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Peter A Matos 12.31.25 miAmi BEACH BOARD AND COMMITTEE CHECKLIST APPOINTEE: Peter A Matos DATE OF APPOINTMENT: 2/7/2024 BOARD/COMMITTEE: Transportation, Parking, Bicycle Appointed by: City Commission FOR SCANNER FOR CLERK STAFF Scan o o Letter of Appointment TERM END: 113 1 TERM LIMIT: a'3 I �'1 Scan o o Letter of Reappointment I o Copy of Letter of Appointment/Reappointment e-mailed to Committee Liaison on 71'6) Scan o o Board and Committee Application(Completed on ) Scan o o Resume/Curriculum Vitae / I L� ) o Diversity Statistics Reporting (Completed on 1 Scan o o Oath IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK ✓ City Code Ordinance Section applicable to the agency, board or committee RECEIVEC ✓ 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) FEB 4 8 eD24 ✓ Amendments to the Code of Ethics Ordinance(September 2009 through July 2012) ✓ Highlights of the Miami-Dade County Ethics Code CITY OF MIAMI BEACH ✓ Sunshine Law and Public Records—Frequently Asked Questions OFF?CE OF THE CITY CLERK ✓ 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 0 0 Source of Income Statement Scan 0 0 Acknowledgment Statement o Board and Committees Liaison Responsibilities O Diversity Statistics Reporting I I acknowledge that pursuant to Sec. 2-22(9) of the Miami Beach Code of Ordinances, I will be removed from my board/committee upon failure to attend 33% of the regularly scheduled meetings. Sec. 2-22(9) If any member of an agency, board or committee fails to attend 33 percent of the regularly scheduled meetings per calendar year, such member shall be automatically removed. To calculate the number of absences under the 33 percent formula, .4 or less rounds down to the next whole number and.5 or more rounds up to the next whole number. NOTE:Members of the Land Use Boards will be removed upon failure to attend three of the regularly scheduled meetings per calendar year, or upon abstaining from voting due to a conflict of interest on four different applications within a calendar year. A member who is removed shall not be reappointed to membership on the board for at least one year from the date of removal. Received on: 2/8/24 Signed X by (f Date r Board or Committee Member Processed on: 1111 2`C By Employee: ate City Clerk's ffice Staff Initials We are committed to providing excellent public service and safety to all who live,work,and ploy in our vibrant,tropical,historic community. MIAMI BEACH City of Miami Beach, 1700 Carw nhon Censer Drive, Miami Beach, Florida 33139 www.miamlbeaciifl.gw OFFICE Of TFE CITY CLERK,Rafael E.Granado,City Clerk Tel:305.673.7411,Fax:305.673.7254 Email:CilyClerk@miamibeochfl.gov February 07, 2024 Mr. Peter Matos 1465 Cleveland Rd Miami Beach, FL 33141 RE: Transportation. Parking and Bicycle-Pedestrian Facilities Committee Dear Mr. Peter Matos: Congratulations!You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2025. 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 as they concern your duties, responsibilities, and requirements as a board or committee member. Congratulations again and good luck. 7,..)si Regards, L Rafael Granado City Clerk cc: Monica Beltran, Parking Director Monica Beltran, City Liaison ENCLOSURES: Oath of Office/Oath of Civility/Acknowledgements 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 City Wide Permit Application -(Parking Department Form) Booklet- Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees Ml A f\/\ I AC City of Miami Beach, 1700 Conven1ion Confer Drive,Miami Beach,Florida 33139 www,miamlbeachll.gov OFFICE OF THE CITY CLERK,Rafael E.Granado,City Clerk Tel:305.673.7411,Foie 305.673.7254 Email:C1yClerk@emiamibeochll.gov Oath of Office Oath of Civility and Acknowledgements TO: Mr. Peter Matos RE:Transportation, Parking and Bicycle-Pedestrian Facilities 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: 12/31/2025. 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. Mr. Peter Matos Sworn to and subscribed before me this day of , 2024 Kei Mena Caceres Deputy Clerk `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. it RECEIVED MAMI BEACH 08 CITY OF MIAMI BEACH C 0 Conven io B each Center Drive OFF!CE FEB OF THE CI2024 TY CLERF( Miami Beach, Florida 33139 OFFICE OF THE CITY CLERK Email: BC�a miamibeachfl Qov Telephone:305.673.741 1 AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH l am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4), as (check(I) all that apply): I� l I am a resident of the City of Miami Beach for six months or longer. Home Address:1465 Cleveland Rd, Miami Beach FL 33141 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: Business Address: 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 truer 2/8/24 Signature Date Peter Matos Printed Name MI/\M City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miarnibeachfl.gov OFFICE OF THE CITY CLERK Email BC@miamibeachfl.gov Telephone: 305.673.741 1 DIVERSITY STATISTICS REPORT Matos Peter A 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: ElMale Di Female U Other Lb I prefer not to answer. Race/Ethnic Categories: What is your race? Eli African American/Black Li Asian or Pacific Islander �✓ J Caucasian/White La Native American/American Indian ( J Other—Print Race: �l I prefer not to answer. Do you consider yourself to be Spanish, Hispanic, or Latino/a? Eh Yes Li No Ea I prefer not to answer. Do you consider yourself Physically Disabled? Yes IZJI No I prefer not to answer this question. Page 6 of 6 F:ICLERt$ALL\REGIBOARD AND COMMITTEE APPLICATIONS FINAL DRAFTS\BOARD AND COMMITTEE APPLICATION REG FINAL.docx Updated:June 2020 MIAMI BEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl,gov OFFICE OF THE CITY CLERK Email: BC( miamibeachfl.gov Telephone: 305.673.7411 BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS Matos Peter A Last Name First Name Middle Initial Acknowledgment 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) 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 $500, 60 days in jail, or both. Acknowledgment to Comply with Miami Beach Code of Ordinances Division 1 Sec. 2-22 (23) I understand that commencing with terms beginning on or after January 1, 2024, and as a condition of applying for appointment to a City agency, board, or committee, I voluntarily agree that in the event I file with the City Clerk a Statement of Candidate formally announcing candidacy for City elective office, such filing with the City Clerk shall be deemed a tender of resignation from the City agency, board, or committee Signature Date ' Members of the Planning Board and Board of Adjustment will be notified directly by the State of Florida, pursuant to F.S. §112.3145(1)(a),to file a Statement of Financial Interests(Form 1)with the Miami-Dade County Supervisor of Elections by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their Form 1 with the County Supervisor of Elections automatically satisfy the County's financial disclosure requirement as a Miami Beach City Board/Committee member and need not file an additional form with the Office of the City Clerk. However, compliance with the County disclosure requirement does not satisfy the State requirement. Page 6 of 6 F:\CLER1$ALLIBOARD AND COMMIT TEES DATABASE1Board and Committee Application\BOARD AND COMMITTEE APPLICATION OCT 2023.docx Updated:January 9,2023 MIAMIDADE SOURCE OF INCOME STATEMENT COUNTY 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 Last Name First Name Middle Name/Initial 2023 Matos Peter Anthony Mailing Address—Street Number,Street Name,or P.D.Box 1465 Cleveland Rd City,State,Zip Miami, FL 33141 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.El Filing as an Employee(check one) ❑ County Q Public Health Trust ❑ Municipal: (Municipality) Department Position or Title Employee ID Number Work address Work telephone Employment began on/ended on Filing as a Board Member(check one) © County El Municipal: Miami Beach (Municipality) Board where serving Transportation, Parking and Bicycle-Pedestrian Facilities Committee Alternate address(if home address is exempt) Work telephone Term began on/ended on 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 ano her 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 Malloy & Malloy, PL 2800 SW 3rd Ave, Miami FL Attorney/Legal Services 33129 I hereby swear(or affirm)that the information above is a true and correct statement. RECEIVED BY ELECTIONS DEPARTMENT: �- ❑Hardcopy —`'"= `` ❑Electronic Copy 08 2024 riignature of Person Disclosing CAN oF > .' t OFFICEFi yECf7B nACH Date signed Ef?K OFFICE USE ONLY Accepted: Y/N Deficiency. Processed Dale/Initials: Scanned Date/Initials: 138 SP•14 COE 2016 ANI\A JE ,s. BOARD & COMMITTEESCity of Miami Beach,PARKINGDEPARTMENT PARKING APPLICATION 1755 Meridian Avenue,Suite 200 Miami Beach,FL 33139/Ph:(305)673-7505 or(305) 673-7000 ext.6200 PARKI c i As a Board/Committee member you are entitled to a Citywide Parking Permit, which includes City Hall garage (G7) parking access (Access Card), or a complimentary Citi Bike/Deco Bike Membership, or a discounted MDC Monthly Transit Pass throughout your term. Board Member Information Date of Application: 2/7/2024 Applicant Name: Peter Matos Board/Committee Name: Transportation, Parking and Bicycle-Pedestrian Facilities Committee Address: 1465 Cleveland Rd, Miami Beach FL 33141 E-Mail Address: pmatos@malloylaw.com Work Phone: Home Phone: Cell Phone: 3055461959 Preferred Contact Method: Telephone Please Choose One (1) Option: c, Citywide Parking Permit/G7 Access Card 0 Citi Bike/Deco Bike Membership 0 MDC Monthly Transit Pass j Vehicle Information (For Citywide Parking Permit/Access Card Only) Tag: LTVQ93 Color: Orange State: FL Year: 2020 Make: JEEP Model: Wrangler JL 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". 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, _r_,_ Applicant Signature:_es. Please provide signed foam to the Parking Department located.at 1755 Meridian Avenue, 2nd floor. Working hours are 8:30 to 5:00 p.m. or email to: ParkinaReception@miamibeachfl.gov e-mail subject: BOARD &COMMITTEE PARKING APPLICATION - APPLICANT NAME f:\ping\$manvor\forms\cw boords&commlllees parking f orm.doc loan updated 1/18/2024