Yale Herskowitz Application PackageHerskowitz Yale B
Last Name First Name Middle Initial
4345 Jefferson Ave Miami Beach
Home Address City
FL 33140
State Zip Code
HomeWork
ybh5@cornell.edu
Email Address
3057887229
Cellular
Miami Beach
Business Address
4300 Alton Rd
City
FL
State
33140
Zip Code
Mt Sinai Medical Center
Occupation:Business Name:
Resident physician
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:
Next Generation Council
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
Resident TRN34772 4/27/2022 6/30/2024
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:No
AFFILIATION WITH THE CITY OF MIAMI BEACH
a.
● I am resident of:Middle 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):Yes
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:No If yes, which board?
● 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:
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:
No Owned Property Information submitted.
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 Yale Herskowitz agreed to the following terms on 6/23/2022 4:00:36 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.
Yale Herskowitz
4345 Jefferson Ave Miami Beach, FL 33140 | Cell: (305) 788-7229 | E-mail: ybh5@cornell.edu
Work/Volunteer Experience
Resident Physician Mt. Sinai Medical Center Miami Beach, FL June 2022-present
• Internal Medicine resident physician (FL DOH TRN34772)
Commission Aide Commissioner Fernandez/City of Miami Beach Miami Beach, FL November 2021-June 2022
• Reviewed $750M City budget, prepared legislation, researched innovative solutions & engaged
community
• Projects: building incentive program; high school internship program; pension reform; traffic
management
Paramedic Volunteer Hatzalah of Miami-Dade Miami, FL 2015 to 2016
• Responded to emergency calls in Miami Beach
Research Assistant Arkady Uryash, M.D./Ph.D., Mt. Sinai Miami Beach, FL Summer 2012
• Investigated mechanical stimulation technique of periodic acceleration (pGz) on stimulating intrinsic
endothelial nitric oxide synthase (eNOS) in decreasing peripheral vascular resistance
EMT Volunteer Emergency Medical Services, Cornell University Ithaca, NY Fall 2010 to Fall 2011
• Responded to 911 calls across campus and trained community in basic life support
Education
American University of Integrative Sciences Atlanta, GA M.D., May 2021
• Created 50+ YouTube video library for USMLE Step 2 Clinical Skills (channel: medRebel)
University of Miami Miller School of Medicine Miami, FL Fall 2016-Spring 2019
• Treasurer, Cardiology Interest Group (2017-18)
• Operations Manager, Business in Medicine (2017-18)
• Department of Community Service (DOCS): Certified Application Counselor for Affordable Care Act (2016-
17), Hialeah Health Fair (2017)
Miami-Dade College Paramedic Certificate Program Miami, FL Paramedic, August 2016
• Completed 4-semester sequence and obtained licensure as FL paramedic (PMD 529851)
Cornell University Ithaca, NY B.S. cum laude, May 2013
• Majored in Applied Economics in 3 years; Dean’s List since Spring 2011
Interests
• Basketball, Hiking, Investing (Benjamin Graham, Philip Fisher), Running, Sailing, Skiing, Swimming
References
• Ari Ciment, M.D., Mt. Sinai Medical Center, Miami Beach, FL, (305) 968-2601, airciment@aol.com
• Alex Fernandez, Commissioner, City of Miami Beach, (786) 999-5662, alex@miamibeachfl.gov
• Alexey Podcheko, M.D./Ph.D., Dean, American University of Integrative Sciences, apodcheko@auis.edu
• Peter Rogers, Ph.D., Professor, American University of Integrative Sciences, progers@auis.edu
• Damien Doute, M.D., Spine & Orthopedics of Atlanta, GA, (470) 294-0863, spineorthoatl@gmail.com