Melba Pearson 12.31.24BOARD AND COMMITTEE CHECKLIST
Scan o
Scan o
APPOINTEE. Melba Pearson DATE OF APPOINTMENT. 2/1/2023
BOARD/COMMITTEE. Black Affairs Advisory Commit({ Appointed by. ayor Dan Gelber
FOR SCANNER FORCLERK STAFF ] l] Jen)
Scan o o Letter of Appointment TERM END.I I 2k TERM LIMIT. 2l
Scan o o Letter of Reappointment
o Cop~ Letter of Appointment/Reappointment e-mailed to Committee Liaison on
21i[23 1.
o Board' and Committee Application (Completed on yd J]
o R6sum/curriculum Vitae .}J
o Diversity Statistics Reporting (Completed on 2 J2
o Oath Scan o
RECEIVED
FEB 22023
CITY OF MIAMI BEACH
OFFICE OF THF CITY CLERK
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓City Code Ordinance Section applicable to the agency, board or committee
✓City Code Sections 2-21, 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
✓County Code Section 2-11.1 -- Conflict of Interest and Code of Ethics Ordinance (as
amended through December 2010)
✓Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓Highlights of the Miami-Dade County Ethics Code
✓Sunshine Law and Public Records - Frequently Asked Questions
✓Memorandum - Solicitation by City Board and Committee Members
o Citywide Permit Application (Parking Department Form)
o Booklet - Guide to Sunshine Amendment & Code of Ethics for Public Officers and Employees
Scan o o Source of Income Statement
Scan o o Acknowledgment of Financial Disclosure Requirement
o Board and Committees Liaison Responsibilities
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O DIVERSITY STATISTICS REPORTING Kee' 5i ORIGINAL for Annual Report.
Received 6j. 2/3/2023 Signed By %
Date
Processed on. 0VO By Employee: l I
Date
Scanned on: 00° By Employee: I
Date
CONCLUDED & RESIGNATION LETTERS
Term Expired Letter Date Processed Initials Scan o
Resignation Letter Date Processed Initials Scan o
Removal Letter due to absences Date processed Initials Scan o
F:\CLER\BO A RD AND CO M M ITT IES DATA BA SE\CHEC K LI ST M A STER\B&C Checklist 2015 MASTER.docx
We re committed to providing excellent public service and safety to al who live, work, and pa y in o ur vibrant, topical, historic community.
City of Miami Beach, 1ZOO Convention Coner Drive, Miami Florida 33139 yyy_miamibggchl]go
OF F ICE OF THE CITY CLERK, Raf aal E. Gran ado, City Cl erk
Tel: 305.673.7411, Fax: 305.673.7254
Email: Ci#yClerk@miamiboochfl.gov
January 31, 2023
M s. M elba Pearson
1521 Al ton Road S uite 198
M iam i Beach, FL 33139
RE: Black Affairs Advisory Committee
Dear M s. M elba Pearson:
C ongra tulations! Y ou have been appointed by Mayor Dan Gelber to the above-referenced B oard or
Com m ittee, fo r a term ending: 12/31/2024.
P ursuant to C ity of M iam i B each C ode S ection 2-22 (5)a:
Notw ithstanding any other pro vision of the C ity C ode or of any R esolution, com m enci ng w ith
term s beginning on or after January 1, 2007, the term of every board m em ber w ho is directly
appointed by a m em ber of the C ity C om m ission shall autom atically expire upon the latter of:
D ecem ber 31 of the year the appointing C ity C om m issioner leaves office or upon the
appointm ent/election of the successor C ity C om m ission m em ber.
If you are unable to accept this appointm ent, or have any questions, please call the O ffi ce of the C ity
C lerk at 305.673. 7 411.
P lease read the enclosed m aterials carefully as they concern your duties, responsibilities, and
requirem ents as a board or com m ittee m em ber.
C ongratulations again and good luck.
R egards,
cc: M onica B eltran, P arking Di rector
Li ssette A rro gante, C ity Li aison
ENCLOSURES:
O ath of O ffice/O ath of C ivility/A cknow ledgem ents
C ity C ode/O rdinance section applicable to agency, board or com m ittee
C ity C ode S ection s 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 an d 2-459
O rdinance No. 2006-3543 - Am en dm en t to C ity C ode S ection 2-22
M iam i-Dade C ounty C ode S ection 2-11.1 - C onflict of Interest and C ode of Ethics
C ity W ide P erm it Ap pl ication - (P arkin g Departm ent Fo rm )
Booklet - G uid e to the S unshine A m endm ent and C ode of Ethics fo r P ublic O fficers and Em ployees
M IAM I BEACH
City of Miami Beach, 1ZOO Convention Coner Drive, Miami Beach, Florida 33139 wyy_miaIibgachfl_go
OFFICE OF THE CITY CIERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax: 305.673.7254
Email: CilyClerk@miamibeachfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Ms. Melba Pearson
RE: Black Affairs Advisory Committee
I 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: 12/31/2024.
To my colleagues and to all of those I represent and serve, I pledge fairness, integrity and civility, in all
actions taken and all communications made by me as a public servant.
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 1st, following the closing
of the calendar year on which I have served.
Ms. Melba Pearson
Sworn to and subscribed before me this _l. '-<-2023
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.
MI A H
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305 .673 7411
RECEIVED
FEB 2 2023
CITY OF MIAMI BEACH
OFFICE r TE CITY CLERK
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check
(✓)all that apply):
rn I am a resident of the City of Miami Beach for six months or longer.
Home Address -------------------------
El I have an ownership interest (for a minimum of six months) in a business established in the City of
Miami Beach (for a minimum of six months).
Name of Business MVP Law, LLC
Business Address 1521 Alton Road, Suite 198, Miami Beach, 33139
□I am a full-time employee of 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).
Name of Business _
Business Address ------------------------
"Ownership Interest" means the ownership of ten percent (10%) or more (including the ownership of
10% or more of the outstanding capital stock) in a business.
"Business" means any sole proprietorship, sponsorship, corporation, limited liability company, or other
entity or business association.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it
are 1Iu9,_. 2_, 3Ps=e>
Signature Date
Printed Name
NOTARY
Sworn to (or affirmed) and subscribed before me, by means of□physical presence or online notarization,
this C"lay or Feb ruary , 2023_by Melba Pearson
_________ (City of Miami Beach Board/Committee Member).
Produced ID
Form of Identification
' Personally Known p /
--------- 1 4 0-A,,l;_,vfvi ~ ---
Signature of Notary Public / f (/'
Name of Notary, Typed, Printed, or Stamped
MI A
City of Miami Beach
1700 Convention Center Drive
M ia mi Beach, Florida 33 l 39
www.miamibeach[l. gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPORT
Pearson Melba V
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:
LJ Mate
LI Female
D Other
0 I prefer not to answer.
Race/Ethnic Categories:
What is your race?
[Z]African American/Black
D Asian or Pacific Islander
D Caucasian/White
Dl Native American/American Indian D Other- Print Race: _
0 I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
Ives
Ho
OJ I prefer not to answer.
Do you consider yourself Physically Disabled?
las
Lzh o
D I prefer not to answer this question.
Page 6 of 6
F:\C L E R \$A LL\R E G \B O A R D A N D C O M M ITT E E A P P LI C A T IO N S FIN A L D R A FT S \B O A R D A N D C O M M ITT E E A P P LI C A T IO N R E G FINAL.docx
Updated: June 2020
MIAMI BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
wwwmiamibeachll, goy
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7411
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)
Nb
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.
Baa 2/2/2023
~--------------- 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.
Page 5 of 6
F:\CLER\$ALL\REG\BOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx
Updated: June 2020
MIAMl·DADE-
EMI 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 I Last Name First Name Middle Name/Initial
2022 M elba V
Mailing Address - Street Number, Street Name, or P.O. Box
1521 Alton R oad S uite 198
City, State, Zip
M ia m i B each, FL 33139
If your hom e 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. DI
Filing as an Employee (check one)
[] county 0 Public Health Trust [] Municipal:
(Municipality)
Department
Position or Title Employee ID Number
Work address I Work telephone Employment began on/ended on
Filing as a Board Member (check one)
[] County [] Municipal: Miami Beach
(Municipality)
Board where serving
Miami Beach Black Affairs Advisory Committee
Alternate address (if home address is exempt) I Work telephone I Term began on/ended on
1521 Alton Road #198, Miami Beach, 33139 305.491.2404 2/2/2023
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
Florida International University 11200 SW 8th St, Miami 33199 university
Bryant & Stratton College Orchard Park, NY college
MVP Law 1521 Alton Road, Suite 198, Miami law/consulting firm
Beach 33139
I hereby swear (or affirm) that the information above is a true and correct statement.
Signature of Person Disclosing
2/2/2023
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
□Hardcopy RECEIVED
□Electronic Copy
FEB 2 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
REMEMBER TO PRINT, SIGN, AND SUBMIT TO THE OFFICE OF THE CITY CLERK VIA EMAIL OR HARD COPY.
C ITYW ID E {C W ) BO A RD & COMMITTEES
City of Miami Beach, PARKING DEPARTMENT PARKING APPLICATION
1755 Meridian Avenue, Suite 200/Miami Bech, FL 33139/Ph: (305) 673-7505 r (305) 673-7000 ex4. 6200
A citywide (CW) parking permit is honored at metered parking spaces and restricted residential zones
parking spaces. A CW parking permit IS NOT honored in prohibited areas. An Access Card will be
provided to you for City Hall Garage (G7) access.
IMPORTANT NOTE: Your vehicle license plate serves as your "parking permit". In order to avoid
any unnecessary enforcement actions, it is important that our records reflect the most current and
accurate information regarding your vehicle license plate. Inaccurate and/or outdated vehicle
information may lead to the issuance of parking citation(s) and/or the towing of your vehicle.
Please note that this new access card CANNOT be hole-punched or perforated in any manner. To use
the new card please hold the card at close proximity to the reader until the gate opens. You may need
to try the other side of the card. Please ensure you hold the entire surface of the card against the reader
until the gate opens.
ACKNOWLEDGEMENT: I acknowledge that should my access card be lost, stolen or
damage, I will be responsible to pay a $10.00 replacement fee.
Board Member Information
Date of Application:
Applicant Name:
Board/Committee Name:
Address: 1521 Alton Road Suite 198, Miami Beach, 33139
E-Mail Address' melbapearsonesq@gmail.com
Work Phone: Home Phone
Cell Phone: 305.491.2404 Preferred Contact Method:
Vehicle Information
Tag: MVPBLM Color: Black
State: Florida Year: 2008
Make: Porsche Model: 911
Applicant Sianature: e 3zer >>
Please provide signed form to the Parking Department located at 1755 Meridian Avenue, 2d floor. Working
hours are 8:30 to 5:00 p.m. or email to: ParkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
p, ·ki D ar Ina epartment ection
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
Issued By Print Name: Print Name:
Signature: 6 Signature:
Date Issued: Date Completed:
s .
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