Michael Chavies - Eric Poms A' c, J "-- CENh`1Plct4iH/ft
MIAMI BEACH RECEIVED
Office Convention o Cite Clerk 2018 MAR 26 PH 2: 32
1700 Center Drive
Miami Beach, FL 33139
305.673.7411 f t r) C
- CI Ivn
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. If you have nothing to report in a particular
section, you must write "none° or "nla" 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 forms 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:
CHAVIES MICHAEL B.
NAME OF LOBBYIST (Last) (First) (Middle Name)
AKERMAN LLP, 98 SW 7TH STREET, THREE BRICKELL CITY CENTRE, MIAMI, FL 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-374-5600 MICHAEL.CHAVIES@AKERMAN.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) (CO) (State) (Zip Code)
305-341-4700 305-773-4288 ERIGPOMS@ORANGEHOWLORG
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 2-482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write NIA): --ter--Ce
M~ITA-HE0
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): N/A - A NON-PROFIT
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 NIA):
NONE
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2485.3):
NONE -$0.00
Page 2 of 5
The following six(6)questions MUST be answered;
1I Pursuant to City Code Section 2-488,entitled'Prohibited Campaign Contributions By Lobbyists On Procurement Issues".
_Yes XNo: Are you lobbying on a present or pending bid for goods.eauloment or services,or on a present or
ponding award for goods equipment or service?
2) Pursuant to City Code Section 2.490,entitled'Prohibited Campaign Contributi0ns By Lobbyists On Real Estate Development
Issues"'
_Yes XNo: Are you lobbving one pending application for a Development Agreement with the City or application
ter theme of zoning moo designation or change to the City's Future Lend Use Mao?
3) Pursuant to Cily Code Section 2-482(h), any person (except those exempt from the definition of'lobbyist' as set forth In
Section 2-481)who only appears as a representative o1 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 ony item.shall register with
the city clerk as required by this section,but shall not be required to pay any regeirati0n fees.
Z'Yes_No. Are you represengno a Ilot4ormrQNt corporation or entity without ,Halal compensation or
reimbursement?
4) Pursuant to Clly Code Section 2-481, the term"lohbylsl`specifically excludes the following persons: Expert witnesses who
provide only scientific,technical or other specialized intonation or testimony in public meetings;any person who only appears
as a representative of a neighborhood association without compensation or reimbursement fur 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.
res No: Are you providing only scientific. technical or other specialized Information: epoearino as
representative of a neighborhood association without special compensation or reiplbmsement or
leofesengna a not-for-profit based organization for the comae of requesting a grant without
special compensation or rein bursement?
5) Pursuant to City Code Section 2-49111),no campaign consultant shall lobby the City Commission for a period of 12 months
following the swearing In of any elected officials)for whom the campaign consultant provided campaign consulting services
within the past election cycle See Section 2-491 for more information
Yes XNo: Have von provided campalen consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,piease list he Incumbent mombedei of the City Commission'
_Yes No: 11 yes,ha It been less than 12 months since the elected offclalfel whom you provided°smoainn
Oonselting services was sworn In?
b) Pursuant In City Code Sedan 2482(a)(4)a.,a lobbyist who has within the past election cycle provided campaign consulting
services to an Incumbent member of the City Cammwbn(which lobbying activity ie not otherwise prohibited by Code section
2-491) shall disclose such particular service on blether lobbyist registration form and shell orally disclose such Dedicator
service before lobbvino the CIN Commission al a pubic meelrp.
_YesXNo: Have you provided camHlon consulting services to en incumbent member of the City Commission
within the past election cycle?H yea Meese list the incumbent memberisl of the City Commission:
Yes No: if yes, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO DE COMPLETED BYCITYCLERR'S STAFF ONLY
Annual Reglelratlon tee: I I Yes l)C110 Amount Peldf y MCRA Afc-P Date Paid
Lobbyist Reelatrallon Form received end verified by: _)ASoJ J-�V,'Tt'c
F.ti rfR •i.iL\efOnFISLLOM/1st ton MS\labby'rr formeevled el'ul Revised 01/e1/2018
Page 3 of 6
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CRY CLERIC A
SIGNED STATFMENL UNDFR OATH. LISTING LOBBYING EXPENDRUREB AS WELL AS COMPENSATION
ItFCFeDtFD. FOR THE PRECED i CALENDAR YEAR WITH REGARD TO THE SPECIFICJSSUE ON WHICH THE
LOBBYIST HAS BEEN ENGA r Les • •1= : •A STATEMENT SHALL BE FILED ENI THERE HAS BEEN NO
_ • TURE OR CO.-_NJ .,i - i. 06 .RE-•RTNr • ; OA. ,A
Signature of Lobbyist, - _ _ - Date l .-9:-3 20
I do solemnly swear or affirm that EfII of the foregoing fade, statements and dlscicsuree In this form are true and correct,
and that I have read or am faml'i the centalned In Chapter 2,Art.VII, sivsion .entitled•Lobbyists•of
the Miami Beach City Coda : • all
-Pot • r menta.
Signature of Lobbyls resat- Date Jx �✓2 .%J
azesirpie
Signature of Principal.\= Date _ I
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: ,I PRINCIPAL
State or I I0( 5 (,CC State of 4I LP[A
County of: Mt CS rvl-TY%FR County of H I KAI -DkDC
Swop to(or affirm eeee����@@@@nondtl subscribed before me Sworn to(or affirmed)and subscribed before me
th1isJ,•2Ia) day of / 20[j by ths22 day of MkfP.N 20 I?by
NMidio€I 1L0, tat)1/4 laJc nnhA{
NAME OF LOBBYIST E OF PRINCIPAL
_Produced ID _/ :: ,;
dID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
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Synrture of Notary Public "rASre of -- ary Pu•Ik
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Name of Notary,Typed.Pdnted Cr Stamped me of Notary,Typed,Printed or Stamped
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I The term"lobbyist"specifically excludes the following persons.
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 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•aprine malive of
notfor-pront community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance
Page 4 of 6
is
City of Miami Beach,1700 Conve.rbn Cerner DINT.Miami Beech,Flo('a'o 13139,www.mlamboachr!gov
Office of the City Clerk
Rofoel E.Granada,Cly Clerk ClyClerkOmiormiF eochll goy
Tar:305.673.74 I I,Fox:305.673 7254
NAME OF LOBBYIST: MICHAEL CHAVIES
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shah 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 shah 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 he
$500w Oursusnt to Section 2-482 of the Miami Beach City Code. /
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$ignetdre of Lobbyist Date/
rC_ SALL% ORMameav,v roaas�.roera R.ee=wwofm w.r..oIa I.ronom=.
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.fla partners.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
>m licursi@orangebowl.org<mailto:mlicursi@orangebowl.org>
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