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William W. Riley/OneGroup, LLCr ,. . ' . . -.. Z 3 "J w ~ cc~-e City of Miami Beach Office of the°City Clerk . 1700 Convention Center Drive,-Miami .Beach, FL 33139 ` .LOBBYIST REGISTRATION FORM ~ . Lobbyist means all persons ernployed or retained, whether paid or not; by a principal. vvho seeks to encourage the passage; defeat or ,modification of any ordinance; resolution, action :or decision of any commissioner; any action; `decision,. ,recommendation of the Gity Manager or any city board or committee;. or any action, decision or recommendation of any city personnel during the. time period of theentire 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. . _ Riley.. ~ ~ ~~ . William ~ ~ W. ~a>. , _ NAME OF LOBBYIST:' _ (Last)- -: (First) ~ (M.I) Bilzin Sumberg Baena Price &~Axelrod LLP. 200 So. Biscayne Blvd. Suite 2500 Miami FI 33131 ' F' BUSINESS_NAME AND ADDRESS (NumbE.rand Street) (City) (State) Zip Code): ' "305-375-6139 305-35:1-2285 ~ wriley~bilzin com- TELEPHONE NUMBER: FAX NUMBER: ~ ' ~ `, EMAIL:. = " 'I:. t LOBBYIST'RETAINED BY: • OneGroup, L.L.C. ~ . . NAME OF PRINCIPAL/CLIENT:. ~ ' 1503'Buenos Aires Blvd:._Suite 181. The Villages, FL : ~ 32159 ~'.: .BUSINESS NAME AND'ADDRESS (Number and Street) (City) (State) (Zip Code) ,, ... . • ~ ,4917) 400-4200. y ~ .. - :. TELEPHONE.NUMBER:'. ~ FAX NUMBER: (Optiona) ~ 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; SEE ATTACHED ' • . IDENTIFY ALC'PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A'5% OR MORE OWNERSHIP • INTEREST IN SUCH CORPORATION, PARTNERSHIP. OR TRUST:. ,. 'll. SPECIFIC`L.OBBY.ISSUE: ; `. ' ' Zoning tissues relating#o 2377 Collins Avenue.. Issue to be lobbied (Describe in detail): ~ : ~ ~ - .III': .' •CtTY AGENCIES/INDIVIDUALS TO'BE.LOBBIED: ' A)'FuIFName of'Individual/Title. - B) Any Financial, Familial or Professional Relafioriship Planning Board and Staff no •. City Commission and Staff • _ - °• no , _ . .~ Historic Preservation.'Board and :Staff np ~ -, - v, ._d . ~ - IV. `DISCLOSURE OF TERMS ANID AMOUNTS OF LOBBYIST COMPENSATION {DISCLOSE WHETHER HOURLY; , FLAT RATE Oi4 OTHER) ,,. ~ ~ „ ;A) LOBBYIST DISCLOSURE: {Reguiied) ~ - _ . • . B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required)... _ . :._:. The following information-must be answered: 1). Pursuant, to Miami Beach City. Code Section •288 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues'`,: ~. = .~ q Yes ®Noc Are vau IobbVEnq on a.-c~resent or r~endirrg bid`for goads, eauipmerit or services, or on a present or , aendrnctaward for Qonds, equipment or service? ' ~ 2)-: > > Pursuantao Miami Beach City.C:ode 2190 Entitled "Prohibited 'Campaign Contributions By .Lobbyists On Real Estate . Development Issues": - . . f .mg, . . ' q Yes ®No: Are,stou lotibvin .o~n=a peridinq appiication for a DeveiotamentAnreement°wth the City or.agplicativn ' far. change of zoninci r'nap:desranatron or change i© 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 281 above) vuho only appears as a representative of a n"ot-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.. t q Yes ®No: Are ;you renresentina a .riot-#or-profit" corporation °or entity vvithout• speciat~_ i:ompensaUon :or ,' reimbursement? _ , - ~ , ~. • V. SIGNATURE UNDER OATH: - ON OCTOBER 1~ OF EACH YEAR, EACH L0B8YIST 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. ' .: , V. ~ .. - _ _ ' -- ~ ~ ~~ ' = '. „Signatu of Lobbyist= _ ~ V.•Ih'c.~ R.ler ~` I 'do solemnly sweaP that. all of the foregoing facts are true-and correct and.. that l have read or am familiar with the provisions contained in Section 2-482 of the Miarn Beach Ci ode and all reporting requirements.. _ ~.. w ;3 Signature of Lobbyist: V/ ' , _ .. '. ~ ", c :Signature of ~P~rincipallClient:., _. _ . o r ..--.,, <~,~~~", _ .° , .._• .' _..,, .._, . ~ ,. VL LOBBYIST IDENTIFICATION: V41i,11iam VV. Riley _ ..- • `~ PRINCIPAL IDENTIFICATIOIV: ' :~-.' _~ , ' °•, q ~ Produced ID Produced ID:~~w~.~ ~~~ '737 _'JC~'" (~(v~` C~ Form of Identification 4 Form ofldentification ' q .Personally known fbbylst) q Personally known (Pr ~^ • ~~~~ ISABELSATCHELL Vtl. SIGNATURE AND STAMP OF NOTARY: ~~ ~`~ ~~ r MVCOMMISSIONNDDS7999t" . 'I;:,~, ~ +- EXPIFES: April 13, 2013 4 ~ "~ R,~; 9onded Thru Notary PubFcUndeiwritaro State of Florida, County-of'Miami-Dade ~ State of Florida, County of Miarry`l~~ .. , ' Sworn to and subscribed before me` - .Sworn grid subscribed bef re me .. , , .This • ` ay,of .. 010 ~ . = ,This ~ y of . i 2010 .. 1 ... ._ ` ,Sign ufe i~blic Nt~algk 0t#fiIDf .lori ~ Si nat r of Public ota -State of,florida _ 9 N „Note "a o~ LPd'f~il§lf~i~1l~ri~t6p8~7 Notarization of Principal's signature EXPIRES. December,l7, 2010.; ~ z"7 / ~ - .. .. • _. ~ i ' .' :~~~: "',FOR'CLERK'S USE ONLY "" •Annu "I~ei "t~i~on ee: [ Yes Nom' Amount Paid~~~ ~-- MCR.#~~ /~/ Date Paid Lobbyist Registration,Forrri received and verified by: ` `~ ~..`., ~. _ .. ~ -~ =;F:ICLERI$ALLIMARIA-M\Lobbyist\LOBBYIST FORM°05.doc ~ ~ :. Revised' 2708704' . •. MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, - ~ www.miami6eachfl,~. '- . LQBBYLST NAME: William W. Rileyl ' f 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 alf active lobbying issues. . 1') Lobbyist Expenditure Form e . 2) Disclosure Form Failure to file these forms on ~i timely. basis will result in my name being transmitted to the Miami- ` , ~Dade,County Commissioh on ethics and for code violation evaluation. In addition, -once `an issue I have registered to lobby on has. been resoled, I am required to - immediately notify the City Clerk's Office of lobbyist withdrawal in writing.. ... _ ~ :~,- ~. ~/ ~ z~ ~o . Sign re: D MIAMI 2158322.1 7319017141 ~ "