Societe, or Public Achnini.stration o Menlbel, Master of Public Administration Graduate Certificates in: Public Finance, Procurement, and Contract Management Academy of Leaders Graduate Track. Public Policy Horrors: Pi .alpha Alplra Horror Society, o President Erneritus Masters of Ptrhlit lrlrrrirristrrrtiort Pr•ogrrrttr Corrrrrrittee o Student lRepresentath-w The International Pithlic Afanagejrrrent Association for Harnian Rccortr•Ws o Student Rcprescrrtarrve Government Fine-mcc Cif}icers Association (FIU Chcrptt'I o Co-Fo n cler{ Councillor- Student Gtgcrrri.7ations o Represerrtatiue_/c.r Goi.er•rrnrctrt Flrrrrrrc:°e Qj�ccr:s �ssoclrrtiorr fFILI Clrrrptc�r-) tlrnerican Societe: for Public Administration o Member Capstone; Policy Brie .' Medicare fiaud, ►caste and abuse Florida International University, (Miami, FL) Undergraduate: BPA c/o 2018 Bachelors of Public Administration Undergraduate Certificate. in: Leadership Studies Horrors: Pi Alpha Alpha Hunor Society, o Alenrber• Dean 's List 017-?018, u-ith an Upper levc•13. 71 GPA Capstone: Exploring the Correlation of Cringe and Property Value Gold Coast Schools (Miami, FL) Certification (2017) Real Estate Sales Associate License Submitted into the public record for item(s) SPA, on 11-18-2020, City Cleric Miami Police Training Center (Miami FL) Certification (2012) Certified Police Officer Certification o Class Leader EXPERIENCE S L Realty and Property Management LLC Mii=ar, FL Sales Associate 1211912019-Present • Generating client leads to buy, sell, and rent property. • Counseling clients on market conditions, p6ces, and mortgages. • Developing a competitive mark -et price by comparing properties. • Creating lists for real estate sale properties. with information location, features, sgUare footage, etc. • Showing properties to potential buyers and renters. • Presenting purchase offers to sellers. • Facilitating negotiations between buyers and sellers. • Reviewing purchase contracts to ensure terms are met. • Promoting properties with ads, listings, and open houses. • Preparing loyalty contracts, purchase agreements. rental agreements, deeds and other documents for each real estate transaction. • A: -range for title searches to determine whether clients have clear property titles. Social Security Administration Atlanta region (Plantation, FL) Recent Pathivays Graduate Contact Representative 0911 fi12019-Present • Interviewing beneficiaries to explain technical provisions, Fliciting relevant facts and resolves problems with payments or eligibility. Provides beneficiaries with inforztlation,"illsti actions about eligibility and benefits being paid under retirement, survivors, and disability and Medicare insurance programs, the Black Lung program and Supplemental Security Income. Also furnishing information to inquirers about work incentive provisions, compliance with the various beneficiary reporting requirements and submitting appropriate reports to continue, suspend or terminate monthly payments. • Completing SSI abbreviated applications, making detennination of ineligibility to SSI benefits when reason for denial is clear. Considers all nonmedical eligibility requirements including all possible exclusions to income and resources before denying claims. Documents reason for denials and inputs systems record creating denial notices and protecting claimants' appeal rights. • Identifying persons requiring representative payees in most past entitlement situations. Selects the payee through qucalifiCat1011S, and at specified intervals. reassessing the continuing, suitability of current payees. • Identifying Title XV I overpayments. Detenninin,T amount of excess payment and resolves overpayment by recovery, waiver and/or determination that the ❑verpaynwnt did not exist or is uncollectible. Documents SSI file and issues appropriate notices. • Receiving requests for waiver- of overpayment in Title XVI cases. Completes Request for Waiver and Recovery Questionnaires. Verifies allegations as necessary. Determines if individuals are without fault in causing overpayments and if other waiver provisions are met. Documents decisions and generates notices of decision and appeal rights. Submitted into the public record for items) SP.1, on 11-1� $___2Q20, City Clerk • Investigating case situations and reconciles discrepancies causing interruption in the receipt of monthly benefits. Decides when critical payment system (CPS) and/or immediate payment (IP) procedures should be used in sensitive or dire need situations. Completes documentation and snakes payment authorization. Checks for outstanding overpayment, withholding (SMI), computing any underpayment due, determining payment amount and posting the system. Investigating case situations and reconciles discrepancies causing interruption in receipt of monthly benefits or Medicare payments; pursues to completion incidents of dissatisfaction with Medicare reimbursement rates or ether practices which are remedial through administrative processes. • Providing information and advice about specific retirement options and computes estimated monthly benefits payable at various ages to enable individuals to make retirement decisions that will affect there the rest of their lives. i Answering questions and resolves problems concerning Medicare payment. Pursues to completion incidents of dissatisfaction with Medicare reimbursement rates or other practices. Prov7ding assistance in the preparation of Medicare claims and appeal forms. Explains and processes requests about state buy -In rules and initiates action with State agencies to enroll individuals. Explains options about initial enrollment periods (ILP), general enrollment periods (GEP) and special enrollment periods (SEP) and provides complete information that will allow individuals to decide the most advantageous month to enroll. Takes and processes enrollment applications, and, if necessary, secures evidence for entitlement to an SEP. Makes equitable relief and good cause recommendations conceminYg the month of enrollment and premium surcharges. ■ Processing even the most complex Social Security Number applications. Codes, evaluates evidence per legislative requirements and checks documents for authenticity. Initiating contacts with beneficiaries or others to obtain omitted reports and clarify inconsistent or incomplete reports. Investigates and resolves systems -identified discrepancies and questionable situations. Identifyinu need for social services of people interviewedand refers them to appropriate private, nonprofit or government organizations supplying such services. I [at�dles Medicaid eligibility questions, including resolution and referral, as appropriate. • Identifying situations with public affairs implications or problems and issues of such complexity or magnitude to warrant referral and refers them to superiors or other organizational components. • As assigned, participates in training sessions as an instructor. • Performing cashier duties througl1 the use of the '1`ltird Party Draft System for the payment of certain administrative expenses (such as claims evidence, local travel, small purchases, etc.). Maintaining accurate receipts and controls to account for all draft activity and is responsible for safeguarding drafts. Ensuring the drafts are issued for authorized purposes. htputs payment information into the Agency's central accounting system via PC Email. The Office of Inspector General for the United States Department of Health and Hurnan Services (Office of Investigations) Miati-i Region (Miami Lakes) 0511212019-0911312019 Summer Path iva. ss 111t0718hip 2019 Student Trainee (Program Support Assistant) • Identifying various data required for use by management. • Identifying various resources required to support programoperations. Submitted into the public record for item(s) SPA on 11-18-2020, City Clerk • Writing reports of study findings for multiple projects, • Researching and investigating new or improved business and management practices for application to agency programs and operations. • Creating an Ar:tion plan. • Evaluating the success of projects in attaining their productive goals. • Assisting in assembling data and consolidating and preparing reports assigned for projects. • Typing memorandums, reports and other documents as assigned and reviews for correctness and conformance to organizational policies. • Accruing data from Polaris and NCMEC to investigate labor exploitation and sex trafficking. • Accruing data of labor and sex trafficking exploitation to be presented at appropriations committee by Special Agents in Charge (Miami) and an Assistant Inspector Genera! of Investigations. • Creating External Directory. ■ Accruing data for Project Child Vi►-tue and Project Safety -Net, • Accruing Data for- Genetic Testing Scam. • Assisting in researching and collecting, data, studies, and patterns, on regional/nationwide healthcare fraud activities in support of the prevention of HHS related fraud. • Assisting in preparing and/or reviewing written memorandums to support investigations and other work assi,nments. L • Assisting in utilizing databases and technologies to more effectively and efficiently support cases. Conducts searches and data analysis, inputs complaints and prepares reports, utilizes claims data systems such as ONE PI as well as NCIC, Sunbiz. and DMV databases to further investigations, inputs billing data and bank records into various computer software databases and applications. • Performing various administrative functions to support the day to day operations of the office; assists with ad hoc assignments, as directed/ by management. Participate in intra and/or inter regionallbranch activities as directed by management. • Reviewed legal documents (subpoenas) to assist with pending civil and criminal cases ■ Prepared reports and presentations directed by Management. • Reviewed MRO inspection report with ASAC and discuss implementing changes to Standard Operating Procedures. • Assisted Administrative Officer with time keeping. • A presenter during recruitment at local universities. Independent Contractor 0 l /2014-05/201 9 Marketing Research Auditor • Ensuring compliance with company procedures. Examining records, reports, operating practices, and documentation. Recommending new policies and procedures. • Verifying assets and liabilities by comparing items to documentation. • Apprising adequacy of internal control by completing audit questionnaires. • Maintains internal control systems by updating audit programs and questionnaires; recommending new policies and procedures. • Communicating audit findings by preparing a final report; discussing findings with auditees. • Compiling with federal, state. and local legal requirements. • Enflorcing adherence to policies and procedures; advising management on needed actions.. • Preparing special audit and control reports by collecting, analyzing, and summarizing operating information and trends. City of Mianti Police Department (Do the Right Thing of Miami, lire.) Submitted into the public record for items) SPA, on 11-1$-2020. City Clerk 12/2010-09/2011 Administrative Assistant to a Director in the Community Relations Unit • Chaired- sLUnnier "community coming together to help the environment • Administered administrative support to ensure efficient operation of die office. • Critiqued all reports. ■ unproved Organizing and scheduling. • Minute and note taker during board meetings. • Liaise with executive and senior administrative staff to handle requests and queries. • Grant writer, Bank of A,xnerica 05/2010-09/2010 Summer Internship 2010 Student Lender • Washington, D.C., National Leadership Summit (Civic, social and business leadership skills development). • Alumni project for Boys and Girls Club of America. • Developed co -curricular community engagement programs. RECOGNITION Awards • Student Leader ANvardee, Bank of America (Merrill Lynch). Awarded by Mr-. Gene Schaefer (President of Bank of America) 11/2010 • Certificate of Achievement, City of Miami. Awarded by: Chief Miguel Esposito (Clueforthe City of Miami Police Department) and The Honorable Tomas Regalado (Mayer- of the City of .Miami) 06/2010 ■ 5,000 Role Model of Excellence Program Award. Awarded by: Congresswoman Frederica Wilson (U.S- Congresswoman of District 17) 06/2010 Presidents Education Awarded by: Sec. Arne Duncan (Sectary of Education) and President. Barack Obanin (President of The United States of America) 05/2010 SERVICE Community Involvement (Volunteer) • Mt. Calvary Missionary Baptist Church09/1991-Present • Parents of Murdered Kids Member01/2014-Present ■ 5,000 Role Model Mentor (Miatni Central Sr. High School) 09/2010-Present • Boys and Girls Club of America (North West) 05I2010-08/2014 • Shirting Knights of Hope Mentoring Program 12/2009-03/2010 Submitted into the public record for item(s) SP.L on 11-18-2020, City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for itern(s) SP.1, on 11-18-2020, City Clerk p ED PM 4• 26 CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT 0'ry OF CI+ Y �1-��?!� HIAMf CITY OF MIAMI, FLORIDA STATE OF FLORIDA COUNTY OF MIAMI-DADE CITY OF MIAMI Mark L. Pitts first duly sworn under penalty of perjury, deposes and says: 1. My name is Mark L. Pitts (hereinafter "affiant"), being 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that i must maintain an actual and real residence within the district for the duration of my term of office. 3. I have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 511 I presently reside at the following address (must include zip code); 1274 NW 55 Terrace, Miami, Florida 33142 which is my legal address, and I have resided continually at said address from the 1 day of Septem ber 1993 to the present. 4_ Immediately prior to residing at the above -stated address, i have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: 2980 NW 59 Street For the Period: 10/05/1978 - 09/01/1993 Pare I Of 3 Rev. 10/2020 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles: N/A 6. Affiant's spouse resides at the following address (must include city, state and zip code) N/A 7. Affiant's caFn :fJ minor children reside at the following address (must include city, CC1 �e -&d code): w i rt N/A =c, 'n_, -0 = M 8. At the resent time, affiant is is no registered to vote in an city, count or a " other p (� i ��) 9 Y Y Y x �n than as stipulated in subparagraph 3 above. 9. Dame and business address of affiant's employer: Miami Dade County, 111 NW 1st Street, Miami 33128 Miami Dade County, 111 NW 1 st Street, Miami 33128 10. Affiant's occupation: Courtroom Clerk Affiant's business telephone number(s): 305-679-2999 11. Affiant has been employed in the above -cited capacity for the following period of time: 19 years (Nate: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) forthe period of one year prior to the date of this affidavit). 12. Affiant represents that he/she (is) is not currently holding another elective or appointive office — whether city, county or mun pa€ — the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Pam 2of3 Submitted into the public Rev. 10,2020 record for item(s) SP.1, on 11-18-2020. City Clerk Submitted into the public record for item(s)SP.1, on 11-I8-2020 City Clerk 44� SIGNED THIS DAY OF BEFORE ME, the undersigned authority, by means of V/ physical or online presence appeared MafV- who, after first being duly sworn (or affirmed), deposes and states that executed the foregoing to the best of 'nis knowledge andbelief. (SEAL) 1�VClTY K, CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced: _ 5ANQRAF©SGES NZryNk-SW,ofFb,& �} Comm�sson GG0646'a My Comm. Expres haf 19, 2021 arty_ BOiUtCC/ou�Ha�alNc�ryk�. •n Q =i G� Cs r FrI n -X i-Ti n r CD r •• ry CY% NBC 3 43 Rev. 10/2020 FORM 1 STATEMENT OF Wave print or type your name, moiling FINANCIAL INTERESTS a(Uress, agency name, and position below; UST AME — FIRSTNAME -- MIDDLE NAME 11�1� V\ MAILING ADDRESS CITY: ZIP-. COUNTY: NAME OF AGENCY NAME OF OFFICE OR POSl PION HELL) OR SOUGHT CHECK ONLY IF aNGI&AT-C—r, OR ® NEW EMPLOYEE OR APPOINTEE 2019 FOR OFFICE USE ONLY: r_ o -�; P CD 7j rrn N C's **** THIS SECTION MIDST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31. 2019- MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH APSE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (mus-tt,check one): El COMPARATIVE (PERCENTAGE) THRESHOLDS OR E j DOLLAR VALUE THRESHOLDS PART A — PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (if you have nothing to report, write "none" or "nia") NAME car 6UUKUL OF INCOME SOURCE'S ADDRESS DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY rF41K I ti — =L;UNUAKY bVUKL:ES Uh INUCIME IMajor customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nla") NAME OF NAME OF MAJOR SOURCES ADDRESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nia") Submitted into the public record for itern(s) SP.1, on 1111-1�2020 City Clerk PRINCIPAL BUSINESS ACTIVITY OF SOURCE You are not limited to the space on the lines on this Form. Attach additional sheets, if necessary. FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on wha must file this form and how to fill it out begin on page 3. CE FORM I - EHecriw January 1, 2620 [Continued an re,.erse side) PAGE 1 Incurporaled by reference to Rule 34-4 2a7{1). F.A.C. PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (it you have nothing to report, write "none" or"ola") TYPE: OF INTANGIBLE PART E — LIABILITIES [Major debts - See instructions] (If you have nothing to report, write "none" or "nia") NAME OF CREDITOR BUSINESS ENTITY TO WHICH THE PROPERTY RELATES ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses . See instructions] (If you have nothing to report, write "none" or 1. Wail) 1 BUSINESS ENTITY 41 BUSINESS ENTITY # 2 NAME OF BUSINESS ENTITY � na p ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENT17Y "-- €o _ I OWN MORE THAN A 5% INTEREST IN THE BUSINESS !MATURE OF MY OWNERSHIP INTEREST -C PART G — TRAINING r— For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F-S. 1 CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET PLEASE CHECK HERE Q SIGNATURE OF FILER: Signature: , 4 r Date Signed: - I FILING INSTRUC:TIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the Form to that location. To determine what category your position fails under, see page 3 of instructions. Local officerslemployees file with the Supervisor of Elections 3f the county in which they permanently reside. (If you do not uermanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) Farm 1 filers who file with :he Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to Ise. Do not email you form_ _to the Commission on Ethics, it will be -eturne . State officers or specif7ed state employees who file with the Dommission on Ethics may file by mail or email. To file by mail, >end the completed form to P.Q. Drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd, Bldg E, Ste 200, Tallahassee, FL 32303. To Fie with the Commission by email, scan tour completed form and any attachments as a pdf (do not use any )ther format], send it to CEForrnI@leg.state.il.us and retain a copy or your records. Do not file by bath mail and email. Choose only one ilinq method. Farm 6s will not be accepted via email. CE FORM 1 - Elrecava- January 1. 20X InwrA Wod by reference in Rule 3a-8-202(7), FA-C. CPA or ATTORNEY SIGNATURE ONLY if a certified public accountant licensed under Chapter 473, or attomey in good standing with the Florida Bar prs paved this form for you, he or she must complete the following statement 1, prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and hslief, the disclosure herein is true and correct. CPAlAttamey Signature: Date Signed: Candidates file this form together with their fling papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEN TO F]LE: Initially, each local officerlem ployee 1 state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they Fie their qualifying papers - Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form IF) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2019. Submitted into the public PAGE 2 record for item(s) 5P.L on 11-18-202fI, City Clerk CANDIDATE OATH — NONPARTISAN OFFICE rEC E, I V ED (Do not use this form if a Judicial or School Board Candidate) 2020 KOV _l 3 PM 4'. 26 Check box only if you are seeking to qualify as a write-in candidate: CFF:''E DF ThE CITY CLEEK CITY OF MIAMI ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) I, Mark L. Pitts (Print name above as you wish it to appear on the ballot, if your last name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be matte after the end of qualifying_ Although a write-in candidate's name is not printed on the ballot the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of jjttiifll l u� fy is U1� 5 (Office) (District #) I am a qualified elector of Miami -Dade County, Florida; (Circuit #j (Group or Seat #} I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to he nominated or elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida doter Registration Number (located on your voter information card). 1 0961 5769 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ey be used by persons with disabilities (see instructions on page 2 of this form): [Notapplicable to write-in candidates.] ball7r, r• (305) 7259 073 marklpitts@hotmail.com Signature of Ca dilate Telephone Number Email Address 1274 NW 55 Terrace Miami Florida 33142 Address City iai ZIP Code STATE OF FLORIDA Sig ur of Notary Public GOUNTY OF �� k - j a, Print, Type, or Stamp Commissioned Name of Notary Public below: Swam to or affirmed and subscribed before me b * 5Fuk-FGRGES ( ) Y Physical or ��;'� 8.`C; I��ary�a6i�-StalevfFarCa Cam. issm � GG OWA © online presence this day of �. -: '` -' Mycamm.Ezrfuma +9,2021 Pmrp UVO N Vj 4;,. Personally Known; or Produced Identification: Type of Identification Produced: 3 . Ciitm1 4 4 AA- .Li - .. «, «ice Puv11k ❑s-DE saantp (Rev. a�alzn) retard for item(s) SP.1. 1s-2.400y, F.A.C. an 11-1`202D City Clerk STATE OF FLORIDA COUNTY OF MIAMI-DA❑E L LOYALTY OATH Submitted into the public record for item(s) SP.1, on 11-18, 2020, City Cleric Pitts First Name Middle Initial Last Name a citizen o#dheaBtate of Florida and of the United States of America, ... and a candidate for public office ... do hereby sol tnlyswear or affirm that I will support the Constitution of the nited Sta s and of the State of Florida. Ltj Lea E's �4 Sign*,urL6f Candidate CITY OF MIAMI OATH OF CANDIDATE OFFICE OF A%r� !,l . Before me, an officer authorized to administer oaths, personally appeared Mark L. Pitts (PLEASE PRINT NAh1E) who, being sworn, says he/she is a candidate for the office of �11f\Vh016t\o .) , for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has quailed for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks„ and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida S 1274 N W 55 Terrace Sian tureb didate Miami 1' Florida 33142 Address City State ZIP Cade The Loyalty Oath and Oath of Candidate are sworn to (or affinned) and subscribed before me by EfPhysical or r �j.�`'1'41 F online presence, this 1 �J day of NAOVE C , 20 ?tD Slgnat of o Ic r Administering Oath or Notary Public Personally Known: CAR Produced Identification: FV17 Type of Identification Produced: FL } �yerr Lce vi -, �_Ytk cucics Name of Notary Typed, Pri ntW or Stamped SA11DRA FORGES r . Wary Pokc-Sveatra,Ma - , cmmisson a GG U4618 MyCcim_WrasMa!13.2021 RONed IN ,* Naser.4 SyWyHra, }oi_02A Submitted into the public record for item(s) S ve 11-1-8-2020 , City Clerk AkRK PITT F6one: (305)725-1073 Email: MarrhL.Pirrs@hs_�ail.com Strong people -skills, excellent communication skills, upbeat -friendly attitudelpersonality, organized, and creative, Experience with Microsoft {office applications: Ward, Excel, PowerPoint, Outlook. Proficient in (1) prornotionslmarketing (2) sports marketing (3) public relations (4) advertising Education Connecticut School of Broadcasting, Davie,FL, 2005 Miami Dade Community College 1998-2000 Professional Experience Broadcasting intern Miami Heat Miami, Fl 02/07 Responsible for brainstorming, planning, and execution of a variety of different marketing programs. Assist with Event preparation and setup for special events Build local and national support with an enthusiastic attitude Assist with event planning for business etiquette seminars_ Interact with print, broadcast, radio and web journalists. A 'Proofread and edit materials as needed. Answer phonas as needed. Set up and confirm media interviews. a Review web site articles. Research broadcasting information on the internet Video Tape operator Channel 7 News Miami, FL 033/06-09f06 Responsibie for assisting the AudioAlideo Department through publicity strategies and Public Relations. Gathered information and researched stories used for newscast, Pulled stories from news wires * identified and retrieved video files for newscast Learned to operate editing equipment Organized and maintained tape library ® lumbered, logged and shelved all tapes Assisted in the duplication needs of the department o Edited rough cuts as assigned Served as production assistant Judicial Clerk Juvenile Clerk of Courts Miami, FL 05/01 •prasent Responsible for managing the administrative activities of the clerk's office. Informs clients and attorneys with juvenile records inquiries, courtroom updates Provide status reports on open and closes cases ® Transports court documents to designated court offices ® Identifies and responds to judges needs in a timely and efficient manner * Maintains liaison and coordinates court operations with representatives of allied government agencies Assures that personal conduct and communications foster a positive work atmosphere Acts as liaison with various governmental agencies on a variety of court matters Technical[ Skiffs Software: Micxosofifl Word, Excel, Project, PowerPoint Hardware: Character Generator, Teleprompter, Switcher, 360 Machines, Audio Board, Cool Edit, Control Hoard C rV r,nI o C c M-< co (�nnnecffeut #rIJOVI U ,ys r-1 � C L W, QCUCU CS o E UCU .� V) 4-a Eaut!, N 4� KICIT The Nation's Oldest and largest Group of Communications Schools 3538 4wittil IIniurr UIj Briuc, 4nuic, YWOL)tt 33328 r5 Z,Zrfifiz�i t1lat Al a r h-- ,q ir t t 5 11a.5 aurrr00futIg rtimpirtrb training ill rabic anb triruiaiatt braabrttating minh rrreiurl aNTaiireb i tatt-ttrtion ill tier fir[b of mill"'"Ili ratiails am) utritia Dperatiatta 4:3 to Ill a Submitted into the public record for item(s) SPA, on 11-18-2020 City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) on 11-18-2020, City Clerk CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENTr, CITY OF MIAMI, FLORIDA c `' r� STATE OF Ft-OR1DA ] 1�_< COUNTY OF MIAMI-DADE } CITY OF MIAMI } Stephanie Thomas first duly sworn under penalty of perjury, deposes and says My name is Stephanie Thomas Q w cn (hereinafter "affiant"), being 2, 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office. 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and 1 am a registered voter and a duly qualified elector in District 5. 1 am presently registered to vote in Precinct No. 515 presently reside at the following address (must include zip code): which is my legal address, and I have resided continually at said address from the 1 day of August 2018 to the present. 4. Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: For the Period: 7/2017 - 8/2018 4/2006 - 712017 Page l ur3 Rev 1 [].'? fS? f} 5. In addition to the residence that I have listed as my present address, I also reside at the following fisted addresses on a temporary basis as a secondary domicile or domiciles: NIA. 6. Affiant's spouse resides at the followinq address must include city, state and zip code): 7_ Affiant's minor children reside at the following address (must include citycstat(�and-Ttip code): qni -- = -� rrl —,Cj 8. At the present time, affiant (is) is not' registered to vote in any city, county o�stp other than as stipulated in subparagraph 3 above, :;9 9. Name and business address of aff!ant's employer: City of North Miami, 775 NE 125 St, North Miami, FL 33131 City of North Miami, 775 NE 125 St, North Miami, FL 33151 10. Affiant's occupation: Assistant to CP&D Director Affiant's business telephone number(s): 305-893-651 1 11. Aff!ant has been employed in the above -cited capacity for the following period of time: 2002 - present (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit). 12. Affiant represents that he/shenpf)-currently holding another elective or appointive office - whether city, county or municipal - the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Affiant represents that, if appointed, he/she shall serve in the office so appointed. Submitted into the public rb z or3 record for item(s) s�, x��. is znza on I1-^ S- O , City Clerk Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk `Ch SIGNED THIS ��J DAY OF hew bef , 90,;Lo . ,r A IANT BEFORE ME, the undersigned authority, by means of V physical of online presence appeared � T �-T1nOMAS who, after first being duly sworn (or affirmed), deposes and states that 5n� executed the foregoing to the best of knowledge and belief. (SEAL) CITY K, CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced: FU DAgei' Uu ytac SANRRAFQRC NWgPot -SWeofNota ( " _ Commission �GGD64Sti8 .� C7] "My C"m. Dykes Mar 19,202$ �� rn CD Page 3 of 3 Rev. 10!2020 FORM I STATEMENT OF 2019 Please Print or type your Flame, ma.ifing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and position below: LAST NAME -- FIRST NAME -- MIDDLE NAME: fvTA[l -n rr _ Cirr C--) CITY: ZIP : COUNTY : _ 1� C3 NAME OF GENCY: � r11111 I 1 c]"he4— i, l n- r- � a' NAME OF OFFICE OR POSITION HELD OR SOUGHT: CHECK ONLY IF OR NEW EMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THE OPTION OF USING REPORTING THRESHOLDS THATARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON 'PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one): 0 COMPARATIVE (PERCENTAGE) THRESHOLDS OR 17 DOLLAR VALUE THRESHOLDS PART A •• PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or'Wa" ) NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL ACTIVITY (j �y �1 rr 'l I(fl t!-72� f.- L. • �J., _.~- y/BUSINESS �(.el;17iYr6,- PART B -- SECONDARY SOURCES OF INCOME [Major customers, clients, and other sources of income to businesses owned by the reporting person - See instructions] (If you have nothing to report, write "none" or "nfa") NAME OF NAME OF MAJOR SOURCES ADDRESS PRINCIPAL BUSINESS BUSINESS ENTITY OF BUSINESS' INCOME OF SOURCE ACTIVITY OF SOURCE PART C -- REAL PROPERTY [Land, buildings owned by the reporting person - See instructions] You are not limited to the space on the (If you have nothing to report, write "none" or "nla" ) lines on this form. Attach additional sheets, if necessary. �j Submitted into the Public FILING INSTRUCTIONS for when 1 Y record for item(s) SP.1, and where to file this form are located at the bottom of page 2. Orl 11-18-202Q, CitY Clerk INSTRUCTIONS on who must file this form and how to fill It out begin on page 3. CE FORM i - EAeOve. January 1, 200 (Continued on reverse eou,l PAGE 1 lncorpordted by reference in Rule 34-0.202(1), F.A.C. PART D — INTANGIBLE PERSONAL PROPERTY [Stocks, bonds, certificates of deposit, etc. - See instructions] (if you have nothing to report, write "none" or "nla") i TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E — LIABILITIES [Major debts - See Instructionsl (if you have nothing to report, write "none" or "nla") OFF ". 0F Ti7E Cl T Y CLERK I IITY OF_MIAMI NAME OF CREDITOR ADDRESS OF CREDITOR P RT — INT R STS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See Instructions] (If you have nothing to report, write "none" or'Wa") BUSINESS ENTITY # 1 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST BUSINESS ENTITY # 2 Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk PART G — TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112,3142, F.S. a I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING.. IF ANY OF PARTS A THROUGH G ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK 'HERE Q SIGNATURE OF FILER: CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter473" or attorney Signature: in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement: —� J. prepared the CE Form 1 in accordance with Section 112.3145, Florida Statutes, and the instructions to the form. Upon my reasonable knowledge and belief, the } disclosure herein is true and correct. Date Sig'ed: j CPA/Attorney Signature: Date Signed: FILING INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. To determine what category your position falls under, see page 3 of instructions. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor Of the county where your agency has its headquarters.) Form 1 filers who file with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Elections for the mailing address or email address to use. Do not email your form p the Comrnissign on Ethics. it will be returnP . State officers or specified state employees who file with the Commission on Ethics may file by mail or email. To file by mail, send the completed form to P-d. drawer 15709, Tallahassee, FL 32317-5709; physical address: 325 John Knox Fed, Bldg E, Ste 200, Tallahassee, FL 32303. To file with the Commission by email, scan your completed form and any attachments as a pdf (do not use any other format), send it to CEForm1 leg.stateAus and retain a copy for your records. Do not file by -both mail and email. Choose only One filing method. Form ss will not be accepted via email. Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY; A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections, WHEN TO FILE: Initially, each local off icerlemployee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July 1 following each calendar year in which they hold their positions. Finally, file a final disclosure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form 1 F (Final Statement of Financial interests) does not relieve the filer of filing a CE Form 1 if the filer was in his or her position on December 31, 2419. CE FORM i - Elfecliwe Januw+y 1. 2020- PAGE 2 lrwpnraled by reference in Rule 34-8.202(1 }, F A.0 CANDIDATE OATH — NONPARTISAN OFFICE RECEIVED (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a AM 10: 36 write-in candidate: OF THE 'CITY CLERK © Write-in candidate; L,1TYOFMIAMI OFFICE USE ONLY Candidate Oath (Section 99.021(1 )(a), Florida Statutes} S- I, Stephanie Thomas (Print name above as you wish it to appear can the ballot. If your last name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of Commissioner 5 (Office) (District #} ;I am a qualified electorof Miami -Dade H County, Florida; — (circuit ##) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected-, I have qualified for no other public office in the state, the term of which office: or any part thereof runs concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes-, and l will support the Constitution of the United States and the Constitution of the Stale of Florida. Candidate's Florida Voter Registration Number (located on your voter information card): 109291899 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Not applicable to write-in candidates-] ii Ste phthomascampaign @ grnaILcom Signature of Candidate Telephone Number Email Address Address City 5ta ZIP Code STATE OF FLORIDA Sign t f Notary Public COUNTY OF N iCkM 4 -tb2e, Print, Lype, or 5lamp Commissioned Name or Notary Public below: i'' 'Sworn to (or affirmed} and subscribed before me byVphysical or : Mo, :online presence this day of Q .`` ttyC nm.FxGxes lvlar e9.202i Personally Known. or Produced lddeentification: ` - Type of Identification Produced: i` t- ZJ'f1� J S �luntr_ Submitted into the public record fnr itprntct co T DS DE 302NP (Rev. 04120) on 11-18-2020 City Clerk ale lS-2ADQ1 F.A.C. STATE OF FLORIDA COUNTY OF MIAMI-DADE e "ETV LOYALTY OATH Middle Inilial Submitted into the public record for item(s) S on 1111-1�, City Clerk '0e?5 Last Name Ll7 �z a citizu of&e Mate of Florida and of the United States of America, ... and a candidate for public office ... do here�104-nlear or affirm that I will support the Constitution of the United States and of the State of Florida. _ .CZ U W ro> IOU- -t Ljj Q ,- ignature of C didate tl�e CITY OF MIAMI OATH OF CANDIDATE OFFICEOF Before me, an officer authorized to administer oaths, personally appeared (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of ;V-1 y, t �1 it for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021, Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to resign or take a leave of absence, pursuant to Section 99.012, Florida Statutes. Address City Stale ZIP Code t�t ai I flu. The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by / physical or online presence, this �5TAN day of �YVI t , 20 ZQ �'S�fa signature ofn r dminiis�tering Oath or Notary Public Name of Notary Typed, PrinteojF Stamped SANORAFCRGES Personally Known. 1j OR Produced Identification: M Notm Pot —Stale orFlonda Coffin 9 GG DPW • My Comm,&oues Mtar 19, 2021 "^ D • s V e V-j II 1.� , �s '�•,••' gWrdprp�' katitn9l alotvy�4sar� Type of Identification Produced: t;`n,Q �ty— P20Ia Submitted into the public record for items) SPI on 11-18-2D20 City Cleric STEPHANIE S THOMAS Biography With a healthy dose of tenacity, compassion, commitment, ingenuity, dedication, integrity, and a love for family and community, Stephanie Thomas brings a wealth of experience to just about any role. A seasoned public sector professional with nearly two decades of service, Stephanie is the embodiment of infectious selflessness. It is no surprise then that this dedicated public servant is ready to fight for her district, making a choice to serve the community in which she was born and raised —and still lives today, in the same house. A proud Haitian -American whose parents migrated from Haiti in the 19605, Stephanie recounts her childhood with a palpable fondness. She especially relishes memories of family outings to the historic Gesu Raman Catholic Church as well as her tenure at Edison Elementary School, Morningside Elementary School, Nautilus Middle School, and Miami Beach Senior High Schaal. An avid learner, Stephanie went on to earn her Associates's Degree in Pharmacy from Miami -Dade College, a Bachelor of Science in Health Information Management, as well as a Master's in Health Informatics & Managements Systems from Florida International i University, and a Master's degrees concentrating in Public Administration from the University of Miami. But she's not done. A devoted wife and mother of two young adults, Stephanie will earn her Doctorate in Health Sciences (DHSc) from the Eastern Virginia Medical School (May 2021). It's little wonder she finds herself eager to use her experiences as a public servant, wife, mother, volunteer, and healthcare professional & enthusiast to serve District 5 and the City of Miami. Her public service includes; City of North Miami Deputy City Clerk (City of North Miami) ■ Community Planning & Development Business Tax Receipt Manager, CBTO Constituent Services Coordinator ■ Confidential Secretary (Mayor & Council) Affiliations, Memberships & Volunteerism • American Society for Public Administration (ASPA) South Florida Chapter + American Health Information Management Association (AHIMA) IWVIH Ali'kil" • Florida Association of Business Tax Officials (FABTO) )41d310 �1113 'Pi- jB q` 1 JA0 C? _0 Hd , C 14 AON 0Z91 03A, 1033 Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk • Florida Association of City Clerks (FACC), Chair of the By-Laws/Manual Revisions Committee • Florida Bar Association Health Law Section • Florida Bioethics Network (FBN) • Haitian -American Chamber of Commerce of Florida (HACCOF) • Health Council of South Florida (HCSF) ■ Health Information Management Society (HIMSSS) • Health Law Section — The Florida Bar • International Institute of Municipal Clerics (IIMC) National Forum for Black Public Administrators (NFBPA), South Florida Chapter, Event Committee Chair • Pi Alpha Alpha National Honor Society for Public Affairs & Administration, University of Miami Chapter Her husband Shawn, a double organ recipient, Stephanie makes it her mission to bring awareness to organ donation and counts the following among her chief concerns for her beloved District 5: • Affordable Housing • Bridging socioeconomic gaps ■ Climate Control • Economic Development • Education • Gentrification • Healthcare ■ Homeownership • Maternal Mortality • Safety & Infrastructure "I think it's time to invoke Gandhi. It's time for me to STEP up and 'be the change."' — Stephanie Thomas, Candidate, City of Miami's District 5. Needless to say, Stephanie draws on her name in her commitment to the community, choosing to STEP in and STEP out to ensure its safety, development, and prosperity. -r. a rr �C -rl TI _ fTj M w Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk \rSQ,����STEPHANIE THOMAS pgandcompany@aol.com EDUCATION Eastern Virginia Medical School August 2018 - present Doctorate of Health Sciences [DHSc] University of Miami Coral Gables, FL Master in Public Administration June 2018 Florida International University Miami, FL Master of Science Health Informatics & Management Systems August 2013 Bachelor of Science Health Information Management May 1999 Miami -Dade College Miami, FL Associate in Arts June 1997 EXPERIENCE City of North Miami, North Miami, FL 2002 - Present Community Planning & Development 2020 - Present Business Tax Receipt Manager, CBTO 2017-2020 • Enforces Local Business Tax Receipt Ordinances • Maintains records on Local Business Tax Receipts and completes related reports. • Issues Local Business Tax Receipts and permits as appropriate. • Ensures that all active businesses in the City have the required Business Tax Receipts ■ Assists in administering the Business Tax functions, including the application process, fee assessment and collection, and Business Tax issuance. • Researches and analyzes data and information relative to Business Tax Receipts • Assists in resolving complex and sensitive customer service issues, either personally, by • telephone or in writing. Deputy City Clerk, M MC 2014 - 2017 • Perform follow-up activities resulting from Council meetings, including distributing minutes, ensuring that resolutions and ordinances are in proper format and are signed; track committee and commission actions; prepare letters of acce pta nce/rejecti on • Recommend and coordinate the development and maintenance of computerized applications and systems; maintain centralized records management system, archive, and records retention • Index, process, copy, distribute, file, and certify copies of ordinances, resolutions, official minutes, and other public records; maintain and update Municipal Codebooks • Prepared and publish legal & public notices in coordination with City Departments • Assist City Clerk in the administration of municipal elections • Perform duties as Supervisor of Municipal Elections Assist in the development and preparation of annual budget Process and execute passport applications Issue Business Tax Receipts (BTR) Constituent Services Coordinator 2010 - 2014 Confidential Secretary 2002 - 2010 • Principal administrative aide to the Mayor and five -member Council • Supervised staff of three or more • Decreased office expenditures 15% by implementing needed controls on stock/supplies and standardizing ordering procedures T Submitted into the public record for items) SPA, on 11-18-2020, City Clerk • Scheduled and maintained meetings and appointments for Mayor and City Council • Coordinated travel logistics For conferences and seminars • Attended board, committee, community meetings and conferences on behalf of the department. • Directed complex projects and events from concept to fully operational status, including prospective letters to sponsors, bringing in more than over$150,000 through the years • Served as a resource for members of the public seeking assistance across government services • Managed office budget of $100,000 Barry University, Miami Shores, FL 1999 - 2001 Administrative Assistant - Student Health Services and Alumni Relations • Served as executive assistant to the management team, handled a busy phone system, functioned as primary liaison to customers, and ensured a consistently positive customer experience • Helped drive a 10% increase in student services and alumni participation/enrollment • Created automated daily stats report that reduced inaccuracies, providing management with 'important decision - ma king too Is Earned a reputation for maintaining a positive attitude and producing high -quality work • Trained, supervised, and evaluated interns and volunteers Expertise in ICD-9-CM, CPT coding, and electronic medical record -keeping and retention • Maintained database of Alumni and minutes for board meetings • Assisted Alumni Board and staff in coordinating Homecoming Vicente Roger, MD, and Associates, Bay Harbor, FL Medical Billing and Collections Manager 1993 -1999 • Trained, supervised daily activities of staff, evaluated staff performance, and coached management skills • Document specialist in auditing medical records for ICD-S-CM and CPT coding and record retention • Knowledge of licensing, reimbursement, and accreditation standards. Provided ongoing training to staff on the intricacies of insurance submissions, codes, and intake procedures to minimize rejections for referrals • Built mutually respectful relationships with third -party payers, HMOs, PPDs, Medicaid, and independent commercial carriers • Responsible for patient billing and correspondence Julian H. Groff, MD, and Associates, North Miami Beach, FL Medical Billing and Collections Manager • Maximized reimbursement by ensuring accurate iCD-9-CM and CPT coding • Conducted audits of providers` selected codes compared to chart documentation 1990 - 1994 • Built mutually -respectful relationships with third -party payers, HMOs, PPOs, Medicare, Medicaid, workers' compensation (WC) carriers, and independent commercial carriers • Collected $50,000 in bad debt previously denied by Medicare, Medicaid, and other insurance carriers • Responsible for accounts receivable accounts valued over $500,000 ■ Maintained verbal and written communication between patients and insurance carriers Harold Weiner, MD, and Associates, Miami Beath, FL Medical Administrative Assistant 1988 -1994 MEMBERSHIPS & AFFILIATIONS % International Institute of Municipal Clerks (IiMC) p� r CQ Florida Association of City Clerks (FACC), Bylaws and Manual Committee Chair►; *►� Florida Association of Business Tax Officials (FABTO).y rl American Society for Public Administration (ASPA) South Florida Chapter ,'t �� , Pi Alpha Alpha Honor Society (UM) � National Forum for Black Public Administrators (NFBPA), South Florida Chapter, Event Committee Ciwir Submitted into the public record for items) SPA on 11-18-2020, City Clerk October 29, 2020 Samuel Blatt 212 [ N. Bayshore Drive Apt. 905 Miami, FL 33137 SENT VIA EMAIL : krussell@miamigov.com The Honorable Commissioner Ken Russell City of Miami — City Hall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MIAMI DISTRICT 5 APPOINTMENT Dear Commissioner Russell: It is with great pleasure and enthusiasm that I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. I have personally worked with Stephanie as a public servant in government for more than three years, and I know her character and passion for serving others. The City of Miami would benefit tremendously by having her sit on your dais and serve its residents. Stephanie is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. Stephanie does not covet power or elected office for the sake of it, but rather because of her deep commitment to serving the community. She has been a public servant for over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting Resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district that has shaped her to be a future pilar in the community. I thank you for your time and sincere consideration. Sincerely, N�37 14VIW,4.9A119 �+i'I0-slfl Samuel Blatt, CEcD submitted into the public record for item(s) SPA on 11-18-2024, City Clerk October 29, 2020 Samuel Blatt 2121 N. Bayshore Drive Apt. 906 Miami, FL 33137 SENT VIA EMAIL.: mreyes@miamigov.com The Honorable Commissioner Manolo Reyes City of Miami -- City Hall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MIANII DISTRICT 5 APPOINTMENT Dear Commissioner Reyes: It is with great pleasure and enthusiasm that I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. I have personally worked with Stephanie as a public servant in governmen t for more than three years, and I know her character and passion for serving others. The City of Miami would benefit tremendously by having her sit on your dais and serve its residents. Stephanie is the ideal candidate because of her integrity and compassion for her District_ Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. Stephanie does not covet power or elected office for the sake of it, but rather because of her deep commitment to serving the community. She has been a public servant for over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting Resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district that has shaped her to be a future pilar in the community. I thank you for your time and sincere consideration. Sincerely, Samuel Blatt, CEc> 1WV1W Al A112 Yld7JO A110 3l'l 40 3;' ,Ai1 I Z :ZI kd £ I I10N a10I Submitted into the public record for item(s) SP.1, on 11-18-2020, City Clerk J October 29, 2020 Samuel Blatt 2121 N. Bayshore Drive Apt. 906 Miami, FL 33137 SENT VIA EMAIL : adiazdeiaportilla@miamigov.com The Honorable Commissioner Ales Diaz de la Portilla City of Miami -- City Hall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF NMkIN111 DISTRICT 5 APPOINTNtENT Dear Commissioner Diaz de la Portilla: It is with great pleasure and enthusiasm that I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. 1 have personally worked with Stephanie as a public servant in government for more than three years, and I know her character and passion for serving ethers. The City of Miami would benefit tremendously by having her sit on your dais and serve its residents. Stephanie is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. Stephanie does not covet power or elected office for the sake of it, but rather because of her deep commitment to serving the community. She has been a public servant For over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation_ I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district that has shaped her to be a future pilar in the community. I thank you for your time and sincere consideration. Sincerely, Samuel Blatt, CEcD IZ:Z1 Nd £i AGN UK aIA� 03. Submitted into the public record for items), PU on 11-18-2020, City Clerk October 29, 2020 Samuel Blatt 2121 N. Bayshore Drive Apt. 906 Miami, FL 33137 SENT VIA EMAIL: jcarollo@miamigov.corn The Honorable Commissioner Joe Carollo City of Miami — City Hall 3500 Pan American Drive Miami,l~L 33133 REF: CITY OF M'1AMI DISTRICT 5 APPQINTINI ENT Dear Commissioner Carollo: It is with great pleasure and enthusiasts that I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. I have personally worked with Stephanie as a public servant in goverrunent for more than three years, and I know her character and passion for serving others. The City of Miami would benefit tremendously by having her sit on your dais and serve its residents. Stephanie is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. Stephanie does not covet power or elected office for the sake of it, but rather because of her deep commitment to serving the community. She has been a public servant for over IS years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting Resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence Iegislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district that has shaped her to be a future pilar in the community. I thank you for your time and sincere consideration. Sincerely, IW'j1W J6,k112 110 31-I t 3O ?." #37 hZ 21 NJ C I AON UK 03A13333 Submitted into the public record for items) SP.1, on 11-1^ S-2020 City Clerk November 1, 2020 5ENT VIA EMAIL: adiaxdelaportiIla@miamigov.com The Honorable Commissioner Alex de la Portilla City of Miami- City hall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MIAMI DISTRICT 5 APPOINTMENT Dear Commissioner Diaz de la Portilla, It is with extreme pleasure and enthusiasm that I write this letter in Support of Stephanie Thomas to be appointed Commissioner of City of Miami District 5. 1 believe that Stephanie is the epitome of the ideal commissioner not only because of how immensely devoted she is to giving back to her community, but for her passion and the drive she has to make a change for the better. Not only has she been a resident in District 5 since 1978, but she has also attended school and raised her children, wh❑ attend college and on of whom plans to join the United States Coast Guard upon graduation in 2021. Stephanie has more than enough experience with how local governments operate and what it takes to be an exceptional civil servant because she has been one for well over 18 years for the City of North Miami. Therefore, she understands the commitment and dedication it takes to be a commissioner, She is already a member of various boards and a very well appreciated, respected, and loyal public servant. I urge you to appoint the ideal person for District 5. Someone who will exhaust every resource available and never stop fighting or giving back to the residents of District 5. That person is Stephanie Thomas. If Stephanie is not appointed, a special election is preferred. Thank you for your time and consideration. Sincer#Va Ariaya District 5 resident 5927 NE 4 Court QVIW 33 A112 A813 `Also 311, jo ?:! a'1 G--]A1333 Submitted into the public record for item(s) 5P.1. on 11_18-2624, City Clerk November 1, 2020 SENTVIA EMAIL: krusseell@miamigov.com The Honorable Commissioner Ken Russell City of Miami- City Hall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MIAMI DISTRICT 5 APPOINTMENT Dear Commissioner Russell, It is with extreme pleasure and enthusiasm that I write this letter in support of Stephanie Thomas to be appointed Commissioner of City of Miami District 5. 1 believe that Stephanie is the epitome of the ideal commissioner not only because of how immensely devoted she is to giving back to her community, but for her passion and the drive she has to make a change for the better. Not only has she been a resident in District 5 since 1978, but she has also attended school and raised her children, who attend college and one of whom plans to join the united States Coast Guard upon graduation in 2021. Stephanie has more than enough experience with how local governments operate and what it takes to be an exceptional civil servant because she has been one for well over 18 years for the City of North Miami. Therefore, she understands the commitment and dedication it takes to be a commissioner. She is already a member of various boards and a very well appreciated, respected, and loyal public servant. I urge you to appoint the ideal person for District 5. Someone who will exhaust every resource available and never stop fighting or giving back to the residents of District 5. That person is Stephanie Thomas. If Stephanie is not appointed, a speciai election is preferred. Thank you for your time and consideration. Sincerely, Jaya V I District 5 resident 5927 NE 4 Court IWVIW A A112 }#'d339 K110 3H1 30 3 ' J30 hZ =Zi Nd c l- ACIN OW Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk November 1, 2020 SENT VIA EMAIL. jcarollo@miamigov.com The Honorable Commissioner,loe Carollo 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MIAMI DISTRICT 5 APPOINTMENT Dear Commissioner Rollo, It is with extreme pleasure and enthusiasm that I write this letter in support of Stephanie Thomas to be appointed Commissioner of City of Miami District 5. 1 believe that Stephanie is the epitome of the ideal commissioner not only because of how immensely devoted she is to giving hack to her community, but for her passion and the drive she has to make a change for the better. Not only has she been a resident in District S since 1978, but she has also attended school and raised her children, who attend college and one of whom plans to join the United States Coast Guard upon graduation in 2021. Stephanie has More than enough experience with how local governments operate and what it takes to be an exceptional civil servant because she has been one for well over 18 years for the City of North Miami. Therefore, she understands the commitment and dedication it takes to be a commissioner. She is already a member of various beards and a very weII appreciated, respected, and loyal public servant. I urge you to appoint the ideal person for District S. Someone who will exhaust every resource available and never stop fighting or giving back to the residents of District 5. That person is Stephanie Thomas. If Stephanie is not appointed, a special election is preferred. Thank you for your time and consideration. Sincerely, A r i a y na V I District 5 resident 5927 NE 4 Court 1WVJW J0 h :Z! I AON 07,01 Submitted into the public record for item(s) SP.-L on 11-18-2020 City Clerk November 1, 2020 SENTVIA EMAIL: mreyes@miamigov.com The Honorable Commissioner Manolo Reyes City of Miami- City Fall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MIAMI DISTRICT 5 APPOINTMENT Dear Commissioner Reyes, It is with extreme pleasure and enthusiasm that I write this letter in support of Stephanie Thomas to be appointed Commissioner of City of Miami District 5. 1 believe that Stephanie is the epitome of the ideal commissioner not only because of how immensely devoted she is to giving back to her community, but for her passion and the drive she has to make a change for the better. Not only has she been a resident in District 5 since 1978, but she has also attended school and raised her children, who attend college and one of whom plans to join the United States Coast Guard upon graduation in 2021. Stephanie has more than enough experience with how local governments operate and what it takes to be an exceptional civil servant because she has been one for well over 18 years for the City of North Miami. Therefore, she understands the commitment and dedication it takes to be a commissioner. She is already a member of various boards and a very well appreciated, respected, and loyal public servant. I urge you to appoint the ideal person for District 5. Someone who will exhaust every resource available and never stop fighting or giving back to the residents of District 5. That person is Stephanie Thomas. If Stephanie is not appointed, a special election is preferred. Thank you for your time and consideration. Sincerely*yn V I District 5 resident 5927 NE 4 Court JWVlW 30'ltlz N'd37IJ A113 3111 JO 1"3J0 qZ -ZI Rd C i AON BUZ 02AE J3, Submitted into the public record for item(s) SPJ7. on 11-18-2023 City Clerk October 14, 2020 SENT VIA EMAIL: krusscll@ml-amigov.com The Honorable Commissioner Ken Russell City of Miami — City Hall 3500 Pan American Drive Miami, FL 33133 REF: CITY OF MUNII DISTRICT 5 APPOINTMENT Dear Commissioner Russell - With great pleasure and enthusiasm, I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. Stephanie is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began herprofessional career in public service while still residing in District 5. She has been a public servant for over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting Resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give hack tirelessly to the district has shaped her to be a future pillar in the community. Thank you for your time and sincere consideration. Sincerely, Dr. Enid C. Pinkney Organization, Founding President, Emeritus, Historic Hampton House Community Trust, Inc.; A-8310 ),Il0?'!1 �0 3;'1j"' h Z -Z1 Hd £ i &ON UZot 034333d Submitted into the public record for item(s) SP.1, on 11.-18-2020, City Clerk October 14, 2020 SENT VIA EMAIL: mreyes@miamigov.com The Honorable Commissioner Manolo Reyes City of Miami — City Hall 3500 Pan American Drive Miami, FL 33133 REEF: CITY OF MTANU DISTRICT S APPOINTMENT Dear Comrnissionner Reyes: With great pleasure and enthusiasm, I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. Stephanie is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. She has been a public servant for over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting Resolutions and Ordinances. In her capacity as a Ioyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district has shaped her to be a future pillar in the community. Thank you for your time and sincere consideration_ Sincerely, Dr. -En & C--P6YL%� Dr. Enid C. Pinkncy Organization, Founding President, Emeritus, Historic Hampton House Community Trust, Inc.:. V43IIlk 10 2NI �jojal3-40 �z :a wd c r uw azo, Submitted into the public record for item(s) 2.1, on 11-18-2020, City Clerk October 14, 2020 SENT VIA EMAIL. adiazdelaportilla@a,miamigov.com The Honorable Commissioner Alex Diaz de la Portilla City of Miami — City Hall 3500 Pan, American Drive Miami, FL 33133 REF: CITY OF MIAI►rII DISTRICT 5 APPOINTNMN-f Dear Commissioner Diaz de la Portilla: With great pleasure and enthusiasm, I write this letter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. Stephanie is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. She has been a public servant for over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adopting Resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district has shaped her to be a firture pillar in the community. Thank you for your time and sincere consideration. Sincerely, Dr. Enu&C. Ply ❑r. Enid C. Pinkney Organization, Founding President, Emeritus, Historic Hampton House Community Trust, Inc.: ?WV1W 3a AVC, C'110010 Al.13 341 Ja 3,"3.40 s 0 'd R ON 0101 0I1hl13- Submitted into the public record for itemN S , on 1111-18-2020, City Clerk October 14, 2020 SENT VIA EMAIL: jearollo@mianu'gov.com The Honorable Commissioner Joe Carollo City of Miami — City Hall 3504 Pan American Drive Miami, FL 33133 REF: CITY OF NIIANU DISTRICT 5 APPOINTMENT Dear Commissioner Corollo: With great pleasure and enthusiasm, I write this Ietter of support for Stephanie Thomas to be appointed Commissioner of City of Miami District 5. Stephanie- is the ideal candidate because of her integrity and compassion for her District. Stephanie moved to District 5 in 1978, attended the local public schools and universities, and began her professional career in public service while still residing in District 5. She has been a public servant for over 18 years, working in government for the Mayor and Council Office, Finance Department, Community Planning Development Department as a Deputy City Clerk who understands the importance of creating and adapting Resolutions and Ordinances. In her capacity as a loyal and respected civil servant, Stephanie sits on various boards that impact and influence legislation. I ask that you appoint a true compassionate champion for District 5. One who will be a role model and will give back tirelessly to the district has shaped her to be a future pillar in the community. Thank you for your time and sincere consideration. Sincerely, Dr. 'En. & C. P6nk4wy Dr_ Enid C. Pinkney Organization, Founding President, Emeritus, Historic Hampton House Community Trust, Inc.: Submitted into the public record for item(s) SPA, on 11-18-2020, City Clerk INTENTIONALLY LEFT BLANK Submitted into the public record for item(s) SSA on 11-18-2020, City Clerk _ r K F _ �l p►7 �7 CITY COMMISSION VACANCY AFFIDAVIT OF APPOINTMENT CITY OF MIAMI, FLORIDA F7 { p= x M STATE OF FLORIDA r COUNTY OF MIAMI-DARE )Ln CITY OF MIAMI } Jeffrey Watson (hereinafter "affiant"), being first duly sworn under penalty of perjury, deposes and says: 1. My name is Jeffrey Watson 2. 1 am offering myself as an appointee to fill the unexpired term for the vacant office of Commissioner in District Number 5 of the City of Miami, Florida. I fully understand that I must maintain an actual and real residence within the district for the duration of my term of office, 3. 1 have resided in the Commission District Number 5 for a minimum of one year before qualifying, and I am a registered voter and a duly qualified elector- in District 5. 1 am presently registered to vote in Precinct No. 518 I presently reside at the fallowing address (must inclu 43 NW 39th St ram, c,,j T�_ 3311,_7 p code): which is my legal address, and I have residers continually at said address from the 23 day of April , 1997 to the present. 4, Immediately prior to residing at the above -stated address, I have resided at the hereinbelow listed addresses for the cited periods of time (list hereinbelow all addresses at which you have resided for the past five years, as well as the length of time at each address): Prior Addresses: For the Period: 'V/ A 0 Pale 1 dr3 Rev. 1012020 Submitted into the public record for items) on 11-18_2o2p City Clerk 5. In addition to the residence that I have listed as my present address, I also reside at the following listed addresses on a temporary basis as a secondary domicile or domiciles; 54 NW 401h S0 Miami 33127; APlhough not my pdntary res'denr I own ad a secondary reslJer•,Co. Oomi "iu as 1911 15Ih 51 NW Wasninglon 6G 20DO9 Glom 1994-2010 6. Affiant's spouse resides at the following address (must include city, state and zip cod 54 NW 40th St Miami 33127 7. Affiant's minor children reside code): none at the following address (must include city, ail "rl f`i i7 "ta M1� rr1 C.Ji 8. At the present time, affiant (is) is not} rstered to vote in any city, county or site other than as stipulated in subparagrap ove. 9. name and business address of affiant's employer: 1 L 01 *- 10. Affiant's occupation: Economic Development Consultant AFfiant's business telephone number(s): (202)573-4890 11. Affiant has been employed in the above -cited capacity for the following period of time: 5 years (Note: In the event the occupation of affiant has been for a period of less than one year, or the employment period with the same employer has been for a period of less than one year, affiant shall give the name(s) and address(es) of his/her employer(s) and occupation(s) for the period of one year prior to the date of this affidavit]. 12. Affiant represents that he/she (is) Qs not} u ently holding another elective or appointive office — whether city, county or munici al -- the term of which or any part thereof runs concurrently with that of the office he/she seeks, and that he/she has resigned from any office from which he/she is required to resign pursuant to F.S.99.012 and/or the City of Miami Charter. 13. Afflant represents that, if appointed, he/she shall serve in the office so appointed. Page 2 oF3 Rev. 1 W2020 Submitted into the public record for item(s) SP.1, on 11-18-2020 City Clerk SIGNED THIS r DAY OF , 4DP�D UAFFIANT E ME the undersigned authority,b ea f physical or online BEFORE _ g y means a presence appeared .'•� kl�ko� who, after first being duly sworn (or affirmed), deposes and states that fin' executed the foregoing to the best: of �) Cs knowledge and belief. (SEAL) ev, TY L I CITY OF MIAMI, FLORIDA Did take an oath Produced identification Type of identification produced:► ,Jr►�f l-tC-� 5 SA4PRA=LRGES ha�ar�r� Ec-Siam #Fain Ccmr�s5c�IGG08461 '•- I my comm. Ewes Mar 19. M21 Page 3 of Rev.1012020 FORM 1 STATEMENT OF 2019 Please print or typo your name, mailing FINANCIAL INTERESTS FOR OFFICE USE ONLY: address, agency name, and posldon below: LAST NAME — FIRST NAME — MIDDLE NAME Watson ,Jeff7ey MAILING ADDRESS 54 N W 40th St c:. CITY : ZIP: CCUNTY ; CD [ Miami 33127 Dade �1�i �C NAME of AGENCY: r City of Miami NAME of OFFICE OR POSITION HELD OR SOUGHT: v District 5 Commissioner CHECK ONLY IF Q CANDIDATE OR Li PVW)FMPLOYEE OR APPOINTEE **** THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR CALENDAR YEAR ENDING DECEMBER 31, 2019. MANNER OF CALCULATING REPORTABLE INTERESTS: FILERS HAVE THEOPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). CHECK THE ONE YOU ARE USING (must check one)' 0 COMPARATIVE (PERCENTAGE) THRESHOLDS -0 R ❑ DOLLAR VALUE THRESHOLDS PART A — PRIMARY SOURCES OF INCOME [Major sources of income to the reporting person - See instructions] (If you have nothing to report, write "none" or nnla") NAME OF SOURCE SOURCE'S DESCRIPTION OF THE SOURCE'S OF INCOME ADDRESS PRINCIPAL BUSINESS ACTIVITY Gonsultinff a41N'W 40th St Economic Develonment Consultat PART 6 -- SECONDARY SOURCES OF INCOME [Major custorners, clients, and other sources of income io businesses owned by the reporting person - See instructions) (If you have nothing to report, write "none" or "nla") NAME OF NAME of MAJOR SOURCES ADDRESS BUSINESS ENTITY OF BUSINESS' INCOME I OF SOURCE C — REAL PROPERTY [Land, buildings owr•.ed by the repcong person - See instructions] (if you have nothing to report, write "none" or "nla") A/C GE MRb1 I - E4ecVIZ. Janaary L 2OZO Inwwaled dY reference in Rabe 3d 829Zi11, FA C. Submitted into the public record for item(s) �� on 11-18-2020, City Clerk iCoatinued on re terse sidej PRiNCIPAL $USINESS ACTIVITY OF SOURCE You are not limited to the space on the IInes on this form. Attach additional streets, if necessary. FILING INSTRUCTIONS far when and where to file this form are located at the bottom of page 2. INSTRUCTI0NS on wha must file this form and how to fill it out begin on page S. PAGE I PART ❑ — INTANGIBLE PERSONAL PROPERTY (Slacks, bonds, certi'acates of deposit, etc. - See instructions; (If you have nothing to report, write "none" or "nla") TYPE OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES TLD Entertainment Media The Now Comp CBD PART Er LIABILITIES [Major debts - See instructions} (if you have nothing to report, write "none" or "nla") NAME OF CREDITOR ADDRESS OF CREDITOR NONE PART F—INTERESTS iN SPECIFIED BUSINESSES [ownership or positions in certain types of businesses - See instrtA3ns1 Crl _ 1 (If you have nothing to report, write "none" or "nla") in -,' BUSINESS ENTITY 0 1 BUS RS$8 EN� NAME OF BUSINESS ENTITY I I µC ADDRESS OF BUSINESS ENTITY N/A NIA 3'c PRINCIPAL BUSINESS ACTIVITY r-1 LM POSITION HELD WITH ENTITY ._ I OINN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST PART G -- TRAINING For elected municipal officers required to complete annual ethics training pursuant to section 112.3142, F.S. Ll I CERTIFY THAT I HAVE COMPLETED THE REQUIRED TRAINING. i IP ANY OF PARTS A THROUGH G ARE CONTiNUED ON A SEPARATE SHEET, PLEASE CHECK HERE I] SIGNATURE OF FILER: Signature: Date Signed: November 13th 2020 F11JNG INSTRUCTIONS: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclnsura filing, return the form to that location. To determine what category your position faU under, see page 3 of instructions. Local officersfemployess file with the Supervisor of Elections of the county in which they permanently reside. Cif you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters_) Form 1 filers who fife with the Supervisor of Elections may file by mail or email. Contact your Supervisor of Eleetforis for the mailing address or email address to use. ❑o not email your form to the Commission on Ethics. it will be returned. state officers or specified state employees who file with the Commission on Ethics may rile by mail or email. To File by mail, send the completed form to P.O. Drawer 15709. Tallahassee, FL 32317-5709; physical address: 325 John Knox Rd. Bldg E, Ste 200, Tallahassee; FL 32303. To file with the Commission by entail., scan your completed form and any attachments as a pdf (do not use any other format), send it to 0EFarm1@leg.state. It -us and retain a copy for your records. Do not file by bQ)h mail and email. Choose only one filning me had. Form 6s will not be accepted via email. I;E FORM 7 - Eilecbma Junlrary 1, 202a Inmptxalud by reference in [Bola 3.1-.262(lj. FAC. CPA or ATTORNEY SIGNATURE ONLY If a certified public accountant licensed under Chapter 473, or attorney in good standing with the Florida Bar prepared this form for you, he or she must complete the following statement_ I, prepared the CE Form f in aeanrrlance with Section 112.3145. Florida Statutes, and the instructions to the form, Upon my reasonable knowlecge and Ge[iaf, the disclosure herein is true and correct. CPAIAttomey Signature. Date Signed: Candidates file this form together with their filing papers. MULTIPLE FILING UNNECESSARY: A candidate who files a Form 1 with a qualifying officer is not required to file with the Commission or Supervisor of Elections. WHEAT TO FILE: Initially, each local officerlempioyee, state officer, and specified state employee must file within 30 days of the data of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must fife prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates must file at the same time they file their qualifying papers. Thereafter, file by July i following each calendar year in which they hold their positions. Finally, file a final disciasure form (Form 1 F) within 60 days of leaving office or employment. Filing a CE Form i F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 it the filer was in his or her piasition on December 31, 2019. Submitted into the public PAGE record for item(s) SPA, on 11-18-2020 City Clerk CANDIDATE OATH — NONPARTISAN OFFICE (do not use this farm if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: ❑ Write-in candidate Candidate Oath (Section 99.021(i ){a), Florida Statutes) 2020 Noy .17 PM 4—. 52 I lip CITY CLERK CITY OF MIAMI OFFICE USE ONLY 1, Jeffrey Watson (Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no hyphen, check box ❑. (See page 2 - Compound fast !lames). No change can be made after the end of qualifying, Although a write-in candidate's name is not printed on the ballot, the name must be printed above foroath purposes.) am a candidate For the nonpartisan office of City Commissioner rJ (office) (District #) ; I am a qualified elector of Miami -Dade County, Florida; (Circuit #) (Group or Seat #) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no Ether public office in the state, the term of which office or any part thereof runs concurrent with the office I seek; and l have resigned from any office frorn which I am required to resign pursuant to Section 99.012, Florida Statutes: and I will support the Constitution of the United States and the Constitution of the State of Florida. Candidate's Florida Voter Registration Number (located on your voter information cardy 109166886 Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish It to be pronounced on the audio ballot as may be used by persons with disabilities (see Instructions on page 2 of this form): [Notapplicable to write-in candidates. j X -(202)5734890 watsonjeffrey@hotmail.com S' na ure of Candidate Teiephone Number Email Address Address City �ta to ZIP Cwdp STATE OF FLORIDA f i nature of Notary P lic COUNTY OF ��' r e Print, Type, or Stamp Cor-nm Toned Name of Notary Public below Sworn to (or affirmed and subscribed before me by Zahysical or VWWRAMOS J '_ �fYC0MUISSI0N9G ❑ online presence this 4 3 day of U=r`�'t'""- , 20 � _ . oY p(ptf�E$ May4,L2022 Bonded ThV WM puvc , Personally Known: or Produced IdentlfiGalion� Type of Identification Produced: DS-DE 302NP (Rev.04/20) Submitted into the public record for itern(s) Sp,2, on 11-18-2020 City Clerk Rule 1S-2.0001, F.A.C. LOYALTY OATH STATE OF FLORIDA COUNTY OF MlAM1-LADE Submitted into the public record for item(s) SP_1, on 11-18-2020, City Clerk Jeffrey H Watson !Name Middle Initial Last Name w Z; a cen ff th��ate of Florida and of the United States of America, .. and a candidate for public office ... do heEz�y sol m-wear or affirm that i will support the Constitution o he United States and of the State of Florida. z Signature of Candidate CCj {— CITY OF MIAMI OATH OF CANDIDATE Camrrlissioner OFFICE OFi F v , c, S Before me, an officer authorized to administer oaths, personally appeared Jeffrey Watson (PLEASE PRINT NAME) who, being sworn, says he/she is a candidate for the office of C®mm!55ioner , ,for the City of Miami, Florida; that he/she is a qualified elector of the City of Miami, Florida; that he/she is qualified under the Constitution, the Laws of Florida, and City of Miami Charter to hold the office to which he/she desires to be elected; that he/she has taken the oath required by Section 99.021. Florida Statutes; that he/she has qualified for no other public office in the State, the term of which office or any part thereof runs concurrent with that of the office he/she seeks; and that he/she has resigned or taken a leave of absence from any office from which he/she is required to re-sign or take a leave of absence, pursuant to Section 99.012, Florida Statutes, Signature of Candidate 54 NW 40th ST Miami � � Florida 33127 Address City State ZIP Code The Loyalty Oath and Oath of Candidate are sworn to (or affirmed) and subscribed before me by a physical or Donline presenrthis 13 day of N ove m ber of Office ;AdrriirisVj ng path or Notary Public Personally Known: OR Produced Identification. Typo of Identification Produced: LORENIIPAIAW WCOMM="1GO213M OMM Min4 endrdtM�flo�rr Pitic►lnderr�7lr� Nance of N ypeU,- rinted or Stamped ■ LU _02 u Forges, Sandra From: jeffrey watson <watsonjeffrey@hotmail.com Sent: Wednesday, November 18, 2020 9:41 AM Submitted into the public record for item(s) SP.1, on 11-18-202 C, City Clerk To: Forges, Sandra Subject: Re: Special City Commission - City Commission District S Vacancy - Meeting Guidelines Attachments: 1HW-Eio (15).docx CAUTION. This is an email from an external source_ Do not click links or open attachments unless you recognize the sender and know the content is safe. fyi, i was asked to send this to you for commission colleagues From: Forges, Sandra csfo rges@ m is migov.com3 Sent: Tuesday, November 17, 2020 6:56 PM To: jeffrey watson <watsonjeffrey@hotmail.com? Subject: RE: Special City Commission - City Commission District 5 Vacancy - Meeting Guidelines Great! Thank you for letting me know. We will see you tomorrow. Have a good evening. ,5and-a Forgc5, A45A Flcction5 Coordnatar Cit-y of Miami — Clerk's Q%fice 3500 ran American 'Drive Miami, FL33 9 33 V: 3-o5-�50-536_9 &: 3Q5-8 8-1610 ®.sfor es miami ov.com From: jeffrey Watson [mailto:watsonjeffrey@hotmail.com] Sent: Tuesday, November 17, 2020 5:55 PM To: Forges, Sandra 4sforges@miamigov.com> Subject: Re: Special City Commission - City Commission District 5 Vacancy - Meeting Guidelines CAUTION: This is an email from an external source. Do not Click links or open attachments unless you recognize the sender and know the content is safe. Fhank you received! Get Outlook for Android From: Forges, Sandra <sfarges@miamigov.com> Sent: Tuesday, November 17, 2020 5:09:35 PM To: Watsonieffrey@hotmail.com <Watsonjeffre hotmail.com5 Subject: FW: Special City Commission - City Commission District 5 Vacancy - Meeting Guidelines Good afternoon Mr. Watson, Attached is the public notice outlining the various methods for public comment for the November 18, 2020 special meeting pertaining to the City Commission District 5 vacancy. Jeffrey Watson Submitted into the public record for item(s) SP.1, on 11-18-202O, City Clerk 2.02-573-4890 Jeffrey H. Watson is the CEO of Solairgen Energy Corp. a renewable energy developer and operator of solar parks and wind farms with 435 MW's of projects under development, to respond to the need for innovative renewable energy solutions in markets that are energy deficient and over reliant on fossil fuels. Solairgen is currently developing projects in Africa, the Caribbean and Central America using three different types of technologies. Mr. Watson is a seasoned economic development and finance professional with expertise in nonprofit, public and corporate strategy with a consistent history of working beyond traditional infrastructure strategies to leverage networks, partnerships and cultural assets for optimized outcomes for cities and state Governments. Having over 30 years of experience in economic development consulting and financial and business strategy development in public and private sectors within the U.S. and multinational markets Mr. Watson Founded J. Watson & Company, an economic development consulting and government relation firm in 1996. Additionally, Mr. Watson Altgen Capital Partners, a private equity company that invests in small cap companies Prior to founding 1. Watson & Company, Mr, Watson was a Vice President for Government Relations at The Jefferson Group, a Washington, DC based consulting firm, where he formulated legislative strategy for public and non-profit entities seeking to obtain federal financial assistance. Mr. Watson's national public career includes serving as an Interim Assistant and Deputy Assistant to the President for Intergovernmental Affairs in the White House under the Clinton Administration. Mr. Watson served as a Director of the Presidential transition team and served in various states as a State Field Director and ultimately the Deputy National Field Director of the Clinton/Gore 1992 Presidential election campaign. At the White House, Mr. Watson coordinated the development of the Administration's policy initiatives and facilitated communications between the White House and state and local government officials. Prior to joining the Clinton White House, Mr. Watson served as a Senior Administrative Assistant for Mayor of Miami Xavier Suarez, and also served as Finance Administrator for the City of Miami's Department of Development and Housing Conservation Agency where he successfully directed the City's efforts to obtain federal funding (i.e. HLID Section 108 loans and Section 312 loans) for retirement of debt and commercial rehabilitation projects. Mr. Watson served as Senior Tax Accountant with Arthur Anderson & Company CPA's and Senior Auditor for Coopers and Lybrand CPA's, Mr. Watson currently serves as a board of director member for the Institute of Caribbean Studies. He has served as member of the board of directors for RENEX Corp. (a publiciy traded dialysis company) and Vice Chair of the Miami -Dade County Housing and Finance Authority.. Mr. Watson was presented with an Honorary Degree by Miami Dade College, received the African - American Achievers Award sponsored by JM Family Enterprises, Inc., and received a National Community Service Award sponsored by Support Network, Inc.