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Euphrason Rebello - New World Symphony RCIV E D Ai\IAN11 EAS "AUG. • Office of the City Clerk 4� X020 : 1700 Convention:Center Drive . Miami Beach, FL 33139 OF MIAMI 305.673.7411 CITY. MI.BEACH OFF!;,F,O F'IRE CITY:CLERK - 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; anyaction, decision, recommendation of the City Manager:or any City board or committee; or any action, decision or recommendatioh.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"Lobbyist" has specifcexclusions. Please refer to City:Code Chapter 2:, Article VII, Division:3,.entitled"Lobbyists," :: for additional:information. .. .. ... . .. .. • - Instructions: Please complete all sections ofthis.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 reportin,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 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: - REBELLO -- EUPHRASON (KNOWN AS "YURI") is i . :NAME OF LOBBYIST (Last): : ' :(First): : ' _. : (Middle Name) :•: ' NEW WORLD SYMPHONY 500 17th STREETBEACH L :. MIAMI F 33139:•• •: LOBBYIST BUSINESS NAME AND ADDRESS. . , •-(Number and Street) • ' ' (City) . ..... , -- - (State)' . ... {Zip Code) ' • . ' • - (305)428-6767 . . . (305)733=1779... . . YURI,REBELLO@NWS.EDU LOBBYIST'BUSINESS TELEPHONE NUMBER :: • :: •CELLULAR TELEPHONE:NUMBER : ' :: EMAIL ADDRESS : II. PRINCIPAL INFORMATION: . • .. .. HERRING. . :- CHARLES . .HOWARD :NAME OF PRINCIPAL_ :.. (Last): : :(First)::_ : ::.(Middle Name) .. NEW WORLD SYMPHONY:. : 500.17th STREET :: :MIAMI BEACH. :. FL 33:139: :: PRINCIPAL BUSINESS.NAME AND ADDRESS . : (Number and Street), (City): .. : '. ' (State) : .. :.::(ZipCode) • (305)428-6700 ." - (786) 897-7411 • ::.:•. HOWARD HERRING @NWS:EDU: ... PRINCIPAL BUSINESS TELEPHONE NUMBER . . . : -" -- CELLULAR.TELEPHONE NUMBER- . . " , ,EMAIL ADDRESS ' purTs'ua f to City Cade Section 2Y482(h)(1i)(a).'A pnneipal ofcorporation, partneIstiiip, or other entity who appears:;as a'lobbyis't on beh'alfffithal entity„ special compensation reimbursement for whether'direct indirect, or contingent,to express sus sort of or"o.sosition to an item shall register;with the:Clerk as required b this subsection but shall[Catore0uired )fp9an ; . : If the principal:is'a Corporation Partnership or Trust; the following:information MUST be provided pursuant to City Code Section 2-482(c): • . HOWARD HERRING -CEO -- • • •-NAME OF CHIEF.OFFICER,PARTNER,OR BENEFICIARY(if none;write N/A): • NAME OF ALL PERSONS HOLDING,bIRECTLY OR INDIRECTLY,A 5%OR:MORE OWNERSHIP INTEREST IN SUCH • ' •• CORPORATION,PARTNERSHIP OR TRUST:(if none,write N/A):; • • N/A o •. Page 1 f 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. SOUNDSCAPE PARK IMPROVEMENTS AND PROGRAMMING/ACTIVATIONS LINCOLN ROAD IMPROVEMENTS AND LINCOLN RD/CONVENTION CENTER STREETSCAPE PARKING GARAGES IMPROVEMENTS CULTURAL PROGRAMMING/FUNDING 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 COMMISSION (VARIOUS) X CITY STAFF (VARIOUS) X MAYOR GELBER 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): 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): N/A Page 2 of 5 The following six(6)questions MUST be answered: :: : :: .: 1) Pursuant to City Code Section 2-488;entitled"Prohibited Campaign Contributions ByLobbyists On Procurement Issues": Yes 1 No: Are you lobbying on a present or pending bid. for goods, equipment or services, or on a presenter .. . . 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 •: sluesI ": .. . .. Yes✓No;.. . . Are you lobbying on a pending application fora 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 City Code•Section 2482(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. 1Yes._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 Onljr 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 reimbursementfor the appearance:: . Yesy'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 organisation 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 1:2 months. .. . . . ••'following.the.swearing*in of any elected official(sy for whom.the.campaighconsultant provided campaign consulting services . .. . . within the past election cycle. See Section 2-491 for more information. . Yes I No: Have you provided campaign consulting'services to an incumbent member of the a City Commission • within the past election cycle?.If yes,please list the incumbent member(s)of the City Commission: . Yes No: If yes, has�it been less tF.an12, moths since th.a.elecfed officials) wFiom you provided campaign • C°Melting seniYices.was swOr inif . 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 at a public meeting. Yes ✓No: : . 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: If yes, were you promised'Or did you receive economic'consideration`in x hangs for campaig ponsultinq servicesr :: : : i. :. : TO BE.COMPLETED BY.CITY CLERK'S STA�FF1)ONLY. :. :: H H • Annual Registration fee: [ ].Yes[ ]:No Amount Paid-$- '' •...,,....: MCR#,' : if. . Date Paid S t%�� — "t J Lobbyist Registration Form received and verified by: .F::\:CLER\.BALL\aFORMS\ OBB'(IST FORMS:\Lobbyist Registration Form Revised' 03-11-20 REG.doe . . :Revised.03/11/2020 Page3of5 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 BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.1 Signature of Lobbyist: 1414467 Date B " — AZO I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true 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 Code and all reporting requirements. Signature of Lobbyist: QAtt Date r 2° Lo Signature of Principal: Date a • VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL A State of 444 F I O(i d& State of F l o r 1 act. County of: ILI (Con t-64de County of: !-'1 I Com I - Sworn to (or affirmed) and subscribed before me, Sworn to(or affirmed) and subscribed before me, by means of E physical presence by means of gphysical presence or❑ onlige notarization, or 0 o I•ne notarization, this to"'+C dray of /4 J 5-c.)S 1-- , 2QLf)by this day of 6-r)s'E"' ,201t' by v,pn r asp n v t�4DeIJo C iar les 1--1-o uJosc . f k crl NAME OF LOBBYIST NAME OF PRINCIPAL • _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION _✓Personally Known / Personally Known /fob . nt ()jet. i4-�q_ C Si natdre of Notaryg Public Signatu Notary Public g Oso H. V �Gt- Osco H. Vila- Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped (NOTARY SEA , - • , (NOTARY SEAL) - • ' .yr Pty Notary Public State of Florida �**� Notary Public State of Florida 4" • (f Rosa M.Vila ° Rosa M.Vila • ' " My Commission GG 128604 My Commission GG 128604 it,°ve�` Expires 07/28/2021 1 The term"lobbyist"sp., i ':xclaSstR $wi � ng persons. f 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 • . . . , • MIAMI BEACH ' :.City of Miami Beach,1700:Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachl.goy Office of the City Clerk Rafael b;Grarado, City Clerk CityClerk@miamibeaclifl:gov Tel.:305.673.7411;_Fax:305:673.7254 : EUPHRASON REBELLO 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 failt 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 : dye, 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-afterhotification. Anyiobb gist, who fails to: file the required::Statement byApril :30th of each year; shall be . : Y , 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 have, been engaged to lobby: 2):H LOBBYIST WITHDRAWAL: Once an issue I have:registered to :lobby; has concluded: or I;am no longer lobbying on ; that issue, I shallimmediately file:a.Notice of Withdrawal with the Officeof 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, andthe fee for such annual registration shall be $500.00.pursuant to Section 2-482 of the Miami Beach:City Code. Ztn Zo • Signature of Lobbyist Date F:\CLER\$ALL\eFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc o . Pages f5 . :