Javier Aviño -Sydell Indian Creek LLC rA
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive Miami Beach FL 33139 1
LOBBYIST REGISTRATION FORM �1_
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 aq4n, de j 'sion,
recommendation of the City Manager or any city board or committee; or any action, decision or recomrr�ndat of a9: city
personnel during the time period of the entire decision-making process on such action, decision or 4'Wdmm�!Oation at
foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term speciflcally Inludes the
principal as well as any employee engaged in lobbying activities.The term "Lobbyists" has specific exclusid�s. Please refer
to Ordinance 2004-3435.
• 'may �, �-�1
Avino. Javier F.
NAME OF LOBBYIST: (Last) (First) I)O,.
� OS
Bilzin Sumberg Baena Price&Axelrod LLP 1450 Brickell Avenue Suite 2300 Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Z'IprCode)
305-350-7202 305-351-2275 javifiMcD-bilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
Sydell Indian Creek LLC
NAME OF PRINCIPAL/CLIENT:
30 West 26 Street New York NY 10010
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
646-307=9606 ibabbittCa�sydellgroup.com
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: X41P0Q;W
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5% OR MORE OWNERSHIP
INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Zoning analysis licensing and permitting issues for renovation/expansion of hotel at 2727 Indian Creek Drive and 233
27th Street Miami Beach FL
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Sec 2-482(a)(4) Full Name of Individuall and title of B)Contractual Relationship(Explain) YES NO
person to be lobbied
City of Miami Beach, Planning Department Staff and
Zoning Department Staff
City of Miami Beach—City Manager's Office/Jorge
Gomez
City Miami Beach Commissioners and Planning Board
and Board of Adjustment
�V
�0
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) $475/hr
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $475/hr
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 qNo: 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 qNo: 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 RI .
ignature f 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 Miam' Beach City Code r d all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID ❑ Produced ID
- / Form of Identification Form of Identification
� Personally known(Lobbyist) ❑ Personally known (Principal)
VII.SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and subs ib d efore me Sworn and subscribed before me
ndayof 20 This day of , 20
ig ature of ublic Notary— tate of Florida Signature of Public Notary—State of Florida
ri n of Lobbyist's signature Notarization of Principal's signature
O,�PFIY P�Bli CHRISTINE A.BOWER
MY COMMISSION#DD 959346
V EXPIRES:February 20,2014
Ij�'OF E Do*Thru 60-0 N91m 6A a
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A)LOBBYIST DISCLOSURE: (Required)
B)PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):(Required). $476/hr
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":
0 Yes 4NO: Are you lobbying on a present or pending b!d 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 4NO: Are you lobbying on a pending apI2112ation for a Development Agreement with the City or application
for change of zoning map designation�or change to the C�it c'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..
0 Yes 4No: Are you representing a not or profll corporation or entity without special compensation ar
reimbuM m�et
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,DAR YEAR.A STATEN NS SHALL BE FILED EVEN IF THERE HAVE BEEN NO
BEACH FOR THE PRECEDING CALF j
EXPENDITURES OR COMPENSATION DURING THE REPORTING RI . -
L�7
ignature f 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 Mlam Beach City�lC._ode d all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
D Produced ID 0 Produced 10,
/ Form of identification Form of identification
� Personally known(Lobbyist) 9/ Personally known(Principal)
VII.SIGNATURE AND STAMP OF NOTARY: ,l N *V,
State of Florida,County of Miami-Dade State of Reddel,County of Miami-Bade-
Sworn t and subs ib d before me Sworn and subscr bed before me
0
7hl day of 20! Thi 6 day of
gof ubtic Notary— tate of Florida Si alure of Public otary State of•F�le '6`T^
n of Lobbyist's signature Notarization of Principal's signature,®�` E� I�f.
00 CHRiS11NE A 1301fVFR de���,• O , y,,'r•/�
0 .
a�*1N �*MY COMMi33fOfi t 00 859346 Q No.01 FL0286689 4�.1
*
EXPIRES:Febraery20,2014 = QUALIFIED IN ,�
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COMM.EXP.
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OCT 9
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MIAMI BEACH .S _ i
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City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,
www.miamibeachfl.gov
LOBBYIST NAME: Javier F. Avin6
I understand that no later than February 28th of each year, I must file the following forms,
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 Form 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.
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 appealed to the Miami-
Dade County Commission on Ethics and Public Trust.
Sig ature: Date:
MIAMI 33 5615 8.1 80079/41466