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Rafael E. Andrade - Sixt Rent A Car, LLC • akip 1\,/ k I L 2P-10,,,,, 1 (9. City of Miami Beach Office of the City Clerk t� 1700 Convention Center Drive, Miami Beach, FL 33139 fCi°;-- Cj/ 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. Andrade Rafael E. NAME OF LOBBYIST: (Last) (First) (M.I) Law Offices of Rafael E. Andrade, P.A., 1111 Lincoln Road, Suite 400, Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 531-9511 (305) 673-5734 ralph @randradelaw.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: Sixt Rent A Car, LLC NAME OF PRINCIPAUCLIENT: Sixt Rent A Car, LLC 3900 NW 25th Street# 407 Miami FL 33142 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (888) 942-7498 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: See attached amendment • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached amendment II.SPECIFIC LOBBY ISSUE: Amendment to the LDR's to permit the outdoor/indoor storage/parking of rental agency vehicles in the TC-1 Zoning District. Issue to be lobbied(Describe in detail): 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 Bch person's commencement of service with the city to the present date,stating the general nature of the subject contractual relationship. 5 Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) _-N.ES-_-NO title of person to be lobbied Mayor&City Commission,City Manager's Office, X City Attorney's Office,and All City Boards and Committees (,r) 4-0 X oU Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familiabr 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 None C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) No Compensation B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). No compensation 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 XNo: 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 XNo: 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. _YesXNo: 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 B EN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the foregoing facts are - d correct and that I •-ve read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City C••- = • eporting requirement Signature of Lobbyist: Signature of Principal/Client: " are LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID `•� Form of Identification Form of Identification �_— tom " fp t Q a Personally known(Lobbyist) V Personally known(Principal) o: « N Qv;� o- iu SIGNATURE AND STAMP OF NOTARY: o°- O : rn Lu LE- I—at, to of Florida,County of Miami-Dade State of Florida,County of Miami-Dade x01—1- o x- C, U1 lit S ,a orn o and subscribed before me Swomnd subscribed before me t' I is • day of 204 This 4' 1 . day pf5-10..V\ , 2015 tif . I✓. ♦. . AA O ...�A. Mill ^ ` ... • ature of Public No'y y—Sta e of Florida gliatuare of Public Notary—State,.f lorida • Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[,/rNo Amount Paid$ * MCR# 7-76-277 77 Date Paid ®q/0//5 Lobbyist.Registration Form received and verified by: 41,1 ;,r C:\Users\clerhatl\AppData\Local\Microsoft\Windows\T-mporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc Attachment to Lobbyist Registration Form 1. Name of Chief Officer, Partner, or Beneficiary a. Evan Wexler,Vincent Todd Sazera,Johannes Boeinghoff 2. Identify all persons holding, directly or indirectly, a 5%or more ownership interest in such corporation, partnership,or trust: a. Sixt Rent A Car LLC is wholly owned by Sixt Transatlantik GMBH b. Sixt Transatlantik GMBH is wholly owned by Sixt SE c. Sixt SE is a publicly traded German company 9 t. 9_o 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: Rafael E. Andrade 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, 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, 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 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc M�scellaneo s Cash Receipt , ,,, , '' ''''-' 1 -1.2 ,, -',,,'.,-.,' ,,.,-,-...•,-. _,, . . 01() ., , ‘..-,:s. --... _. -,,,,,-, - /2010 . ,)(,) ' „-70,,.r-------- CITY OF MIAMI BEACH A4.1,- -r- . ,. - 1 t 4 ','''-',.i:,,,,,7,',',';''':'''-4 ''Check#-,-, 0 Cash .Credit Card 4 it 1 2oj5 __. F l 1� 2hy„C1-Fe t 1 4 .; 1 Received of _ __ . # .„, _ Address �. _�; _ ��"'' For t ev Y*4 ,_ CO' -, k :- ,,' << DireCtoP � � �, :::,,, , ',- ,,r:.,..:.v:,',.Y �, Offic e of Finance THIS ti+IF�RMATION MUST B�'��,l�� " �' ,- 3 'c '� yr '„ . r • :taw 1 - Account Number: a a � 1-k, EXT• ��' "a i De t• • s Preparer. � s1 L "� ,,,,'4,--''''i afi d 1 L� _ , CITY HALL CASHIER OFFI 1700 CONVENTION CNTR DR r h1IAN1I BEACH, FL 33139 03110/2015 15:24:44 Merchant ID. 000000005148978 Terminal ID: 02013135 1090573940 City of Miami Beach-Florida Finance Department CREDIT CARD AMEX SALE 1 City Hall CARD# XXXXXXX>O(XX2010 1506913-i 03/101'2Q15 BFt1 T121,4-24 INVOICE 0007 Tire Mar 10;2015 G3:26PM T rangy# Batch#: 001484 24 $350,GQ MCPCLERK - MCR-City Clerk Batch al Code: 546986 MC$3: 402753 Entry Method: S�viped 1 ITEM(S�: TOTAL: $350,00 Mode: Online Credit Car PAID $350.00 Have a nice day SALE AN'OUNT $35Ol00 CUSTOMER COPY