Manuel E. Diaz, Jr. Beach Towing ServicesII i Y~ F~ d,~t ~ ~v ~ S~' ~ 1. ~ r~. ~ / V
~~ $ ~ ~ ~ > $ ~~~ 4 ~ ~ ~3 ~6.~`,%>'z ~ €~ :~ ~~a""°r _ to J 1
`/,l"
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 modification of
any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation 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 decision-making process on such
action, decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term
specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has speclflc exclusions. Please
refer to Ordinance 2004-3435.
.Diaz Jr. Manuel E,
NAME OF LOBBYIST. (Last) (First) (M.I)
1349 Dade Boulevard, Miami Beach, F1 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 534-2128
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address, phone,; or a-mail address.
LOBBYIST RETAINED BY:
Beach Towing Services, Inc.
NAME OF PRINCIPAUCLIENT: /
1349 Dade B~ulevard, Miami~Beach, F1 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 534-2128
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: /05E /`~o,r~iP/G vF'~-
• .IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
Towing fees and related matter
Issue to be lobbied (Describe rn detail).
nl. CITY AGENCIES/INDIVIDUALS TO BE -LOBBIED: Pursuant to City Code Section 2-482(8) include
a statement of the extent of any business, financial, familial, professional or other relationship, giving rise 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 said City
personnel' commencement of service with the City to the present date, stating the general nature of the subject
contractual relation.
A Full Name of Individual Title B) An Financial, Familial or Professional Relationshi
Mayor and City Commissioners None
City Manager/Assistant City
Maria er None
Parking Department/Staff None
8fi ~~ ~d y ! ~~5 u'uv
~, /
e .
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
Al ,LO BYIST DISCLOSURE: (Required)
WWit out compens tlon (annual registration & issue fee paid by principal)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required).
Without compensation annua registration & issue ee pai y principal)
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 ®No• Are you lobbvina on a present or pendina bid for aoods eauipment or services or on a
present or pendina award for aoods, eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes ®No: Are you lobbvina on a pendina application for a Development Agreement with the City or
application for chance of zoning map designation or chance to the Citv's Future Land Use
Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees.
^ Yes ~ No: Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST 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 CALENDAR YEAR A STATEMENT SHALL
I do solemnly swear that all of the foregoing facts are
provisions contained in Section 2-4$2~f ~e-Pdti~nsi~a
Signature of Lobbyist: ~"~ ~=
Signature of Principal/Clien
+~' .
® ~~ VI. LOBBYIST IDENTIFICATION:
~s
~ 3 a ^ Produced ID
Form of Identification
~~~~:~
o ersonalfy known (Lobbyist)
ai as ~.
~ ~
® ~ VII. SIGNATURE AND STAMP OF NOTARY:
o
o State of Flo ,County of Miami-Dade
a Swom to an bscribed~e ore me
°/ This ~ y of ~ ~~ , 2010
Signature of Pub 1d~o~Eary -State of Florida .
Notarization of L b fist's signature
nd correcfa-"'f-I"Fiave read or am familiar with the
Code and all reporting requirements.
PRINCIPAL IDENTIFICATION:
~ Produced ID
Form of Identification
personally known (Principal)
State of Flor' a, County of Miami-Dade
Sworn and scribed before me
This ~~ of , 2010
Signature o ry -State of Florida
Notarization of inci al's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration'fee: [ j Yes..[ ] No Amount Paid $ : D ~^-- _ MCR # ~ `Date Paid
Lobbyist Regtstration Form received and verified by: ~ -
F:\CLER\$ALL \a FORMS\LOBBYIST FORMS\Lobbyist RegistrationForm.doc ~ ' RevispH AS
;,,
~ ~
b c ~,
y LL
- `o ~
_m o~ _
=° ~ o
c
V ~.Q~
.o m
N
eo t U •=
p .V ~ Q
Z.~ ~ W
~~~0~
n o~
0
°~. s~
i ~ ~ ...<
~~
~ t .~
~. ~ ~ ';
City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
Acknowledgement of fines/suspension from lobbying for failure to
comply with City of Miami Beach lobbying Laws
LOBBYIST NAME: Manuel E . Diaz sr .
~~6~~~
I understand that no later than r, 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 preceding
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 detail, 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 WHO 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-DADS 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 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.
September l6, 2010
Date: