Jarrett Nasca - Eric Poms L-LlAI>71�r�%i;Fhp
MIAMI BEACHRECE 1J rr
Office of the City Clerk
1700 Convention Center Drive 7018 MAR 2 D �� 2; 32
Miami Beach, FL 33139
305.673.7411
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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 City Code Chapter 2,Article VII, Division 3,entitled"Lobbyists,"
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. It you have nothing to report in a particular
section, you must write "none" or "n/a' in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the fors filed throughout the period that the lobbying occurs.
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
NASCA JARRETT
NAME OF LOBBYIST (Last) (First) (Middle Name)
ORANGE BOWL COMMITTEE, 14360 NW 77 COURT, MIAMI LAKES FL 33016
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-341-4719 305-341-4759 JNASCA@ORANGEBOWL.COM
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
POMS ERIC
NAME OF PRINCIPAL (Last) (First) (Middle Name)
SOUTH FLORIDA CFPNCG HOST COMMITTEE, INC., 14360 NW 77 COURT, MIAMI LAKES FL 33016
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-341-4700 305-773-4288 ERICPOMS@ORANGEBOWL.ORG
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): S(—
Ai (ACTED
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
N/A-A NON PROFIT
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA):
Page 1 of 5
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
COLLEGE FOOTBALL PLAYOFF NATIONAL CHAMPIONSHIP GAME
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship(If yes,explain) YES NO
Title of Person to be Lobbied
CITY OF MIAMI BEACH NONE 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.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
NONE
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
NONE - $0.00
Page 2 of 5
The following six(6)questions MUST be answered:
1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues".
_Yes XNo: Are You lobbylna on a present or pending bid for goods..auloment or services.or on a present or
pending award for goods,eauloment or service?
2) Pursuant to City Code Section 2-490,entitled"Prohibited Campaign Contdbutions By Lobbyists On Real Estate Development
Issues..
_Yes )(No: Are you lobbying on a oendine application for a Development Agreement with the City or application
for change of zoning moo designation or change to the Cites Future Land Use Mao?
3) Pursuant to Ciy Code Section 2-462(h), any person (except those exempt from the definition of"lobbyist" as set forth in
Section 2-481)who only appears as a representative of a not-for-profit comoraLen 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 city clerk as required by this section,but shall not be required to pay any registration fees.
Z(Yes No: Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement?
4) Pursuant to City Code Section 2-481, the term"lobbyist"specifically excludes the following persons'. Expert witnesses who
provide only scientific,technical or other specialized infomlation or testimony in public meetings',any person who only appears
as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct.
Indirect or contingent,to express support of or opposition to any item:and any person who only appears as a representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or
reimbursement for the appearance.
XYes_No: Are you providing only scientific. technical or other soacWeed information: sowarina as a
representative of a neighborhood association without special cornoensadon or reimbumement or
reoresentino a not-for-profit based organization for the Purooee of reouestna a grant without
special cocnoensatlon or raimbursenront?
5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services
within the past election cycle.See Section 2-491 for more information.
_Yes XNo: Have you provided campaign consulting services to an Incumbent member of the City Commission
within the oast election cycle?If yes,please list the incumbent member's)of the City Commission:
Yes No: if yes.has It been less than 12 months since the elected ofliclans)whom you orovlded csrrlpning
consutdnaservi es was sworn in?
6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting
services to an incumbent member of the City Commission(which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular
service before lobbying the City Commission ate public meeting.
Yes No: Have you provided campaign consulting services to an incumbent member of the City Commission
within the oast election cycle?If yes.please list the incumbent memberts)of the City Commission;
Yes No: If cos.were you promised or did you receive economic consideration in exchange for camwian
consulting service.?
TO BE COMPLETED BY CRY CLERK'S STAFF ONLY
Annual ReglseMlon fee: [ )Yes k4lo Amount Paid MCRA pJ Date Paid
Lobbyist Registration Form received and verified by: �)$ )0 J S, _ _ m'td/W
F:\CLER\SALL\aFORMS\LOBBYIST fORJS\LObbytrt Regisbation Form Revised 01-0115 REG dac Revised 01/01/2018
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH. LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION
RECEIVED. FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBY.A STATEMENT SHALL Bg FILED EVEN IF THERE HAS BEEN NO
WCENDITURE OR CAMPER-A e„ RI THE REPORTING PERIOD
Signature of Lobbyls' srf---- Date 3/22/Ig
I do solemnly swear or affirm that all of the foregoing facts,statements,and disclosures In this form are hue and correct,
and that I have read or am familiar with the provisions contained In Chapter 2,Art.VII, Division 3,entitled'Lobbyists'of
the Miami Beach City C•• - _ 1a >•• ' r.requirements.
Signature of Lobb l Date 31/2 I1%
Signature of Principal: Date 311 It
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of 'FU)RI DA State of FLGII Oft
County of: MIAMI-DPW C., County Of: MIMAI - DA'p(:
Sworn tg(or affimed)and subsalbed before me Sworn to(or affirm d) s*lbscdbed before e
this '77.-q day of OW(i'�f' 20, Z by this
12, days of M 2011 by
ifshag-? f.imr& NAME DT PRINCIPALPos
NAME OF LOBBYIST
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Name of Notary,Typed,Printed or Stamped Name of Notary,Typed,Printed or Stamped
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I The tem lobbyist specifically excludes the(Slowing persona:
Expert witnesses who provide only scientific,technical or other specialized Information or testimony in public meetings;any person who
only appears as a representative of a reighbahood association without campaneatlon or reimbursement for the appearance,whether
direct,indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
not-for-prott community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of S , _, __
ASHLEIGHTAYLOR FAl10ERE I
Notary Public-Stated Arida
.ii Commixbnl GG071410
My Comm.Expwsiebt 3031
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fry of Miami leadr, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.minmibeachf.gov
Office of the City Clerk
Rafael E.Granada,Ciy Clerk CiyClerk®miamibeachfl.gov
Tel:305.673.7411,Fax:305.673.7254
NAME OF LOBBYIST: JARRETT NASCA
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
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F:ICLER,fALL1ffORMSI OBBYIST FOBMSRabbfcl Reeielrthca Form Revl¢ed C1-01-111REG doc
Page 5 of 5
Salvatore, Jason
From: Mireya Carballosa <mcarballosa@flapartners.com>
Sent: Tuesday, March 27, 2018 11:37 AM
To: Salvatore, Jason
Subject: Lobbyist registrations confirmation email
Hi Jason,
Per your request, below is an email confirming the CEO to South Florida CPNCG Host Committee, Inc.
Thank you,
Mireya Carballosa
235 Catalonia Avenue
Coral Gables, FL 33134
305-461-4260 Office
mcarballosa@flapartners.com
www.flapartners.com <http://www.flapartners.com/>
On 3/27/18, 11:31 AM, "Licursi, Maureen" <MLicursi(&OrangeBowl.org>wrote:
>Hi Mireya,
>From Eric:
>Eric Poms is the CEO of the corporation as it currently exists, with
>the following three designated officers:
>-Michael Chavies, President
>-Brad Houser, Secretary
>-Frank Gonzalez,Treasurer
>They are in the process of making changes, but as of now the
>information above is correct.
>Let me know what I can do to assist in making any updates to the
>paperwork.
>Thank you!
>Maureen Licursi
>Orange Bowl Committee
>mlicursi@ora ngebowl.org<ma ilto:m licursi @orangebowl.org>
1