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Margaret "Peggy" Benua 12/31/2014 \A at-4 3%City of Miami Beach, 1700 Convention Center Drive, Miami Beach;Florida 33139,www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 Email CityClerk @miamibeach.gov 2/11/2013 Margaret (Peggy) Benua 115 W. Sunrise Avenue Coral Gables, Florida 33133 S. J, CT. Visitor and Convention Authority Congratulations! You have been reappointed by the City Commission to the above referenced agency, board or committee for a term ending: 12/31/2014. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-7411. .r Please read the enclosed material carefully. Again, congratulations and good luck. Sincerely, .q_'O" Ra ael E. ranado City Clerk cc: Saul Frances, Parking Director Grisette Roque ATTACHMENTS: Letter of Appointment Oath City Code/Ordinance section applicable to agency, board or committee City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-2458, 2-459 Ordinance 2006-3543 -Amendment to City Code Section 2-22 Miami-Dade County Code Section 2-11.1 -Conflict of Interest and Code of Ethics Ordinance City Wide Permit Application - (Parking Department Form) Booklet- Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granada,City Clerk Tel: (305)673-7411, Fax: (305)673-7254 Email CityClerk @miamibeach.gov TO Margaret(Peggy) Benua RE: * Visitor and Convention Authority do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of a member of the above-mentioned board or committee of the City of Miami Beach to which I have been appointed for a term ending: 12/31/2014. 1 have been issued a copy of Section 2-11.1 of the Miami-Dade County Code (Conflict of Interest and Code of Ethics Ordinance), as well as the Florida Commission on Ethics Guide to the Sunshine Amend- ment and Code of Ethics for Public Officers and Employees, and understand that as a member of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure*requirements of Miami-Dade County or ithe State of Florida (depending on the board or committee on which I serve)on July 1, following the closing of the calendar year on which I have served. Margaret(Peggy) Benua Sworn to and subscribed before me this day of 2013. iliam R. Hatfiiel Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfi.gov under City Clerk/Board and Comm for additional information regarding the Financial Disclosure Requirement We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,historic community. CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM BENUA _ Margaret(Peggy) ..._ A Last Name First Name Middle Initial _115 W Sunrise Avenue Coral Gables FL 33133. Home Address City State Zip Code _(305)668-4769 (305)423-6250 (305)793-7164 peggybenua @dream south beach.com_ Home Telephone Work Telephone Cellular Telephone Email address _Dream South Beach Hotel Position:_General Manager. Business Name _1111 Collins Avenue Miami Beach FL_ 33139 Business Address - City State Zip Code Professional License(describe)_FL DBPR Community Association Manager_CAM31436_Expires:. 09-30-2014 Attach a copy of the license Pursuant to City Code section 2-22(4)a and b: Members of agencies, boards and committees shall be affiliated with the city: this requirement shall be fulfilled in the following ways: a. An individual shall have been a resident of the city for a minimum of six months; or b. An individual shall demonstrate ownersh i ph nte rest for a minimum of six months in a business established in the city for a minimum of six months. • Resident of Miami Beach for a minimum of six(6)months: Yes IJ or No X • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six months: Yes X or No •Are you a registered voter in Miami Beach: Yes Li or No X • I am now a resident of: North Beach�.] South Beach 1:3 Middle Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: _I have held senior management positions in Miami Beach hotels since January 2000. .Are you presently a registered lobbyist with the City of Miami Beach?Yes: or No.-:X Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that ohl .`three 3.:chc iceslvirill be-Ul$ery .b, 'the Cit Clerk's Office, Re ula Boards of Cit _. ❑Affordable Housing Advisory Committee ❑Fine Arts Board ❑Normandy Shores Local Government _,. Ne;ghborhood Improvement ❑Art in Public Places Committee ❑Gay, Lesbian, Bisexual and Transgender 0 Parks and Recreation Facilities Board Enhancement Committee GLBT ❑Beautification Committee 0 Golf Advisory Committee 0 Personnel Board L. ❑Board of Adjustment* ❑Health Advisory Committee ❑Planning Board* ❑Budget Advisory Committee ❑Health Facilities Authority,Board ❑Police Citizens Relations Committee 0 Capital Improvements Projects ❑Hispanic Affairs Committee ❑Production Industry Council Oversight Committee O Committee on the Homeless 0 Historic Preservation Board ❑Safety Committee ❑Committee for Quality Education in MB ❑Hous I ing Authority 0--Single Family-Residential Review Panel ❑Community Development ❑Loan Review Committee D.Sustainabili :;Committee 0 Community Relations Board 0 Marine Authoeit ;. 0 Tennis 1Adviso :Committee O Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Trans orfation and Parkin..Committee ❑Debarment Committee ❑Miami Beach Cultural Arts Council X.,Vi4itor:and Convention Authority, ❑Design Review Board* o.Miami Beach Human Rights Committee ii Youth Center°Advisory Board O Disabilit Access Committee ❑Miami Beach Sister Cities Pro ram ❑_Waterfront Protection Committee * Board Required to File State Disclosure Form If you seek appointment to a professional seat(e.g.,lawyer,architect)on the Board of Adjustment,Design Review Board, Historic Preservation Board,or Planning Board,attach a copy of your currently-effectively license,and furnish the following information: Type of Professional License License Number , License Issuance Date ,and License Expiration Date i O C:\Userslmbenua\DocumentslVCA1VCA Application 01,2013.doc Note: If applying for Youth Advisory Beard,please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board:Yes No LJ Years of Service: 2. Present participation in Youth Center activities by your children Yes 1:3 No 1:1. If yes, please list the names of your children, their ages and which programs. List below: Child's name: Age: Program: Child's name: Age: Program: •Have you ever been convicted of a felony:Yes U or No X If yes,please explain in detail: • Do you currently have a violation(s)of City of Miami Beach codes:Yes�j or No X. If yes,please explain in detail: • Do you currently owe the City of Miami Beach any money:Yes 0 or No X If yes,explain in detail •Are you currently serving on any City Boards or Committees-Yes X or No U. If yes;which board? Visitors Convention Authority •What organizations in the City of Miami Beach do you currently hold membership in? Miami Beach Chamber of Commerce Pillar Board Member Name Title _GM&Beaches Hotel Association Executive Board Member Name Title • List all properties owned or have an interest in,which are located within the City of Miami Beach: Dream South Beach Hotel • I am now employed by the City of Miami Beach:Yes�:j or No X.Which department? • Pursuant to City Code Section 2-25(b): Do you have a parent U,spouse 1"i,child U brother 0,or sister`J who is employed by the City of Miami Beach'?Check all that apply. Identify the department(s): The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is being asked to comply with federal equal opportunity reporting requirements. Ethnic Origin:Check one only(1) Gender: Male ID Female X rrXWhite (Not of Hispanic Origin):All persons having origins in any of the original peoples of Europe,North Africa or the Middle East. �� !mil African-American/Black (Not of Hispanic Origin):All persons having origins in any of the Black racial groups of Africa. UHispanic: All persons of Mexican, Puerto Rican,Cuban,Central or South American,or other Spanish culture or origin,regardless of race. Asian or Pacific Islander:All persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,or the Pacific Islands. This area includes,for example,China,India,Japan,Korea,the Philippine Islands and Somoa. American Indian or Alaskan Native: All persons having origins in any of the original peoples of North America,and who maintain Cultural identification thro(u '�tribal affiliation or community recognition. Physically Challenged: Yes�!or No Employment Status: Employed X Retired Homemaker Other Please remember to attach a current resume and a copy of any applicable professional license. Attach additional sheets, if necessary, to provide required information. C:1Userslmbenua\DocumentslVCA1VCA Application 01.2013.doc NOTE: IF APPOINTED,YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTEE MEMBERS. THESE LAWS INCLUDE,BUT ARE NOT LIMITED TO,THE FOLLOWING: o Prohibition from directly or indirectly lobbying city personnel(Miami Beach City Code section 2-459). o Prohibition from contracting with the city(Miami-Dade County Code section 2-11.1). o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach City Code section 2-26). o Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1). o CMB Community Development Advisory Committee: prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties(CFR 570.611). Upon request,copies of these laws may be obtained from the City Clerk. I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION, AND I HAVE RECEIVED, READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII — OF THE CITY CODE "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS." Margaret A,Benua "Applicant', _.ignatUre`: Qate Nam of Applicant(PLEASE PRINT) / �3 Received in the City Clerk's Office by: IG - � Name of Deputy Clerk Control No. date .i 2"I� C-.\Users\mbenua\Documents\VCA\VCA Application 01,201 Idoc �l� 1 BEAD H I city of Miami Beach, 1700 Convention-Center Drive, Miami Beach,Florida 33139, vwrvr miamibeochfL2oV CITY CLERK Office CityClerkCmiamibeochfi..gov Tel: 305.673-7411 , Fax: 305.673.7254 Acknowledgement of fines/.suspension for Board Mein hers for.failure to comply with Miami-Dade County Financial .Disclosure Code Provision Code -Section 2-11-.1(i) .(2) Board Member name. I understand that no .later-than July '1, of .each year all members of.Boards and Committees of the .City.of Miami Beach, including those of a purely advisory nature, are required to.comply with Miami-Dade County Disclosure Requirements, This means that-the members of City Advisory:Boards, whose.sole-or primary responsibility -is to recommend legislation or give advice to-the City Commission,-must-file,:even though you may have.been recently appointed. You must file one ofthe-following with the City Clerk of Miami Beach, 17D0 Convention Center.Drive, Miami Beach, Florida,by July 1.each:year. 1. A"Source.of.Income.Statement" (attached)or 2. A"Financial Statement" (attached(or] I A Copy'of the-person's current Federal income Tax Return. Failure to file, according-to the Miami-Dade:County Code Chapter 1, General Provision, Section 1-5 may subject the.person-or firm to a:fi ne not to exceed .$500.00 or by imprisonment'in the county_jail for r-a period not to exceed sixty days, or.both. Z I aoJ Date: Signature: M I A M I•DADE SOURCE OF INCOME STATEMENT Please Print or Type First Name Middle Name/Initial Last Name Disclosure For Tax Year Name: MA&H-e-i &lie Z601JA Ending: /� Z l 2 Mailing Address: 11 GJ S��r�� C4VC City/state/zip: L Cvd �1� fiL 3,33 Social Security Number: Filing as a: ® County Employee: ® Municipal Employee of: Position held or sought: Board where serving: Term or Employment Began on: Z_4f,da-,3 Department where employed: Work Address: 1 �,I►�� V V[�r,,,� jr,�,, 3 13�/ If your home address is exempt from public records pursuant toi Florida Statutes§119.07 please check here(read instructions): Work Telephone: l� Home Address: _5jAn;'' Street Add re L� �3i33 City State Zip Code Please list below in descending order with the largest source first, the name, address and principal business activity of every source of your income including public salary you received or any person received for your benefit or use during the disclosure period. The income of your spouse or any business partner need not be disclosed. If continued on a separate sheet,check here: Description of the Principal Name of Source of Income Address Business Activity BS uM 1;.n f 33 119!5 I hereby swear(or affirm)that the aforesaid information is a true and correct statement. 13 �3 sicrnafito of person disclosing Date signed