Heriberto J. Sosa Application Package Iv\I A
BOARD AND COMMITTEE APPLICATION FORM
Sosa Heriberto Jorge
Last Name First Name Middle Initial
831 Ninth Street Miami Beach Florida 33139
Home Address City State Zip Code
786-271-6982 herbsosa@yahoo.com
Home Telephone Work Telephone Cellular Telephone Email address
Unity Coalition I Coalicion Unida Exec. Director
Business Name Occupation
777 Brickell Ave, Suite 500, Miami, Florida 33131
Business Address City State Zip Code
Professional License (describe): 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 a]or No
• Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes ag or No
•Are you a registered voter in Miami Beach: Yes Hi or No
• I am now a resident of: North Beach South Beach PA Middle Beach
• I am applying for an appointment because I have special abilities, knowledge and experience. Please list below:
I am Exec. Director of the first& only Latino I Hispanic LGBT non profit in South Horida, and
have served as member& chair of the Historic Preservation board.
• Are you presently a registered lobbyist with the City of Miami Beach?Yes or No Lia
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 Office of the City Clerk.
❑Affordable Housing Advisory Committee ❑Health Facilities Authority Board 0 Normandy Shores Local Government
Neighborhood Improvement
❑Art in Public Places Committee ❑Hispanic Affairs Committee
0 Parks and Recreation Facilities Board o0
❑Board of Adjustment** ❑Historic Preservation Board * ❑Personnel Board
❑Budget Advisory Committee ❑Housing Authority U Planning Board**
u Committee on the Homeless LGBT Advisory Committee ❑Police Citizens Relations Committee
❑Committee for Quality Education in MB ❑Marine&Waterfront Protection Authority ❑Production Industry Council
❑Convention Center Advisory Board ❑Miami Beach Commission for Women ❑Sustainability Committee
❑Design Review Board** ❑Miami Beach Cultural Arts Council 0 Transportation,Parking,&Bicycle-Pedestrian
Facilities Committee
U Disability Access Committee ❑Miami Beach Human Rights Committee 0 Visitor and Convention Authority
D Health Advisory Committee ❑Miami Beach Sister Cities Program
* 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, ( sign Review
Board, Historic Preservation Board or Planning Board, attach a copy of your currently-effective Ilcensi, and;furnish the
following information: CD
Type of Professional License License Number
Ev
License Issuance Date License Expiration Date
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°O Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board,please indicate your affiliation with
the Scott Rakow Youth Center and/or the North Shore Parks Youth Center:
• Please describe your past service with the City's Youth Centers(include dates of service):
• Present participation in Youth Center activities by your children:Yes Zji No Zi
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 or No al If yes,please explain in detail:
•Do you currently have a violation(s)of City of Miami Beach Code?Yes :1 or NoI If yes, please explain in detail:
•Do you currently owe the City of Miami Beach any money?Yes Li or No 21 If yes,explain in detail:
•Are you currently serving on any City Board or Committee?Yes or No If yes,which board/committee?
Historic Preservation board - Termed out Dec 1, 201
•In what organizations)in the City of Miami Beach do you currently hold membership?
Miami Beach UNITED - Board Member
Name Position
Name Position
•List all properties owned or in which you have an interest within the City of Miami Beach:
831 Ninth Street, Miami Beach, Florida 33139
•Are you now employed by the City of Miami Beach?Yes CD or No al
Which department and title?
• Pursuant to City Code Section 2-25 (b): Do you have 1,a parent Z spouse Z1, child L1 brother or sister Li who is
employed by the City of Miami Beach?Yes or No E
If"Yes,*identify person(s)and 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 City diversity reporting requirements.
Gender: Male EI Female Li
Race/Ethnic Categories
What is your race?
lagAfrican-American/Black
�.�1 Caucasian/White
Asian or Pacific Islander
Native-American/American Indian
Page 2 of 4
F:ICLER$ALL1aFORMSIBOARD AND COMMITTEES\BC APPLICATION REVISED 06052015.docx
1-110ther—Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a?Mark the "No"box if not Spanish, Hispanic, Latino/a.
f, I 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:
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 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.
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 ACCORDING "
J /
Oct 22,2015 Herb Soso
Applicant's Signature Date . Name of Applicant(PLEASE PRINT)
•
Received in the Office of the City Clerk by: "°/71-p1— f J
Name of Deputy erk Control No. Date
PLEASE 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
F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06052015.docx
HERB sosA
831 9th Street, Miami Beach, Florida 33139
786.271.6982 herb @herbsosa.com .
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Community activist, historian, preservationist and freelance writer, Herb Sosa is a founding
member of, and currently serves as President of Unity Coalition I Coalicion Unida, offering
Leadership, Protection & Promotion of Latino I Hispanic LGBTQ rights (lesbian, gay, bisexual,
transgender, questioning)-the only organization of its kind in South Florida since 2002.
Sosa also is Pubisher I Editor-In-chief of AMBIENTE Magazine, the first & only LGBT
publication offered in English, Spanish & Portuguese, produced bi-monthly, offered free of
charge, and distributed digitally around the globe to thousands of our readers each issue.
Mr. Sosa brings over 20 years of corporate and not-for-profit leadership experience in the
community. Previously, Mr. Sosa was Corporate Creative Director for Burdines Dept. stores, was
Executive Director of Miami Design Preservation League and the Art Deco Weekend Festival in
Miami Beach.
In 1995 Mr. Sosa created and developed the Ba-Balu Store concept in Miami & Miami
Beach, earning the store the unique distinction of being named one of Conde N'ast Traveler
Magazines top 100 destinations in the world in 1996. Mr. Sosa has receive various career and
personal accolades from his peers, including the Up and Comers Business Leaders Award (1996),
City of Miami Beach Herb Sosa Day proclamation (1997), and featured in Café Con Leche, a
documentary on first-generation Cuban-Americans (1996). Sosa served as chairman of Miami
Beach's Historic Preservation Board for over six years, and has served on the Board of Directors of
the Miami Design Preservation League, Miami Beach Community Development Corp.,
Shelbourne & Fernwood HIV/AIDS Housing, and variety of other organizations throughout South
Florida. While president of Dade Heritage Trust, Sosa was honored to be involved in the
restoration and re-lighting of the 1925 Cape Florida lighthouse in Key Biscayne, culminating with
a Gala Re-Lighting Ceremony in July 1996, capping Miami's Centennial.
In January 2004, Herb Sosa was named one of Tentaciones Magazines Top Ten Latina/o
activists in the U.S. and in 2005 was named one of OUT magazines Top 100 LGBT Activists and
featured on LOGO TV. On April 2008 Sosa was named Terra.com's Activist of the Month.
In 2009 Sosa received a City Proclamation from Miami Beach - Herb Sosa Day - for his
community work, was nominated for a Glaad Media Award in 2009 for Outstanding Digital
Journalism for his work in Ambiente Magazine and was named one of the 25 Most Influential
GLBT Latinos by miapogeo.com. Sosa currently serves on the City of Miami Beach Historic
Preservation Design Review Board and in May 2011 was named one of 5 "People To Know" in
Miami Beach by the Miami Herald, and was recently featured in PBS' In the Life: Orgullo Latino
(2012) and The Day It Snowed in Miami (2014).
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