Rafael E. Andrade - Alchemy Miami Beach, LLC •
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.
DEC - 2020
" t 4. i p d r I— .. ..
-i w" 1 ' . Office of the City Clerk CITY OF BEAGH9
1700 Convention Center Drive • ORF"'r- '' �'CI_E:RK
Miami Beach, FL 33139 .
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• 305.673.7411
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LOBBY• IST REGISTRATION FORM
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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 pdriod 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 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 "Wan in that section. Any change to any information originally filed: or any addi$ional City
• Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registrTtion 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.-
L LOBBYIST INFORMATION: •
Andrade, Rafael E. •
NAME OF LOBBYIST (Last) (First) (Middle Name)
Law Offices of Rafael E. Andrade, P.A., 1688 Meridian Avenue, 7th Floor, Miami Beach, FL 3139
- LOBBYIST BUSINESS NAME AND ADDRESS . (Number and Street) . . (City) . .. . (State) . (2.ip Code) •
(305) 216-2028 ralph@randradelaw.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL `DDRESS
•
IL PRINCIPAL INFORMATION:
Freedman, Michael A.
NAME OF PRINCIPAL . (Last) (First) (Middle Name)
•
Alchemy Miami Beach, LLC 1384 Broadway, Suite 804 NY NY 10018
PRINCIPAL BUSINESS NAME AND ADDRESS • (Number and Street) (City) (State) (Zi i Code)
• •
(646).971-1884 • • maf@alchemcymdia.net
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER . EMAIL DDRESS
'sur t i;sra,F Mode Sectism e' Frfrn t�a.* A 'eip'a1'or ary teff-ion,pa•net' ill other enti ,tvis ggEiggig g.M 1 b=hal of boat
entity ntipmgt.p-erai ersatienief"ffingigl appe sence (.'i'=it .re `.` �:.x ress5 'pPr7 r," ooposttrnnto
a 1+te* el regis e_with tie>i ler ...s.required'y his.subsectieit:b_ut.s r.gOM.•Lo oay_any regis_tralo ee ; .
if the 'principal .is a Corporation, Partnership or Trust, the following information MUST be •rovided
pursuant to City Code Section 2-482(c):
NAME OFCHIEF_OFFICER,PARTNER, OR.BENEFICIARY(if none;write NIA): . P', m� /�N� /
NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY, A 5%OR MORE OWNERSHIP INTEREST 1 SUCH
CORPORATION, PARTNERSHIP OR TRUST(if none,write N/A): ••
. Page l 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.
Agreement between the City of Miami Beach and Alchemy Miami Beach, LLC for City Municipal
Garage Advertising Services (RFP 2017-081-WG) and related matters
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 unaid) 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 relationhip.
Fuii Name of Individual and Contractual Relationship (If yes,explain) YES NO
Title of Person to be Lobbied
Mayor and City Commission X
City Manager and all City staff X
Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extept of any
business, financial, familial or professional relationship, or other relationship giving ne 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 Butiness, Financial, Familial or Professional Relationship, or other relationship giving dee to an
appearance of impropriety(if none,write N/A):
Not applicable.
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION —.BO Specific. (No e that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
$2,500.00 per month, plus $350 lobbyist registration fee
F'age 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":
,1Yes_ lo: Are you lobbying on.a present or pending bid for goods, equipment or services, or on 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 pendingapplication for 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 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.
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 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 compi nsation or
reimbursement for the appearance. . .
_Yes XNo: 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 member(s)of the City Commission:.
Yes No: if yes has it boen less+than 12 months since.the>Medal ilofficialts) whom you biovided;campaign
consulting services 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 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: If.yes, were you promisedor'did You receive economic'consideration in exchangelfor campaign
consulting serVices? . .
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ -1 YesKNo Amount Paid$ MCR# 1Z7 0`1 Z Date Paid L2 /'l/at Z.,,
Lobbyist Registration Form received and verified by: {f
F\CLER\$ALL,\aFORMS\L'OSSYIST€ARMS\Lobbyist Registration FormRevised.03-11-20 REG.doc Revised'03/11/2020
Page3.of5
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 'URING _....:E REPORTING PERIOD.'
Signature of Lobbyist: `41111111111r - Date
/� ll/2.,
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 - >-forting re• ' -ments.
Signature of Lobbyist: 7 Date 7.'2_///2_,
Signature of Principal: Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of �L0P-ID1@ State of
County of: M.41/1 I 'DA- County of:
Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me,
by means ofAphysical presence by means of 0 physical presence
or 0 online notarization, or 0 online notarization,
this I t day of C.G.AA I51 i ,202Q by this_day of ,20_, by
(2.A0-EL /31-14 1)..A-%
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
Personally Known _Personally Known
ignature of Notary Public Signature of Notary Public
jam. ; c_
Name of Notary,Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
(NOTARY S Iq•• '►••. (NOTARY SEAL)
•,, JASON SALYATORE
*j •, MY COMMISSION S HH 000062
%-t-, -; *'r, EXPIRES:September 14,2024
lidifi1 The term"lobbyis � � -�'• �. I-'- v. is . -4 s: -
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
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:COMPENS• .MIcrDURING THE REPORTING PERIOD.'
Signature of Lobbyist O Date
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true apd correct,
and that I haveread or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and -II -porting requirements,
Signature of Lobbyist: / - . �— Date /,4*-7442=ar-
;Signature of Principal a l Date-
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of State of (CA4 4 eG-4'Llit
County of County of t` q � 'C 1
J.
Sworn to (or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before e,
by means of 0 physical presence by means ofd'physical presence
or 0 online notarization, or 0 online notarization,
this day of , 20_, by this day of DeG(`'%7S lr' 2 1, by
R.C.CLetil irrre ecqAttlivi)
NAME OF LOBBYIST NAME OF PRINCIPAL (� l
Produced ID Produced ID IcJ p' Ver-S `x'_15 9
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personally Known Personally Kno n
Signature of Notary Public Signature of Notary Public
ttCL5-1-%he 04:01:6-A2f/6r ,
Name of Notary; Typed, Printed or Stamped Name of Notary, Typed, PrinteQof,Stamped .
f
(NOTARY SEAL) (NOTARY SEAL).
AUGUSTINIE'v{ARBRIELL9
NOTAI F PU..LIC =
MY GOMMISSION_F-XP1RE,S�MAR.31;2022
'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 reprepentative of
not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page4of5
AA.1I\ JBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov.
Office of the City Clerk: ..
RaFael E. Granado, City Clerk CityClerk@miam`ibeachfl.gov
Tel: 305.673.7411., Fax: 305.673.7254
NAME OF LOBBYIST: Rafael E. Andrade
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 g`tatement
(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 loblbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the Ci 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
$500.00.pursuant to Section 2-482.of the Miami Beach City Code..
/Z-37
Signature of Lobbyist Date f
F:ICLERI$ALL1aFORMSILOBBYIST FORMSIi.obbyist Registration Form Revised 03-11-20 REG.doc .
Page 5 of 5
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