Jimmy Moralesm i~lA,"~-~IBEACH .~~.,~L, ey
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 20043435.
Morales Jimmy L-
NAME OF LOBBYIST: (Last) (First) (M.I)
Stearns Weaver Miller 150 W. Flagler St., #2200 Miami, FL 33130
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-789-3200 305-789-3395 jmorales@stearnsweaver.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Patina Restaurant Group/Nick Valenti
NAME OF PRINCIPAUCLIENT:
120 West 45th Street, 16th Floor, New York, NY 10036
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
212-789-8145 212-789-8227 nvalenti@patinagroup.com
NUMBER: FAX
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: N1Ck Valenti
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST: None
II.SPECIFIC LOBBY ISSUE:
Smith & Wollenskv Concession Agreement
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(g) include
a statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an
appearance of an impropriety with any City personnel sought to be lobbied -- further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding said City
personnels' commencement of service with the City to the present date, stating the general nature of the subject
contractual relation.
A Full Name of Individual Title B) An Financial, Familial or Professional Relationship
City Commission N/A
Jorge Gonzalez N/A
Hilda Fernandez N/A
1
~~ ~ ,..,
/V_'
IV- DISCLOSURE OF TER, .ND AMOUNTS OF LOBBYIST COMPENSATION (L _OSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) ~ 4 ~ ~ . Q ~ per hour
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~'`~ `°`d
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B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ~ 4 0 O - O ~ per hour
(Required).
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 ENO' Are you lobbyinq on a present or pendinq bid for goods equipment or services or on a
present or pendinq award for goods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes ENO' Are you lobbyinq on a pendinq application for a Development Agreement with the City or
application for change of zoning map designation or change 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 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 ~lo• Are Vou representing anot-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 PREC DING CALENDA YEAR. A STATEMENT SHALL
BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITUR OR COMPENS ION DURING THE REPORTING
PERIOD.
ignature of bbylst
I do solemnly swear that all o~the foregoing fact re true an correct an that I have read or am familiar with the
provisions contained in Sectio 2-482 of the Mia i each City ode and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
f~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
PRINCIPAL IDENTIFICATION:
~ Produced ID
Form of Identification
^ Personally known (Principal)
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and subscribed before me Sworn and subscribed before me
This ~_day of , 2~(~~ This day of , 2009
Sig to o ublic Notary -State of Florida Signature of Public Notary -State of Florida
Notar' ation of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY LERK'S STAFF ONL
Annual Registration fee: ]Yes [ ] No Amount Paid $ MCR # Date Paid
Lobbyist Registration Form received and verified by: '
,•:+<i.E.L?a ~»<a~#.. ~s~s~'~~`~~,s..ieax:>~'.z~a ~+.~;u~$~y~.,:3:~~~~~~~: sZ~€~~3~e€.,3.~~~a a39 ~s.__>e.a;i, i, eVlSed 02~11~2009
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IV. DISCLOSURE OF TERM5 AND AMOUNTS OF LOBBYIST COMPENSATION (D15CLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) L068YIST DISCLOSURE: (Required} ~ ~ Q ~ ~ ~ Q pew }lOLlY'
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ~ 4 ~ O • O ~ per hOUr'
(Required).
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 ENO' Are you lobbying on a present or pending bid for goods equipment or services, or on a
present or pendina award for goods equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes ENO: Are you lobbyina on a pending application for a Development Agreement with the City or
application for change of zoning map designation or chance to the Citv'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 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 ~O' Are You representing anot-for-profit Corporation or entity without special compensation or
~.... reimbursement. .
V. SIGNATURE UNDER OATH:
..., l.n~r~n~n RS7 n~ rnnu vi
of
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I do solemnly swear that atl o the foregoing
provisions contained in Sec6o~i 2-482 of the P
true an~t~correct ~n~ that I hie read or am familiar with the
JENNIFER SHURDUT
~ ~ NOTARY f+UEIIC-STATE OF NEW YO
State ofFle`'~~a, County of P~a'rr~i'-'f3ade~• NCS• Q4SH61481 18
Sworn and subscr'sb{eY~d(~bJe~fo~re me Gu(~Ilflpd In Npw Ybtk Couhfy
The , tl day o~~'~ *~' 200~y Commitslon Explf~! D~eadrriiypP O8, 2B
Signature of Lobbyist:
Signature of Principal/Client: `
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
f~ Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~}' day of , 2~ O~j
Sig to o ublic Notary -State of Flog ridaCL~~
Notar' tion of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
0 Produced ID
Form of Identification
Personally known (Principal)
Sigriatulle of~ubliL`°f~lotary -State of Florida
Notarisation o€ Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Regtstrationfee: j . ] Ye9 [ ] No Amount Paid $' MCR# Date Paid
Lobbyist Registration -Form received and verified by:
F:~CiER~SALLIaFQRA7S~LUB6YZST FORM5~labbyEst Registration Farm 21109.doc Revised 02/11/2009
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Cifiy of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
CilyClerk@miamibeachfl.gov
LOBBYIST NAME: Jimmy L Morales
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 CAlerk's Office of lobbyist withdrawal in writing.
0 00
Signature Date:
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