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Michael J. Marrero/Mario Patronia'-' 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 rn lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Marrero Michael J. NAME OF LOBBYIST: (Last) (First) (M.I) Bercow, Radell & Fernandez, P.A. 200 South Biscayne Blvd., Suite: 850 Miami, Florida 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 377-6238 (305) 377-6222 mmarreroCalbrzoninolaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Mario Patroni NAME OF PRINCIPAL/CLIENT: Da Leo Trattoria 819 Lincoln Road Miami Beach FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 674-0350 (305) 674-0488 daleotrattoria@aol.com TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: C"7 N Q IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IIQ~UC~ CORPORATION, PARTNERSHIP OR TRUST: ~`'_' C7 l ~ r~ r° c•'~ II. SPECIFIC LOBBY ISSUE: ~- G ~~ ~.' Sidewalk cafe license issues ~~ I G ~ /I Cv~n ~~ ~ ~ _c : ~-) Issue to be lobbied (Describe in detail): ~; .. -~ ~: ~ III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: r'' ~ A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship Ci Mana er's office None Plannin Board None Ci Commission None f IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHERf A) LOBBYIST DISCLOSURE: (Required) $310.00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $310.00 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": ^ Yes X No• Are you lobbying on a present or pending bid for goods, e~uinment or services, or on a present or Wending award for goods, eauinment or service? 2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ^Yes X No: Are you lobbying on a en nding aRplication for a Development Agreement with the Citv or application for change of zoning man designation or change to the Citv's Future Land Use I~ap? 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 anot-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 X No: Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDTTURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING ALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN ~PENDIT R COM ENSATION DURING THE REPORTING PERIOD. '~ l /) Signature of LoB6yist 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~o_ntained in 2-482 of the Miami Beach City Code and all reporting requirements. ~- Signature of Lobbyist: ~ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification PRINCIPAL IDENTIFICATION: Produced ID Form of Identification Personally known (Lobbyist) 0 c ~ VII. SIGNATURE AND STAMP OF NOTARY: ~ ~. ~ ~ ~ State of Florida, County of Miami-Dade Sworn to nd subscribed before me ~g ~ This ~,~day of , 2i rq~¢ ~ Signatu a of P N ary - ate of Florida °~•s`'~ Notarization obbyist'ssignature ^ Personally known (Principal) RAFAELJ. GARCw ' ,~,v CainmiN DOWle23~ =y~~~ aa~a.a rww~ poo~.azs, ~a~R` Fbrld~NofaryAttn.,lnc State of Florida, County of Miami=l7aae""""""""""""""""` Swor d subsc ed be ore me This ~da of 'ldWl , 200 vtJ Signature of Public N tary -State of Florida Notarization of Principal's signature FOR CLERK'S USE ONLY ~ ~-7 Q Annual Registration fee: [ -'Yes [ ] No Amount Paid ~S' ~" MCR ~Da e Paid Lobbyist Registration Form received and verified by: C/ `~ Entered By: c F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc Revised 12/08/04 m City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office Tel: 305.673.741 1 ,Fax: 305.673.7254 CityClerk@miamibeachfl.gov LOBBYIST NAME: ~l (.~~~~1 ~ ~~'/V~p (~ I understand that no later than October 1st of each year, I must file the following forms, 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 Form 2) Disclosure 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, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. - I ~ a~ a ~ Sig ature: Da e: F:ICLERILOBBYIST\Lal~byist Registration Form 32708.doc