Juan C. David - 1510 Drexel LLC 5
I A B LE A H
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City of Miami Beach Office of the City CUR SEP -7 AM 9: 56
1.700 Convention Center Drive, Miami Beach, FL 33139
CITY '
LOBBYIST REGISTRATION FORM (-, '---i 'S 0 F F I C:F
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.
DAVID JUAN C
NAME OF LOBBYIST: (Last) (First) (M.1)
1385 CORAL WAY MIAMI FL 33145
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)285-4343 mariad @jcdarchitect.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:
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1510 DREXEL LLC I
NAME OF PRINCIPAUCLIENT:
1510 DREXEL LLC 2601 S.BAYSHORE DR#725 MIAMI FL 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305.859.6050 305.859.6051 37mc@libero.it
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill Outthis section if principal is a Corporation,Partnership or Trust[Section 2.482(c)]
NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Giuseppe Varvaro (administrator)
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IDENTIFY ALL'PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: prima holdings corp;37 me SRL,Francesco Nicosia 70%&Alessandra Frioni 30%
n.SPECIFIC LOBBY ISSUE:
PLANNING DEPARTMENT-BOARD OF ADJUSTMENT-FLOOD PLAIN MANAGEMENT ORDINANCE REQUIREMENTS
Issue to be lobbied(Describe in detail): 19 0 Dvex CA Al,
III.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 eneral nature of the subject contractual relationship. i
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO 1
title of person to be lobbied
A D �
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
F;ICLERULL1aF0RMStL0BBYIST FORMS1Lobbyist Registration Form.doc
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION'(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
N/A
8) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). NONE(PROFESSIONAL OF RECORD-REGISTERED ARCHITECT)
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 an a present or pending
award for goods,equipment or service?
2) Pursuant to Miami Beach Cify Code Section 2-490 Entitled"Prohibited Campaign Contdbutions By Lobbyists On Real Estate
Development Issues":
_Yes XNo: Are you lobbying on a pendinn 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 Section 2-482(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-far-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.
YesX No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH LISTING LOBBYING EXPENDITURES,AS WELL AS COMPIENS/ITIOM RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL A VILEO EV IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature f obb4th
I do solemnly swear that all of reg ing f is are true and corr aI have read or am familiar with the provisions contained
in Section 2-482 of the Miami ea Ci' Cod and all reporting requirements.
Signature of Lobbyist: ,.
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Signature of Principal/Client: I`. ' 1,.,
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Vl. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
®Produced ID Produced ID
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known(Principal)
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Notarization of Lobbyist's signature Sd Notarization of Principal's signature
TO BE COMPL , CITY CLERK'S STAFF O LY __
Annual Registration fee: [ es[ )No Amount P-id$ MCR# Date Paid 01110 1 UL
Lobbyist Registration Form Ireceived and verified by: �%
F:\CLER\$ALL\aOORMS\LOBBYIST FORMS\Lobbyist Annual RegistratiWl Form.doc Revised 04/27/2012
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Forrn.doc
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City of Miami 136ach, 1700 Convention Center Drive,Miami Beach, Florida.33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado, City'Clerk CityClerk@miamibeachfl.gov
Tel:305.673:7411 ,Fax: 305.673.7254
LOBBYIST NAME: JUAN CARLOS DAVID
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.
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1) LOBBYIST EXPENDITURE AND COMPENSATION FORM
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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
-..< Ionger 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 fails 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
ap I peaLed to the Miami-Dade County Commission on Ethics and Public Trust.
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Sig ure: Date:
CADocuments and SettingslclermarmlLoca!Settings\Tempomry Internet Files10LK111Lobbyist Registration Formrevised 5-30-2012.doc
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