Michael J. Marrero - Scott Duffner (Yard House, Inc) DIP MIAMIBEACS
Avt;
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.
Marrero Michael J.
NAME OF LOBBYIST: (Last) (First) (M.I)
Bercow Radell&Fernandez, PA 200 S. Biscayne Blvd,Suite 850 Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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(305)377-6238 (305)377-6222 mmarrero @brzoninglaw.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:
Scott Duffner,Vice President of Construction&Development ` Y&s4 rIU vs-e- 1'4 c
NAME OF PRINCIPAL/CLIENT:
Yard House Restaurants 7700 Irvine Center Drive,Suite 300 Irvine California 92618
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(949)727-0959,ext. 1103 (949)727-0831
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: ���� ��e Gi &7/o c-
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH N
CORPORATION, PARTNERSHIP OR TRUST: cn i
II. SPECIFIC LOBBY ISSUE: '
Development approvals and permitting issues for property located at 1681 Lenox Ave, Miami Beach
Issue to be lobbied(Describe in detail): C:D
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III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
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Pursuant to City Code Section 2-482(a)(4)include the commissioner of personnel sought to be lobbied,and whether the lobbyist
has entered into 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 2482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning Department and Building Department None X
Staff
PB, HPB, BOA,City Commission, as necessary* None X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to sta h e e any business,financial,familial or
professional relationship,or other relationship giving rise to an appearance of arith any current city commissioner
or city personnel who is sought to be lobbied as identified on the lobbyist registration form file
Sec 2-482 Any Financial,Familial or Professional Relationship
None. ,
*Unless an issue is legislative in nature,PB,HPB,BOA,&City Commission members are not lobbied outside of,a public eanngS'se`tting
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLATRATEOR
OTHERr
A) LOBBYIST DISCLOSURE: (Required) $395.00
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). $395.00
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 X 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?
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2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
❑Yes X 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 X No: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28a' 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 STATEMEPJT SHALL BE FILED EVEN IF THERE HAVE BEEN
NO EXPENDITURES OR COMPENSATION DURING THE REPORTING E OD.
Signature of Lob yis
I do solemnly swear that all of the foregoing facts re true and correct and that I have read or am familiar with the
provisions contained in Section 2-4 a i B ach Cl Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
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❑ Produced ID E'i0 � ❑ Produced ID
Form of Identificat' n ,.4e' Form of Identification
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Personally known (Lobbyist) 9 , ❑ Personally known (Principal)
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VII. SIGNATURE AND STAMP OF NOT m Cr
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State of Florida, County of Miami-Dade "M w a State of Florida, County of Miami-Dade
Sworn nd subscrib d efore me co T Sworn and subscribed before me
This day of , 201 This day of , 20_ Ord
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Signature of ublic Notary—State of Florida Signature of Public Notary—State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
FOR C LARK'S USE ONL /�
Annual Registration fee: [ ]Yes[ ] No Amount Paid S 0 MCR# 1 ate Paid l !�
Lobbyist Registration Form received and verified by: Entered By:
Revised 1/11/2011
listv ativii Fov wwduc Revised 04/27/727012
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City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miomibeachfl.gov
CITY CLERK Office
Rafael E. Granada, City Clerk CityClerk@miamibeachfi.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: a rro rt
I understand that no later than February 28 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, or I am no
longer lobbying on that issue or for that principal, I am required to immediately notify
the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist(or principal) who
fails to timely file a Statement and In addition to any other penalties which may be
Imposed as provided In Section 2-485.1, a fine of$50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who falls to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
ale a e In
appealed d to the ii mi- �� mission on Ethics and Public Trust.
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Signature: /6ate:
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State of California ) CALIFORNIA ALL-PURPOSE
County of Om"Q e, )
CERTIFICATE OF ACKNOWLEDGMENT
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authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity
upon behalf of which the person(s)acted,executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the
State of California that the foregoing paragraph is true and correct.
LINDA D KEITH
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WITNESS my hand and official seal. a Notary Public •California c
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Comm. fires June 26,2015
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Signature
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OPTIONAL INFORMATION 3
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Although the information in this section is not required by law,it could prevent fraudulent removal and reattachment of this
acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document.
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Exhibit"B"
YARD HOUSE USA, INC.
Ownership
23,5%
Taimes L, O'Hara 18.9%
K Hadley MmIlin 18,18%
Alax,andar,g,llaiios 17.6%
John.Kenn.oiv
10.6%
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