BR Villa Luisa LLC
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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 defined in any
manner in this section, 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 Ordinance 2004-3435.
NAME OF LOBBYIST:
Gonzalez
(Last)
Alfredo
(First)
BUSINESS NAME AND ADDRESS
1221 Brickell Avenue
(Number and Street)
Miami
(City)
Florida
(State)
gonzalezaj@gtlaw,com
EMAIL:
J.
(M,I)
33131
(Zip Code)
305-579-0588
TELEPHONE NUM8ER:
305-961-5588
FAX NUMBER:
I. LOBBYIST RETAINED BY:
BR VILLA LUISA LLC
NAME OF PRINCIPAL/CLIENT:
8USIN ESS NAM E AN D ADDRESS
3110 NE 2ND AVENUE MIAMI
(Number and Street) (City)
FLORIDA
(State)
33137
(Zip Code)
305-757-0001
TELEPHONE NUMBER:
305-757-0017
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-4B2 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
MICHAEL SAMUEL
. IDENTIFY ALL PERSONS HOLDING, DIRECfL Y OR INDIRECfL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
SOUTH OF FIFTH LLC, BR VL HOLDINGS LLC & OCEAN DRIVE LLC
II. SPECIFIC LOBBY ISSUE:
VARIANCES
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/ntle B) Any Financial, Familial or Professional Relationship
Planning and Zoning Department
City Commission
Board of Adjustment
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOUR L Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $250,00 HOURLY
B PRINClPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $250,00 HOURLY
1)
Yes ~
2)
yese
v.
. I
Pursuant to OrdinallClll No. 2003-3393 Amendino Miami Beach City Code Chaoter 2. Article VII. Division S
Thereof Entitled "Camoaion Finance Refonnn Via The Addition Of Code Section 2-488 Entitled "Prohibited
Campaign Contributions BY Lobbvists On Procurement Issuesn:
Are YOU lobbvina on a DreSent or Dencling bid for aoods.. eauiDlllel1t or services. or on a oresent
or Dendina award for aoods. eauiDment or service?
Pursuant to Ordinance No. 2003-3395 Amendino Miami Beach City Code Chaot.er 2. Article VII Division S
thereof Entitled "Campaign Finance Refonnn. Via The Addition Of Code Seelion 2-490 Entitled "Prohibited
Camoaion Contributions BY Lobbyists On Real Estare Develooment Issues":
~n~naoen~a:~fo~~tw~Citvor
aDDlication for chanae of zonina maD deslanation or chanae to the City's Future Land Use MaD?
SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR PENSATION DURING THE
REPORTING PERIOD.
I do SOlemnly swear that all of the foreg 'ng facts are true and rorrect and that I have read or am
familiar with the provisions contai in ion 2 2 of the 'ami Beach City Code and all reporting
requirements. ---------
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: \
X Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
PRINCIPAL IDENTIFICATION:
o Produced ID
o Produced ID
Fonn of Identification
rsonally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subsaibed before me
This c..O clay of 20.s2~
i"" a\ Maria-Jose Lopez
\,;\1.. ; ~ Commission 00373825
"'"o~ Exolres December 03, 2008
State of Florida, County of Miami-Dade
Sworn and subsaibed before me
n;,.- '" ~ ,20-'"
Signature of P;;bliC No ry - State of AoricIa
Notarization of Prinapal's signature
o A L
ANNETTE J SANGSTER
NorARY PUBLIC STATE OF FLORIDA
COMMISSION NO, DOl 10259
MY COMMISSION ~, APR. 21,2006
ONLY ,I
MCR#~ 73fO OatePaid fL.-,;)../- -0'-(
\MARIA-M\LOBBYIST\LOBBYIST FORM 04
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER}.
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
Tl'1e following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
~ Procurement Issues":
~8: :~~~~ ::rb::~~~n~na~:~7;tao::'~~:~~:~e~: O~o::~i~::iDment or services. or on a
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
. Estate Development Issues":
~: :~~I~:til~:~~~n~~~a~D;n:~~:D~:~J~~~af::t~o~e:re~~:::;~:~:ec7~?: ~:~r~h~~~u~~
Mn1
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) 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 clerk as required by this
n v...J:~~ion but, shall not be required to pay any registration fees..
~: :~~~:b~e~::~~~n~ a not-for-Drofit corDoration or entity without soecial comDensation
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO X NDITURES OR COMPENSATION DURING THE
REPORTING PERIOD,
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
I] Produced ID
II Produced ID
Form of Identification
Form of Identification
Personally known (Lobbyist)
[] Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of . 20_
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This _day of , 20_
Signature of Public Notary - State of Florida
Notarization of Lobbyist's signature
Signature of Public Notary - State of Florida
Notarization of Principal's signature
FOR CLERK'S USE ONLY
Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR #
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc
Date Paid
Revised 12/08/04