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Francis Trullenque 12/31/2015 V -J City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Gronado, City Clerk Tel: (305)673-7411, Fax: (305)673-7254 2/6/2014 Francis Trullenque 5620 Alton Rd Miami Beach, Florida 33140 Hispanic Affairs Committee Congratulations! You have been reappointed by Commissioner Ed Tobin to the above referenced agency, board or committee for a term ending: 12131/2015. If you are unable to accept this appointment, please notify the City Clerk's Office at (305) 673-7411. Please read the enclosed material carefully. Again, congratulations and good luck. Sincerely, �J Ra ael E. arnado City Clerk cc: Saul Frances, Parking Director Nannette Rodriguez 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. City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granado,City Clerk Tel: (305)673-7411,Fax: (305)673-7254 TO: Francis J. Trullenque RE: Hispanic Affairs committee I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United States,the State of Florida, and the City of Miami Beach, and to perform all the duties of a member of the above-mentioned board or committee of the City of Miami Beach to which I have been appointed for a term ending: 12/31/2015. 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 Florida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public Officers andunderstand that as a member of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure* requirements of Miami-Dade County or the State of Florida (depending on the board or committee on which I serve) on July 1st, following the closing of the calen r y�r--on which have served. cis J. Trullenque Sworn to and subscribed before a this day of,A5�Y` 2014 a Silvia Prieto Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. We arei C�@ (�i���rt�t99ci�� 9c�r14�@�,�@t?hitalr� f6lc�6Js�i t9��� ;� ew �?r�4r��� 1+rn'cgr4tt�rilprua dcxhFti6��iirfaai�mmunity. Trullengue Francis J Last Name First Name Middle Initial 5620 Alton Road Miami Beach Florida 33140 Home Address City State Zip Code (305)864-6945 (305)519-1657 (305)519-1657 Home Telephone Work Telephone Cellular Telephone Email address TELEMEDIA Marketing&Advertising Business Name Occupation 400 Alton Road Suite 706 Miami Beach Florida 33140 Business Address City State Zip Code Professional License(describe): Expires: Pursuant to City Code section 2-22(4)a & 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 ownershipAnterest 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 X or No 0 • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes X or No 0 •Are you a registered voter in Miami Beach: Yes X or No 0 • I am now a resident of: North Beach 0 South Beach F-1 Middle Beach X • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Experienced advertising and marketing, PR professional with a proven history of developing award-winning campaigns/events that create awareness, make brands famous and generate strong business results for clients. •Ongoing leadership of integrated Hispanic communications programs; responsible for operations across all projects and track record of building lasting client relationships across a variety of industries. • Dedicated to shaping the ongoing evolution of agency culture with a focus on mentoring people and their ideas. Specialties: Marketing, Advertising, City Government, Music Administration, Publishing, Public Relations, Strategy, Media Solutions •Are you presently a registered lobbyist with the City of Miami Beach?Yes 0 or No X Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three 3 choices will be observed by the City Clerk's Office. ❑Affordable Housing Advisory Committee ❑Fine Arts Board ❑Normandy Shores Local Government Neighborhood Improvement ❑Art in Public Places Committee ❑Disability Access Committee ❑Parks and Recreation Facilities Board ❑Beautification Committee ❑Gay, Lesbian, Bisexual and Transgender ❑Personnel Board Enhancement Committee GLB ❑Bicycle-Pedestrian Advisory Committee ❑Golf Advisory Committee ❑Planning Board ❑Board of Adjustment* ❑Health Advisory Committee ❑Police Citizens Relations Committee ❑Budget Advisory Committee ❑Health Facilities Authority Board ❑Production Industry Council ❑Capital Improvements Projects ❑Hispanic Affairs Committee ❑Safety Committee Oversight Committee ❑Committee on the Homeless ❑Historic Preservation Board ❑Single Family Residential Review Panel ❑Committee for Quality Education in MB ❑Housing Authority ❑Sustainability Committee ❑Community Development Advisory ❑Loan Review Committee ❑Tennis Advisory Committee ❑Community Relations Board ❑Marine Authority El Transportation and Parking Committee 11 Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Visitor and Convention Authority Page 1 of 4 ❑Debarment Committee 0 Miami Beach Cultural Arts Council 0 Youth Center Advisory Board 0 Design Review Board* ❑Miami Beach Human Rights Committee ❑Waterfront Protection Committee 0 Miami Beach Sister Cities Program Note: If applying for Youth Center Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board:Yes No 0 Dates of Service: 2. Present participation in Youth Center activities by your children:Yes 0 No El If yes, please list below the names of your children,their ages and the programs in which they participate: Child's name: Age: Program: Child's name: Age: Program: • Have you ever been convicted of a felony?Yes 0 or No-X If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach Code?Yes 0 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 Board or Committee?YES -X or No 0 If yes,which board/committee?Hispanic Affairs Committee • In what organization(s)in the City of Miami Beach do you currently hold membership? Name Position Name Position • List all properties owned or in which you have an interest within the City of Miami Beach: -5620 Alton Road, Miami Beach, Florida 33140 •Are you now employed by the City of Miami Beach?Yes 0 or:No.- Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent 0, spouse 1-1, child 0 brother 0 or sister El who is employed by the City of Miami Beach?Check all that apply. If"Yes,"identify person(s)and department(s): No-�X /No Relation works for the City of Miami Beach 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 City diversity reporting requirements. Gender: Male X Female Race/Ethnic Categories What is your race? ED African-American/Black X Caucasian/White Page 2 of 4 LJ Asian or Pacific Islander Native-American/American Indian 0 Other—Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a?Mark the "No"box if not Spanish, Hispanic, Latino/a. 0 No X Yes Do you consider yourself Physically Disabled? X No 0 Yes 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: 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 the 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). o Sunshine Law - Florida's Government-in-the-Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in of the Florida Statutes. These statutes establish a basic right of access to most meetings of boards,commissions and other governing bodies of state and local governmental agencies or authorities. o Voting conflict—Form 8B is for use by any person serving at the county,city or other local level of government on an appointed or elected board, council, commission, authority or committee. It applies equally to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. 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 MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATUTES ACCORDIN L ' Francis Trullen ue Applic 7ithe ure Date Name of Applicant(PLEASE PRINT) Receive City Clerk's Office by Name of Deputy Clerk Control No. Date PLEASE REMEMBER TO ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3 of 4 City of Wlianli Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, CITY CLERK'S OFFICE CityClerk @miamibeachfl.gov Telephone: 305.673.7411 Fax: 305.673.7254 Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami- Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) Board Member's Name: Francis Trullenque I understand that no later than July 1, of each year all members of Boards and Committees of the City of Miami Beach, including those of a purely advisory nature, are required to comply with Miami-Dade County Financial Disclosure Requirements. 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 they may have been recently appointed. One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida, no later than 12:00 noon of July 1, of each year. 1. A"Source of income Statement" For your convenience, the form is attached. The form can also be downloaded at: 2. A "Statement of Financial Interests (Form 1)" For your convenience, the form is attached. The form can also be downloaded at: 3. A Copy of your 2012 Federal Income Tax Return Failure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine of no more than $500, 60 days in jail or both. 'li ail S' ature Date F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC Application revised 5-22-13 FINAL.doc Updated:Friday,February 21,2014 Page 4 of 4 h1°®�'DE SOURCE OF INCOME STATEMENT Disclosure for Tax Year Ending Last Name First Name Middle Name/Initial �7 70/'� '*... A v 1 G c Mailing Address—Street Number,Street Name,or P.O. x S2-- Zcr- City,State,Zip ID Number 04" If your home address is your mailing address,and your home address is exempt from public records pursuant to Fla.Stat.§119.07,read instructions on the following page and check here.❑ Filing as an Employee ❑County Employee Municipal Employee, Name of Municipality: Position held or sought Department where employed Work address Work telephone Term began on Filing as a Board Member ❑ County Board Member Municipal Board Member, Name of Municipality: Board where serving /il *V—s Work address Work telephone Term began on List below every source of income you received,along with the address and the principal activity of each source.Include your public salary.Place the sources of income in descending order,with the largest source first.Also,include any source of income received by another person for your benefit.However,the income of your spouse or any business partner need not be disclosed. If continued on a separate sheet,check here.❑ Name of Source of Income Address Description of the Principal usiness Activity f , I hereby swear(or affirm)th a information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy Signat o closin �;i 1 11 >t ' a ( ) , ! f /f �� v C 1�' z 2✓ '1 � � z I X30£!QZ Print name Dat6 sign T OFFICE USE ONLY Accepted: Y/ N Deficiency: Processed Date/Initials: Scanned Date/Initials: 138 SP-14 2/13 /\AJANA1 BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach,Florida 33139, www.miamibeachfl.00v CITY CLERK Office CityClerk @miomibeachfl.gov Tel:305.673.741 1 ,Fax:305.673.7254 Acknowledgement of fines/suspension for Board Members for failure to comply with Miami-Dade County Financial Disclosure Code Provision Code Section 2-1 1 .1 (i) (2) Board Member name: Z// 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 of the following with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach,.Florida, by July 1, 2010: 1. A "Source of Income Statement(attached) or 2. A "Financial Statement (attached( or] 3. 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 fine not to exceed $500.00 or by imprisonment in the county jail for a period not to exceed sixty days, or both. . aaify ignat re: ate: