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Nancy Calara - Deco Walk Hotel & Golf Club, LLC 9C3 RECEIVED �� t�H APR 2� 20zI Ea Office of the City Clerk CITY OF 1700 Convention Center Drive OFFICE OFITIIAiV7i BEACH Miami Beach,FL 33139HE Clay CLERK M I AM I 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 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 "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: Calara, Nancy (Middle Name) NAME OF LOBBYIST (Last) (First) Deco Walk Hotel & Golf Club. LLC. 928 Ocean Drive. Miami Beach. FL 33139(State) (Zip Code) LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (MY) 305-206-6404 njcalara@gmail.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Calara, Nancy NAME OF PRINCIPAL (Last) (First) (Middle Name) Deco Walk Hotel & Golf Club, LLC, 928 Ocean Drive, Miami Beach, FL 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) • 305-206-6404 njcalara@gmail.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to City Code Section 2-482(h)(1)(a)_„A principal of any corporation, partnership,or other entity who appears as a lobbyist on behalf of that; entity,without special compensation or reimbursement for the appearance,whether direct,indirect,or contingent,to express support of or opposition to; an Item shall register with the Clerk as required bythis subsection but shall not be required to pey any registration fees. 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):Mandy Calara: Nancy Calara NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): Mandy Calara 50%; Nancy Calara 50% Page 1 of 5 j f III. ISSUE TO BE LOBBIED: but not limfic description where ractical,including ublicto hearingaspecinumber. Describe with as much detail quest for proposal,invitation to bid, or public applicable of a pending q Conditional Use Permit P Tannin• Board Hearin. PB18-0252-Voodoo Loun•e 928 Ocean Dr IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:Pursuanpersonnel sought to be 4 list the City Commissioner or City p aid l unpaid) withb lobbied, and City Code Section 2-482(a)( ), from 12 months preceding such commencement of service whether the lobbyist has entered into any contractual relationship p Baththey Commissioner or Citye personnel with City to the present date,stating the general nature of the subject contractualrelationship. Full Name of individual and Contractual Relationship(If yes,explain) YES No Title of Person to be Lobbied X Cit of Miami Beach Committees and Boards None None X City of Miami Beach Attorneys Office and Administration None X Ci of Miami Beach Ma or and Commissioners 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 By Lobbyists On Procurement Issues": Yes x No: 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 x No: 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? 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 LNo: 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 organ¢ation for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Yes x 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 LNo: 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 x No: If yes, has it been less than 12 months since the elected official(s)whom you provided 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 lobbvina 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 x No: If yes, were you promised or did you receive economic consideration in exchange for campaign consulting services? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY �,rr'' C , (!I Date Paid ~— Annual Registration fee: [ l Yes` I No Amount Paid$ MCR# )i 1\ �X Lobbyist Registration Form received and verified by: Revised 03/11J2020 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 3 of 5 I I VI. SIGNATURES UNDER OATH: ON FEBRUARY OF EACH YEAR EACH LOBBYIST BYING EXPENDITURESLL SUBMIT TO AS OFFICE WELL AS COMPENSATIONE SIGNED STATEMENT UNDER OATH LISTING TO RECEIVED FOR THE PRECEDING CALENDAR A STATEMENT SHALL BE FILED SPECIFIC ISSUE ON THERE HAS BEEN NO . LOBBYIST HAS BEEN ENGAGED TO LOBBY. , EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD? �-Z3 �2 Signature of Lobbyist: Y '� Date I do solemnly swear or affirm that all of the foregoing facts, state ine ts,Chand ndr disclosures iscloArr Is Divis in o form eareled trua and correct, of and that I have read or am familiar with the provisions contained the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: i!1 = N>' Date u.?��2-rt u Date_a13--.12-4-- Signature of Principal: VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL t Q State of c\O r �^ State of �— County of ��m l 1�C1c1�.— County of: r�oma le- Swom to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means ofhysical presence I by means of�physical presence or 0 online notarizafon, thisor online day of tion ` 204 by this day of 1 r 2O. by r _ of ' '1i auv�,,,.,�>� Cts- 4,, ,. ALMON_ NAM OF L BB5IST NAME 0 PRIN r I•'L (LProduced ID VD, 4Produced ID__Lac-_ FORM OF IDENTIFICATION FORM OF IDENTIFICATION Perso - ly Klown __Pers° illy K own A lame Sa ur'e owl= ary Public Sig - re`s I •tary Public 1 � 't'i' \ Cine SC� Q' C S Name of Notary,Typed,Printed or Stamped Name of Notary,Typed,Printed or Stamped °,�yytY P.Ni VANESSATORRES (NOTARY SEAL) (NOTARY SEAL) r • Commission#GG 276465 =actstY ruk VANESSATORRES N�.4� ' Expires November 20,2022 Commission i►GG 278465 t '°i Banded ThmBudgotNotary Services �, c Expires November 20,2022 Fnc A.° 1 'r � BandodThNBudpelNotarySorvlcoe The term"lobbyist'specifically excludes the following persons: Fora° Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; ance,whether person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appear direct, indirect or contingent,based to express x anizationf or the purport of or osestion to of requesting a granitem; andt wiithny ou special comperson who only ensationears as a representative of or reimbursement for not-for-profit communityr9 the appearance. Page 4 of 5 MAMEACH City e Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl-gov Office of the City Clerk CityClerkC�?miamibeachfl.gov Rafael E.Granada,City Clerk Tel:305.673.7411,Fax: 305.673.7254 NAME OF LOBBYIST: Nanc Calera 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 phatiture mayabe nd Cmposed ompensaas protion teid atemed m (Statement). In addition to any other penalties tSection 2-485.1, a fine of $50.00 a day shall Dadee essed for County Commission s on Ethics csr and the due date. The City Clerk shall notify the Miami-Dade Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. th of each Any lobbyist, who fails to file the required Statement April paid30unless the finerhas been , shall be automatically suspended from lobbying until all fines are appealed to the Miami-Dade County Commission on Ethics and Public Trust. the ty Clerk I hereby acknowledge that on February 28of lobbyist exph year, I enditures,endituresshall l suasbwellmit tas comipensat on a signed Statement under oath listing all toby P 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 lobbye has concluded or I am no loner lobying of Withdrawal with the Office of9he Cty Clerk.n that issue, I shall immediately file a Not 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. , �� Signature og_dbbyist Date FICLERISALLIaFORMSILOBBYIST FORMS1Lobbyist Registration Forth Revised 03-11-20 REG.doc Page 5 of 5