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Alfredo Gonzalez - Greenview Hotelm MIAMIBEACH 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 encourage the passage, defeat or modificatioi any ordinance, resolution, adion or dedsion of any commissioner; any action, dedsion, recommendation of the City Manager or any dty boarc committee; or any action, decision or recommendation of any city personnel during the time period of the entire dedsion-making process on si action, dedsion or recommendation that foreseeably will be heard or reNewed by the dry commission, or a city board or committee. The ti specifically indudes the principal as well as any employee engaged in lobbying adivities. The term "Lobbyists" has speclflc exclusions. Plei refer to Ordinance 2004.3435. Gonzalez Alfredo J. NAME OF 1221 Bridcell Avenue, (First) Miami, Florida 33131 of or 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: Greenview Hotel, LLC )F PRINCIPAUCLIENT: Go Marcelo Tenenbaum 1570 Kennedy Causeway, North Bay Villat, (Number TELEPHONE N FAX out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)) • .NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Marcelo Tenenbaum FL 33141 ~ (Zip Code) ' (Optional) • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Greenview Hotel, LLC u.SPECIFIC LOBBY ISSUE: Hotel Addition @ 1671 Washington Avenue Issue to be lobbied (Describe in detail): IIL CITY ~ AGE_NCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code section 2~482(g) ~.....,r include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to~an appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2- 482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the commencement of service of City personnel to be lobbied.) ~ or Building, Planning and Zoning Dept. Board of Adjustment, Historic Preservation Board Public Works Dept. and City Administration ~~~,~ ~~ p_N g N is rd ~~~g " '~ ~~ r N. DISCLOSURE OF Tte"RMIS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCIASE WfB:THER NOtlRLY, fLAi RATBOR OTMiEt~: A) LOBBYIST DISCLOSURE: (Rogtdred) $400.00 FioUrly B) PRINCIPAL'S DLSt:LOSURE (OF LOBBYIST COMPENSATION): $400.00 Hourly lRe4s~df• The following IMomratlon must be ar>swered: 1) Pursuant to Miami Beam Cfty Code Sectbrt 2.488 F_rrttUed °Prohibited Campaign CoMribulbns By Lobby~m On Procurement Issues': ^ Yes X No: Ara you lobbvino on a BxeseM or,gg~g~d Mr ooods. mBUftmtent or sarvloea. ~~ ~~ Bi!tesent or osndtnsr award Mr Bloods, eaubm~ent or servlcs9 2) Pursuant to Miami Beach City Code 2-490 Entitled'Prott~ited Campaign Contributions BY Lobbyists On Real Estate. DevetopmeM Issues': ^ Yas X No: Are you lobbvino on a nendina,a~Micatl!+~+ for m !+~~~+ A_~reemmrt wNh iho ^~ o; aBrolicatton for Ghana®of mnina mac dsslanatbn or ~anaie to t_~ Citv's FL~are Land Use Mau? 3) Pursuant to M1and Beach City Code 2-484 (h) Any person (except those exempt from the deflnMbn of '1~by1sY ~ set forth in Section 2-481 above) who only appears as a represernadve of snot-for-profit corporation or entigr without spedal compensatl~ a reimbursement for the appearatrce, wheitrer dhed, ar indirect, to express support of. or opposil3on to any Bern, shan register with the cleric as requ~ed by thfs section but, shag not be required to pay any nagistratbn fees. ^ Yes X No: Are vau renrasantn~* a r!ot.~for=•~•••a~ s%+r"oraNOn Or amity wNho;.~ °t .:.;...a:.:.~ -- -- relmburaemenf. . V. 8It~NATURE UNDER OATH: I do solernny swear tlrat an of a foregoing fabts,ar~true provisions contained in Sad o the Miami ch-6 signature of Lobby _ Siputature of PrirrCllent: _ w~~~- v1. Los13YIST IDENnFlcanoN: ^ Produced ID ~I Form of Identification 1°~ PAY (fib) Vn. SIGNATURE AND STAMP OF NOTARY: State of Florida o i-Dade Svuom and bscribed~-~~e~ end that I have read or am famntar with the an reporting requtremerlts. PRINCIPAL IDENTIFICATION: ~ Produced ID ~,~ Form of Identiflcaitton LK Personalty known (Principal) State of Fbrtda, Sworn Thy ay of of of Miami-0ade Notary Putitic State of Florida German Previsdomini My Commission D0928888 Expires 1 210 7 /2 01 3 m AiuAIV~IBEACH City of Miami Beoeh, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Tel: 305.673.741'1 ,Fax: 305.673.7254 CityClerk@mia m ibeachfl.gov Acknowledgement of fines/suspension from lobbying for failu comply with City of Miami Beach lobbying Laws LOBBYIST NAME: ~ ~T•`~u Z to I understand that no later than October 1st of each year, lobbyists subject to lobbyist registration requirements shall submit to the city clerk a signed statement under oath listing all lobbying expenditures, as well as compensation received, for the pri ceding calendar year with regard to the specific issue on which the lobbyist has been engaged to lobby. A statement shall be filed even if there have been no expenditures or compensation during the reporting period. The statement shall list, in deta~l, each expenditure by category, including food and beverage, entertainment, research, communication, media advertising, publications, travel., lodging and special events. FAILURE TO TIMELY FILE THE EXPENDITURE AND FEE DISCLOSURE REPORT WILL RESULT IN A FINE OF $50.00 PER DAY. ANY LOBBYIST WHOA FAILS TO FILE THE REQUIRED EXPENDITURE REPORT BY DECEMBER 1, SHALL AUTOMATICALLY BE SUSPENDED FROM LOBBYING UNTIL ALL FINES ARE PAID, UNLESS THE FINE HAS BEEN APPEALED TO THE MIAMI-DADE COUNTY COMMISSION ON ETHICS AND PUBLIC TRUST. In the event a lobbyist fails to either file the report and/or pay the .assessed fines, the Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust. IN ADDITION, ONCE AN ISSUE 1 HAVE REGISTERED TO LOBBY O BEEN RESOLVED, I AM REQUIRED TO IMMEDIATELY NOTIFY TH CLERK'S O~FIf',E-~OF HOBBYIST WITHDRAWAL tN WRITING. ~ ~ 1~ a r Da HAS CITY