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John C. Shawde/Alberto G. Ribas A2 Group, Inc. ~ ~ MIAMIBEACH 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 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: Berger Singerman BUSINESS NAME AND ADDRESS 305-755-9500 TELEPHONE NUMBER: Shawde John (Last) (First) 200 S. Biscayne Blvd, #1000, Miami, (Number and Street) (City) 305-714-4340 FL C. (M.!) 33131 FAX NUMBER: (State) (Zip Code) jshawde@bergersingerman.com EMAIL: I. LOBBYIST RETAINED BY: Alberto G. Ribas, P.E. - President NAME OF PRINCIPAl/CLIENT: N Group, Inc. BUSINESS NAME AND ADDRESS 7300 N. Kendall Drive, #340, Miami, (Number and Street) (City) 305-668-9454 FAX NUMBER: (Optional) FL 33156 (State) (Zip Code) ribasa@a2group.com EMAIL: (Optional) 305-668-8939 TELEPHONE NUMBER: Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Alberto G. Ribas, P.E. - President . IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Alberto G. Ribas, P.E. - President II. SPECIFIC LOBBY ISSUE: South Pointe Park Improvements, ITB # 09-06/07 & ITB# 26-06/07 Issue to be lobbied (Describe in detail): III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Jorge M. Gonzalez (City Manager) None Mayor & City Commissioners (see attached list) None Gus Lopez & John Ellis (Procurement) & City Administrative Staff None IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLA T RA TE OR 077lER). Hourly A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $475.00 per hour The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": eo Yes D No: Are YOU lobbyina on a oresent or oendina bid for aoods. eauioment or services. or on a oresent or oendina award for aoods. eauioment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes l"fNo: Are YOU lobbyina on a oendina aoolication for a Deyelooment Aareement with the City or aoolication for chanae of zonina mao desianation or chanae to the City's Future Land Use Mao? 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 section but, shall not be required to pay any registration fees.. D Yes ~No: Are YOU reoresentina a not-for-orofit corDOration or entity without soecial comoensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT 0 THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDIN A NDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPE UO COMPENSATION DURING THE REPORTING PERIOD. I do solemnly swear that all of the ~ familiar with the provisions contain requirements. ( Signature of Lobbyist: Signature of Principal/Client: g facts are true and correct and that I have read or am i n 2-482 of the Miami Beach City Code and all reporting VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: D Produced ID D Produced ID Form of Identification " Personally known (Lobbyist) Form of Identification eo Personally known (Principal) State of Florida, County of Miami-Dade Sworn to a~ubscribed before me This .:21 '" ...' '"''':.':'':''';':''' .~'V''''I:,~ . :: . _;// /J? n-, i~' ~. }ity' - ,State of Flori' "'bb~oMtu~ " d.?: - ,":OR JO 650204 , 011 Underwriters I , .' ,<,O~~~.v. ~~6>({, KARLA SALGADO . . MY COMMISSION # DD 309712 * " EXPIRES: April 12, 2008 State of Florida, County of Miami-Da ~ ~0" BOl1dedThru Budget Notary Servlces Sworn and subscribed before me ~OH\.O This ~day of Ho.rch . 2007 ~jJ~ Signature of Public ~ary - State of Florida Notarization of Principal's signature VII. SIGNATURE AND STAMP OF NOTARY: , . FOR CLERK'S Annual Registration fee: ~ ] Yes [ ] No Amount Paid Lobbyist Registration Form received and verified by: F: \CLER\$ALL \MARIA-M\Lobbyist\LOBBYIST fORM OS.doc .SE ON~~R # ~9q f 'f Qoate Paid CI)/.2l.I01 Revised 12/08/04 Mayor & Commissioners MIAMIB Resident Visitor Page 1 of2 Business Employee E-Government Calend MAYOR8( COMMISSIONERS The City of Miami Beach is governed by a City Commission/City Manager type government. The City Coml consists of six elected Commissioners and an elected Mayor, Commissioners are elected for a term of fou with a term limit of two terms, Terms are staggered so that half the members of the Commission are electe two years, The Mayor is elected every two years. The Commission appoints the City who overs, City Administration, MaYOLDavid Dermer Current term: 2005 - 2007 First elected: 2001 Profession: Attorney Telephone: 305-673-7035 Email: m<:lYOIQerrner@mLamio.e<:lGM~goY Cpmmi$$iol1er MaUiHe....era6ower Current term: 2003 - 2007 First elected: 1999 Profession: Commissioner Telephone: 305-673-7107 Email: m<:ltti@miamipe<:lGhJLgO'l[ Comml$$lonerSimonC..y~ Current term: 2003 - 2007 First elected: 1997 Profession: Business/Real Estate Telephone: 305-673-7102 Email: simon@mi<:lmibe<:lchJI,gO'l[ Commi$$ionerMichael.G6ngora Current term: 2006 - 2007 First elected: 2006 Profession: Attorney Telephone: 305-673-7105 Email: michael@miamibeachfLgov Vice MayorSauJGrO$$ Current term: 2005 - 2009 First elected: 2001 Profession: Business/Real Estate Telephone: 305-673-7104 Email: ~C!.lJl@miamibeac..bJj.gov Commi$$iQnerJerrynliJtbJn Current term: 2005 - 2009 First elected: 2005 Profession: Financial Planner Telephone: 305-673-7106 Email: jerry@mi<:lmiOe<:lchfl,gov http://www ,miami beachfl. gOY Inewcity 1 ci ty halll elected.asp 3/27/2007 Mayor & Commissioners Page 2 of2 CQmm i$$ionerRichardSteJnberg Current term: 2005 - 2009 First elected: 2001 Profession: Attorney Telephone: 305-673-7103 Email: riChClrc:l@miClmip~ClchfLgOV The Mayor or Commissioners may be contacted by Email or by writing to: \f\jepCClst Qf.,CQn1rni~siQnM~~til1g com mi$~iQn MeetllliLAgendas COmlJll?~iQIlMeetin9-~ After Action Reports Commi~sion_Meeting ~ch.e_Q\Jl~ CommissionC.Qmmjtt~~~ r;1~c.t:jQn.1 n fQrrn CltjO 11 \,!Q@.Miarn i 13~a_c.h MCly'QrLC9rnrnissiQn~rs- J~17tQc:lClte The Office of the Mayor and Commission City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 http://www ,miamibeachfl. gOY Inewci ty 1 city halll elected,asp 3/27/2007