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Alfredo J. Gonzalez - Shore Club Property Owner LLCi 0 f. E. O A B EAC . 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. Gonzalez Alfredo J. NAME OF LOBBYIST: (Last) (First) (M.I) Greenberg Traurig,P.A. 333 SE 2nd Avenue,44th Floor Miami Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0588 305-961-5588 gonzalezaj @gtiaw.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: Laurie F.Golub NAME OF PRINCIPAUCLIENT: Shore Club Property Owner LLC 600 M_adison.Avenue,15th Floor New York NY 10022 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 212-300-8018 TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) FIII out this section If principal Is a Corporation,Partnership or Trust[Section 2.482(c)] • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Laurie F.Golub • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTL %OR MOR OWNERSHIP I T EST IN H CORPORA TION, PARTNERSHIP OR TRUST: 6i II.SPECIFIC LOBBY ISSUE: Redevelopment,and licensing as applicable of the Shore Club Issue to be lobbied(Describe in detail): III.CITY AGENCIESIINDIVIDUALS 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. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be.lobbied ` Board of Adjustment;Dept of Public Works,Historic Preservation Board City of Miami Beach Commissioners,City Manager,City Attorney,Fire Dept. Planning Board,Design Review Board,Building.Dept.,Planning Dept. Pursuant to City Code Section 2-482(8)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 0 : d c A F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc l I �•-7/zc,l� IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) Hourly$500.00 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): - (REQUIRED). Hourly$500.00 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 o: Are you lobbvina on a present or pending bid for Bloods,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✓ lo: Are you lobbvina on a pendina application for a Development Agreement with the City or application for change of zoning map designation or chancre to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2482(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. _Yesn4o: 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 BEE"0 EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. �--- - . Sig ture of yi t i I do solemnly swear that all of the foregoing facts a a true an orrect and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City C e II re rtin requirements. Signature of Lobbyist: � - - Signature of Principal/Client: t CHRISTINE M.IOVINO VI. LOBBYIST IDENTIFICATION: 1 PRINCIPAL ID CA�I�N Public-State New York Flo.0110626044 04 q a Qualified in Queens County N C4 Produced ID Produced ID My`Commission Expi sApril 30,2016 W6 r e Form of Identification Form of Identification CM WS � ° cc cc W6 /Personally known(Lobbyist) Personally known(Principal) ill. SIGNATURE AND STAMP OF NOTARY: �. a of Florida,County of Miami-Dade State of Fleride,County of khomM)a% v n t d ubscribed before me A Sworn and subscribed before me 'Thi day of �I� This_a r°bay of ,201 ;0 ture of Public Notary-State of Florida Signature of Public Notary—State of ization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLF.TMIBY CITY CLERK'S STAF O Annual Registration fee: j Yes i }No Amou Pa a CR Date Paid Lobbyist Registration Form received and verified F.\C ER\$AL.1aFotlNS\L 0S6Y15'F'ORNS�Labbylst Ann trav. - Revised 01/22/2014 F:ICLERI$ALLIaFORMSILOBBYIST FORMS1Lobbyist Registration Form.doc At\vA �f t. . , t B.-,.r w ,roe a City of Miami Beath, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachf.gov CITY CLERK Office Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411 ,Fax':305.673.7254 LOBBYIST (NAME: Alfredo J. Gonzalez 1 understand that no later than February 28 of each year, I must file the following form, pursuant to Section 2-455 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,wl� fails to file the required Statement by April $01 of each year,shall be automatically s spended from being until all fines are paid, unless the fine has been appealed to fth Mia 0-Dade my Commission on Ethi_ca-and-Public Trust. Sign -�-=- -_'� Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc I REORDER 805•U.S.PATENT NO.5538290,5575508,5641183,5785353,5984364,6030000 Vendor No. 02571 Check No. 640542 GREENBERG TRAURIG Vendor Name:CITY OF MIAMI BEACH Check Date:10/20/14 10/20/2014 01102014350 Lobbyist Registration Laurie Golub $ 350.00 TOTAL: j $ 350.00 IJ Miscellaneous Gash Receipt ,'I ': , +,+i1,,•'.'U CITY OF MIAMI BEACH No. 37023 0 Cash 0Cred1t Card— Check# $_ Received of Address For For 1A � i f (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director By Account Nurnb�er: �. � 1 Pre parer: C` EXT: Jf