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Alan Faena - The Faena Group MIAMI BEACH 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. Faena Alan NAME OF LOBBYIST: (Last) (First) (M.1) The Faena Group 3201 Collins Avenue Miami Beach FL 33140 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.535.3009 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone,or e-mail address. I. LOBBYIST RETAINED BY: The Faena Group NAME OF PRINCIPAUCLIENT: 3201 Collins Avenue Miami Beach FL 33140 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305.535.3009 TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Fill out this section If principal is a Corporation,Partnership or Trust[Section 2482(c)] • NAME OF CHIEF OFFICER.PARTNER,OR BENEFICIARY: • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION. PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: Faena District Zoning Overlay Issue to be lobbied(Describe in detail): III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the present date stating the general nature of the subject contractual relationship. Sec 2-482(x)(4)Full Name of Individual and Contractual Relationship(Explain) YES I NO title of person to be lobbied Planning Dept., City Commissioners, City Mayor none x 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. Sec 2482 Any Financial,Familial or Professional Relationship none F:\CLER\$ALL\aF0RMS\L0B13YIST FORMS\Lobbyist Registration Form.doc i IV. DISCLOSURE OF TERMS AND AMOUNTS F LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) /4S B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION). (REQUIRED).w5na -i 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": _Yes✓QNo: 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 Miami Beach City Code Section 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes QNo: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map desianation or chance to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2-482(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. _Yes[]No:_Are yyou representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 OF EACH YEAR,EACH LOBBYIST SHAL UBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS Cdf P NSATIQ EC VED IN THE CITY OF MIAMI BEACH FOR PRECEDING THE C D YEAR. A STATEMENT SHALL ILED E N I HERE H VE BE N O EXPENDITURES R COMPENSATION DURING THE REPORTING PERIOD, Signature Lobbyist + do solemnly swear that all th foregoing facts are true and co ect and that I h e r ad or am familiar with the provisions contained in Section 2482 of the Miam Be ch Ty Code and all reporting re uirements. Signature of Lobbyist: Signature of Principal/Client: y 1 ,0.0.4 A�2 VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: _Produced ID _Produced ID Form of Identification Form of Identification XPersonally known(Lobbyist) X Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: tFAr v� •.4¢ BARBARA T YEE State of Florida,County of Miami-Dade * MY COMMISSION I EE 121637 State of Florida,County of Miami-Dade Sworn to nd subscribe f re me s�+ �� EXPIRES:August 15,2015 Sworn d subscnb d afore me 1 This da of of. 12014 20`� rfoFFL� 8ortded Tlvu 13uttgel Abtiry Saveoa s day of —, 20 % 6V rAAN 20 o`'a*p"�4 BARBARA T YEE n Ure otary State of Florida Sig toe lc ary—State of*I * MY COMMISSION 0 EE 121637 Notari ion of Lob is s signature Notariz n of Principal's signature t EXPIRES:August 15,2015 ��OF FL�� 8"oded ft dgBt N0 p Svvke3 TO BE COMPLETED JX CITY CLERK'S STAFf ONLY Annual Registration fee: ( ]Yes( )No Amount Paid$ MCR# Date jPaid Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORM5\LOBBYIST FORMS\Lobbyist Annual Registration Form.dot Revised ii/ 8/2013 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 1 Jrr City of Miami Beach, 1700 Convention Cerner Drive.Miami Beach, Florida 33139,www.miamibeachfi.gov CITY CLERK Office Rafael E.Gronado,City Clerk CityClerk @miamibeachfl.gov Tel:305.673.741 1 , Fox:305.673.7254 LOBBYIST NAME: Alan Faena I understand that no later than February 28 of each year, I must file the following form, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) LOBBYIST EXPENDITURE AND COMPENSATION FORM Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby on has been resolved, or I am no longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2-485 (d),the City Clerk shall notify any lobbyist(or principal)who fails to timely file a Statement and in addition to any other penalties which may be Imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. Any to byist, who fails to file the required Statement by April 30, shall be automatically suspe ed from lobbying until all fines are paid, unless the fine has been appealed to the MI ml ade C n Commission on Ethics and Public Trust. Signat re Date FACLERI$ALL1aF0RMSIL0BBYIST FORMS\Lobbyist Registration Form.doc _ { yy 4r•_ mn R CL A. ._ . : VIP _ al. • 06 a ' sum � CL 3 - LR _ - -' -_ �_ � _ - _ -dam" +rr• � - A t rN yW r ' AM _ :�'�+ ° _