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Alfredo Gonzalez - Car Charging, Inc.J . m MIAMIBEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 .LOBBYIST REGI8TRATION FORM L means aD persarm employed ar retabred, whether paid or ~. by a prbrdpal who aeei®to eroourage the passage, deieat a moth d enY ordinance. resdutlor~ adforr or dedsion or erry oorrsrde~er; any aC@ab dedsion, ~ of the Citi- a arhr eiq- board ar cammtaeec a eny setion, deoisioa or recarorterrdefian of arty dqr personnel during the time pedod of the er-&e dedslar-+naldng process art such setion, dedsbn a reoorrsrrerbs6an ttret foreseeaby ~ be heard or re~wed by the cdy coma, ar a ~- hoard ar oomndtbee. The term sped~lly irrdudes the prirrdpat re waU as erry employee engapad 8r IoDbyinB adiuf~s. The term °Lobbylst8' has spec8ie eooehrsbrro. Ptrese refer to Ordinarree t00434~d~ Gonzalez Alfredo J NAME OF LOBBYIST: (Last) (Ftrst) (M-0 Greenberg Treurig, P. A 1221 Bridcell Avenue, Miami Fbtida 33131 BUSINESS NAME ANn Al)nRFSS Mrrmhnr arut r,7ratM1 lt:itvl /S9ate1 Oln r:nrlel 305-379.0588 305-961-5588 gonzalezajQgtlaw.aom TELEPHONE NUMBER: FAX NUMBER EMAIL: P~e,~se noi~r thlsl~ fif y+aw ~o_Infbrmatlon changes: :abre~.:p~ron~ otKS-mall~dds: LOBBYIST t~raa®sY: Car Charging. Ina NAME OF PRINCIPAUCLIENT: 1691 Michigan Avenue, Ste. 425 Mrami Fbrida 33139 BUSINESS NAME AND ADDRESS Humber and St-eet) lCiNl !Slats) Rb Code! /3051521-0200 (3051 521-0201 TELEPHONE NUMBER FAX NUMBER (OpfionsiQ FJrIAII: (OptionaQ or • NAME OF CHIEF OFFICER. P OR BENEFICIARY: ~ICInAeI ~ct?jS~ ~~C7 • IDIMIFY ALL PERSONS HOLDING. DIRECTLY OR INDIRECTLY, A 596 OR MOB OWNERSHIP INTEREST IN SUCH-CORPORATtON, PARTNERSHIP OR TRUST: =x ~~' ~ g.~ ~~ Electric Vehlde Charging REP-47-09/10 Issue to De lobbied (Destsibe bt dew: ,3nn:, gl. `~ - ~ ' Puestmnt to Ct4- Code Seetion 2.482(9) trrehrde a afaterrurrrt of Ute extent o! any business. financial, farnigaf„ professbrml or other retatbrtship, gMng rtes to an appearence of an bnproprlety wdh arty City pereonrre! sough ~ be bbWed - itrrtlrer. pursuant tD Clty Code Section 2- 482(a)(4) include a sfaterrtent of any ContracWal releflonshtp (paid ar unpaid) from 12 months preceding said CUy personneP tmmrrrencemerrt of servke whit the Ctal to the present data. affitlng the genbal nature of the subject contractual relatlon. City Commission City Manager Ofrice ProcxrremeM / Parkir~ Dept /~ N. DISCL~URE OF TERtr18 AND AAlIOUNTS OF LOBBYIST WAAPt?ISATION (DISCL08E WHETHER HOtJRLr° FLAT RATE' OR OTHEI~-: A) LOBBYIST DISCLOSURE: (Requtrat0 400 per hour By PRINCIPAL'S DtscLOSURE (oF LOBBYIST COMPENSATION): 400 p~ hau ~gstr'~I• The following tnforma8on must be arrsw+eeed: 1) Pursuant m AAiarN Beach Cite Code Section 2.488 Entitled °Prnhr"brbed Garrrpafgn Contributions Br Lobby~ts On Procurement issueg': X Yes ^ No: A~ you lobbvina on s present or pending btd for . eoutpment or services. or on a present or pendirro sward for ooods. equipment or seniice? 2) Pursuant tD Miami Beach City Code 2.490 Entitled °Prohibited Campaign Contributions By L~byisrs On Real Estate Aevebprrrent Issues': 3) Putsuarrt to Miami Beach Ctiy Code 2-484 (h) Any person (except ttwss e~mpf from the definition of °IobbyisY as set forth ~ SeGion 2-481 above) who only app~rs as a represerrtative of snot-for-profd corp~ation or entity without special c:ornpensation ~ re6nbursement for the appearance, whether direct, ~ irviirec~ to egress support of or opposition ip arty item shag register wr~h the clerk as required by the section but. shag not be required to Pay anY registration fees. ^ Yes ~ No: Are you repre~nNrro a not-for~orofit corporation or enBty wNhout soeelal compensation or rstmbursemettt.. V. 816NATURE UNDER OATH: I do solemnly swear that atl of the 6 gotr>g facts proviaiorrs corrtairred n of e . rBnature of ignature of Prinapauaier>x ~ J S g ao 9 o g LOBBYIST IDENTIFICATION: ~ G ~~ ~ a m ^ PcodUCed ID o. ~. Form of identifi~tiOrr ~~ z ~ ~ XX Personatly known Mbbybt) `,,, gN~N1/I n L SIGNATURE AND STAMP OF NOTARY: =s°~ ~~ of Fbrkla. County of Mimi-Dade e0 and c~(rtecd/and that i have read or am famTiar with the City Code and atl reporting requinemerrts. PRINC~AL IDENTIFICATION: O ProducedlD Form ofldentiflcation 4~'. I~ePersonaly known (PrtnctPal) 3 , 20 re o c No~ry State of Florida lion of „~ ~,,,, ,~~ypr pL . Csrmen Viilegas State of Fbrida. County of NGeml-Dade ?a°`• ~' COMMissioN 8 DD981474 Sworn a~ sum before me 9 ~s fDCPIR6: APR. 12, 2014 This 31 day//of//00 .r ~ 2010 ~aerp~~~ ~~N~~,~ - '~e~ Signatrrre of Pul~lfc -State of Florida Notarizafiat of Prind~i's s~nature m MIAMIBEACH ~Y of Miami BeQdy 1700 Comerrt'wn Center Drire, Miami Beach, Florida 33139, www.miomibeachfl.gov CITY CIFRK OfFice Tel: 305.673J411 , Fmc 305.673.7254 C'rtyClerk~miamibaochH.gov Acknowledgement of fines/suspension from lobbying for failure b comply with City of Miami Bench lobbying Laws Alfredo J. Gonzalez LOBBYIST NAME: 1 understand that no later than Ocbber .1st of each dear. lobbyists subject to lobbyist registration requirements shall submit to the city clerk a sinned statement under oath listing all lobbying expenditures, as well os compensation received, for the .preceding cclendar year with regard b 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 TIME EXPENDITURE AND FEE DISCLOSURE REPORT WILL RESULT IN A F[NE QF $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-DARE COUNTY COMMISSION ON ETHICS AND PUBLIC TRUST. In the event a lobbyist fails to either file the report cnd/or pay the assessed dines, the Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust. IN ADDITION, ONCE AN ISSUE 1 HAVE REGISTERED TO LOBBY ON HAS BEEN RESOL ~, 1 AM REQUIRED TO IMMEDIATELY NOTIFY THE C11Y CLERK'S OFFI~:E/O~ LOBBY WITHDRAWAL IN WRITING. sr3~rio~o `~ _ Date: