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David A. Mancini „t(s 1Drvl3 se ill CA �11oi��A� MIAMIBEACH i t 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. Mancini David A. NAME OF LOBBYIST (Last) (First) (M.I) David Mancini & Sons, Inc 1210 Washington Ave Suite#250 Miami Beach, Fl 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-532-8827 305-532-8835 dmancini @dmsi co TELEPHONE NUMBER: FAX NUMBER: EMAIL. Please notify this office if your con tactinforniatiod changes:address,phone, Or a-mail address. I. LOBBYIST RETAINED BY David Mancini & Sons, Inc. NAME OF PRINCIPAL/CLIENT 1210 Washington Ave Suite#250 Miami, Fl 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-532-8827 305-532-8835 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 David A. Mancini, President. • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST David A. Mancini (100%) uSPECIFIC LOBBY ISSUE: Capital Improvement Projects Contractual Modifications Ptsrf—'ne (34r1" Issue to be lobbied(Describe in detail): Ill.CITY AGENCIES/INDIVIDUALS`TO-BE LOBBIED: Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the 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 lobbied *See attached list* None X 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. D I i O S, I J Ana Sec 2-482(g)Any Financial, Familial or Professional Relationship None I ti :Z Wd 6— 3301102 i _) if 1 C I IV DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER). A) LOBBYIST DISCLOSURE.(Required) None B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): None (Required). 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 IN 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"- El Yes ® 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 ❑ Yes ®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 BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist 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: ,arA/-- Signature of Principal/Client: ---- VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification n Personally known(Lobbyist) ® Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY. State Df 1 ida,County o'u.,,. ,., Y State of F;•-'da, .- uadv.of '. '2oi_r;.aria — — fair Sworr . . • subscribed ot-f• ,,,'3'■4, JOEGLYS D.PAREDES F. Sworn . ' .1bsc ?•e¢+° �r,S me ; • This ,� day of De ;j 'z This • r' . of`I) s' ° OEGLYS D.PAR PES F • Notary Public-State of Flea ..�cl_t 2 1 �. ( E1,1*,:i My Comm.Expires Sep 2,,2015 s. .�� . Notary PuEHc-St�}p;ol florWe ok, My Comm.Expires Sep 24,2015 • mission N EE 123923 -• mission#EE 123923 Si•; !ri' blic Notary- Stdtt9• I. '., Signature of ' i•���•...�.ry- S(. '4 • orida 1,A, N. ,zati1rj of Lobbyist' 'g •t e • ' Notarizatio TI: \'al',: •• _ • ---.-- ,,!►—-..-qb TO BE COMPLE e D BY CITY CLERK'S STAFF O Y m Annual Registration fee: ]Yes[ ]No Amount Paid ''' • "A . KR# - Date Paid I J' 'I - -' Lobbyist Registration Form received and verified by C alli, ,P\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual --. r- 1.4-11'-cYr Revised1/11/2011 J Mayor Matti Herrera Bower Current term• 2009- 2011 First elected: 1999 Profession. Mayor Ph. 305.673 7035 Email. Commissioner Jerry Libbin Current term. 2009 - 2013 Group 1 First elected 2005 Profession: Chamber of Commerce CEO Ph. 305 673.7106 Email Commissioner Jorge Exposito Group 2 Current term• 2009 - 2013 First elected. 2009 Profession. Vice-President Claims Ph. 305.673.7104 Email Commissioner Michael Gongora Group 3 Current term. 2009 - 2013 First elected 2006 Profession Attorney Ph. 305 673.7103 Email Commissioner Jonah Wolfson Group 4 Current Term 2007-2011 First Elected. 2007 Profession• Attorney Ph. 305.673.7102 Email. Vice-Mayor Edward L. Tobin Group 5 Current Term 2007-2011 First Elected 2007 Profession: Attorney Ph. 305 673.7107 Email. Commissioner Deede Weithorn Group 6 Current Term. 2007-2011 First Elected 2007 Profession. CPA Ph 305 673 7105 12/6/11 City Manager @ City of Miami Beach Tuesday, December 06,2011 SearchMB Traduzca: English(U.S.) I.± HOME I RESIDENTS I BUSINESS I VISITORS I GOVERNMENT I PUBLIC SAFETY About Me CITY MANAGER JORGE M.GONZALEZ + ` 1 QUICKUNKS My Team Since August 21, 2000, I have had the honor of '- Your Government ?,47,,, 7 serving as the City Manager of what is no doubt one City Manager Home Page of the most exciting and dynamic cities in the world As �:_= Mission, Vision and Values Annual Reviews - , �y *,r the City Manager,and as a resident, I am committed Strategic Priorities t t m 3,' ®'' '�to ensuring that our government and our staff of Community Surveys Awards `4 ]dedicated professionals are providing efficient and ,t, Contact Me .'.. '' i effective services to meet the needs of our residents, Citywide Workplan &Budget •° businesses and visitors. ��• a f ; Letters to Commissioners ,„ During my tenure, I have made it a priority to ensure What's New? that the City achieves its strategic vision by + ', i implementing programs and initiatives that have ,` ,4,K%,made us cleaner and safer;made our community more ""�' ° {, ti d�€ . beautiful and vibrant, while embracing our unique FRIEN©ORFOLLOW history; established us as a cultural, entertainment 't..,,. and tourism capital, promoted our community as an innovative place for ,z '.1`,..i,,-.'. . 1;:".... business, improved our infrastructure -a challenge in such a dense and active j ' environment;and created the framework to sustain this vision long-term. ( - s faceboak For those of you who currently live here,thank you for choosing to make this 4` .P wonderful place your home I encourage you to become involved and engaged 1 - ...,., in this community - and to tell us how we are doing, either during our Community Satisfaction Surveys, or by contacting us Our businesses are important to us We work hard every day to improve our processes so that you can continue to serve our residents and our many visitors And if you are n,"* visiting or plan to visit Miami Beach -a warm welcome from the City that is 25/7 There is so much to do,you'll need an extra hour! ��" Sincerely, &.L Jorge M Gonzalez : . 305 673-7010 1700 Co, -,ert cn Ce:-ter Drive `lierr.. Beech, FL 3313?, Ph. 305.673 7000 r, 200 Corr-act Us I Po ices &Disciairriers 1 Site Mop www.miamibeachfl.gov/citymanager/ 1/1 Hilda M. Fernandez Assistant City Manager Jorge Gomez Assistant City Manager Duncan Ballantyne Assistant City Manager Patricia Walker Chief Financial Officer Dolores Mejia Special Projects Coordinator Kathie G. Brooks Director, Office of Budget & Performance Improvement Fernando Vasquez CIP Director Fred Beckman Public Works Director All Public Works Staff All CIP Staff IA MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl gov Tel 305 673.741 1 ,Fax:305 673.7254 LOBBYIST NAME. David A. Mancini 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. i 12/06/11 Signature. Date