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Timothy M. Nardi - GMBHAm MIAMIBEA.CN ~nof= ~'o~. B71-~ City ofi Miami Beach Oi~fice of the City Clerk 1.7aQ Conwentiorl Center Driue, Miami Beach, FL 33139 #~OBB1fIST REGISTRATION FORM ' E.oioby~st. rnean9 all perscros employed a retained, whether paid or not, by s principal wl'lo seEk4 fi encourage fire passage, det~eit or maitfiaation of any ordiRsnee, resolution, action or C!®Cis~on pi any oammissiorrer any action, decision, recommendation of the City Manager yr eny ~ eoartl or committee: or any actfan, decision or recornmendaiion of arry city personnel dttrirrg the time period or the entire decision-making process on such Actief'~, Gecfsion yr recommenGation Ihet forDly Will ire herd. or reviewe4 by the city commission, or a city ooard Or oammitt66. ,The term sp2tific~lly irlc~udes thte prinopari as well ss any e+maoyee e~+gaged rn IoDbyfrtg acttvfti2s. "tire t®mla "l.obl~ylata" na3 spectile erceluslor~a. Please referlp Qrdtnance 2004-3x35, _ NAME OF LOB6YfST~: •I~ {Last) f ~~ (First) T~ I(IVI I)?~ I ~ ~~ ~ ~ BUSINESS NAME ~1ND ADDRESS ICI I I 111~~. RA 7EInEPHONE NUMBER: i. BBYIST RETAINED Blf: ~/ giber and Skreet) .~~ s -.~ . FAX NUM6EF~. (C~) ~~ J I (State) ai D~ (/zip Code) ~-~, FMAIL_ ~ ,~c1;fPf ~~E.... NAiU4E 1= PRINC PALICt.IENT: ___--~~ ~~ /'''~/~'~~ -- gt~ fNES N , ND A DRESS (Number and Street) (City) (State) (Zip Code) ~~- 7El,ERHONE NU1ti11BEF~_ FAX NUMBER: (Otrtiortiat) EMAIL: 0 oval) Fill out this secri~rn i# principal 1s a Corp~orAtiOt1. Partnership or Trusi [Section 2.482 (c)] a NAfV1f°. Ot= CHIEF OFFICER, PARTNER, OR Bi=NEFICIARY: • IDEIYTI~ALL PERSONS Ht7LDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE CWNEf2S!-IIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST. ~F~C LOBBY iS~UE: Issue to be lobbed ( ascribe in cietall): m. CITY AIG~(~CIESIINDIViDUA~LS TO BE LOBB1BIa: P~ursuantto City Code~SeCtipn 2-452(g) include ~ $taCamant of the extent of any business, financial,. familial, protesslanal or other relatlonshlp, giving rise to an appearance of an impropriety Wirth any Clty personnel Sought to be lobbied -- further. pursuant to Cltjr Code Section 2- d8~(a)(4) includ®a sLatsrnant ofi any CorwtiraCtual relationship (paid or unpaid) from 72 rt~onth9 preceding ~safd City personnel' commencement of ~rvlce with the Gity to the present date, stat3rag tkte general nature of the subf ect corrtractual relatloll. A .Full NA111e of Irtdi~d~ual tle B) Art Financial. Faimilial or Professional RelErtion9hi U~ ~ ~~~~~C~~~~- J .,,~ ~.- > > ~~ ` ......p - (~/. ~0^y~(iLL?~~J{-2~"Cl~; F ~I'C6YIJ HIV V HIVfV~iN 1 -~1 V.P 1-vCfo ~ W ~ ~vn~~ ~~.a~.-~ ~ ~v~~ Svivv-vv-. ....- -.~ , - - - ` ~ ',~}, ~LQBSYIST pISCIOSURE: ~Req~ired} ~" ~) PPINCIPAL'S D1SCL©SURE (OF L,OBBY~~C011/1P~,I~SATION): ~~ f;Requ~r~d)_ ~ - ------ ,. 'The fallowing inforrrtatRan rhdst tie ar~*yrnrer~d: 1) l Pursuant to Miami Eeach City Code Section 2488 Er;kitled "Prohibited Campaign. Contribt,tions 8y Lobbyists - ... On Procurement 'issues"; .No: Ars u~ iobb in on a resent or endir~ bid for oods a ui mentor se~-r'cea or on_a ®s ,. _ _ . present or• pe~dwnq avlrard fat' goads, ec~uiyment o servile©~ . 2) 'Pursuant to Miami Beach'Cit~r Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On ,~ ~ ~ ~ Real estate Devefoprnent issues", - Yes 1N ~ro au~idbb on a endin a ii ation.#or~a~ D~eveFo a roemen~ with a Ci ar ` ; ~ - ~,pptiicafion for change: of zoning map designation or change to the Cit~r's Future_;>Land~l~e. 3) Pursuant td Miami t3eacll City Code 2-34 th) Any` person (except those exerrzpt .from the definition of ". "lobbyist" as set "forth in. Section 2-481 af~vve) whfl onl~r appears as a repr®sentative. of a n~o~t-fior-praf~ evrporafion or.entity "without .special cor"npensation or relrnbursement 1'vr. the~appe~rance, whether direct, or indirect, to express. support ofi or opposition .to any item,. ~tiall register with the clerk as required. by this " section but, sF+all not be required to pay any registration fees. . " ~Ye~s Na: r - ou re re9entlr~ ~ o ~-for- roft cor ors o Q wi out. s ecial. co f~ion or u. ' S'1GN~TURE UNDER 4ATk~; ' O~1_OCTOBER 1~ OF E,AC~I YEAR, EACH ~LOBS'~f1iS7 SHALL. ~SU6MIT TO THE _Cl~' CLEF~K. ~. SiGNED ST,~TEJ,I~ENT• ..U;NDEI~._Q TH, LISTIFVG LO~I~YING EXPENDITURES, AS , WELL_._AS COIUIPENSA~T,iON - RECEIVED iN ~ CITY OF MIAMI ®E CH O THE PRECEDING CA NDAP~YFA STATEMENT SHALL BE ;FILED E1/~N ERE HAVE BEEN- O E DITURES dR NCO 'PENSATION ti G TWE f~EPORTING PERIQD. ~ , _ ~ Sign6Cure of L hby~st - l do so r. hit lemnly swea t all of the foregoing #ac are true and correct and that.l have read or am #am~l~ar wdh the ' provisions contained in Section 2482 Mi ~ each "City C~~e and ail reporting requirements. Signature of Lobbyist:- .. Sign N~ Fto~o ~ Notary Pudic -State of Florida lfl. i~b~J~6~~llor l2.2di2 _ ~ 2, 2012 - C+sion ! 00 >s3T115 Commission ~ DO 837115 . ' cedes' If~iortai Notar Assn.. Throupfi National Notary Assn: , . _ o e i ~ r~" ~ Form of identiification . • ~ PersQr.~afl-y--known~~~.o~bby~st) Personally known. Princi al) ~ ~. °. ~ ~ r . 1ftl. •SIGNATURE ~ANf3 STA~YII' 4~ NOTARY. . • ~ Stag of F4orida, County of l~liarnispade ~ ~ State o€ Florida., County,a€ Miami-Dade ' Sworn to end subscribe before me - Sworn, , c~,subscrib~c~befare me This ~~ ~'" day of " , 2Q1a . Thi day of ~.1, ; 2b'i0 r ~ • Signature of Putilic Notary - Sts#e ,o€.Florida Signature of ,Public Notary - State of Florida Notarization of Lobbyist's si Dature -~- ' ~-- . g . ~ ~ " 1'~otar ixafion of Principal's signatr~re ~d/~ r~~ ~ ~,~'O ~ ~ "/' TO BL± CQMPLETED $Y. CITY GLERK'S STAFF ~NI.Y Aranusl Fle,~is#ration f®e~: [ . 7 Yes [ J No RmGUnt I'~aid $ MCR ~! .-----'~ . Dak~ 'Paid - ~.obbyist Registration Form r~coiv~d and veri>lied by: .. :~~6:c~~~;,~~,~\r~l~a~h'~SjLrJ~l~1(.~.S~ f~,R;~~S~i.oY~byasr ~~c~~s'~.-~a~ion roan: 2tA?~.ci-oc fj~(f! ~y Reltii5~t! 0~~~'~~~010 m MIAMI~E,~~t~ City 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 CityClerk@miamibeachfl.gov Acknowledgement of fines/suspension from lobbying for failure to comply with City of Miami Beach lobbying Laws LOBBYIST NAME: I I/1~1 I understand that no later than October 1st of each year, lobbyists subject to lobbyist registration requirements shall submit to the city clerk a signed statement under oath listing all lobbying expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which the lobbyist has been engaged to .lobby. A statement shall be filed even if there have been no expenditures or compensation. during the reporting period. The statement shall list, in detail, each expenditure by category, including food. and beverage, entertainment,. ~ research, communication, media advertising, publications, travel, lodging and special events. Failure to timely file the expenditure and fee disclosure .report will result in a fine of $.50.00 per day. Any lobbyist who fails to file the required expenditure report by December 1, shall automatically be .suspended from lobbying until all fines are ,paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. In the event a .lobbyist fails to either file the report and/or pay the assessed fines, the Clerk shall notify the Miami,-Dade County Commission on Ethics and Public Trust. 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. sy~ow,e Gt jrrh