Ira D. Giller - Z Capital Florida Resort LLC GA,"15 ken
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33132016 FEB -14 NI 0 9 3
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.
GILLER IRA D.
NAME OF LOBBYIST: (Last) (First) (M.I)
GILLER & GILLER, INC. 975 ARTHUR GODFREY RD. #600, MIAMI BEACH,FL 33140
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-538-6324 305-538-5921 IRA @GILLERANDGILLER.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:
Z CAPITAL FLORIDA RESORT LLC
NAMF OP8IN K, 150 FIELD DRIVE SUITE#300, LAKE FOREST, IL 60045
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)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: ik�_
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
n ISPECIFIC LOBBY ISSUE:
\HISTORIC PRESERVATION_B OARD-APPLICATION FOR—ALTERATIONS-TO THE CARILLON HOTEL _ (,,. 0�,__ \�
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
PLANNING DEPT. STAFF X
HISTORIC PRESERVATION BOARD X
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
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) FLAT FEE
B) PRINCIPAL'S DISCLOSURE(OF LOBBYI$R?111lPPrrtt��ISATION):
(REQUIRED). �r""
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 ou lobb in• on a •resent or •endin• bid for•oods e•ui•ment or services or on a •resent or •endin•
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.
Yes XNo: 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 : ALL ' U:•:IT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES,AS WEL AS COM'` -ATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT S •LL B- ED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD. //
,4
Signature o •bbyist
I do solemnly swear tha•all of th viregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the 'ami B: • C) de and all reporting requirements.
Signature of Lobbyist: '� / n c 2
om
Signature of Principal/Client: = M Q T
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: S �'Q D.
Produced ID _Produced ID .1 o 4 D
Form of Identification Form of Identification -D m m _
�Personall 5- 4,of ettpublic State of Florida i4 Personally known(Principal) w n w o> ...
s ,, , Steve Gary Bernard a 0 lc
o* Z
VII. SIGNATU E !s'!,- T�re tiVrI OV2i I L o a -•o
Aiew l od� �"w 0(A �.2 N i
State of Florida, County of Miami-Dade State of F.letid County of Mie ri-Btu " '
Sworn to and subscribed before me Sworn and subscribed before me /
This I T day of ,20142 This 3,Aday : Cb(f1,201
Signature of Public Notary—State of Florida Signature of Public Notary—State of Ig'. .,- `'
Notarization of Lobbyist's signature Notarization of Principal's signatu -
TO BE COMPLETED BY CITY CLERK'S STAFF •NLY
Annual Registration fee: [ ]Yes:[ No Amount Paid$ . CR _ e 1• • Date.Paid
Lobbyist Registration Form receive verified by: �N!r c�' `
F:\CLER\GALL\aFORMS\LOBBYIST FORMS\Lobbyist Arinual Registration Form.doc Revised-01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
I
M
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: \f2P GiL Tt
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 lobbyis who fails to file the required Statement by April 30th of each year, shall be
automati• ly = 'spended from lobbying until all fines are paid, unless the fine has been
appeal-d to Miami-Dade County Commission on Ethics and Public Trust.
/
0. -O /6
Signature: Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• Name of Chief Officer, Partner, or Beneficiary:
Thomas P. Wicky, Manager
James J. Zenni, Jr., Manager
Andrei Scrivens, Manager
Neal Nath, Manager
Matthew Kane, Manager
• Identify All Persons holding, directly or indirectly, a 5% or more ownership interest
in such corporation, partnership, or trust:
James J. Zenni, Jr.
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Giller & Giller, Inc.
The Giller Building
975 Arthur Godfrey Road
Miami Beach,Florida 33140
(305)538-6324 fax/modem(305)538-5921
Reg.#AA C001364
August 17, 2016
Office of the City Clerk
City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
Attn: Jason Salvatore
Re: Lobbyist Registration Update
6801 Collins Ave.
Principal: Z Capital Florida Resort LLC
Mr. Salvatore:
In response to your email of this date, please be advised as follows:
Compensation for lobbying services is a flat fee of$4,500.00.
Please note that your attached letter dated August 1, 2016 was incorrectly addressed
(and apparently mailed) to a Coral Gables address. Please correct the City records to
reflect the above address.
Sinc: ely,
ur,a
President
ARCHITECTS INTERIOR DESIGNERS CONSTRUCTION MANAGERS