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Robin J. Schwartz - Aqua Foundation . CA M 1 A 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, defea or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the ity Manager or any city board or committee, or any action, decision or recommendation of any city personnel during the time period of ithe 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 Sc HvJ/ ? V I N NA OF LOBBYIST (st) (First) (M I) I �1 a0 ,' k,u- , 0meAA ' c ; isc- :u../ k3kEo Mlgom 1 7 BUSIN SS NAME AND ADDRESS (Number and Street) (City) , (State) (Z' Code) 3vcf7 - p13 (Ai w „ � V O44u2,1 , 0 TELEPHONE NUMBER. FAX NUMBER: gMAIL. C Please notify this office if your contact information changes address, phone, or e-mail address I LOBBYIST RETAI£ D BY 1 , 4_ NAME OF PRINCIPAUCLIENT S frv X-- BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 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 • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION PARTNERSHIP OR TRUST c', N c=1 ii SPECIFIC �LOBBY,ISSUE c-) o 71 r •c ..-; v( 4 1 - 3D .n .,r,i Issue to be lobbied (Describe in detail) ..._ cr: 3 III. CITY AGENCIES /INDIVIDUALS TORBE'LOBBIED: Ca "Ti n fV Pursuant to City Code Section 2- 482(a)(4) include the commissioner or personnel sought to be lobbied, and w(lther The lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 moths jceding such persoh's commencement of service with the city to the present date, stating the general nature of the subject contractuail relationship . Sec 2 -482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO title of person to be lobbied • Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any,business, financial, familial or professiona, relationship, or other relationship giving rise to an appearance of an impropriety, with any current city commissioner or city personnel whc is sought to be lobbied as identified on the lobbyist registration form filed. r Sec 2 - 482(g) Any Financial, Fa ilial or Professional Relationship iti 1 IV DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY FLAT RATE OR OTHER) A) LOBBYIST DISCLOSURE (Required) J A B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). The following information must be answered• II 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement issues" , Yes lo: 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? t 2) Pursuant to Miami Beach City Code 2 -49Q Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues ii i. i Yes 1KNo. Are you lobbying on a pending application for a Development Agreement with the City or application for i ( change of zoning map designation or change to the City's Future Land Use Map? j 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. -'Y es 1 No. 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 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 Bt..........._ a EV5 iiiir THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD . ar Signature of Loy •yist i do solemnly swear that all of the forego . ' Ire true and correct and that I have read o~ am familiar with the provisions contained in Section 2 -482 of the Miami Beach lty iii- . - — % all reporting requirements Signature of Lobbyist: — � � / ��� Signature of Principal /Client VI LOBBYIST IDENTIFICATION• PRINCIPAL IDENTIFICATION Produced ID FL!L4_ 5(123 - `I30. 711 -0 f'Produced ID F 30 L 1k 5 7 0-G2.1lf z Form of Identification Form of Identification Personally known (Lo r fl Personail y kno ISABEL SATCHEL i ' ISABEL SATCHEL ' � 4 • b+l'1 SSION tt DD 87989 i f )_ I i ' ,• . MY COMMSSION # DD 879891 VII SIGNATURE AND ST NO S April 13 2013 1'.y\ , EXPIRES:April13 2013 ' '' 4;: 7 Bonded Thru Notary Public Underwriters i • Social ; Sad Thru Notary Public Undem ts ers P,G, State of F - "`� Flonda County of Mta "" State of Florida Courit Sworn to and subscribe• before me Sworgand subscribe b ore me This •ay of _ •i . 2011 { day of • t 201 1 e Signature of 7. hilt Not ry - State of Florida ' lorida Si gn• ' - of Pub is ot. - State of Flonda Notarization • Lobbyist's signature Notari :lion of Principal's signature TO BE COMPLETED TED CITY CLERK' STAFF ONLY Annual Registration fee. [ ] Yes [ 1 No Amount Paid S MCR # / - i s , , lJ'41 Date Paid /�. Lobbyist Registration Form received and verified by 0 r i =• ORMS\LOBR' iS- FORM5 \LDDbvls: Annual Regist,rntion Porm.csoc � � >� p Revised 1/21 2021 City of Miami Beach, 1700 Convention Center Drive, Miami Beach Florida 33139, www miomibeachll.gov CITY CLERK Office CityClerk @miamibeochfl gov Tel 305 673 7411 Fox: 305 673 7254 LOBBYIST NAME Cr6 0• J C 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 issues 1) Lobbyist Expenditure and Compensation 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 °// 1 Signature Date