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Heriberto (Herb) Sosa 12/31/2018MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeochfl.gov OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk Tel: 305.673.741 1, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov March 09, 2017 Mr. Heriberto (Herb) Sosa 831 Ninth Street Miami Beach, Florida 33139 SUBJECT: LGBTQ Advisory Committee Dear Mr. Heriberto (Herb) Sosa: Congratulations! You have been appointed by Commissioner John Aleman to the agency, board or committee named above for a term ending: 12/31/2018. Pursuant to City of Miami Beach Code Section 2-22 (5)a,"Notwithstanding any other provision of the City Code or of any resolution, commencing with terms beginning on or after January 1, 2007, the term of every board member who is directly appointed by a member of the City Commission shall automatically expire upon the latter of: December 31 of the year the appointing City Commissioner leaves office or upon the appointment/election of the successor City Commission member." If you are unable to accept this appointment, or have any questions, please call the Office of the City Clerk at 305.673.7411. Please read the enclosed materials carefully. Congratulations again and good luck. Regar Ra1fael Granado City Clerk cc: Saul Frances, Parking Director Morgan Goldberg, City Liaison 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, 2-458 and 2-459 Ordinance No. 2006-3543 - Amendment to City Code Section 2-22 Miami -Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics 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 E. Granada, City Clerk Tel: 305.673.7411, Fax: 305.673.7254 Email: CityClerk@miamibeachfl.gov TO: Mr. Heriberto (Herb) Sosa RE: LGBTQ Advisory 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: 12/31/2018. 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 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 the State of Florida (depending on the board or committee on which I serve) on July 1st), following the closing of the calendar year on which I have served. f Mr. feriberto (Herb) Sosa Sworn to and subscribed before me this day of / / &,Vb17 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 are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. MIAMI BEACH Sosa Heriberto Last Name First Name 831 Ninth Street Miami Beach Home Address 786-271-6982 Home Telephone Work Telephone Unity Coalition 1 Coalicion Unida City BOARD AND COMMITTEE APPLICATION FORM Jorge Middle Initial Florida 33139 State Zip Code herbsosa@yahoo.com Cellular Telephone Exec. Director Business Name Occupation 777 Brickell Ave, Suite 500, Miami, Florida 33131 Business Address Email address Professional License (describe): City State Zip Code 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 or No • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: Yes Z1 or No • Are you a registered voter in Miami Beach: Yes or No • I am now a resident of: North Beach South Beach [21 Middle Beach L] • 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 Hispanic LGBT non profit in 5outh Florida, and have served as member & chair of the Historic Preservation board. • Are you presently a registered lobbyist with the City of Miami Beach? Yes LJ or No 1)0 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. 0 Affordable Housing Advisory Committee ❑ Art in Public Places Committee 0 Board ofAdjustment 'y 0 Health Facilities Authority Board 0 Hispanic Affairs Committee 0 Budget Advisory Committee Li Committee on the Homeless ❑ Historic Preservation Board 0 Committee for Quality Education in MB 0 Convention Center Advisory Board 0 Design Review Board* ❑ Disability Access Committee 0 Health Advisory Committee 0 Housing Authority 1) LGBT Advisory Committee 0 Marine & Waterfront Protection Authority 0 Miami Beach Commission for Women 0 Miami Beach Cultural Arts Council 0 Miami Beach Human Rights Committee 0 Miami Beach Sister Cities Program Normandy Shores Local Government Neighborhood Improvement 0 Parks and Recreation Facilities Board °° L1 Personnel Board LJ Planning Board** 0 Police Citizens Relations Committee 0 Production Industry Council 0 Sustainability Committee 0 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 Adjustmi,nt, Design Review Board, Historic Preservation Board or Planning Board, attach a copy of your currently -effective license, and furnish the following information: Type of Professional License License Number License Issuance Date ry License Expiration Date Page 1 of 4 F:ICLER\SALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06052015.doccanned ; v c'4"'1f� 0,,s 04- /hz,/16 NOV 0 6 2015 4 °° 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 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 Zi or No al If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code? Yes UI or No[11 If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money? Yes ❑ or No 21 If yes, explain in detail: • Are you currently serving on any City Board or Committee? Yes 3.(.1 or No ❑ If yes, which board/committee? Historic Preservation board - Termed out Dec 1, 2015 • In what organization(s) 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 ❑ or No Which department and title? • Pursuant to City Code Section 2-25 (b: Do you have a parent ❑ spouse ❑, child brother ❑ or sister LI who is employed by the City of Miami Beach? Yes or No 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 Lj Female Race/Ethnic Categories What is your race? I�,.. African-American/Black �.ol Caucasian/White Asian or Pacific Islander Native-American/American Indian F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVIPage 2 of 4 SED O60520 5.docx Other - Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. UD Yes ailyou consider yourself Physically Disabled? Do �.dd N o 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 ACCORDINGL " Applicant's Signature Received in the Office of the City Clerk by: Oct 22, 2015 Date Herb Sosa Name of Applicant (PLEASE PRINT) Name of Deputy C'(erk Control No. c)-d-/i— 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 Community activist, historian, preservationist and freelance writer, Herb Sosa is a founding member of, and currently serves as President of Unity Coalition 1 Coalicion Unida, offering Leadership, Protection & Promotion of Latino 1 Hispanic LGBTQ rights (lesbian, gay, bisexual, transgender, questioning)- the only organization of its kind in South Florida since 2002. Sosa also is Pubisher 1 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 Cafe 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). MIAMI•DADE COUNTY SOURCE OF INCOME STATEMENT Section 2-11.1(i) of the County Ethics Code requires that certain employees and public officials file a financial disclosure Statement on a yearly basis by July lst of every year. Disclosure for Tax Year Ending 2016 Last Name First Name X054 /Qr, Mailing Address — Street Number Street Name, or P.0. Box Middle Name/Initial 4 City, State, Zip 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 (check one) Filing as a Board Member (check one) El County 0 Municipal: LP c Atiwt Q� (Municipality) Board where serving L Co IPJ t- C ad vi �v r Alternate address (if home address is exempt) m t44; 1`>� 42.C� Work telephone Term began on/ended 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. Examples of sources of income include: compensation for services, income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. 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 County Il Public Health Trust Municipal: (Municipality) Department Position or Title Employee ID Number Work address Work telephone Employment began on/ended on Filing as a Board Member (check one) El County 0 Municipal: LP c Atiwt Q� (Municipality) Board where serving L Co IPJ t- C ad vi �v r Alternate address (if home address is exempt) m t44; 1`>� 42.C� Work telephone Term began on/ended 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. Examples of sources of income include: compensation for services, income from business, gains from property dealings, interest, rents, dividends, pensions, IRA distributions, and social security payments. 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 Business Activity 45 p &o, yn ,- I ,Ui`-- Hirn.1--i1"TA -AQA _lG I hereby swear (or affir)n);that the information above is a true and correct statement. Signature ofJ'rson Disclosing --; --i r) Date signed ) RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: 138 SP -14 COE 2016 Scanned Date/Initials: City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, wtvw.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(1) (2) Board Member's Name: jk1 ' e4=?/'6 ( htJ -1) 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" 2. A "Statement of Financial Interests (Form 1)" 3. A Copy of your latest 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. Signature Updated: Monday, April 20, 2015 Page 4 (31'4 F:\:CLER\SALL\._FORMS\BOARD AND COMMITTEESiSC APPLICATION REVISED 06022014.docx Date /\AIAI\A BE. DIVERSITY STATISTICS REPORTING Name: tier/he/Jo (c/lei6 05cr Board / Committee: � 6 (1 Ut 5Crm • # e Appointment Date: 3/ 5 /7 Pursuant to City of Miami Bach Ordinance 2009-3632, the City is required to annually prepare and present a report to the City Commission identifying the City's diversity statistics. This form allows board and committee applicants and members to voluntarily self -identify their race, ethnicity, disabled status and gender. Please check the appropriate box for each category: Gender: Male emale L Race/Ethnic Categories What is your race? African-American/Black L CaucasianiWhite Asian or Pacific Islander Li Native-American/American Indian D Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Marr the "Na" oox Spanish, Hispanic, Latinos. LA No 'es Do you consider yourself Physically Disabled? Kilo Li Yes � se car v: � a...s4C�NTrr2"J`�""��%�.)ctd�i_t.�,.c�.f.ilCrCo;.:t.tiivinfj;.,.vorc;ft.pQ!?('d ifit3�:1?' -•�....._:C;tl(:? ' tJtl:'... .. information form 05-20-13 F1NAL.doc Updated: Monday, January 26. 2015