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Frank Mena Application Package (2) Page 1 of 6 F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION.docx Updated: June 2020 BOARD AND COMMITTEE APPLICATION Last Name First Name Middle Initial Home Address City State Zip Code Cellular Telephone Work Telephone Home Telephone Email address Business Name Occupation Business Address City State Zip Code 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 Advisory Committee Normandy Shores Local Government Neighborhood Improvement District Advisory Council Animal Welfare Committee Health Facilities Authority Board Parks and Recreational Facilities Board Art in Public Places Committee Hispanic Affairs Committee Personnel Board Audit Committee Historic Preservation Board  Planning Board Black Affairs Advisory Committee Housing Authority Police/Citizens Relations Committee Board of Adjustment Human Rights Committee Production Industry Council Budget Advisory Committee LGBTQ Advisory Committee Program for Public Information Committee Committee for Quality Education in Miami Beach Marine & Waterfront Protection Authority Senior Affairs Committee Committee on the Homeless Mayor’s 41st Street Committee Sustainability Committee Convention Center Advisory Board Mayor’s General Obligation Bond Oversight Committee Transportation, Parking, and Bicycle- Pedestrian Facilities Committee Cultural Arts Council Mayor’s Panel on Ocean Drive Visitor and Convention Authority Design Review Board Miami Beach Commission for Women Youth Commission Disability Access Committee Next Generation Council 1. _____________________________________ 2. _____________________________________ 3. _____________________________________ Professional License Type of Professional License License Number State of Issuance License Issuance Date License Expiration Date Note: If you are seeking appointment to a professional seat (e.g. attorney, architect, etc.), you must attach a copy of your currently effective corresponding professional license. Mena Frank C 1621 Collins Avenue, Unit 1005 Miami Beach FL 33139 305-776-0971 786-600-3970 fmena@lynkventures.com Lynk Ventures Attorney, Healthcare and Assisted Living Facility Consultant 1621 Collins Avenue, Unit 1005 Miami Beach FL 33139 Health Advisory Committe Assisted Living Facility Administrator Control #: 990028520 Florida 12/8/2007 7/25/2021 Page 2 of 6 F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION.docx Updated: June 2020 ● I am applying for an appointment because I have special abilities , knowledge, and experience. Please list below: AFFILIATION WITH THE CITY OF MIAMI BEACH Pursuant to City Code section 2-22(4) a, b, and c: Members of Agencies, Boards, and Committees shall be affiliated with the City. This requirement shall be fulfilled in the following ways: a. Resident of the City for a minimum of six months: Yes or No ● I am a resident of: South Beach Middle Beach North Beach Or b. Demonstrates an ownership interest (for a minimum of six months) in a business established in the City (for a minimum of six months): Yes or No “Ownership Interest” shall mean the ownership of ten percent (10%) or more (including the ownership of 10% o r more of the outstanding capital stock) in a business. “Business” shall mean any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. Or c. Full-time employee of such a business (for a minimum of six months); and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months): Yes or No Notwithstanding the requirements set forth herein, the qualified full-time employee of a business must be approved by a 4/7th vote of the Mayor and City Commission. NOTE: Members of Agencies, Boards, and Committees shall be required to demonstrate compliance with the City affiliation requirements of sections 2-22 (4) a and b of the Miami Beach City Code by executing an affidavit, stipulating that they have met either (or both) of said affiliation requirements. The original affidavit shall be filed with the Office of the City Clerk prior to being sworn in as a member. I have been involved with Assisted Living Facilities and working with the elderly for well over 10+ years. I have been a resident of Miami Beach for 20 years. Page 3 of 6 F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION.docx Updated: June 2020 ● Are you a registered active lobbyist with the City of Miami Beach? Yes or No ● 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 or No If yes, please explain in detail: ● Do you currently owe the City of Miami Beach money? Yes or No If yes, please explain in detail: ● Are you currently serving on any City Board or Committee? Yes or No 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 the address of 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 or No If so, which department and title? _________________________________________________________________________________________________ ● Pursuant to City Code Section 2-25 (b): Do you have a parent , spouse , child brother or sister who is employed by the City of Miami Beach? Yes or No If “Yes,” identify person(s) and department(s):  Note: If applying for the At-Large position of the Historic Preservation Board, please answer the below questions: • Have you ever resided in one of the City’s Historic Districts for at least one year? Yes or No If you answered “Yes,” please indicate: From: To Address Dates From: To Address Dates Health Advisory Committee Health Advisory Committee Member 1621 Collins Ave, Units 903, 907, and 1005. 1623 Collins Avenue, Unit 916 Page 4 of 6 F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION.docx Updated: June 2020 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 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. 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.” _________________________________________________________________________________________________ Applicant’s Signature Date Name of Applicant (PLEASE PRINT) Board and Committee Application Checklist: Please ensure you have provided all information before applying or reapplying to any Board and Committee □ I have answered all questions fully. □ I have attached additional sheets, if necessary, to provide required information. □ I have attached a current resume, photograph, and a copy of any applicable professional license. □ I have completed and attached the Board & Committee Financial Acknowledgement Statement. □ I have completed and attached the Diversity Statistics Report. □ Submit complete application package. Via Email: BC@miamibeachfl.gov Via U.S. Mail or in Person: City of Miami Beach Office of the City Clerk / Board and Committee Section 1700 Convention Center Drive, 1st Floor Miami Beach, FL 33139 If you have any questions, please contact the Office of the City Clerk via email: BC@miamibeachfl.gov or telephone: 305.673.7411. Note: Florida Statutes §119.071: The role of the Office of the City Clerk is to receive and maintain forms filed as public records. If your home address, telephone numbers, and/or photograph are exempt from disclosure and you do not wish your home address, telephone numbers, and/or photograph to be made public, please: 1) Use your office or other address for your mailing address; 2) Use your office or other telephone number for your contact number; and 3) Do not attach a photograph. 11/5/2020 Frank Mena Page 5 of 6 F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION.docx Updated: June 2020 BC@miamibeachfl.gov BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT 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) Last Name First Name Middle Initial 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. 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;” or 2. A “Statement of Financial Interests (Form 1)1;” or 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 Date 1 Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112.3145(1)(a), to file a Statement of Financial Interests (Form 1) with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County’s financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Mena Frank C 11/5/2020 Page 6 of 6 F:\CLER\$ALL\BOARD AND COMMITTIES DATABASE\CHECKLIST MASTER\BOARD AND COMMITTEE APPLICATION.docx Updated: June 2020 Email: BC@miamibeachfl.gov DIVERSITY STATISTICS REPORT Last Name First Name Middle Initial The following information is voluntary and has no bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. Gender: Male Female Other I prefer not to answer. Race/Ethnic Categories: What is your race? African American/Black Asian or Pacific Islander Caucasian/White Native American/American Indian Other – Print Race: I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? Yes No I prefer not to answer. Do you consider yourself Physically Disabled? Yes No I prefer not to answer this question. Mena Frank C Brown Frank C. Mena, Esq. Frank acquired his first elderly healthcare company in 2007. Since then, Frank has owned, operated and/or managed multiple health care and residential properties and companies throughout Florida. Frank has also owned, operated and/or served as a Board Member to multiple health care entities including Assisted Living Facilities (ALFs), Adult Daycare, Primary and Specialty Care Medical Centers, Management Services Organizations (MSOs), Physician and Physician Extender Homecare, Home Healthcare (Nursing, Physical Therapy, Home Health Aides), Durable Medical Equipment (DME) and health care staffing companies. Frank is a member of the Florida Bar and received his Juris Doctorate from Columbia University School of Law in 2000, where he was awarded the Parker Certificate for Achievement in International and Comparative Law, was selected to the Columbia Journal of Transnational Law, and was the President of the Latin American Law Students Association. Frank began his career at one of the most prestigious law firms in the State of Florida where he represented state and foreign government entities, banks and private multi-national companies. Frank then accepted a job as Executive Vice-President and General Counsel for a finance company with approximately 250 locations throughout the country. Frank transitioned into healthcare in 2007 when he acquired the ALF where his grandmother was a resident at the time. Since then, Frank opened an additional four ALFs and provided care to hundreds of elderly residents throughout South Florida. Frank is licensed by the Florida Agency for Health Care Administration (“AHCA”) as an ALF Administrator. Frank sourced the properties, arranged the financing, led the design and renovations/construction, handled the zoning and land use requirements, secured the licensing, and managed the start-up, stabilization and continued operation of the facilities. The facilities have included Limited Nursing Services Licensing, Mental Health Licensing, and contracted Hospice care services. The healthcare entities have handled over 50 governmental and quasi-governmental audits and inspections by AHCA, Medicaid Department of Children and Families (DCF), Florida Department of Health (DOH), Ombudsman, and Miami- Dade Fire Department. For over 10 years, Frank has also served on the Board and provided general consulting to one of the largest privately owned non-hospital based home health companies in Miami-Dade County. Frank is also a principal and Board Member for Illumina Medical Centers LLC. Frank’s passion for healthcare is driven by a lifelong affinity with the elderly. He believes that ensuring the best healthcare services to the elderly will allow him to do well by doing good. His vision is to provide the best care possible to those who cared for us.