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Marc Umlas Application PackageUmlas Marc E Last Name First Name Middle Initial 1424 South Biscayne Point Road Miami Beach Home Address City Florida 33141 State Zip Code 30586556053055324224 HomeWork umlas@bellsouth.net Email Address 3057334481 Cellular Miami Beach Business Address 4302 Alton Road, Suite 950 City Florida State 33140 Zip Code Marc E Umlas, MD, PA Occupation:Business Name: Orthopaedic Surgeon 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: Choice 2: Choice 3: Health Advisory Committee Health Facilities Authority Board BOARD AND COMMITTEE APPLICATION FORM 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 No Address in City Historic District submitted. Professional License License Number Issuance Date Expire Date Medical License ME0066812 8/4/1994 1/31/2020 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. 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: YesResident of the City for a minimum of six (6) months: Demonstrate an ownership interest in a business established in the City for a minimum of six (6) months:Yes AFFILIATION WITH THE CITY OF MIAMI BEACH a. ● I am resident of:North Beach Or b. "Ownership Interest" shall mean the ownership of ten percent (10%) or more (including the ownership of 10% or 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. 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):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 section 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 filled with the Office of the City Clerk prior to being sworn in as a member. Or No● Have you ever been convicted of a felony: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? Health Advisory Committee ● Are you presently a registered lobbyist with the City of Miami Beach?No ● I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: I have practiced medicine in Miami Beach for 25 years. I have previously served on the Health Facilities Authority Board. 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 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). 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 equality to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143. Florida Statutes. ● In what organization(s) in the City of Miami Beach do you currently hold membership in? No Organization Information Submitted. ● List the address of all properties owned or in which you have an interest within the City of Miami Beach: Property 1424 S Biscayne Point Rd If so, which department and title?No● Are you now employed by the City of Miami Beach: ● 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?No If "Yes", identify person(s) and department(s): No relative's information submitted. BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami-Dade County Financial Disclosure Code Section 2-11.1(i)(2) 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 filled 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. _____________________________ 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. DIVERSITY STATISTICS REPORT 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. WhiteRace/Ethnic Categories What is your race? No details providedOther Description: Gender:Male Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino.No Physically Challenged:No 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.” I Marc Umlas agreed to the following terms on 12/6/2020 5:07:48 PM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date Board and Committee Application Checklist: Please ensure you have provided all information before applying or reapplying to any Board and Committee. YES YES YES YES I have answered all questions fully. I have uploaded a current resume, photograph, and a copy of any applicable professional license. I have completed and attached the Board & Committee Financial Acknowledgment Statement. I have completed and attached the Diversity Statistics Report. 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. Curriculum Vitae MARC EVAN UMLAS, M.D., F.A.C.S., F.A.A.O.S. CURRENT ADDRESS: BUSINESS ADDRESS: DATE AND PLACE OF BIRTH: MARITAL STATUS: ACADEMIC APPOINTMENTS : 1424 S. Biscayne Point Road Miami Beach, Florida 33141 (305) 865-5605 Marc E. Umlas, M.D., P.A. 4302 Alton Road, Suite 950 Miami Beach, Florida 33140 (305) 532-4224 September 28, 1962 - New York, New York Married, Wife: Rachel Umlas, Children: Jordan, Max, Hannah Chairman, Department of Orthopaedic Surgery and Rehabilitation Mount Sinai Medical Center Miami Beach, Florida July 2013 - Present Chief, Division of Orthopaedic Surgery Mount Sinai Medical Center Miami Beach, Florida October 2009 - July, 2013 Acting Chief, Division of Orthopaedic Surgery Mount Sinai Medical Center Miami Beach, Florida 2004, 2008 - September 2009 Clinical Professor Department of Orthopaedic Surgery Florida International University School of Medicine 2013 - Present Clinical Associate Professor Department of Orthopaedic Surgery Florida International University School of Medicine 2010- 2013 Clinical Assistant Professor Department of Orthopaedic Surgery Florida International University School of Medicine 2009 - 2010 Voluntary Clinical Assistant Professor Department of Orthopaedics and Rehabilitation University of Miami School of Medicine, 1997-2003 Medical Student Clinical Clerkship Director, Orthopaedic Surgery Mount Sinai Medical Center 2009-Present Consultant Reviewer, Editorial Staff, Journal of Bone and Joint Surgery, 2008-Present Appointee, American Academy of Orthopaedic Surgery- Adult Reconstruction - Knee Program Committee, 2012-Present 2 Appointee, American Academy of Orthopaedic Surgery - Adult Reconstruction - Hip Program Committee, 2009-2012 BOARD CERTIFICATION: Diplomat, American Board of Orthopaedic Surgery, 1997 Recertified 2006. ACADEMY MEMBERSHIP: Fellow, American Academy of Orthopaedic Surgery, 1999 Fellow, American College of Surgeons, 2001 Member, American Association of Hip and Knee Surgeons, 2000 EDUCATION: FELLOWSHIP: Fellowship in Arthritis Surgery and Joint Reconstruction Clinical Fellowship under the Direction of Dr. Chitranjan Ranawat Professor, Cornell University Medical School Center for Total Joint Replacement Lenox Hill Hospital New York, New York 8/94 - 7/95 FELLOWSHIP: Adult Reconstructive Surgery/Total Joint Fellowship Clinical Fellowship under the Direction of Dr. Donald Reilly Harvard Medical School Beth Israel Hospital Boston, Massachusetts 2/94 - 7/94 RESIDENCY: Harvard Combined Orthopaedic Surgery Program Harvard Medical School Boston, Massachusetts Resident in Orthopaedic Surgery, 1989 - 1993 INTERNSHIP: Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts Intern in General Surgery, 1988 - 1989 MEDICAL SCHOOL: Stanford University School of Medicine Stanford, California Degree: M.D., 1988 COLLEGE: Harvard University Cambridge, Massachusetts Degree: A B., Magna Cum Laude in Biochemical Sciences, 1984 HIGH SCHOOL: North Miami Beach Senior High School North Miami Beach, Florida Valedictorian, 1980 EMPLOYMENT: Associate in Orthopaedic Surgery Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts July 1, 1993 - December 31, 1993 Mount Sinai Medical Center Miami Beach, Florida 33140 November 20, 1995 - June 30,1999. 3 Marc E. Umlas, M.D., P.A. 4302 Alton Road, Suite 950 Miami Beach, Florida 33140 July 1, 1999 - present CURRENT HOSPITAL PRIVILEGES: Mount Sinai Medical Center, Miami Beach, Florida Jackson Memorial Hospital, Miami, Florida STATE LICENSES: ACADEMIC HONORS: ACADEMIC ACTIVITIES: RESEARCH: 1995- Current 1994 - 1995 1992 - 1993 California, issued 5/25/94 Florida, issued 8/4/94 Magna Cum Laude, Harvard University, 1984 John Harvard Scholar, 1982 -1983 Harvard College Scholar, 1980-1981, 1981-1982, 1983-1984 Dean's List, Harvard College, 1980 -1984 Recipient of the American Cancer Society Research Fellowship, PapanicolaouCancer Research Institute, 1981, 1982, 1983 National Merit Scholar, 1984 Medical Student Clinical Clerkship Director, Orthopaedic Surgery Mount Sinai Medical Center, Miami Beach, Florida (2009-present) Lead Instructor, Medical Student Rotations in Orthopaedic Surgery Mount Sinai Medical Center, Miami Beach (2010-present) Teaching Pre-Clinical FIU Medical Students in Musculoskeletal Physical Examination Florida International University School of Medicine (2009-present) Developed Mount Sinai Medical Center's Orthopaedic Surgery Rotation Curriculum Outcome Studies involving Minimally Invasive Hip/Knee Replacement Surgery, Biomechanics and Clinical Applications of Porous Tantalum, Computer Modeling of Component Wear, Prevention and Management of Osteolysis. Lenox Hill Hospital, Clinical research with Chitranjan S. Ranawat, M.D. Ongoing projects include: Correlating long term results of cemented acetabular sockets with the early radiographic appearance of the bone- cement interfact; Non-invasive evaluation of acetabular component wear; Total knee component alignment and patello-femoral complications; Fat embolism and cement pressurization of the reamed acetabulum; Intermediate results of HA-coated femoral stems. Massachusetts General Hospital Department of Orthopaedic Surgery, Boston. Clinical research with Richard H. Gelberman, M.D. Project involved a prospective study examining patterns of diseased fascia, especiallyspiral cord formation in patients with Dupuytren's Contracture. 5 1992 - 1993 1987 - 1988 1985 - 1988 1982 - 1984 Summers: 1981, 1982, 1983 1978 - 1980 Summer 1979 PUBLICATIONS: Children's Hospital Department of Orthopaedic Surgery, Boston. Clinical research with Michael Millis, M.D. Project involved a retrospective study of the Children's Hospital experience with intertrochanteric osteotomy as a treatment for osteonecrosisof the femoral head. Stanford Medical School Department of Orthopaedic Surgery. Clinical Research under the supervision of Eugene E. Bleck, M.D. Project involved correlating several prognostic indicators for the success of operative clubfoot correction. Research Assistant, Stanford Medical School Department of Medicine. lmmunology/RheumatologyResearch in the laboratory of C. Garrison Fathman, M.D., Associate Professor. Project involved the induction of allograft tolerance through the use of specific anti-L3T4 monoclonal antibodies in murine heart and islet cell transplant model systems. Research Assistant, Laboratory of Biochemical Pharmacology, Dana- Farber Cancer Research Institute, Boston. Radiation Biochemistry and DNA Damage Research under the supervision of William A. Haseltine, Ph.D. Project involved the study of DNA photoproduct induction and photosensitization in defined sequence native DNA and specific clinucleotides. Project culminated in an A.B. Honor's Thesis. Research Assistant, Papanicolaou Cancer Research Institute, Miami. Molecular Biology of Cellular Differentiation Research in the laboratory of Robert Zucker, Ph.D., Assistant Professor. Project involved studying the effects of various agents which induce cellular differentiation on gene expression in a murine erythroleukemic cell line. Research Assistant, University of Miami Medical School/Miami Veterans Administration Hospital. Neurosurgery/Neuropathology Research under the direction of Carl Sutton, M.D., Professor. Project involved the study of the effects of microwave hyperthermia on DNA synthesis and tumor blood flow in a murine ependymoblastoma tumor model. Research Assistant, Rensselaer Polytechnic Institute. Physical Chemistry of Surfaces Research under the direction of S. Ross, Ph.D. Project involved studying the foaming and defoaming characteristics of ternary chemical systems in relation to the phase properties of the system. Umlas, M.E., "Minimally Invasive Total Hip Replacement though a superior Transverse Incision" Submitted for publication. Journal of Arthroplasty. Umlas, M.E. and R.H. Gelberman: "Surgical Management of deQuervain's Disease," In: Master Techniques in Orthopaedic Surgery 3rd Edition. Ed: Gelberman, RH.. Raven Press, New York, 2010. Umlas, M.E. and R.H. Gelberman: "Surgical Management of deQuervain's Disease," In: Master Techniques in Orthopaedic Surgery 2nd Edition. Ed: Thompson, RC. Raven Press, New York, 2002. Rodriguez, Jose A., Ranawat, Chitranjan S., Maniar , Rajesh N. and Umlas, Marc E. lncisional cellulitis after total hip replacement. J. Of Bone and Joint Surgery. 80-B (5):876-878, 1998. Ranawat, C.S., Miyasaka , K, Umlas, ME, and Rodriquez, J.A.,Jr. The Hip. Book Chapter: Textbook of Rheumatology, 5th Ed., Kelley et al., ed s., W.B. Saunders 1997. 4 Ranawat, C.S., Peters, L.E. and Umlas, M.E. Fixation of the Acetabular Component: The Case for Cement. Clin. Orthopaedics and related research, 344:207-215, 1997. Ranawat, C.S., Peters, L.E., and Umlas, M.E.: "Fixation of the Acetabular Component: The Case for Cement". J. Arthroplasty. 11(1):1-3, 1996 . Maniar, R.N., Umlas, M.E., Rodriguez, J.A., and C.S. Ranawat: Supracondylar Femoral Fracture Above a P.F.C. Posterior Cruciate Substituting Total Knee Replacement Treated with Supracondylar Nailing: A Unique Technical Problem. J. Arthroplasty. 11(5):637-9, 1996. Ranawat, C.S., Deshmukh, R.G, Peters, L.E, and M.E. Umlas: Prediction of the Long Term Durability of All-Polyethylene Cemented Sockets Based on the Early Radiographic Appearance of the Bone- Cement Interface. Clin. Orthopaedics, 317:89-105, 1995. Maynard, M.J., Ranawat, C.S., Flynn, W.F ., and M.E. Umlas: Total Hip Replacement Arthroplasty in Patients with Inflammatory Arthritis. Seminars in Arthroplasty Vol. 6(3), p. 145-166, July, 1995. Umlas, M.E., and C.S. Ranawat: In Vivo Comparison of Wear Rates in All- Polyethylene Cemented Acetabular Cups with 22mm and 28mm Femoral Heads: Presentation of a Simplified Technique for Wear Measurements. Abstract and Presentation. Lenox Hill Hospital Orthopaedic Alumni Day Symposium. (Proceedings of the 1st Annual Meeting, New York) June, 1995. Ranawat, C.S.; Deshmukh, R.G.; Peters, I.E.; Umlas, M.E. Prediction of the Long Term Durability of All-polyethylene Cemented Sockets Based on the Early Radiological Appearance of the Bone-Cement Interface: A Five to Fifteen Year Follow-Up of Cemented Total Hip Replacement. Clinical Orthopaedics, No. 309, p. 131-5, December 1994. Umlas, M.E. and R.H. Gelberman: "Prediction of Neurovascular Displacement in Digits with Dupuytren's Contracture" . J. Hand Surgery. 198: 664-6, 1994. Umlas, M.E. and R.H. Gelberman: "Surgical Management of deQuervain's Disease," In: Master Techniques in Orthopaedic Surgery. Ed: Thompson, RC. Raven Press, New York, 1994. Zucker, R.M., M.E. Umlas, D.L. Decal and K.B. Whittington: Hemoglobin Synthesis in Murine Erythroleukemic Cells: Hemin Effects. Cell Biochemistry and Function. 5: 27-35, 1987. Umlas, Marc E., Gerald Chan, and WA Haseltine: Chemical Photosensitizationfor the Induction of Specific Adducts in Defined Sequence DNA. Photochemistry and Photobiology. 42: 265-273, 1985. RECENT PRESENTATIONS Moderator, "Adult Reconstruction Knee II: Primary TKA", Annual Meeting of the American Academy of Orthopaedic Surgery, Orlando, FL, March 1, 2016 Moderator, "Adult Reconstruction Knee II: Infection in TKA", Annual Meeting of the American Academy of Orthopaedic Surgery, Las Vegas NV, March 24, 2015 7 Moderator,"Hip Paper Session I", Thromboembolic Disease/Complications of Total Hip Arthroplasty, Annual Meeting American Academy of Orthopaedic Surgery, San Diego CA, February 7, 2012 "New Horizons in Less Invasive Hip and Knee Arthroplasty", Grand Rounds, Mount Sinai Medical Center Department of Orthopaedic Surgery, April 4, 2011 Moderator, "Hip Paper Session VI", Complications of Total Hip Arthroplasty, Annual Meeting of the American Academy of Orthopaedic Surgery, San Francisco, CA February 17, 2011 "Minimally Invasive Joint Reconstruction of the Hip and Knee", International Medical Congress - Advances in Minimally Invasive Treatments, Florida International University/University of Miami Schools of Medicine, Ritz-Carlton South Beach, July 2, 2010 PROFESSIONAL SOCIETIES AND ACTIVITIES: CURRENT Member, American Association of Hip and Knee Surgeons Fellow, American Academy of Orthopaedic Surgery Member, Eastern Orthopaedic Association Member, Florida Orthopaedic Society Member, Miami Orthopaedic Club Member, Florida Medical Association Member, Stanford University Medical School Alumni Association Member, Harvard Alumni Association, member of Schools Committee Member, Lenox Hill Hospital Alumni Association HOSPITAL COMMITTEES Credentials Committee, MSMC, 2003-present (Chairman [2012-present], Vice Chairman [2009-2012]) Medical Executive Committee, MSMC, 2012-present Quality Assurance Committee, MSMC , 2003- present Perioperative Review Committee, MSMC, 2003-present Surgical Review Committee, MSMC, 2003-present Infections Committee, MSMC, 2003-present Institutional Review Board/Human Subjects Committee, MSMC, 1997-9 Operating Room Committee, MSMC, 1997- 2003 (Vice Chairman 1999-2001) 6 RESIDENCY/ FELLOWSHIP Resident Member, American Academy of Orthopaedic Surgery, 1989 - 1995. Member, American Medical Association Member, Massachusetts Medical Society MEDICAL SCHOOL Senator, Representing the Medical School and Law School and Business School in the Associated Students of Stanford University Senate, 1984 - 1985, 1985 - 1986 Governor, Board of Governors, Stanford Medical School Alumni Association, 1987-1988 Class Representative to Stanford Medical School Students Association Student Senate, 1987-1988 Stanford Medical School Admissions Committee, Student Interviewer and File Reviewer, 1985-1988 American Medical Student Association California Medical Association COMMUNITY Director , National Board of Directors, Museum of Science and Industry, Tampa, Florida (2012-Present) Director, Board of Directors, Fox Observatory, Fort Lauderdale, Florida (2012-present) Health Facilities Authority Board, City of Miami Beach (2007-2014) Judge, Miami Herald Silver Knights Awards (2002-present) Judge, Florida State Science Fair, Florida Foundation for Future Scientists Secretary, South Florida Amateur Astronomy Association, Ft. Lauderdale, Florida Colonel, Honorable Order of Kentucky Colonels, by appointment of the Governor of Kentucky Past Master, Hurricane Lodge #401, Free and Accepted Masons, Grand Lodge of Florida Member, Scottish Rite of Free and Accepted Masons, Valley of Miami Shriner, Mahi Shrine, A.A.O.N.M.S., Miami, Florida Member, Harvard Alumni Association 7 Member, Stanford Alumni Association Member, Stanford Medical Alumni Association Member, Dade Radio Club, Miami, Florida Member (NU2U), American Radio Relay League Member, 332nd Red Tail Squadron Flying Club, Ft. Lauderdale, Florida Member, United States Power Squadrons