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Jose (Joey) M. Sanchez - Horizon Contractors, Inc. I1 1 v ptixa4 1 /- - 5► MIAMIB A H .....----- •ity of Miami Beach Office of the City Clerk 1700 C•nvention Center Drive, Miami Beach, FL 33139 L BYIST REGISTRATION FORM Lobbyist means all persons employed o retained, hether paid or not, by a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolutio , action or decision of any commissioner; any action, decision, recommendation of the City Manager or any city board or committee or any acts n, decision or recommendation of any city personnel during the time period of the entire decision - making process on suc action, de ision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city board or committ=e. The ter specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has s ecific excl sions. Please refer to Ordinance 2004 -3435. Sanchez Jose M (Joey) NAME OF LOBBYIST (Last (First) (M.I) Horizon Contractors, Inc. 8 75 West 32nd Ave, Hialeah, FL 33018 BUSINESS NAME AND ADDRESS (Number an Street) (City) (State) (Zip Code) 305 - 828 -2050 305- 820 -0905 jsanchez @hcimail.net TELEPHONE NUMBER FAX NUMBER EMAIL: Please notify this office if your co tact information changes: address, phone, or e-mail address. I. LOBBYIST RETAINED BY: Horizon Contractors, Inc. NAME OF PRINCIPAL/CLIENT Horizon Contractors, Inc. 8175 West 32nd Ave, Hialeah, FL 33018 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 - 828 -2050 305 -820 -0905 jsanchez @hcimail.net TELEPHONE NUMBER. FAX NU BER: (Optional) EMAIL (Optional) Fill out this section if principal is a Corpor tion, Partne hip or Trust [Section 2 -482 (c)] • NAME OF CHIEF OFFICER, PART ER, OR BENEFICIARY. Jose M Sanchez • IDENTIFY ALL PERSONS HOLDI G, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST Jose M Sanchez n.SPECIFIC LOBBY ISSUE: The right to work in Miami Beach Issue to be lobbied (Describe in detail): III. CITY AGENCIES /INDIVIDUf■LS TO BE LOBBIED: Pursuant to City Code Section 2- 482(a)(4) nclude the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid o unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to he present date, stating the _general nature of the subject contractual relationship. Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be I bbied Michael Gongora n/a X 1 Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2- 482(g) Any Financial, Familial or Professional Relationship ) k None ` O� C `lt'l IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) No compensation B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION). (Required). None 1 The following information must be answered: 1) Pursuant to Miami Beach City Code Sectior 2 -488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ❑ Yes Q 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 ": ❑ Yes C 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 oily 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 LINO: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE ± CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATIO CEIV' D, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EV' N IF T ' RE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. k .ignature • 47, yi drir I do solemnly swear that all • e foregoing . 'true and correct and that I have read or am familiar with the provisions contained in Section 2 -482 of the Mi - : • • - • ing requirements. Signature of Lobbyist: ltrl Signature of Principal /Client , - VI. LOBBYIST IDENTIFICAW: D / PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID � Form of Identification Form of Identification B Personally known (Lob • ' L�" Personally known (P • YVETTE ZULUAGA • . YVETTE ZULU VII. SIGNATURE AND STA 11P11. • c'�'41RY: dm% = Notary Public - State of Florida Notar Pu - State AGA of Florida :• . . • State of Florida, County of Miami ▪ a te ��il • My tow. Expires Nov 1, 2013 - "� �, rc MY Co E Nov 1 2013 , State of Florida, County f � . •.� �r. •e Com , ssi # DD 937246 Sworn to and subscribed before e , o ° o- C .mmission # DD 937248 Sworn and subscribed This I day of U a. " This 1 day of TUI y , 2 11 `�- � y- ``` � Signature of Pubb otary - State of Florida i Signatu a of Publi tary - Stat of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF • LY ,n Annual Registration fee: [ ] Yes [ ] No Amount Paid $ MCR # Flf7Ariar Dat- Paid V Lobbyist Registration Form received and verified by: _ ?MF " , F: \CLER \$ ALL \aFORMS \LOBBYIST FORMS \Lobbyist Annual Registration Form.doc ='� �� Revised 1/11/2011 MAMIEAH City of Miami Beach, 1700 Con ention Cente Drive, Miami Beach, Honda 33139, www.miamibeachfl gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673 7254 LOBBYIST NAME: Jose M Sanchez (Joey) I understand that no later than February 28th of each year, I must file the following form, pursuant to Section 2 -485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issu s. 1) Lobbyist Expendit re and ompensation Form Failure to file these form on a ti ely basis will result in my name being transmitted to the Miami -Dade County Co mission n Ethics and for code violation evaluation. In addition, once an issue I have egistered to lobby on has been resolved, I am required to immediately notify the City Cle k's Office of lobbyist withdrawal in writing. 111 1Pilb AI II\ I I I Signature: Date: