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David J. Berger Application Package miAmtaEc BOARD AND COMMITTEE APPLICATION FORM EKGei D4V -TA- Last Name First Name Middle initial • IS' II Q W4 S+ CtkAt't lerkck Fl- 33 f 'fd Home Address City State Zip Codg 30S ST a-q-S-0 o SOc 2J0C-- 6er Cr-claVPGtoL.Cpttt Home Telephone Work Teleppoine Cellular Telephone Email address ‘4 I 1' L C 1. A r '_ M ! BusmessName Occupation 1q3(0 \,k) • -2- CA-u24- e 1 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 ''=i 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 or No • I am now a resident of: North Beach ► South Beach 11 Middle Beach El • I am applying for an appointment because I have special abilities, knowledge and experience. Please 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 Committee Centennial Celebration ❑Health Advisory Committee yg Parks and Recreation Facilities Board () ❑Affordable Housing Advisory Committee ❑Health Facilities Authority Board ❑Personnel Board ❑Art in Public Places Committee ❑Hispanic Affairs Committee ❑Planning Board ❑Board of Adjustment* * ❑Historic Preservation Board * ❑Police Citizens Relations Committee ❑Budget Advisory Committee ❑Housing Authority ❑Production Industry Council ❑Committee on the Homeless ❑Marine&Waterfront Protection Authority ❑Sustainability Committee ❑Committee for Quality Education in MB ❑Miami Beach Commission for Women ❑Transportation,Parking,&Bicycle-Pedestrian Facilities Committee ❑Convention Center Advisory Board ❑Miami Beach Cultural Arts Council _ ❑Visitor and Convention Authority ❑Design Review Board** ❑Miami Beach Human Rights Committee ❑Disability Access Committee ❑Miami Beach Sister Cities Program ❑Gay,Lesbian,Bisexual and Transgender ❑Normandy Shores Local Government Enhancement Committee(GLBT) Neighborhood Improvement * 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 License Issuance Date License Expiration Date Page 1 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx 0O 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 U1 No Dates of Service: 2. Present participation in Youth Center activities by your children:Yes 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: 1 or No fai If yes, please explain in detail: • Do you currently have a violation(s)of City of Miami Beach Code?Yes Ul or N e —:1! If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money?Yes 111 or No If yes,explain in detail: •Are you currently serving on any City Board or Committee?Yes or No Zji If yes,which board/committee? 74121.5 REc L e yncAJ 4t- FA Li T1 Cs SO • 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: c •Are you now employed by the City of Miami Beach?Yes La or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have a parent U, spouse �, child L.1 brother Ul or sister Ul who is employed by the City of Miami Beach? Check all that apply. 0 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. d Gender: Male Ul Female�1 Race/Ethnic Categories What is your race? Ul African-American/Black Caucasian/White IZ I Asian or Pacific Islander `—=Native-American/American Indian 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. WI No La Yes Do you consider yourself Physically Disabled? Ell 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 ACCORDINGLY." �- it 30 ►s' �-v a Applicant's Signature Date ame of Applicant(PLEASE PRINT) Received in the City Clerk's Office by: f cC 1341v\ / Name of Deputy C -r Control N.. 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 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.gov 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 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: 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.html 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. 11 ,GIIc Signature Date Updated:Wednesday,April 09,2014 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED.docx DAVID J.BERGER David Berger is an attorney,real estate and corporate investor,real estate developer and merchant and investment banker. He is the founder,president and principal shareholder of Mega Capital Corporation,a privately held real estate and corporate investment business and a licensed real estate brokerage entity. All investment transactions originated by Mega Capital are conducted through separate special purpose private investment entities. Mr.Berger brings a broad base of talents and multi-dimensional experiences to his ventures. For sixteen years,he practiced law as a prominent real estate and business attorney. He was a senior partner in the statewide Florida law firm of Broad and Cassel,resident in the Miami office and a member of its management committee and head of its real estate group in Miami. As a lawyer,Mr.Berger has extensive legal experience in the areas of real estate, corporate business,finance,government contracting,lending and other areas. As a lawyer,Mr.Berger has handled a great number of sophisticated and complicated projects well in excess of one billion dollars and has represented creditors,debtors,owners and government agencies involved with a multitude of real estate,business,financing, financial and other creative matters in virtually every product type. Mr.Berger served as Special Counsel to the City of Miami Beach and to its Redevelopment Agency in connection with a variety of transactions including various public private ventures,acquisitions,negotiations,eminent domain, RFPs(including the Loew's Hotel and African-American Hotel RFPs)and tax increment financing transactions. In this capacity he has worked closely with the City Attorney and City Manager offices. He also served as Chair of the Tennis Advisory Committee,Chair of the Tennis Evaluation Committee,Chair of the City's Health Facilities Authority and member of the Convention Center Capital Improvements Committee. Mr.Berger left the practice of law and went into business full time in 1995 as an active real estate and business investor as well as an investment and merchant banker. David is a founding member of a merchant banking and investment banking business involved in debt and equity funding,business and financial negotiations,strategy, consulting and advisory services,business analysis,turnarounds,debt restructures and other matters. David Berger has been a successful real estate and business investor and developer for more than thirty years through a variety of entities and a myriad of product types. His projects include office, industrial,retail,multi- family,leisure,government occupied,and other uses,including a variety of mixed uses,with primary focus on industrial,office,retail and leisure. Mr.Berger's real estate and business activities focus on value-creation where he and his partners develop and implement strategic solutions and structures for his real estate business interests. David Berger received his Bachelor's Degree from the University of Florida and his Juris Doctor Degree from the University of Miami where he was an editor of the law review. Mr.Berger has an AV rating from Martindale- Hubbell which represents the highest rating for legal skills and ethical considerations as determined by other lawyers in Florida. He is a licensed member of the Florida Bar and a licensed Florida real estate broker and Mega Capital Corporation is a licensed Florida brokerage company. Mr.Berger is involved in,and has served on the boards and as chair of numerous charitable and civic organizations. Perhaps most relevant is that David Berger is an avid sportsman,with particular interest in tennis and golf. He grew up in Miami Beach where he continues to reside. He regularly plays tennis at the various City parks(usually Flamingo Park and North Shore Park)several times per week and is familiar with the City's tennis centers and has insight into the needs of the tennis sports community and the management and operations of the tennis facilities. 11/18/15 •' i • • • • .! • • S o s o - ' _,., .El,..- 1 -‘1.±.- '1''''Iler-4. -.-:_:::-.., . ' ' ' ' i P - 146 `° 0 rr. , i r • t ...A r' i�a r • • • l 414k „, 911 it 414/p.ariew- ... , _ .: '--- -• • • • If •i M • I/ a ell eli a . • : : 0 6 • • • Vile f 1 41. ..E- • I 11 .• • 0r 0 •