Jorge L. Esteban - 4465 Alton Rd., LLC UL1LSRFPCfvf
A I\ Al BEAcvl
1 Office of the City Clerk
1700 Convention Center Drive ,91111 jun _7 PM 12: 38
Miami Beach, FL 33139
305.673.7411
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 pnncipal as well as any employee engaged"In bying
entitled
activities. The term'Lobbyists"has specific exclusions.Please refer to City Code Chapter 2,Article VII, Division 3, Lobb Y
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
sectionyou must write "none" or "rife" 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 toms.
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:
Esteban Jorge
NAME OF LOBBYIST (Last) (First) (Middle Name)
Accolade Construction Company LLC 2601 S.Bayshore Drive,Suite 1460,Miami,FL 33133 State (Zip code)
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
305-705-0001 7k6-556-9184 iesteban(alaccottadeIL ACDDRESS
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER
II. PRINCIPAL INFORMATION:
Vanterpool Jason
NAME OF PRINCIPAL (Last) (First (Middle Name)
4465 Alton Rd,LLC 11601 Biscayne Blvd Ste 215, Miami, FL 33181
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 338-1907 vanterpoolllcre@ .
gma com
(305) 676-4541 EMAIL ADDRESS
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER
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(it none,write N/A): Jason Vanterpool
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): Stephanie Lecorps _ ..
Page 1 of 5
III. ISSUE TO BE LOBBIED: 4ECEo,,, _,
I 's�
Describe with as much detail as is practical, including but not limited to a s eI@ itde riBala'1g re
applicable of a pending request for proposal, invitation to bid, or public hearing.number,. _
The applicant proposes the demolition of the existing residence and to construct a new residenc' alproximately
4,163 square feet in size.
R. ix- oa-r ( y1965A7
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 -
IITitle of Person to be Lobbied
1ileet— coral Contract
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
NONE
appearance of impropriety(if none,write N/A): - -
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):
$250.00/HR
Page 2 of 5
The following six(6)questions MUST be answered: ����JUN -7 M
1) Pursuant to City Code Section 2-488.entitled"Prohibited Campaign Contributions B b On Pr cureen ssues':
_YesXNo: Are you lobbying on a present or pending bid for goods, equipinent or servien-ygrion:a present or
pending award for goods,equipment or service?
2) Pursuant to 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?
Pursuant to City 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 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 city clerk as required by this section,but shall not be required to pay any registration fees.
YesXNo: 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 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 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 specialized information: appearing as a
representative of a neighborhood association without special compensation or reimbursement or
representing a not-for-profit based organization for the purpose of requesting a grant without
special compensation or reimbursement?
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 past election cycle?If yes,please list the incumbent memberis)of the City Commission:
Yes_No Grp=eI ,; 1 �+« , .;: «` �. �!' Ti2rj YtleNi"carx7t3i4n
6) Pursuant to City Code Section 2-462(a)(4)a., a lobbyist who has within the past election eyrie prodded 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 at a public meeting
_Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes,please list the incumbent member(s)of the City Commission:
Yes No t' ,..a
TO BE COMPLETED
BY CITY CLERK'S STAFF ONLY /� _.._—_—
Annual Registration fee: 010 Yes[ ]No Amount Paid$
?S YL (p MGR% t 1 91 I Date Paid 04 0-i i
Lobbyist Registration Form received and verified by: `_ 4jak) �• '-' 'v�' -'-- Revised 0l/Ol/20i8
F:\CLER\SPLL\a FORMS\LOBBTIS r FoRMS\LObayist RegtsuSteel nd Revised 01-0115 REG doe
Page 3 of 5
REcnvEr
VI. SIGNATURES UNDER OATH:
2818 JUN -7 PM 12: 38
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER TH, LISTING LOBBYING EXPENDITURES .*snk9gl lit1A$ COMPENSATION
RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD'TO THE S I SSUE ON WHICH THE
LOBBYIST HAS BEENF GE TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COM NS T N DURING THE REPORTING PERIOD.1
Signature of Lobbyist: Date 10 I4(.
•
I do solemnly swear or affirm that all of the fo -going .cis, statements, and disclosures in this form are true and correct,
and that I have read or am familiar with the p o -sion contained in Chapter 2, Art. VII. Division 3. entitled "Lobbyists" of
the Miami Beach City Code and all reporting. :`uirem s.
Jorge L. Esteb.n v 4 s� pate 06/04/18
Signature of Lobbyist'. - _�=— -- - --
Signature of Principal: Jason Vanterpo•/.4h11 _ /te,I Date 06/04/18
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
' State of 0116/0--1
�
State of r Ct. /\l
County of: H 1 orl'I 1 Gc(�C County of: JA��'
Swornt (or affirmed)and subscribed before me Sworn (or affirm d)and subscribed before
TM
this day of Done- 2018 by thisq71 day of 20(Of, by
-.15-0f'9\--P- (-- FSI-CbCfl/ et-JASON l/An/r/QA of
NAME OF IbdBYIST NAME OF PRINCIPAL
_Produced ID _ Produced ID liii---6- 1
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
• :i • .wn •rson l�yl �,
Sign: ("�o Notary Pub c St slut- f No - " •tic
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Name of Notary T •ed, Printed or Stamped Name of Notary Typed, Prmtgd 81x
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I ........... ryPublic C.Vte of Fl '
(NOTARY SEA4E• t•' Notary Fu81ic-State of Florida (NOTARY SEAL) _ j My Comm.Expires 1:
• `- April 04,2021 `
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The term"lobbyist"specifically excludes the following person : �o FOF FLOPxxxxx
�rr11111 hitt\ c
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 representative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
RFCF(V
(-`, ;.-sA,.C L 2018 JUN -7 PM12: 38
o
C. of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,wwN m nibeac lgo 1 f;
Office of the City Clerk
Rafael E. Granada,City Clerk CiyClerk@miomibeachfl.gov
Tel 305 673.7M I, Fox: 305 6733254
Jorge L. Esteban
NAME OF LOBBYIST:
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 301h 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
00.00 pursuant to Section 2-482 of the Miami Beach City Code.
Signature f Lobbyist Date
M i.trA�.+i J.m..xLUwu f aluce«,M;O,,iogo,mtlm oma nM%e a,l l,e,Ea eac
Page 5 of 5
Salvatore, Jason
From: Jorge Esteban <jesteban@accolade.cc>
Sent: Thursday,June 07, 2018 2:42 PM
To: Salvatore,Jason
Cc: jesteban@accolade.cc
Subject: Lobbyist Form
Hi Jason
Thank you for calling with regard to the Lobbyist form. I am authorizing you to revise the submitted form as follows:
1. Section IV, Page 2 Design Review Board and I have NO contractual relationship
2. Section III—The DRB file No. 18-0271,address 4465 Alton rd. Miami Beach, FL
Let me know if you need more information,
Best regards,
Jorge
JORGE I.. ESTEBAN, A.I.A. I AR 0012553 CGC 1517060 I ID 4709
Architect President 1 Accolade Construction Company LLC I AA 26001980
2601 S. Bayshore Drive, Suite 14601M iami, FL 33133
P 305.705.0001 F 305.705.0003 M 786.556.9184
JEsteban,(a�Accolade.cc
www.Accolade.cc
ccolade
. .n„,
inforyi..
The information transmitted,including attachments,may include confidential and/or proprietary material to be used ONLY by the
intended recipient.No confidentiality or privilege is waived or lost by any errant transmission. unauthorized dissemination,
distribution,copying or action taken or omitted, is prohibited and may be unlawful.
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