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Alfredo L. Gonzalez - Sacyr Infrastructure USA LLC 1490- L 1 /5 -��-- M I AM I 'BF:AC H City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 3313920 0, JUL 1 3 Pry (,: I -¢ LOBBYIST REGISTRATION FORM CITY ( I- 0.7i I i it 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 ac es. The term"Lobbyists" has pec is exclusions. Please refer to Ordinance 2004-3435. ac z . 2. NAME OF LOBBYIST: (Last) (First) (M.I) �cm '75abloo.e. Zatzt-Es-kr, )C0 moor Win, Fc 3 1 ) BUSINESS NAME AND ADDRESS (Number acid Street) (City) (State) (Zip Code) 90C-(108--?)03 03onzae 2-P 3 J.6-6,>7• (bier\ TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED `�BY: �(' NAMEQA PR t CI L/CLIENT: a 0- � �A- �e- r7 0 n�S \ r Q t'L� Q �JJL n BUIES,NAMEAND AppRE (Number and Street) (City) ( te) (Zip Code) TELEPHONE NUMBER: ____43..(i Number 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: I0-fe % }{'n�rZ— • PARTNERSHIP IDENTIFY ALL ONSH HOLD DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, IDENTIFY ALL PERSONS H II.S.P_ECIFIC LOBBY ISSUE. _ 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 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 Qr af,a cal ^c ilir.ees ; rrP��;A, z - (113 fc2301S ©*�P o A-4 ebrxatRSio( S 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 noc\-Q- 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) -POLL(LA c s-o. n0 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSAON): , lJQ / �® (REQUIRED). ` `�M �- The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issue ": • _Yes_NVo: 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 Dopment Issues": Yes 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 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 : ILED EVEN IF TH_ RE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. / ''. -!"e of L...yisi 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 .City requirements. Signature of Lobbyist: #7. - . Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: _Produced ID —Produced ID Form of Identification Form of Identification _Personally known(Lobbyist) — Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florid. aunty of Miami-Dade State of Florida, County of Miami-Dade Sworn to . • •• cribe. before me )� Sworn and subscribed before me This /_?r:►�r.,__. 201!0 This day of , 201 • ����� ��f r �►-�`r ���,:.,!;�,. SUZANNE MARTINEZ • PubT • ary-State • I i. - * MY COMMISSION!FF 175221Signature of Public Notary-State of Florida otari_.tion of f.b ' nature ,„N=.7);.4.' EXPIRES...November 11,201EVotarization of Principal's signature i.. .• I` .T- '+r E o F n f Bonded Thru Budget Notary R eim TO BE COMPLETED BY CITY CLERK'S ST FF ONLY, t Annual Registration fee: [ ]Yes[ No Amount Paid$�350.CX7�MCR# '1'2) ' Li S Date Paid'O"7'!5-/i6 Lobbyist Registration Form receive and verified by: _. -- �"' JktgeP'rb F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014 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) 140)(2-f f v' 4sn. o0 1 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMMIPENSA ON): r \,‘ The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2.480 Entitled Prohibited Campaign Contributions By Lobbyists On Procurement Yes o: Are you lobbying on a present or pending bid for goods.eauipment or aenrhaq pr on a present or pending award for goods.equipment or service? 2) Pursuant to Miami Beach City Code Section 24490 Entitled'Prohibited Campaign Contributions By Lobbyists On Real Estate De opment Issues': _Yes No: Are you lobbying on a aendino application for a Development Agreement withtho City or application for change of zoning map designation or change to the Cltv'o Future Land Use Mao? 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 ,shall register with the clerk as required by this section but,shall not be required to pay any registration fees. { _ Veil No' . .: .._ A u;L: _ . • : _•.rte t_1•n r. a '• !• Le i I• -V. SIGNATURE UNDER OATH: ON FEBRUARY 28 QE F-ACh YEAR,JEACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH.LISTING LOBBYING EXPENDITURES,AS WELL AS COMPENSATION RECEIVED—IN THE CITY OF MIAMLBEACH FOR E - CEDIt Y_.; I_ ,t -._ W ?_ a___D .l_: F .1613: ...L = N• PE DII ;E •; COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the foregoing facts are true"aid correct and that I have read or am familiar with the provisions contained in Section 2.482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist Signature of PrincipatlCIient CA L C B_02iziockoit VL LOBBYIST IDENTIFICA • PRINCIPAL IDENTIFICATION: _Produced ID ✓Produced ID R E ZO D9,00 2S Zl/S Form of Identification Form of Identification _Personally known(Lobbyist) _Personally known(Principal) VB. SIGNATURE AND STAMP 0 S of Florida,Co i of • •=.-/ State of Florida.County of Miami-Dade • 4' to and s .{. .r -fore me 1 ;.4:° ISABELMR• • ' ,•fir 201 iI1/ / .��1� L / /' 'i (Ali :Al MY COMMISSION 0 FF 172009 - • orn ' tateofFlo A w t�i .!l l., t I,teofFlorida - , Notarization of Lobbyist's signature R •T :tune TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Rogtsrtiation fee: ( I.Yes( nt,Paid 8 • : MCR 0 Date Paid Lobbyist Registration Form received and`verifiedby i:1CLEM ALL\efORMSLLOBBY'SY �da>:smisr' taigistielkin Forku4oc;:':. • = • Reamed 01/22/2014 F:\CLERt8ALL1aFORMS\LOBBYIST FORMS1Lobbyist Registration Foan.doc • MIAMIBEACH 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: Oleo oLQ2z(Q Gz 'Iez_ 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. ti Signature: D:te: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc . Miscellaneous Cash Receipt . ' . . - - -- •- -- .,.. CITY OF MIAMI BEACH , No• 4 1 07 4 5 ..''.- . . , . . • ., , •. ,,,,.:,_,-;,,..-„, • _ --7. , . 0 Cash r=iCrecht Card bk.:Check# 1 SI-e,0 $ -,... 0 .c)0 .. • . , S .. ., 20 city of Miargep calc.,yed of i,--r,,.. L. Gocle./., ,... MiscellaneotAdifigas 21;11(;) 14 a .."-- • S aocl 51.- Li ',--rioor i /14 iwi, I, 33 i31 000300-0111 Jenel F.1.07)13/2015,04:15PM . . MCR OPEN OF . Payment Amount: 350.00 -,.- MCR410745 . .. . . . (THIS INFORMATION MUST BE COMPLETED) _ Office-of Finance Director-'- By Account Number 01 i .. 0 0 0.,.- 3 6 cl 'Llt-1' 60 ' 0 1- 2(-2 5- °0 ,,.'' 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