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Mayra D. Buttacavoli board application pending photo f !' /01AM1 BEACH BOARD AND COMMITTEE APPLICATION FORMA A-11-1 Last Name First Name. Middle Initial Home Address City State Zip Code Home Telephone Work Telephone Cellular Telephone Email address o Business Name Occupation S•et� Business Address City State Zip Code Professional License(describe):_ 4 Expires: Please attach a copy of currently effective professional license. 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 ownership/interest. 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 0 or No • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes or No •Are you a registered voter in Miami Beach: Yes�a or No ID • I am now a resident of: North Beach C3 South Beach Middle Beach F0 • I am applying for an -Ippointrrlent because I have special abi•ties, knowledge and experience. PI se list below: •Are you presently a registered lobbyist with the City of Miami Beach?Yes or No 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 ❑Ad Hoc Charter Review and Revision Board ❑Disability Access Committee ❑Miami Beach Human Rights Committee ❑Ad Hoc Committee Centennial Celebration ❑Gay,Lesbian,Bisexual and Transgender ❑Miami Beach Sister Cities Program Enhancement Committee(GLB ❑Affordable Housing Advisory Committee ❑Health Advisory Committee ❑Normandy Shores Local Government Neighborhood Improvement ❑Art in Public Places Committee ❑Health Facilities Authority Board ❑Parks and Recreation Facilities Board ❑Board of Adjustment* ❑Hispanic Affairs Committee ❑Personnel Board ❑Budget Advisory Committee ❑Historic Preservation Board ❑Planning Board ❑Committee on the Homeless ❑Housing Authority olice Citizens Relations Committee 711 ❑Committee for Quality Education in MB ❑Marine&Waterfront Protection Authorit ❑Production Industry Council ❑Convention Center Advisory Board WMiami Beach Commission for Women ❑Sustainabili Committee ❑Design Review'Board* ❑Miami Beach Cultural Arts Council ❑Transportation,Parking,&Bicycle-Pedestrian Facilities Committee ❑Visitor and Convention Authority Board members are required to file Form 1 —"Statement of financial Interest"with the State. *If you seek appointment to a professional seat(e.g., lawyer, architect, etc.) 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 c° License Issuance Date License Expiration Date- Page 1 of 4 - � F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx ' Lam`) °O 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 L.J No LJ Dates of Service: 2. Present participation in Youth Center activities by your children:Yes�D No — 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�D or No 1QM If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach Code?Yes[_:a or NoO If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money?Yes Cj or No 15b If yes, explain in detail:. •Are you currently serving on any City Board or Committee?Yes[D or No 5a If yes,which board/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: •Are you now employed by the City of Miami Beach?Yes or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent �, spouse �, child brother or sister who is employed by the City of Miami Beach?Check all that appi . If"Yes,"identify person(s)and department(s): .i!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 Female Race/Ethnic Categories What is your race? African-American/Black Caucasian/White Asian or Pacific Islander I�Native-American/American'Indian 4�Other—Print Race: Page 2 of 4 F:\CLER\$ALL\aFORMS\BOARD.AND COMMITTEES\BC APPLICATION REVISED.docx Do you consider yourself to be Spanish,Hispanic or Latino/a?Mark the"No"box if not Spanish, Hispanic, Latino/a. No Yes Do you consider yourself Physically Disabled? No 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: • Prohibition from directly or indirectly lobbying City personnel.(Miami Beach City Code section 2-459). • Prohibition from contracting with the City(Miami-Dade County Code section 2-11.1). • 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). • Requirement to disclose certain financial interests and gifts(Miami-Dade County Code section 2-11.1). • 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 Chapter 286 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. HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS-OF'THE APPLICATION; AND I HAVE RECENED, 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 ACCORDINGLY." �IadrA Val Applicant's S' nature Date Name of Applicant(PLEASE PRINT) Received in the 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. II Page 3 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx MIAMI BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.aov 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: I understand that no later than Julv 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, iami-Beach,-Florida-,-no-laterthan 12:00-noon--of-July 1,of eachyear.- 1. A "Source of Income Statement" For your convenience, the form is attached. The form can also be downloaded at: http://www.miamidade.gov/elections/Library/source of income statement pdf 2. A "Statement of Financial Interests (Form 1)" For your convenience, the form is attached. The form can also be downloaded at: http://www.ethics.state.fl.us/ethics/forms.htmI 3. A Copy of your 2013 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. � Z VY Signature Date Updated:Thursday,March 1.3,2014 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx his Y-) Pr 1V i s v7 c� �- - ,� p v U r F ' Mayra Diaz Buttacavoli 5451 Alton Road Miami Beach Florida 33140 305.864.9585 FMB 1208kaol.com OBJECTIVE To.obtain a management position where I can use my experience and be challenging, while allowing me to provide guidance and recommendations that will enhance operations. EXPERIENCE City of Miami Beach January 2004—January 2008 Director of Human Resources and Risk Management Departments. Oversight of the City's Compensation, Recruitment, Employment Testing, Classification Audits,Employee Benefits, Employee Relations, Risk Operations, and Labor Relations for negotiation sessions with Police;Fire,AFSME, and GSA unions. April 1993 —December 2003 Assistant City Manager Reported to five different City Managers over this time frame, during which I had oversight of various departments including; Fire, Code Compliance,Internal Audit, Human Resources and Risk Management, Hurricane and Emergency Operations, Information Technology, Procurement,Fleet Management, Asset Management,Parks and Recreation, Special Events, Convention Center,Fillmore Jackie Gleason Theatre, and Bass Museum. As part of my functions I oversaw various capital projects including Fire Station expansions and renovations, 21 Park and Recreation facilities, Miami Beach Golf Course and Clubhouse Renovation, Bass Museum Expansion and Renovation, Convention Center and Fillmore Jackie Gleason Theatre Convention Tax Development renovations, Cultural Center Streetscape and Park planning renovation, and a New Regional Library. I was staff liaison to various Boards and Committees including: Visitors and Convention Authority, Police and Fire Pension Board Trustee, Convention Center Advisory Board, Tourist Expansion Convention Development Tax Authority (TECCEA),Bass Museum Trustee Board and renovation/expansion committee, Miami Beach Golf Course Ad Hoc Committee, Collins Park Cultural Center Oversight Committee,Fire Station 2 Oversight Committee, and Convention Center Capital Projects Oversight Board. N I was lead negotiator in several public/private ventures including;FPL/Publix Supermarket land sale, 7h street parking garage, South Beach Marina,Pavarotti Concert on the Beach agreement, Smith and Wolenski Restaurant lease and the Miami Beach Golf Course Management Agreement. Miami Dade County September 1991 —April 1993 Fiscal Management Bureau Commander—Corrections and Rehabilitation Department Directed and supervised the Finance, Procurement, Property Room, Commissary, Warehouse and Fleet operations for the Department. I supervised over 60 employees. July 1989—July 1991 Family Leave of absence April 1984—July 1998 Director of Administrative Services—General Services Administration Department Administered one of the County's largest departments consisting of seven divisions, 803 budgeted positions, a fiscal budget exceeding $160 million and 800 positions of which I supervised 62. In this position I had oversight of Accounting and Fiscal Management, Computer System Development and Maintenance, Personnel, Parking Operations, Security Management, and Real Estate Management. In the County's self insured trust fund yearly rates were set and billings issued to.county departments for worker's compensation,general liability,health, and police professional liability insurance coverage. I assisted with the coordination of Miami-Dade special events, such as the Inter-American Development Bank Conference (1987), Congressional Partnership Weekend(1987), and the Papal Visit(1987). August 1981 —April 1984 = Administrative Officer III—General Services Administration Department Directed the Finance and Accounting functions for the Department. October 1979—August 1981 Accountant II—Parks and Recreation Department Supervision of the financial reporting of the public revenue facilities of Vizcaya Museum, Marinas, Campgrounds, Trail Glades Range, tennis courts, golf courses, snack bars, and leases. June 1978 October 1979 Auditor I—Internal Audit Department Audited the County's Federally Funded programs and issued reports to the County Manager. EDUCATION University of Miami, Graduate School of Business, Master of Science,June 1978. University of Miami, School of Business, B.B.A. in Accounting, December 1977. Society of Human Resource Management,Professional Resource Management Certificate, January 2007. REFERENCES Available upon request. I;