Frank Mena 12.31.24B O A R D A N D C O MM IT T E E CH E CK L I S T
APP OIN TE E. Fran k Men a DATE OF APP OINTMENT:9/ l[23
BOARD/COMMIT rE Ee . Health A dvi sory Com m itte e Appointed by: _Cly 0mm_1&LO
Fon SCANNER FoRCLERK sTAFF E,4Ju ]
scan L etter of Appointment TERM END . I/) Dk TERM Lurr.l/l 2f
Scan o o Letter of Reappointm ent if}$3" o AoommenuReanointment e.mated to committee uason on
o Board and Committee Application (Completed on_1]4J
Resume/curriculum Vitae b//3
o Diversity Statistics Reporting (Completed on 2([]k] y
o O ath
Scan o
Scan o
Scan o
RECEIVED
FEB 27 2023
CITY O F M IAM I BE AC H
OFFICE OF THE CITY CLERK
IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
City Code Ordinan ce 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
amen ded through Decem ber 2010)
Am endmen ts to the Code of Ethics Ordinance (September 2009 through July 2012)
Highlights of the Miami-D ade County Ethics Code
Sunshine Law and Public Records -- Frequently Asked Questions
v Memorandum - Solicitation by City Board and Commi ttee Memb ers
Scan O
Scan O
o Citywide Permit Application (Parking Departm ent Form)
O Booklet - Guide to Sun shin e Am en dmen t & Code of Ethics for Public Officers and Employees
O Source of Incom e Statement
O Acknowledgment of Financial Disclosure Requiremen t
Scanned on.
O Board and Committees Liaison Respon sibilities
O DIVERSITY STATISTICS REPORTING_ Ke;{p gQPy in file and ORIGINAL for Annual Report.
Rece·1·ve·.ct on·. 219123 s· · d b X ;£2~.- ····- • l][]? ) £_lo...
Date Bohrd or Com mi ttee Memb er
roes«on /ah3 yores 1! Gl, "tz7vs
on«or [ly r[][),«roe
Date Ci ty Clerk's Office Staff Initials
C O N CLU D E D & R E S IGN A TIO N LETTE RS
Term Expired Letter Date Processed Initials Scan O
Resignation Letter Date Processed Initials Scan o
Removal Letter due to ab sen ces Date processed Initials Scan O
F:CLER\BOARD AND COMMIT TIES DATABASE\CHECKLIST MASTER\&C Checklist 2015 MASTER.do0cx
M l
City of M iam i Beach, I/OO Convention Cantor Dri ve, Miami Bea ch, Florida 33 139 yyy.miamibaachllgo
OFFICE OF THE CITY CLERK, Rafaal E. Granado, Ciy Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Emai l:. CilyClerk@miamiboochfl.gov
February 03, 2023
Mr. Frank Mena
1621 Collins Avenue, Unit 1005
Miami Beach, Florida 33139
SUBJECT: Health Advisory Committee
Dear Mr. Frank Mena:
Congratulations! You have been reappointed by the City Commission to the above referenced board or
committee, for a term ending: 12/31/2024.
If you are unable to accept this appointment or have any questions, please call the Office of the City Clerk
at 305.673.7411.
Please read the enclosed materials carefully. Congratulations and good luck.
Respectfully,
cc: Monica Beltran, Parking Director
Marc Chevalier, City Liaison
ATTACHMENTS:
Letter of Appointment
Oath
City Code/Ordinance section applicable to agency, board or committee
City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459
Ordinance No. 2006-3543 - Amendment to City Code Section 2-22
Miami-Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics Ordinance
City Wide Permit Application - (Parking Department Form)
Booklet - Guide to the Sunshine Amendment and Code of-Ethics for Public Officers and Employees
I
City of Miami Beach, 1ZOO Convention Conler Drive, Miami Boach, Florida 33 139 yywy_miaribcachf_go
OFFICE OF THE CITY CLERK, Rafael E. Granado, City Clerk
Tel: 305.673.7411, Fax. 305.673.7254
Email: City Cl erk @m iam ilbeach fl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Frank Mena
RE: Health Advisory Committee
I do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United
S tates, the S tate of F lo rid a , and the C ity o f M ia m i B e ach , a nd to perf orm all the d uties of a m e m b e r o f the
ab o ve-m e ntio n e d b o ard o r co m m itt e e o f the C ity of M ia m i B e a ch to w hich I h ave b e e n a p p o inte d fo r a
term e nding: 12/31/2024.
T o m y co lle ag ue s and to a ll o f tho se I represe nt and se rve , I p le dg e fairn e ss, integ rity and civility, in a ll
a ctio ns taken and a ll com m unicatio ns m ade by m e a s a p ublic se rvan t.
I h a ve bee n issue d a co p y of se ction 2 -11.1 of the M ia m i-D a d e C o u n ty C o de (C o n fl ict o f In tere st and
C o de o f E thics O rdin a nce), a s w ell as Flo rid a C o m m issio n o n E thics G uide to the S u nshine A m e nd m e nt
a nd C o de o f E thics fo r P u b lic O ff icers and und e rsta nd that as a m e m b e r o f a C ity o f M ia m i B each B o ard
a nd/or C o m m itt ee , I m u st com ply w ith the fina ncia l d iscl osure * requ irem e nts of M ia m i-D ade C o unty or the
S tate o f F lo rid a (de pe nd ing on the board o r co m m itt ee on w hich I se rve) on July 1st, fo llow in g the cl o sing
o f the cale nda r yea r on w h ich I have serv ed .
Sworn to and subscribed before me this 27~ ;.a.· 2023
Keil Ren Caceres
Deputy Clerk
*P le a se visit th e C ity of M ia m i B e a ch w e b site a t w w w .m ia m ib e a chfl.g o v u n d e r C ity C le rk/B o a rd an d
C o m m itt ees fo r additio na l info rm a tio n regardin g the F ina ncia l D iscl osure R equirem e n ts.
£ 1 3
r MIAMIBEACH
Ci ty of Miami Beach
1700 Convention Cen ter Drive
Mi oi Beoch , florid 33139
OFFICE OF THE CITY CLERK
Email BC@miambeachfl qoy
Telephone: 305.673.7411
REC EIVED
FEB 27 2023
C ITY O F M IA M I BEACH
OFFICE OF THE CITY CLERK
AFFIDAVIT OF AFFILIATION WITH TH E CI T Y OF MI A MI BEACH
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
l am in com plianc e with the affiliation requirem ent of Miami Beach City Code Sections 2-22 (4) as (check
(/) all th at apply):
lam a resident of the City of Miami Beach for six months or longer.
Home Address 1621 Collins Avenue, ti1005, Miami Beach, FL 33139
D Ih ave an own ersh ip inter est (for a m inim um of six months) in a busin ess established in th e City of
Miami Beach (for a minimum of six months).
[]am% { Py1f@Sr
P4}P+S,, (]Hf?S,5-o-
) lam a full-time employee of a business (for a minimum of six months) and l am based in an office or
other location of the business that is physically located in Miami Beach (for a minimum of six months).
[[a[Pe Pf {fess_«
P S [[@ ,S, JS]{P@So
"Ownership Interest" means the ownership of ten percent (10%) or more (including the ownership of
10% or more ot 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 3 perjury, I declare that l have read the foregoing document and that the facts stated in it
are true~.~ -:::-2_19_12_3 _
Signature Date
Frank Mena
Printed Name
NOTARY e to ( or affir·m-~p) and subscribed before m e, b neaog of n phys,cal presence or?{online not arization ,
we}_a«{do. _}. toy \en« z
----(City of Rligmi [each Hoard/Committee [ember) pt.t.at,t.t.at....4
" bric· Stat e 3t Fi
·I? 'omission # H8H 248147
" My Cmm. Exie 4pr 11, 2
Produced ID
n,,o ten cato
Person0y "@
""" s M.a Name of Notary, Typ e d, Pintel'6 si a'ro d
City of M iam i Beach
1700 Convention Center Drive
Miami Beach, Florido 33139
www.miamibeochfl,gov
O FFIC E OF THE CITY CLERK
Email: BC@miamibeachf.gov
Telephone: 305.673.74 11
BOARD & COMMITTEE FINANCIAL ACKNOWLEDGEMENT STATEMENT
Acknow ledgem e nt of fines/suspension for Board /Comm itt ee Mem bers for fai lure to com pl y with Mi ami-
Dade C ounty Fina ncial Discl osure Code Provision Code Section 2-11.1(i) (2)
M ena Frank C
Last Name First Name Mi d dle Initial
I understand that no later than July_ 1, of each ye ar all memb ers of Boards and Com mittees of the City of Miami
Beach , including those of a purely advisory nature, are required to comply with Miami-Da de County Finan cial
Disclosure Requirements.
Qne of the following form s must bg 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"Statem ent of Finan cial Interests (For m 1)1;" or
3. A Copy of your latest Federal Income Tax Return.
Fa~lure to file one of these forms, pursuant to the Miami-Dade County Code, may subject the person to a fine
of no more than $50, 60 days in jail, or both.
l?_Jf, .. - 7;;-
{::;,- .,P -,-,-----.· Signature
2/9/23
Date
' Membe rs 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 Finan cial Interests (For m 1) with the Miami-Dade County
Sup ervisor of Election s by 12:00 noon, July 1. Plan ning Board and Board of Adjustmen t memb ers who file their
Form 1 with the County Supervisor of Elections automat ically satisfy the County's financial disclosure
requirement as a Miami Beach City Board/Committee memb er and need not file an additional form with the Office
of the City Clerk. However, compliance with the County disclosure requiremen t does not satisfy the State
requirement.
Page 5 of 6
FCLER\SALL'REG'BOAR D AND COMMIT TEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.. docx
U pdate d: June 2020
A } A f/\i/\ E H
City of Miami Beach
17 00 C on v ention Center Drive
Miami Beach, Flor ido 33139
www.miamibeachfl.gov
OF FICE OF THE CITY CLERK
Email:. BC@miamibeachfl.gov
Telephone: 305.673.7411
DIVERSITY STATISTICS REPO RT
Mena Frank C
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:
[J a e
] rem al e
Llomer
El pr efer not to answer.
R ace/E thni c Categories:
W hat is your race?
[] African American/Black
E] Asian or Pacific Isl an der
El Caucasian/white
[]Native American/American Indian
[l other -- Print Race: too
L}1pr e fer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latinola?
[ZJ Yves
[J o
Ll prefer not to answer.
Do you consider yourself Physically Disabled?
las
zh
Ll]prefer not to answer this question.
Page 6 of6
F:CLER'SALL REG\BOARD ND COMMITTEE APPLICATIONS FINAL, DRAFTS B OAR D AND COMM ITTEE APPLICATION REG FINAL. docx
Updated: June 2020
SO U R C E O F IN CO ME STATEMENT
Section 2-11,1(@) of the County Ethics Code requires that certain employees an d public official s file a finan cial 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 Mena Frank C
Mailing Address - Street Number, Street Nam e, or P.0. Box
1621 Collins Ave, #1005
City, State, Zip
Miami Beach, FL 33139
If your home 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. [
Filing as an Employee (check one)
[] county [] 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 Wember (check one)
[] county [K~unicipal: M \o p 1 6ec
(Municipality) "-. pl non ow kke
Iterate address (if home address is exempt) ' I Work telephone I Term began on/ended on
List below every sour ce of income you received, along with the address and the principal activity of each source. Include your public salary. Place the sources of
inc om e in descending order, with the largest sourc e first. Examples ot sourc es of income include: compensation for servi ces, income from business, gains from
pr ope rty dealings, interest, rents, dividends, pen sion s , IRA distributions, an d social security payments. Also, include any source of incom e 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 separa te sheet, check here.{_]
Name of Source of Income Address Description of the Principat Business Activity
Lynk Ventures 1621 Collins Ave, #1005 Real Estate and Senior Housing
Miami Beach, FL 33139
Mena Law PLLC 1621 Collins Ave, #1005 Legal Services
Miami Beach, FL 33139
M&M Real Estate Brokerage 1621 Collins Ave, #1005 Real Estate Broker
Miami Beach, FL 33139
I hereby sw;;· ar or affirm) that the information above is a true and correct statem ent
•0/ 7al -
a Signature of Person Disclosing
2/f3
Date signed
RECEIVED BY ELECTIONS DEPARTMENT:
1or«co»RECEIVED
]Electronic Copy
FEB 27 2023
CITY OF MIAMI BEACH
OFFICE USE ONLY Accepted: Y I N Deficiency.
138_SP-14 COE 201
-- Processed Date/initials'... Scanned Date/iillals:
M1 AN/BE lVM /Vil _
City of Miami Beach, PARKING DEPARTMENT
CITYWIDE (CW) BO ARD & COMMITTEES
PARKIN G APPLICATION
1755 Meridian Avenue, Suite 200/Mi ami Be0ch, FL 33139/Ph: (305) 6737505 r (305) 673-7000 et. 6200
A citywide {CW } parking permit is honored at metered parking spaces and restricted residen tial zones
par king spaces. A CW parking permit IS N O T honored in prohibited are as. An Access Card wi ll be
provided to you for City Hall Garage (GZ) access.
IM PO RTA N T NO TE: Your vehicle license plate serves as your "parking permit". In order to avoid
any unnecessary enforcement actions, it is important that our records rellect the most current and
accurate information regarding your vehicle license plate. Inaccurate and /or outdated vehicle
information may lead to the issuance ol parking citation[s) and/or the towing of your vehicle.
Please note that this new access card CAN N O T 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.
A CK N O W LEDG EM EN T: I ackn owl edge th at sho uld m y access card be lost, stolen or
damage, I will be respon sible to pay a $10.00 replacement fee.
Bo ard M em ber Inform ation --·
Date of Application: 2/9/23
Applicant Name: Frank Mena
Board/Com m ittee Nam e: Health Advisory Committee
Addre ss: 1621 Collins Ave, #1005 Miami Beach, FL 33139
E-Mail Address: fmena@lynkventures.com
Work Phone: 305-776-0971 Hom e Phone
Cell Ph one: Preferred Contact Method: e-mail
V ehicle Inform ation -~,-
Color: Tag: 92B HEE White
State : FL Year: 2019
Make : Honda Model: Odyssey
/
Applicant Sianalure: 22% 41 + «",
Pl ease pr ovi d e signed fo rm to the Parking D ep artm en t located at 1755 M eridia n A ven u e, 2 floor. Working
hours are 8:30 1o 5:00 p.m. or emai l to: PgrkingReception@miamibeachfl.gov
e-mail subject: BOARD & COMMITTEE PARKING APPLICATION - APPLICANT NAME
Park ing Department Section bi eeooeoo .,_..,, ___ aooooooeheeeoooo -'••••••• .. ----•-••A~.•.s•w=.
PERMIT SYSTEM GARAGE ACCESS
Expiration Date: ID Card Serial #:
lssued y Print Name: Print Name:
Sign a ture. e Signat ure : 5
Date Issued: Date Completed:
p0g ,8m a n e t \Pi$ dw at0sortteis jar@gt#f,