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Peter Matos 12/31/2018MIAMJBEACH 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 Email CityClerk@miamibeach.gov November 15, 2016 Mr. Peter Matos 1465 Cleveland Rd Miami Beach, FL 33141 SUBJECT: Convention Center Advisory Board Congratulations! You have been reappointed by Commissioner Ricky Arriola to the above referenced, 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 and good luck. Regards Rafael Grafiado City Clerk cc: Saul Frances, Parking Director Max Sklar, 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 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. MIAMIBEACH 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 Email CityClerk@miamibeach.gov TO: Mr. Peter Matos RE: Convention Center Advisory Board 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. I 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 1s ..following the closing of the calendar year on which I have served. Mr. Peter Matos Sworn to and subscribed before me this to day of 56'4^ 201, a oTga ,� 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. m MIAMIBEACH NAME: Matos CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM Peter A Last Name First Name Middle Initial HOME ADDRESS: 1465 Cleveland Rd Miami Beach FL 33141 Apt No. Home No./Street PHONE: 3058616976 3058588000 City State Zip Code pmatos@malloylaw.com Home Business Name: Malloy & Malloy, P.L. Work Address: 2800 SW 3rd Ave Position: Attorney Miami Email Address FL - Florida 33129 Street City State Zip Code Pursuant to City Code section 2-22(4) a and 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. • Resident of Miami Beach for a minimum of six (6) months Yes • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: No • Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: North Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: In addition to being a resident of Miami Beach, I have over 20 years experience dealing with a variety of businesses and produc • Are you presently a registered lobbyist with the City of Miami Beach? 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. (Regular Boards of City) Choice 1: Convention Center Advisory Board Choice 2: Production Industry Council Choice 3: Committee for Quality Education in Miami Beach Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: No Years of Service: 2. Present participation in Youth Center activities by your children No if yes, please list the names of your children, their ages, and which programs. List below: • Have you ever been convicted of a felony: No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: No If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: No If yes, please explain in detail: • Are you currently serving on any City Boards or Committees: Yes If yes, which board? Convention Center Advisory Board • What organizations in the City of Miami Beach do you currently hold membership in? • List all properties owned or have an interest in, which are located within the City of Miami Beach: Property Residence: 1465 Cleveland Rd Miami Beach, FL 33141 • I am now employed by the city of Miami Beach: No Which department? 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 federal equal opportunity reporting requirements. Gender: Male Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. White Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino. Yes Physically Challenged: No NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members. These laws include, but are not limited to, the following: 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 board/committee you have served on for period of one year after leaving office (Miami Beach Code section 2-26). o Requirement to disclose certain financial interests and gifts (Miami -Dade County Code section 2-11.1). (re: 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). 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 have received, read and will abide by Chapter 2, Article VII — of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." I Peter Matos agreed to the following terms on 11/3/2016 11:48:38 AM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date CURRICULUM VITAE Peter A. Matos, Esq. Malloy & Malloy, P.L. 2800 S.W. 3rd Avenue Miami, Florida 33129 Tel.(305) 858-8000 pmatos@malloylaw.com PROFESSIONAL EXPERIENCE Partner, Malloy & Malloy, P.L., Miami, Florida 1993 -Present with a practice focusing exclusively on intellectual property, including patent drafting and patent, trademark and copyright prosecution, enforcement, licensing, infringement opinions and litigation, and including the prosecution of well over 500 patent applications and over 1000 trademark matters. Admitted to Practice in Florida -- 1993 Admitted to Practice in the United States District Court for the Southern District of Florida —1994 Registered to the Practice Before the United States Patent and Trademark Office — 1994 Registration No. 37,884 Board Certified as a Specialist in Intellectual Property Law by the Florida Bar — Inaugural Certification Class 2007 Adjunct Professor of Intellectual Property at Florida International University — 2014 -Present AV Rated as Preeminent by Martindale -Hubbell EDUCATION B.S. Mechanical Engineering, Rensselaer Polytechnic Institute, Troy, New York — 1989 J.D. University of Miami — 1993 OTHER Author: Conozca a Estados Unidos de America — Published 2009 Contributing Author on the Field of Intellectual Property Frequent Lecturer/Speaker in the Field of Intellectual Property Law including several National and Local Television Programs 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 1st of every year. Disclosure for Tax Year Ending 201g Lat (`lame Fj.�st Name Middle Name/Initial S Mailing Address — Street Number Street Name, or P.O. Box ( l r 6 5 (f -�✓�1 tX City, State, Zip tcc ✓vl. - 'etc tl (L, 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) County -'] Municipal: l- c u— 42-00 (Municipality) Board where servipg e 1 bY) Alternate address (if home address is exempt) WorWtelephone 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 $ County E] 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) County -'] Municipal: l- c u— 42-00 (Municipality) Board where servipg e 1 bY) Alternate address (if home address is exempt) WorWtelephone 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 4 1 10 3 4 Vilid le e -7 .?() .t.-. 2 r 1- J e - I hereby swear (or affirm) that the information above is a true and correct statement. Signature of Person Disclosing - Date signed RECEIVED BY ELECTIONS DEPARTMENT: ❑ Hardcopy ❑ Electronic Copy OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: 138 SP -1- COE2018 Scanned Date/Initials: 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: 194 r' 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. Updated: Monday, April 20, 2015 Page 4 of 4 F:\CLER\$ALL1aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx Date M I AM I BEACH DIVERSITY STATISTICS REPORTING Name: 7e41-00 10Ade,' Board / Committee: /113 Appointment Date: Pursuant to City of Miami Beach 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 Female LA Race/Ethnic Categories What is your race? LJ African-American/Black Caucasian/White _I Asian or Pacific Islander D Native-American/American Indian LJ Other - Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Markthe "No" bc,:x if not Spanish, Hispanic, Latino/a, No -Yes Do you consider yourself Physically Disabled? CAUsers\CENTFraN'AppData\Locar,Microsoft1Windows\Ternoorani Internet FiIes1Content.Outlook\NPe,19C,NW3Criciy information form 05-20-13 FINAL.doc Updated: Monday, January 26„ 2015