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Marissa R. Amuial - Ocean Drive Restaurant LB, LLC s� � Q - a 11\� City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 331391i is LOBBYIST REGISTRATION FORM • Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to entourage 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. Amuial Marissa R. NAME OF LOBBYIST: (Last) (First) (M.I) 1 SE 3rd AVE,25th Floor, Miami, FL, 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.982.5614 305.374.5095 marssa.amuial @akerman.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: Ocean Drive Restaurant LB, LLC NAME OF PRINCIPAL/CLIENT: 1057B Ocean Drive Miami Beach FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] CC:VAt C C '" 'c • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: ����•�11 • IDENTIFY ALL PERSONS HOLDING,DIRECTLY fORINDIF�jECTLY A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: At II SPECIFIC LOBBY ISSUE:. Conditional Use Permit for Outdoor Entertainment Establishment Issue to be lobbied(Describe in detail): Ill.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 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 Staff None Planning Board 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(g)Any Financial,Familial or Professional Relationship None l F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT-RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) V1(D�-t. 1r- 4;. • lout • . .. B) PRINCIPAL'S DISCLOSURE T 0 NSATIQN). (REQUIRED).:: . ....._- V . 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 x 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 x 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 x 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. 0 . Signature of 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 Mia i Beach CisCode and all rep. ing requirements. Signature of Lobbyist: `'�,� .4$A...._IP Are Signature of Principal/Client: --=..---- VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Pro uced ID ,,A;�'�..*•Ha,, Produced ID P^:.0 Form of Identification -�. I� Form of Identification t),144,7,.: r� •Personally known(Lobbyist) o Personally known(Principal) .m� — ax , VII. SIGNATURE AND STAMP OF NOTARY: ' m T., °r-° �.- State of Florida,County of Miami-Dade V cn ci)F y , .o _`: State of Florida, County of Miami-Dade Swor• -0 ,nd subscrib-• f _3 f°�_ g�� � Sworn and subscribed before me is µ day of ,,. �" l►�d�� `,_ m This day of , 201 gP c X11D I Go "s natu ref u•lic No - ',tate of Florida a�' Signature of Public Notary-State of Florida tariza on of Loy- ist's ignature - ..-_.1 Notarization of Principal's signature TO BE COMPLETED B CITY CLERK'S STAFF ONLY • Annual Registration fee: [ ]Yes[ ]No Amount Paid$ ct1 ' MCR# ,FYI:_ —Date Paid Aria ` Lobbyist Registration Form received and verified by: _ _______ ,, ,c,Lr;P.;`.SA .,.Ar-ora s;t.o&r ,sr FORMS,Lobbyt,,A Aa/(114 d y. itctr'Itt'Al OrM.tiOC Revised 01/22/2014 j F:\CLERt$ALLtaFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc I . - . : t . 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: MO{}r 1S5 QrY1 u ICS 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 30th of each year, 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. o2 l 0CP I Signature: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 2/6/2015 ` Detail by Entity Name 3s1 a FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS , ; : "t .;- f Detail by Entity Name Florida Limited Liability Company OCEAN DRIVE RESTAURANT LB, LLC Filing Information Document Number L11000107899 FEI/EIN Number 453354243 Date Filed 09/21/2011 State FL Status ACTIVE Effective Date 09/20/2011 Principal Address 1052B OCEAN DRIVE MIAMI BEACH, FL 33139 Changed: 07/31/2012 Mailing Address 427 SW 8 ST MIAMI, FL 33130 Changed: 01/13/2012 Registered Agent Name & Address SOSA, JOHN 1315 LAIRD STREET #B KEY WEST, FL 33040 Name Changed: 04/28/2012 Address Changed: 06/04/2014 Authorized Person(s) Detail Name & Address Title MGR LA BAGUETTE SANDWICHERIE, INC 427 SW 8 ST MIAMI, FL 33130 Title Manager http.//search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=OC EAN D RIVERS... 1/2 2/6/2015, _ Detail by Entity Name SANCHEZ, MANUEL 1052B OCEAN DRIVE MIAMI BEACH, FL 33139 Annual Reports Report Year Filed Date 2014 06/04/2014 2014 09/10/2014 2015 01/14/2015 Document Images 01/14/2015 -- ANNUAL REPORT View image in PDF format 09/10/2014 -- AMENDED ANNUAL REPORT View image in PDF format 06/04/2014 -- ANNUAL REPORT View image in PDF format 04/30/2013 -- ANNUAL REPORT View image in PDF format 07/31/2012 -- ANNUAL REPORT View image in PDF format 04/28/2012 -- ANNUAL REPORT View image in PDF format 01/13/2012 -- ANNUAL REPORT View image in PDF format 09/21/2011 -- Florida Limited Liability View image in PDF format http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=OC EANDRIVERE... 2/2 Disclosures for Applicant Ocean Drive Restaurant LB, LLC Name and Address % of Stock La Baguette Sandwicherie, Inc. 50% • Anselmo Hemandez- 1331 Brickell Bat Drive, Suite 2705, • 100% Miami, FL 33131 Alberto Cepeda, Carrera 52#74-132. Barranquilla, Colombia 10% Fox Beach Group Corp. 10% • Hernando Hemandez-9055 SW 73 CT, #2302, Miami, FL • 65% 33156 • ;Libado Naranjo Gomez-3900 NW 79 Ave, Suite 328, Doral, FL • 35% 33166 Tukenhaguen, S.L-A Spanish LLC 30% • Miguel Martin-Rabadan- Paseo del Pintor Rosales 38, 28008 • 30% de Madrid • Cesar Perera- Paseo del Pintor Rosales 38, 28008 de Madrid • 30% • Samuel Perera- Paseo del Pintor Rosales 38,28008 de Madrid • 10% • Carmen Cordon- Paseo del Pintor Rosales 38, 28008 de • 10% Madrid • Anne Veronique Holland- Paseo del Pintor Rosales 38, 28008 • 10% de Madrid • Alejandro Martin-Rabadan- Paseo del Pintor Rosales 38, 28008 • 5% de Madrid • Aline Martin-Rabadan- Paseo del Pintor Rosales 38, 28008 de • 5% Madrid (30070309',1) -.-.:::::,-::::::::rff..,..::::::!„,..:::,,,,.::- -'--.:!,,,,,,.,:,...:ii:.?„:-,,_;,-;.,:::.::::',..-:....:.-1:::::::::-,..-•-..,--e::.,e...s.-:(.:-;',-;..'._:',-."':_:,,=":-..,:::,,,:-....:•-,,,,r.._:::,,,-,.:.r._;.:'...-i-,:::::::,•rt=„....,..,,-'-'7.!....,,,!:.i.rj.;:..:7.,.,,,.:.,:41,,I.,,i,,,,..:Z.:=.,'„;;;%.-'„,,: -__4!...---..--.:.._:,:;:,:-J,:i.i, !.."?..sig:?-,--..,:::.v.,.,,,,,.-.. -.9,:iili,-,::.,..--..,-;,..,-..x .--::::,-:-i:,:-.._.;..,.=:...,.-,-....•:::::.-:-,-=:.:-.. .--,-,-;;;;.-„,--,.':'.'45::!;_--,-,:k"--,-.--.-'-?:-=. ..-,:.,',.:,-,=4.=.13)::..i-_-_.;.-Tl• t:',..'-:.,i-q,..-._;7-.-..;,trit.:::-.%'.....[...,?"- -:::,;:.... ; '-',---,-,..'::::',.::,...'"!....., •-•-,,,;:l.g.,.:,--_::ii?:-.:--fi'z-,E.:,",--;;;;----.1 ":„ .„,;-'--;-.:--.-V.-.::::::. 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