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Rafael J. Cruz-Munoz - Ms. Wendy Orange r 11 2 JFe.(SC"IN AA a v,r, P e&d 111--3-7,13q itolmfAIBFAcFi City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 3313p5 JUL 1 1 PH 2: 1 2 LOBBYIST REGISTRATION FORM CITY �..,i i 4 OFF G,_,f 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. V oz k l __ • NAME OF LOBBYIST: (Last) (First) (M.I) I. Cc --Mu A.(2c trcecr • 3 4+0 - k) t o - I BUSINESS NAME AND ADDRESS (Nu ber and Street) (City) (State) (Zip Code)Ot TELEPHON NUMBER: FAX NUMBER: E IL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: • A 17)-e Otzw,) NAME OF PRINCIPAL/CLIENT: 4\V • • V l7 BUSINESS NAME AND ADDRESS Number and Street) (City) (State) (Zip Code) mot- — t3M 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: YDY© L6/ t.rt) • IDENTIFY ALL PERSONS HOLDING,DIRECTLY 0 INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: tC II SPECIFIC LOBBY ISSUE:' - TI0/3 A..D ‘ Issue to be lobbied(Describe in detail): O 12--AN C 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 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 •�- 1?-1om/ tees • gr). 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 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 1 t Iv. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) T1 Nk i B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). ' 'lb. olack-HT��� The following information must be answered: 1) Pursua t to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issu ': _Yes_ o: 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 Deve pment Issues": _Yes_ o: 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 ite ,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. Yes o: 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. far,10 /01=ftbili -- 1 Signature o Lobbyi .fir 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 Miami Be.ch City Code and all reporting requirements. rte' ��� Signature of Lobbyist: — L 1 • sjoympr Signature of Principal/Client: / — VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: �uolex 4, I., 1, y N �‘ Produced ID Produced ID r MR i Form of Identification Form of Identification cA Qa Personally known(Lobbyist) Personally known(Principal) a i Q sib+Z SIGNATURE AND STAMP OF NOTARY: z-c¢,-2 Locc �6 PO $teeq Florida,County of Miami-Dade State of Florida,County of Miami-Dade }X gwotil(0 and subscribed befo - me Sworn and subscribed befor- me , m"' pm* 1,i day of . ,201 - ••'s ,L.ay of ' c / 201 0 d? ' of Public tary—State of Florida Signature o Public Notary—State of Florida =- ,-*.; ':«, ,., r.,--,tion of Lobbyist's signature Notarization of Principals signature TO BE COMPLET_D BY CITY CLERK'S STAFF ONLY ,,✓ Annual Registration fee: [ es[. _]No Amount Paid$ +� . i CR# 4-104i 466 Date Paid 7/1/1/". Lobbyist Registration Fo received and verified by 4,,►w�--� F:\CLER\$ALL\aFORMS\LO BYIST FORMS\Lobbyist Annual Registr `•n •'r k.'od Revised 01/22/2014. F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc N BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk @mi• ibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: r=- 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. • Signature: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc DURABLE GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: THAT I, WENDY ORANGE, of Miami Beach, Florida, as Principal, hereby appoint my attorney, PETER A. FLANAGAN, as my attorney-in-fact, for me and in my name, place and stead: (I) , To open and maintain checking, savings and other accounts in my name or otherwise in any financial institution; to make deposits in, draw checks upon, make withdrawals from and to utilize and manage such accounts; to deal generally in my behalf with any instrument for the payment of money in which I may have an interest;and to have access to and control of the contents of any safe deposit box,rented solely or jointly in my name. (2) To invest and reinvest any monies or other property belonging to me, whether acquired by me or by my attorney-in-fact, in stocks, bonds, mortgages, real property, savings bank accounts or other securities or investments of any kind,, real or personal, in such manner and in such amounts as my attorney-in-fact may deem best, to sell, pledge or otherwise dispose of any or all of the same, including the power to endorse any certificates representing the same or to execute appropriate stock or bond powers; to administer such investments in whatever manner and in such brokerage, safekeeping or investment advisory accounts as my.attorney-in-fact deems appropriate; and to exercise any and all rights incident to the ownership of such investments. (3) To make transfers of my property to or with respect to any descendant of mine for my estate planning purposes, including transfers.to or with respect to any descendant of mine who is currently acting as one of my attorneys-in-fact, except that in any year the aggregate amount of transfers (excluding "qualified transfers" as defined under section 2503(e) of the Internal Revenue Code of 1986 or the successor provision of any future federal tax law) made to or with respect to any attorney-in-fact may not exceed the annual exclusion amount from gift taxes (currently $12,000 per donee) provided under section 2503(b) of the Internal Revenue. Code of 1986 or the successor provision of any future federal tax law. (4) To change the beneficiaries of any life insurance policies or other qualified or non-qualified benefit plans, create any trust, whether revocable or irrevocable, for the benefit of myself or of other persons; and to consent to the creation, amendment, modification or extension of any trust established by other persons for my benefit. (5) To withdraw from any trust, whether revocable or irrevocable, in which I have a current beneficial interest, such amounts of the principal or accrued or collected but "- undistributed income of such trusts as I would be permitted to withdraw, pursuant to any withdrawal right contained in such trusts, for the purpose of making those gifts which my attorney-in-fact is authorized to make pursuant to paragraph (3) hereof. (6) To prepare, execute and file any income, gift or other tax return or claim, federal, state or local, or of a foreign country, for which I am responsible or to which my property is subject, and to do all things reasonably necessary with respect thereto; to pay any taxes, duties or assessments, including interest and penalties, and collect any claims arising therefrom; to negotiate with the appropriate tax authorities, and to litigate and compromise any differences that may arise with respect to any tax obligations. (7) To make demand and accept payment for, reject or compromise all claims to which .I may be entitled or which may be asserted against me; to represent me in all legal actions or proceedings whether instituted by or against me; to do all things reasonably necessary to the prosecution or defense of such action; to pay, adjust, compromise or settle such action in my behalf; and to employ and compensate attorneys and other persons in the pursuance.of any activity in my behalf. (8) To sell, convey, lease, mortgage, improve, insure, manage and control any real property or interest therein owned by me (including, but not limited. to, Florida homestead property), and to execute contracts,deeds and other documents in respect thereto. (9) To borrow funds from any person, corporation or other source upon such terms and conditions as my attorney-in-fact may deem advisable, and to secure the payment of any such loans by the pledge or mortgage of my property. (10) To sign, execute and endorse any and all papers, documents, instruments and records necessary or appropriate to implement, exercise or otherwise carry out any and all.of the foregoing powers, authorizations, and discretions herein given to.my attorney-in-fact. (1 1) Generally, 'to pay my bills, administer my property and act for.me in all matters affecting my property or the administration of my financial affairs, with the same force and effect and to all intents and purposes as though I were personally present and acting for myself, and l hereby ratify and confirm all that my said attorney-in-fact .shall do by authority hereof. (12) To transfer all or any part of my property, real or personal, to the then acting Trustee(s) of the Wendy Orange 2008 Revocable Trust dated April 25, 2008, as such document may be amended from time to time. This Durable General Power of Attorney applies to all of my real and ersonal Y PP Y P property and interests in such property including, without limitation, :my interest in all real property; including my homestead, all personal property, tangible or intangible, all property held in any type of joint tenancy, including a tenancy in common, or joint tenancy with a right of survivorship, all property over which I hold a general, limited, or special power of appointment, -- choses in.action, and all other contractual or statutory rights or elections, including but not limited to any rights or elections in any probate or similar proceeding to which I am or may become entitled. • . My attorneys-in-fact shall not be liable for any acts or decisions,made in good faith and under the terms of this Durable General Power of Attorney. Except as provided: (a) with respect to the execution of stock powers and similar instruments in. paragraph 2, above, the powers of my attorney-in-fact shall be nondelegable; and (b) with respect to making gifts to such attorney-in-fact for my estate planning purposes as provided in paragraph 3, above, the authority granted to any attorney-in-fact shall be held in a fiduciary capacity, and shall not be exercised by such attorney-in-fact for the benefit of such Y Y Y- attorney-in-fact, such attorney-in-fact's creditors, such attorney-in-fact's estate, or the creditors of such attorney-i'n-fact's estate. An individual shall be considered to be incapacitated. if the individual is under a legal disability or by reason of illness or mental or physical disability is unable to give prompt and intelligent consideration to financial matters. The determination as to whether an individual is incapacitated shall be made by my attorney-in-fact (other than the individual), who may rely conclusively upon (1) the written opinion of the individual's primary physician, (2) the written opinion of any two physicians, or (3) the written order of a court appointing a Conservator or Guardian of the individual's person or property. THIS DURABLE GENERAL POWER OF ATTORNEY SHALL NOT BE AFFECTED BY • MY SUBSEQUENT INCAPACITY, EXCEPT AS PROVIDED IN § 709.08, FLORIDA STATUTES, OR ANY SUCCESSOR PROVISION OF LAW. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 25`h day of April, 2008'. i 1:A II ' WENDY ORANGE Principal yC fd 9 . 1 3 Signed and Sealed in the Presence of: of LAc4E. 1k/int J Witness Address of Witness of S" ess Address of Witness STATE OF FLORIDA ) ) ss: COUNTY OF PALM BEACH ) The foregoing Durable General Power of Attorney was acknowledged before me this 25111 day of April, 2008, by WENDY ORANGE, who is personally known to me or who has produced a driver's license as identification. rr_ ...,;,;._.. ._.._.n....�•,_......_.:..,..:._, NOTARY PUBLIC IE •• Y ei • KIM N.KYLE $ .: :. MY COMA FISSION 4 DE)550357 =4... EXPIRES:May iG,2010 't,off* Bonded Thru hcEary Public Unde wriiere r, ua i .. 4 Miscellaneous Cash Receipt F i x ? ; ; - , < ` :CITY OF.MIAMI BEACH - -1 4'ak'r - 1\0. C7 Cash Credit Card 0 Check# .$ - . ' ' ' ' - ' '''' ty 'ik. 20 1 3-' ' - Received of Tc4�` (:,x it' ,— i 0- 'Address _ 0 t r e ke: e 'c, C'". For 1$e .;. 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