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George Heisel Application PackageAAAf BEAC Last Name FrsN e siS1) N 6ul e_d1,cAvv1i ( c,e Home Address City BOARD AND COMMITTEE APPLICATION FORM f-1 State T Middle Initial 331 Zip Code 60t-6i41oLo 30.-c-14-1-92.2.7_ 30,0-'199-2 c,t) 1heiSrleel teu row Home Telephone Work Telephone Cellular Telephone Email address i4sv psicKe() Are SSi4C 26cD -(�esi�er� Business Name Occupation '5c.Cc1rear+ LLC VI IGhA1 FL 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 r No • Demonstrates ownership/interest in a business in Miami Beach fora minimum of six months: Yes No • Are you a registered voter in Miami Beach: Yes br No • I am now a resident of: North Beach South Beach Ltlllliddle Beach • 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 IZt or No Eli 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 Offire of the (itv Mag. Affordable Housing Advisory Committee ArtinPublicPlacesCommittee AuditCommittee BoardofAdjustment* Budget Advisory Committee corn mitteeontheHomeless Comm itteeforQualityEducationin MB Convention Center Advisory Board CulturalArtsCouncil Design ReviewBoard 'Li Disability Access Committee Health Advisory Committee Health Facilities Authority Board Hispanic Affairs Committee Historic Preservation Board 'Cr HousingAuthority Human Rights Committee LGBT Advisory Committee Marine & Waterfront Protection Authority Miami Beach Commission forWomen Normandy Shores Local Govemment Neighborhood Improvement Ad Hoc Anti -Bullying Task Force Parks and Recreation Facilities Board °O Personnel Board PlanningBoard* Police Citizens Relations Committee Production Industry Council SisterCitiesProgram Sustainability Committee Transportation, Parking, & Bicycle -Pedestrian Facilities Committee Visitor and Convention Authority Youth Commission Ad Hoc Small Business Task Force * 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 C\Users\CLERQueR\Desktop\BC APPLICATION.docx c° 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 D No If yes, please list below the names of your children, their ages and the programs in which they participate: Child's name: Child's name: Age: Program: Age: Program: • Have you ever been convicted of a felony? Yes or No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code? Yes ri or Nor If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money? Yes or No If yes, explain in detail: • Are you currently serving on any City Board or Committee? Yes or No Vi 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 1 t or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you hav a parent 1,j, spouse , child _ brother I..,„ or sister n who is employed by the City of Miami Beach? Yes n`or No 1-41 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 VI Female Race/Ethnic Categories What is your race? Africa n -America n/BI ack Caucasian/White Zt Asian or Pacific Islander Native-American/American Indian Page 2 of 4 C:1Users\CLERQueR\Desktop\BC APPLICATION.docx n Other— Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. No Flt 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 GENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATUTES ACCORDINGLY." Applicant's Signature Date Received in the Office of the City Clerk by: Name of Deputy Clerk c-©��� Name o Ap nt (PLEASE PRINT Control No. Date ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3of4 C\Users\CLERQueR\Desktop\BC APPLICATION.docx George T. Heisel President - ExpoCredit gheisei.'eDexpocredit.conn Summary Mr. Helsel is the President of ExpoCredit a specialty finance company. The company purchases over a billion dollars annual in AR & AP. ExpoCredit will be celebrating 20th anniversary shortly. Mr. Helsel was founder of Doctor Diabetic Supply, Inc. (founded 2001) - the largest independent national distributor of direct -to -consumer diabetic testing supplies and related healthcare products to Medicare patients. Mr. Heisel oversaw all stages of its growth and development and sold company in 2011 to a strategic buyer. He is presently an active investor in several portfolio companies, including financial services, distribution, electronics, retail and real estate, and including both domestic and international companies. Prior to Doctor Diabetic, Mr. Heisel was Regional President of Rural Metro Corp., an international healthcare services company, where he oversaw 11 operations across Brazil, Argentina and Bolivia, and a total of 3,500 employees. Prior to moving to South America, he served as the General Manager of Rural Metro's San Diego EMS operation, where he formed the nation's first public/private partnership between a municipality and a private EMS provider. He remains involved with numerous non-profit organizations, including, among others, The Eli Home, Young Presidents' Organization (Miami Chapter), Miami Children's Hospital and Mt. Sinai Hospital, where he served on the Medical Center Foundation Board. Experience President at ExpoCredit March 2012 - Present •ExpoCredit, LLC is a financial services organization that specializes in supplying working capital to growing companies in need of immediate cash flow since 1998. •ExpoCredit partners with clients to fund and manage their account receivables allowing them to better focus on their sales and marketing initiatives. •ExpoCredit partners with clients to fund and manage their accounts payable allowing them to take advantage of early payment discount and improves cash flow. Page 1 ExpoCredit, through subsidiary Storati, partners with clients to finance inventory allowing them to take advantage of volume discounts. Executive board member YPO Miami 2011 - 2017 - years) President - Doctor Diabetic Supply Inc. December 2000 - February 2011 10 years 3 months) DDS was the largest indepedent supplier of diabetic testing supplies to Medicare recipients. Executive - Rural Metro Corporation January 1990 - December 2000 i 1 1 years Educati- Babson College BS, Marketing, 1985 - 1989 Activities and Societies: TKE & Rugby McQuaid Page 2