Damian Gallo 02.28.25B O A R D A N D C O M M IT T E E C H E C K L IS T
A P P O IN T E E : DAMIAN J. G AL L O
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FOR SCANNER FOR CLERK STAFF , l / '
scan o oLetter of Appointment TERMEND: 2,20 2 TERM LIMIT: 2@/2
Scan o o Letter of Reappointment } J
o Copy of Letter of Appointment/Reappointment e-mailec to Committee Liaison o, 3/zl 2]
o Board and Committee Application (Completed on 3j 24 2 _)
o R~sum~/Curriculum Vitae ,J .]
o Diversity Statistics Reporting (Completed on 3, 22'2£
o Oath
DATE OF APPOINTMENr. 3[13]2{
Appointed y..Ch @mnyL£SO .
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IMPORTANT INFORMATION FOR BOARD AND COMMITTEE MEMBERS BOOK
✓City Code Ordinance Section applicable to the agency, board or committee
4ECE}/ED • 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)
\V\AR 22 2024 Amendments to the Code of Ethics Ordinance (September 2009 through July 2012)
✓Highlights of the Miami-Dade County Ethics Code
gT OF ]I\MI BEACH Y Sunshine Law and Public Records - Frequently Asked Questions
E r CITY CL ER K Y 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
Scan o
o Source of Income Statement
o Acknowledgment Statement
o Board and Committees Liaison Responsibilities
o Diversity Statistics Reporting
[ZJ 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: 3 /h24 Signed by X
Date
Processed on: sh2l24 By Employee:
Date ff Initials
WVe ore committed to providing excellent public ser vi ce and solely to all who live, w ork , and play in our vibrant, tropical, historic community
M IA M I BEACH
City of Miami Beach, 1/OO Convention Conler Drive, Miami Boach , Florida 33 139 yyw_miamriboachll_gov
OF FICE OF THE CITY CLERK, Rafaol E. Gran ado , City Clerk
Tl: 305.673.7411, Fax 305.673.7254
Email: CiNyClerk @mi amibeach fl.gov
March 21, 2024
Mr. Damian Gallo
840 CASTILE AVE.
CORAL GABLES, FL 33134
RE: Ad Hoc Permitting Process Improvem ent Advisory Committee
Dear Mr. Damian Gallo:
Congratulations! You have been appointed by the City Commission to the agency, board or committee
named above for a term ending: 02/28/2025.
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 Rafael Granado
City Clerk
cc: Monica Beltran, Parking Director
Eric Carpenter, 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
City o f M ia m i B e a c h , 17O0 Convention Corr Drive, Mami Each, conida 33 139 &cg:._Ii_rib_Ahl]qc:
OFFICE OF THE CITY CL ERK , Ralaal E. Gran ado, City Clerk
Tel: 305.673.74 1I, Fax. 305.673.7254
Email: City Clerk@miamibeochfl.gov
Oath of Office
Oath of Civility
and
Acknowledgements
TO: Mr. Damian Gallo
RE: Ad Hoc Permitting Process Improvement 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: 02/28/20 2 5 .
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 Ji following the closing
of the calendar year on which I have served.
Sworn to and subscribed before me this --- -'PV ,2024
*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.
RECEIVE D
4AR 2 2024
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
CITY Or
rrr
'AMI BEACH
CIT CLERK
OFFICE OF THE CITY CLERK
Email: BC@ miamibeachfl.gov
Telephone: 305.673.741 l
AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH
I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4),
as (check (/) all that apply):
D I am a resident of the City of Miami Beach for six months or longer.
Home Address: ---------------------------
1 I I 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: DAMIAN J. GALLO & ASSOCIATES, INC.
Business Address: 775 17 STREET MIAMI BEACH FL 33139
D 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 entity or business association.
penalt 1 \ of perjury, I declare that I have read the foregoing document and that the facts
state in it ar rue.
03/22/2024
Date
J. GALLO
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.miamibeach[l,gov
OFFICE OF THE CITY CLERK
Email: BC@miamibeachfl.gov
Telephone: 305.673.7 411
DIVERSITY STATISTICS REPORT
GALLO DAMIAN d
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:
[] Mate
[ rem ale
(J other
D I prefer not to answer.
Race/Ethnic Categories:
What is your race?
D African American/Black
L Asta or Pacific Islander
Ll Caucasian/white
D Native American/American Indian
[_] Other - Print Race.
D I prefer not to answer.
Do you consider yourself to be Spanish, Hispanic, or Latino/a?
lves
Jo
El prefer not to answer.
Do you consider yourself Physically Disabled?
Ive,
zho
D I prefer not to answer this question.
Page 6 of 6
F:ICLER\$ALLIREGIBOARD AND COMMITT EE APPLICATIONS FINAL DRAFTSIBOARD AND COMMITT EE APPLICATION REG FINAL.docx
Updated: June 2020
C ity o f M ia m i Be a c h
1700 C onvention C enter Drive
M ia m i Bea ch, Florida 33139
w w w .m ia m ibeachfl.gov
O FFIC E O F TH E C ITY C LERK
Em ail: BC@ m iam ibeachfl.gov
Telep hone : 305.673.7411
GALLO
BOARD & COMMITTEE ACKNOWLEDGEMENT STATEMENTS
DAMIAN J
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 July1, 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 Copy of your latest Federal Income Tax Return.
Members of the Planning Board and the Board of Adjustment must electronically file a "Statement of Financial
Interests (Form 1)" directly with the Florida Commission on Ethics.
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 a "y agency, board, or committee, I voluntarily agree that in the event I file with the City
Clerk a Stateme t of Ca d date formally announcing candidacy for City elective office, such filing with the City
Clerk shall be d emed a e der of resignation from the City agency, board, or committee
03/22/2024
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 electronically file a Statement of Financial Interests (Form 1) with the Florida
Commission on Ethics by 12:00 noon, July 1. Planning Board and Board of Adjustment members who file their
Form 1 with the Florida Commission on Ethics 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.
Page 6 of 6
F:ICLER\$ALLIBOARD AND COMMIT TEES DATABASE\Board and Committee Application\BOARD AND COMMITTEE APPLICATION FEB 2024.docx
U pd ate d : Fe b rua ry 22 , 20 24
M I A M I -D AD E. EIm SOURCE OF INCOME STATEMENT
S ection 2-11.1(i) of the County Ethics Code re quire s that certain em ployees and public offi cials file a financial disclosure Statem ent on a yearly basis by July 1st
of every year.
Disclosure for Tax Year Ending I Last Name First Name Middle Name/Initial
2023 GALLO DAMIAN " Mailing Address - Street Number, Street Name, or P.O. Box
775 17 STREET
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. D
Filing as an Employee (ch eck on e)
[] 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 Member (ch eck on e)
[ county [~unicipal: M a mt eh
(Municipality)
+ omln. fos s
Altern ate address (if home address is exempt) Term began on/ended on
Li st below every source of incom e you received, along w ith the address and the principal activity of each source. Include your public salary. Place the sources of
incom e in descending order, w ith the largest source first. Exam ples of sources of incom e include: com pensation fo r services, incom e fro m business, gains fro m
pro perty dealings, interest, rents, dividends, pensions, IRA distributions, and social security paym ents. Also, include any source of incom e received by another
person for your benefit. How ever, tile incom e 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
BUSINESS 775 17 STREET CONSULTING
tion above is a true and correct statement.
Date signed
RECEIVED BY EL E CTION S DEPARTMENT:
[] Hardcopy
] El ectron ic copy) 2074
CIT OF "
FF\CY
BEACH
r»ERK
OFFICE USE ONLY Accepted: Y / N Deficiency: Processed Date/Initials: Scanned Date/Initials: _
138_SP-14 COE 2016
4 4 A [ - A N f1 ;\· r· /\/\ Is· t n. ti " \ }L, rgy IV1 r} l[ .r.4 i
City of Miami Beach, PARKING DEPARTMENT
1755 Meridian Avenue, Suite 200 Miami Beach, FL 33139/Ph: (305) 673-7505 or (305) 673-7000 ext. 6200
BOARD & COMMITTEES
PARKING APPLICATION La
PARKING
A s a Bo a rd /C o m m itte e m e m b e r yo u ar e en title d to a C ityw id e Par king Pe rm it, w h ic h in cl u d e s C ity H a ll
g ar a g e (G 7) p ar kin g a c c e ss (A c c e ss C ar d ), or a co m p lim e ntar y C iti Bike /D e c o Bike M e m b ersh ip , or a
d isc o u n te d M D C M o n th ly Tra n sit Pas s th ro u g ho u t yo u r te rm .
Bo ard M em b er Info rm atio n
D a te o f A p p lic a tio n : 03/22/2024
A p p lic a n t N a m e : DAMIAN J. GALLO
B o ar d /C o m m itt e e N a m e : A d H o c A d vis o ry C o m m itt e e
A d d re ss: 77 5 17 S TR E E T M IA M I BE A C H F L 3313 9
E-M a il A d d re ss: PERM ITDOCTOR@AOL.COM
W o rk Ph o n e : 305.447-0123 H o m e Ph o n e : 786.444.5193
C e ll P h o n e : 786.444-5193 Pre fe rred C o n ta c t M e tho d : CELL PHO N E
Please Choose O ne 1 0 tio n:
•• C ity w id e Parking Permit/G7 A c c e s s C or d O Citi Bi ke /D e c o Bi ke M e m b e rsh ip 0
V ehicl e Info rm atio n (Fo r Cityw id e Par king Perm it/ Access Card O nly)
Ta g : CHVCHI C o lo r: WHITE
Sta te : FL Y e ar : 2012
M a ke : LAND ROVER M o d e l: RANGE ROVER
A ci ty w id e (C W ) p ar kin g p e rm it is ho n o re d a t m e te red p ar kin g sp a c e s a nd restric te d resid e n tia l zo n e s
p ar kin g sp a c e s. A C W p ar kin g p e rm it IS NO T ho n o re d in p ro h ib ite d ar e as . A n A c c e ss C a rd w ill b e
p ro v id e d to yo u fo r C ity Ha ll G ar a g e (G 7 ) ac c e ss.
IM PO RTA N T NO TE: Y o u r v e h icl e lic e n se p la te se rv es as yo u r "p ar kin g p e rm it". To a vo id an y
u n n e c e ssar y e n fo rc e m e n t a c tio n s, it is im p or ta nt th a t our re c o rd s re fle c t th e m o st cu rre n t and
a c c u ra te in fo rm a tio n re g ar d in g yo u r v e h ic le lic e n se p la te . In a c c u ra te an d /o r o u td a te d ve h icl e
in fo rm a tio n m a y le a d to th e issu a n c e o f p ar kin g ci ta tio n(s) an d /o r th e to w ing o f yo u r ve h ic le .
Ple as e no te th a t th is ne w a c c e ss car d CA NNO T b e ho le -p u n c h e d or pe rfo ra te d in an y m a n n e r. To use
th e ne w c a rd p le as e ho ld th e car d a t cl o se proxim ity to th e rea d e r until th e ga te o p e n s. Yo u m a y
ne e d to try th e o th e r sid e o f th e car d . Ple as e en su re yo u ho ld th e entire su rfa c e o f th e car d ag a in st
th e re a d e r un til th e g a te o p e n s.
AC KN O W LEDG EM ENT: I acknow ledge that should m y access car d be lost, stolen or dam age, I w ill be
resp o nsib le to pay a $10.00 replacem ent fee.
Applicant Signature: es
Pl e a se pr o vi d e si gn e d for m to the Par kin g D ep ar tm en t lo c a te d at 1755 M er idi a n Aven u e , 2d flo or .
W o rkin g ho u rs ar e 8:30 to 5:00 p .m . or e m a il to : Par kinqReception@ m iam ibeachfl.gov
e-m ail sub ject : BO A RD & CO M MI TTE E PA RKING APPL IC A TIO N - APPLIC A NT NA M E
f;\ping\$man\rar\forms\cw boards&committees parkingform.doc form updated 118/2024