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Pablo Acosta/Alberto G. Ribas ~ ~ 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. Acosta, Pablo NAME OF LOBBYIST: (Last) (First) (M.I) Wachovia Building 200 South Biscayne Blvd. Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (lip Code) (305) 773-6559 TELEPHONE NUMBER: pacosta 17@comcast.net FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Alberto G. Ribas, P.E - President NAME OF PRINCIPAUCLlENT: A2 Group, Inc. 7300 N. Kendall Drive, #340, Miami, Florida 33156 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (lip Code) 305 668-8939 TELEPHONE NUMBER: 305 668-9454 FAX NUMBER: (Optional) ribasa@a2group.com EMAIL (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)l 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, ITS #09-06/07 & ITS # 26-06/07 Issue to be lobbied (Describe in detail): III. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED: A) Full Name of IndividualfTitle 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 None Administrative Staff 694666-1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) Monthlv - $2.000 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).$2.000 month Iv The following information must be answered: 1) Pursuant to Miami Beach City Code Section 2-488 Ent~led "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ~ Yes D No: Are you 10bbvinQ on a present or pendinQ bid for Qoods. equipment or services, or on a present or pendinQ award for Qoods, equipment or service? 2) Pursuant to Miami Beach City Code 2-490 Entnled "Prohib~ed Campaign Contributions By Lobbyists On Real Estate Development Issues": DYes DlNo: Are you 10bbvinQ on a pendinQ application for a Development AQreement with the City or application for chanQe of zoninQ map desiQnation or chanQe to the City's Future Land Use Map? 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 representinQ a not-for-profit corporation or entity without special compensation or reimbursement. . 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 EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. ~',,/;' 1// /-c:- --- ..--/ / 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 2-48 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: tV' Produced 10 p/07tt ti (,(. dIU I,R rs /1C"f ICU..... Form of Identification PRINCIPAL IDENTIFICATION: IlYProducedlO FloJ-((d~ fJ/tIt/.1,1 /, ('~"se Form of Identification o Personally known (Lobbyist) VII. SIGNATURE AND STA o Personally known (Principal) State of Florida, County of Miami- S:LUbs,"bed.J>.'OO" ~... This day of aA ~ .?/ Af'7"'Z.- Si re of ublic Notary - State of Florida Notarization of Lobbyist's signature SUSANNA TIMOR FOR E Annual Registration fee: [ ] Yes [ ] No Amoun P, id Lobbyist Registration Form received and verified by: F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM 05. c of Florida, County of Mia' ......... e ..L ...~If.'.f!'t.. SUSANNA llMOR 't' ""'d f . f:~~:~i:=J MY COMMISSION # DO 650204 ay 0 ~~~:,)1 [:i::';RES: March 13, 2011 ?~ ". ~ ':/,'(;;;::\:;::., Gende', ,".,uNolarypubIlcUndarwrters ignature of Public Notary - Sta.-- _c"......... .~ Notarization of Principal's signature , ~SE ON;!R t2f1 ]7 t.f Date Paid ,.. 6~..uuu- I Page 1 of2 ,:'M~10T~' L..ommissioners ....-.... M1AYOR & COMMI\SSlONERS Business Emplovee E-Government Calend 1_lllII ' -::._ _..==~~~._..,~n_ .- -- .. ~jj' ,," - . M\;~~,",t~/;'if~"ii .,. .." ".,,:,,'" ,..,,'~~;~ ~,~f- :i."'~ :.~i.. .', ~ \,~. ,':;,,~:1"1~,1~~ ,~:::: '!r~~.J;~;~M"'jll;' Resident Visitor Thl~ City of Miami Beach Is governed by a City commission/City Manager type government. The City Com cOl\sists of six elected CommissIoners and an elected Mayor. Commissioners are elected for C3 term of fau Wit1 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 Man.,:?ger, wno overs! Cily Administration, MaYQ.rJJjlY..i.dJ~.e.J:fM[ Current term: 2005 - 2007 First elected: 2001 Profession: Attorney Telephone: 305-673-7035 Ema!l: .rmyordfe.r.mm..@..r.oi~(l1i beachfL goV ~m.m.Itii2.MLM.ilu.iJ:te.r.[e,r.i\,.e,p)flil.r Current term: 2003 ~ 2007 First elected: 1999 Profession: Commissioner Telephone: 305-673-7107 Email: lILi!tti@r.ni<;!.rnibeachfl.gov ~mmi~JiiQ.n~ current term: 2003 - 2007 First elected; 1997 Profession: Business/Real Estate Telephone: 305-673-7102 Emall: mmQD..@[!]@lI\i.P~.~~.hflgpv ~~9MLMijj'Ja,eLG..Q.IJfI!m\ Current term: 2006 ~ 2007 First elected: 2006 Profession: Attorney Telephone: 305-673-7105 Email: ~~.I@miamib8achfI.90V Vice Mayor Say.L9..r~ Current term: 2005 - 2009 First elected: 2001 Profession: Business/Real Estate Telephone: 305-673~71 04 Email: 5aul@miamiR~~~ . ,."" .."..._...".._..........., ...,.. ..,.,_",.," 'h'" ~LQn.~I..JjJJ:r.Y....l-Ihbln Current term: 2005 - 2009 Firstelected:-2065 Profession: Financial Planner Telephone: 305-673-7106 Email: j!3rry@miamibe~.\;:.bflg~ ._._.__., .._h..._._. , . iN P. 02 Page 2 of2 > lv1a)'or a L"01UlJ.U,,,",.~_....;rs r ...., ~ ~mj~~Q[J~.".rn"S.telnb,W'.g, Current term: 2005 - 2009 First el8ct8d~ 2001 Profession: Attorney Telephone: 305-673-7103 Email: richard@miamibeacQfLg.QY WSbC8st of .commission Meeting. QQ.JJ1IUj~~ipJ.LM.~tiD.9.Ag~~ .Q..Q.m~.~lQ.DJ~~..5!.ting_:.Aftec A~tiDn Rep-orts Commis!21Q.n Meetin.9_$..~.b.~&1.!.lJ~ Commission Commiti.~~ Election Information Vote Miami Beach Mayor/C.Q1IlmissiojJers. 1917 to date The Mayor or Commissioners may be oontacted by Email or by writing to: The Office of the Mayor and Commission City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 -..-......-.......-. -.'---'. -_._--._~... . . - - -- -.- -- -~..,-_.- -.--. -.-.-...-_. ..-..,.,..,.., .....-....... ..-......,' ...... .- ,,_.. -.' .,."....~.._._._.__....._- -.-......--- ".',. - ..,