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Alfredo J. Gonzalez/ Brilla AJ RMB, LLC~ ~I -e ~ y l• --~~ ! i , ~; -•-- City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to enwurage the passage, defeat or modfication of any ordinance, resolution, action or derision of any commissioner; any action, deasion, rewmmendatian of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel during the time period of the entire derision-malting process on such acton, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a dty board or committee. The term specfically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has spedfic exduslons. Please refer to Ordinance 20043435. Gonzalez Alfredo J NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig 1221 Brickell Avenue, Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0588 305-961-5588 gonzalezaj@gtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Brilla AJ RMB, LLC NAME OF PRINCIPAL/CLIENT: 120 NE 27 Street, Suite 500 Miami, Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Z,p Code) 786-375-5600 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) out this section if prindpal is a Corporation, Partnership or Trust [Sed~on 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Adam Cohen, Manager • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Luis Benshimol II. SPECIFIC LOBBY ISSUE: The Raleigh Hotel operating issues Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Board of Adjustment /Historic Preservation Board . Building Department C ~ w,,, -~ --~ ~ ~, ~t ~ l ~. Planning Department ., .., . t1 ' .. 1~~ ~~~Z ~~ g~ ~ ; t tij.`if - /~ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER A) LOBBYIST DISCLOSURE: (Required) $375.00 Hourly B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $375 00 Hourly The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes x No• Are you lobbving on a Dresent or pending bid for Goods, eguioment or services, or on a Dresent or pending award for goods, eguioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Devebpment Issues": _ Yes X No• Are you lobbvina on a Wending aDDlication for a Development Agreement with the Ciri or auolication for change of zoning map designation or change to the Ciri's Future Land Use M8J2.~. 3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of "bbbyist" as set forth in Section 2-481 above) who only appears as a representative of snot-for-profit corporation or entity without speaal compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any item, shall register with fire clerk as required by this section but, shall not be required to pay any registration fees.. V. SIGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING LENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURE R COMPENSATION DURING THE REPORTING PERIOD. / ~ /( Lobbyist ~x~ ~$~_~ g a~ I do solemnly swear that all of familiar with the provisions cont requirements. Signature of Lobbyist: Signature of Principal/ lie . ~ VI. LOBBYIST IDENTIFICATION: Produced ID in Form of Identification ~~!- Personally known (Lobbyist) SIGNATURE AND STAMP OF NOTARY: of Florida, County of Miami-Dade i to and subscribed before me 22 „~y Of Seote er , 20 09 of of Florida facts are true and correct and that I have read or am n 2-482 of the lyiami Beach City Code and all reporting PRINCIPAL IDENTIFICATION: ~ L "ar . \.~ L . Produced ID ~,S DO - OOy~'~ 3 °- `~~\ -~7. Form of Identification Personally known (Principal) State of Florida, County of Miami-Dade Swom and subscribed before me This ~_day of 9 i Si a f Florida Notarization of Principe s signature FOR CLERK'S USE ONLY nnual Registration fee: [ ]Yes [ ] No Amount Paid~~ MCR # Lobbyist Registratan Form received and verified by: 0 ` F:\CLER\$ALL\MARIA-M\Lobbyist~LOBBYIST fORM 05.da Paid ~ ~ 0 Revised 12/08/04 ~~ . ~ ~ g~~s '' w $ ~'i N ~~~ 1 '~` ~ ~ 1 City of Miami Beoch, 1700 Convention Center Drive, Miomi Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk@miomibeachFl.gov Tel: 305.673.741 1 ,Fax: 305.673.7254 LOBBYIST NAME: I understand that no later than October 1st of each dear, I must file the following forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1 ~ Lobbyist Expenditure Form 2j Disclosure Form Failure to file these forms on a timely basis will result in my .name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. f rf ~ ,_ _ w _~___.__ ~ G -~ ~ `1 s a ~~ ~^~ Date: ,: R~visac9 aa_~o4.;2oos ;:, r, ..