Michael A. Conaghan - Capri Residential Properties, LLC OP /\AIAMI
City of Miami Beach Office of the City Clerk V�
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.
Conaahan Michael A.
NAME OF LOBBYIST: (Last) (First) (M.1)
Fort Capital 176 NE 43 Street Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
608-225-0717 n/a mconaghan@fortcapital.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:
Capri Residential Properties,LLC
NAME OF PRINCIPAL/CLIENT:
176 N.E.43rd Street Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
608-225-0717 mconaghan @fortcapital.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: Nadim Achi
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Ernesto Schuetz,Mehmet Dehreli,Mustafa Koc
II 8 Is'
RM-2 Code Amendment
Issue to be lobbied(Describe in detail):
III 11U .S.
IL
IRD:
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
City of Miami Beach Committees and Boards None ✓
City of Miami Beach Attorneys Office and Administration None ✓
City of Miami Beach Mayors/Commissioners None ✓
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 Any Financial, Familial or Professional Relationship
None
MIADOCS 8269596
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
No special compensation.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): No special compensation
(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//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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_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 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-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 28 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 a f iliar with the provisions contained
in Section 2-482 of the Miami j3Aach City Code and all reportin req Olents.
Signature of Lobbyist: �� C.
Signature of Principal/Client:
vi. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identifi i:) y Notary Public State of Florida Form of Identification
Chartalle R Dietsch
Personally known(Lobbyist) ' ` My Commission FF 044217 Personally known(Principal)
pf Expires 08/11/2017
VII. SIGNATURE AND STAMP OF
�°o Notary Public State of F rida
State of Florida,County of Miami-Dade ; Chantalle R Dietsc ate of Florida, County of Miami-Dade
w rn to and subscribed b fo a me c My Commission FF 421 orn and su scribe b f re me
hi day 12013 OF Expires 08/11/2017 his 2.0d y of 2013
t f is ry a e of Flor S of b e Notary—State o Flo ida
Notarization of Lob ist' s' ature Notarization of Principal's signature
TO BE COMPLETW BY CITY CLERK'S STAFF ONLY
� A Date
Paid
� R vied 04/27/2012
MIADOCS:7442376 1
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AAIAMIBEACH
City of Miami Beath, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
LOBBYIST NAME: Michael A. Conaghan
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, 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.
Signature: Date:
MIADOCS:7442376 1
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SHUTTS
BOWEN
LLP
Founded 1910
ALEXANDER I.TACHMES,ESQ. E-MAIL ADDRESS:
(305)347-7341 Direct Telephone atachmes @shutts.com
(305)347-7754 Direct Facsimile
October 23, 2013
Via Round Trip Courier
Office of the City Clerk c-) �
City of Miami Beach -
1700 Convention Center Drive �
Miami Beach, FL 33139
Attn: Ms. Sylvia Prieto _
Re: Lobbyist Registration N
cn
Dear Ms. Prieto: rn o
Enclosed is a Lobbyist Registration Form for Michael A. Conaghan retained by Capri
Residential Properties, LLC. Also enclosed is this firm's check in the amount of $850.00
representing the lobbyist registration fees.
Please give the courier a receipt for the $850.00 and sign the enclosed Acknowledgement
of Receipt. Should you have any questions or comments, please contact me.
Very truly yours,
Susy Mac t- Legal Assistant to
Alexander I. Tachmes
/Sm
Enclosures
�� rl•201 South Biscayne Boulevard,Miami,Florida 33131 •ph 305.358.6300•fx 305.381.9982•www.shutts.com
MIAMI FORT LAUDERDALE WEST PALM BEACH ORLANDO TAMPA TALLAHASSEE AMSTERDAM
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