Daniel G. Ciraldo - MDPL 302/306 Collins Ave. City of Miami.Hem.Ofd of the City QWk
1700-Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FO>OA S Ave
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, argon or decision of any commissiorw, 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
safe.decision-making-prvcess-on-such-activn.-decision-or•recornnwWallon Ahat'foameably-wM-be'bead-or-reviewed-by to-may
commission,or a city board-or committee. The term specifically inckK[es the principal as well as any employee engaged In lobbying
ate. The term°L abbylats"has specific exclusions. Please refer to Oidirmnce 0"443k
I AQ lnc"",�
NAME OF LOBBYIST: "(Lai) (Firms) (M.n .
'Nov �L 3W 3w 4= I.A0
BUSINESS.. , :048#W). (City):
TELEPHONE NUMBER FAX NUMBER: FUA1L: Aj
PhNamisho, .awe if yotrti'comic!invrt�at�onr. ig -aim oX e-niraddriia�ss:
1. LOBBYIST RETAINED BY:
NAME
OF PRINCIPAUCLIENT: 11019.0 •M,`,'BUSINESS NAME AND ADDRESS �nbEr and A S (CUy}. jState) Code) V
TELEPHONE N FAX NUMBER(Opdwu*. Et1AAIL(Opdiona�
CS- _ Ik tie`r4l,OR
l lea _M= hiP_or bust[Se�aa�4n(c)]._
mrl.f6issectiouaf. .
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY.A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PAFaNERSHIP OR TRUST:
I=w to be bbbied(Describe in detaifft
� .. .._ rr- c'- v'
HL
Pula unnttb Cky Code Sedlon_24$Aq", ./ W-W W_ sough to be wW IA en#obbyio tas of1D
into any COnbaCtlr l or ulgoa w_m sold clay-"nanl�oner�p�o� fr 6ii t 12-mondw precadtng much person's
.Gr ssrdm WIt11" loft rtattrre d111e- CORD
S.
sec 2•�8Z{4tX FWt ne:�cd�+a land Conb'actustRefadonAlp(Explain) YES No
dde be lotbbied:
ftnnwd to l 9) ►M►r+e dab= slush be to 1h I#a exert of my► 1anasl"or prviEsslOnai
onatdP, '- owng rise to an app�ae of an k6Pr60rk*wlth any,cuwa t city cwi�v 1wilinim o►city penon"who Is
sought to be lobbied es:-fd i isd air the; farm flMd,
F.X1 L RWLl.1aF0RMSILOBBY1ST FORMSILbbby -Re l*ation Fwm.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISC OSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
�' � ���///✓✓✓"�""'111 (sue.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST 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 61o: 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_4o: 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.
6es—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 ttW 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 B ch City Co and al eporti requirements.
Signature of Lobbyist:
Signature of Principal/CI'
VI. LOBBYIST IDENTIFIC N: PRINCIPAL IDENTIFICATION:
A
Produced.ID - Produced I •�i� NINA WHITE
Form of Identification -State of Florida
i. My Comm.Expires Nov 21,20
Personally known(Lobbyist) x n Personally ov • ��ci al Commission 8 EE 220827
V fr
VII. SIGNATURE AND STAMP OF NOTARY:
® to ^'
State of Florida,County of Miami-Dade o = State of Florida,County of Miami-Dade
Sworn to and subscribed w�"e C� # = Sworn d subscri b re me
This �� day of I o m t7 This�d o ,201
w m XI Y
Signature of Public Notary–State of Florida ature of Publi ry–State of FI
Notarization of Lobbyist's signature Notarization of Principal's si na
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r
Annual Registration fee: [ ]Yes[- ].No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by;
Fc\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual-Registration Form.doc ReViSed 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
B
MIAtOIBEACH
City of Miami Beach, 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: oa--14d
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$50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30"'of each year, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade Co my Commission on Ethics and Public Trust.
Signature: Date:
FACLERI$ALL1aF0RMSIL0BBYIST FORMS\Lobbyist Registration Fo►m.doc