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Hector De Los Reyes - Altos del Mar Ltd 4 P A 1 . . oi opt Ag 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 specific exclusions. Please refer to Ordinance 2004 -3435. De Los Reyes Hector NAME OF LOBBYIST: (Last) (First) (M.I.) De Los Reyes Engineering, Inc. 8726 N.W. 26 Street, Suites 1 and 2, Miami Florida 33172 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 477 -8826 (305) 477 -8814 hectordelosreyes @delosreyesengineering.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e-mail address. I. LOBBYIST RETAINED BY: Altos Del Mar, Ltd. — For property located at 7801 Collins Avenue NAME OF PRINCIPAUCLIENT: Altos Del Mar, Ltd. 8500 S.W. 8 Street, Suite 238 Miami FL 33144 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 262 -6533 (305) 262 -1703 tpagnotta @greccorp 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: Agustin Herran • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See Exhibit "A" attached II. SPECIFIC LOBBY ISSUE Certificate of Appropriateness for demolition of existing single family house and Certificate of Appropriateness for Design of New Single Family House Issue to be lobbied (Describe in detail): III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2- 482(g) 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's commencement of service with the City to the present date, stating the general nature of the subject contractual relation. A) FuII Name of Individual/Title B) Any Financial, Familial or Professional Relationship City of Miami Beach Planning Board NONE City of Miami Beach Mayor /Commissioners NONE City of Miami Beach Committees NONE , IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER ,: HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) s 1,L OO /touI.A.y B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). JP°1"60. DO /tout L./ 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 M No: Are vou lobbying on a present or pending bid for goods. equipment or services, or on a present or pending award for goods. equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues ": /Yes 171 No: Are vou lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City'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 a not - 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 61 No: Are vou representing a not - for - profit corporation or entity without special compensation or reimbursement. 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 CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2 -482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: �� � Signature of Principal /Client: _' _ ' A: • i .r - -ra P- - ner VI. LOBBYIST IDENTIFICATI •' ' : - PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification ❑ Personally known (Lobbyist) 12i Personally known (Principal VII. SIGNATURE AND STAMP OF NOTARY: �� "' os42., aV 4 P. COMMISSION Jne DD 991267 • a t;p, ' t 16, 2014 State of Florida, County of Miami -Dade State of Florida, Count • f rim Sworn to and subscribed before me Swor nd subscribe. - This day of , 2010 This 9 d y of • .4 m, % :,► 110 t , ..Quatall. • At I Notarization of Lobbyist's signature Signature of Public Notary — State of F • rida Notarization of Principal's signatu e TO MP Annual Registration fee: [ es [ I T N (? ) BE Amou Paid $ LETED Y CITY CLERK'S STAFF ONLY ..- CR # $ • r Date Paid g Lobbyist Registration Form received and verified by: _ `! " F: \CLER \$ALL \aFORMS \LOBBYIST FORMS \Lobbyist Registration - o ' .doc (S &B • ' 01574) Revised 05/28/2010 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER 'HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) 5 2(00. oo h ourt. iy B) PRINCIPAL'S DISCLOSUR (OF LOBBYIST COMPENSATION): (Required). 7 40. 00 kou4e L y 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 ": F lYes 6a No: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues ": nYes 6a No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City'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 a not - 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.. fYes 151 No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. 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 CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. f2 ." 4" \ ector De Los Reyes I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Section 2 -482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Hector De Los Reyes Signature of Principal /Client: Augustin Herran, General Partner VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification Personally known (Lobbyist) ❑ Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida,!ir ou_'n Of/Miami-Dade State of Florida, County of Miami -Dade l�s Sworn to 7r -suJ cnbed me Sworn to and subscribed before me This N c ay-of ° r; ` J . N' , Q,1 This day of , 2010 Ne i : •, ,' ' ; i ' sf 3 $ign Lure Signature of Public Notary — State of Florida • = ,. * Notarization of Principal's signature : IS00t'p 3' MY COMM o • 786 � � ;' EXPIRES 9ciober. QFs X013 ),0 BE COMPLETED : CITY CLERK'S STAFF ON Y (407) 398-0103 , Ann �r':Z1.":t�! :Si' . —a ) !j% „ t � =:j�'] No Amount Paid $ �%L M�° # $ �r��.y Date Paid Lobbyist Registr Lion' f:or;rr received and verified by • F :\CLER \$ ALL \aFORMS \LOBBYIST FORMS \Lobbyist Registra ion Form.doc ( &B #4701574) Revised 05/28/2010 IA IsEAC City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerklmiamibeachfl.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: Hector De Los Reyes 1 understand that no later than Cidasbiscrfis 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 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 -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 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. 11 / q)Jt Hector De Los Reyes Date: • ALTOS DEL MAR, LTD. General Partner Percentage of Interest Victoria & Isabella Real Estate Management, Inc. 0.333% Agustin Herran — 100% Alexdex Corporation 0.333% Oscar Barbara — 100% FSE Investments, Inc. 0.334% James A. Dorsy — 100% Subtotal: 1% Limited Partner Percentage of Interest General Real Estate Corp. 19.80% Agustin Herran — 100% Pedrena Development, Inc. 19.80% Manuel A. Herran — 100% James Dorsy 19.80% Armando J. Guerra Revocable Trust & Maria C. 19.80% Guerra Revocable Trust Armando J. Guerra — 100% Maria C. Guerra — 100% Oscar Barbara 19.80% Subtotal: 99.00% Total: 100.00% MIADOCS 4542258 1 . • • .....1 7, ..., ) ; 1.• I . . , 0 IMO ^ a .. ,.. I • , . . . i . v ...... v 1 i, : •,,,) . ,......... i I II 8 , .... 44 ., u. ....... C5 Nt _.." ......... .._, ....: ......--, i s • ..... _.. - • . . . . .. . - - ,.. . ; ,.... ....., , --. , „... ..... • 4 , ... ,... ,..... . , , ,„ ,. ,„...... • . , 4 „, •. LI :Fi . Ik \,•..., ••,t •-,., , 40 .. ' ,• ,---, 0-b. N , 'fi .: %., , ' , • 4t ILI . , ..I \ . ..., - .• ) . 4a I -... •..v. i --. •, i 0 0 • f ' ..",,...... i ... ■ - - A . i en c .-, ca ' Ik .■ -- .. .. ; - t) a .,. i , - - 0 , ....... -.....,,, , 21 .... 1.... ...., . .., \ - 1 a LI' ■ . e s E:1 •_, • A , 14'. ' 411 • 0 • E ! !? 0 u = co is.. MINS T.L. Illki Z Z 0 iu. . 1 : co - (0 3 a ; 0 ca , Oe • U. 8 -. e ... . .gt-.i .- na. ..., , .-: . ..... .. -' ‘ ` • .. , . 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