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Ines Marrero-Priegues - Pestana Miami LLCi i I j -- j ity of Miami Beach Offi a of the City Clerk 1700 onvention Center Drive Miami. Beach, FL 33139 LOBBYIST REGIST TION FORM I Lobbyist means all persons employed or, retained, whether paid or.not, by a pri cipal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, faction or d cision of any commissioner; any action decision, recommendation of the City Manager or any city board or committee; or any action, Ide~cision or recommendation of any city personnel uring the time period of the entire decision-making process onl such action, decision or recommendation at foreseeably will be heard or review d by the city commission, or a city board or committee. The; term specifically includes the ,principal as IL as any employee engaged in lobbyin activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. N~ARRERO- I IRIEC~JES j IVES I NAME OF LOBBYIST: ~ (Last) (First) (M.I) HOLLAND & KNIC-~iT ALP, 701 Brickell A e., Suite 3000, Miami, FL 33131 .BUSINESS NAME i ND ADDRE S~ ,,(Number and Street) (City) (State) (Zip Code) t (305) 789,--77,76 " (305) 679-63 5 ines.marrero,![hklaw.co~n I TELEPHONE NUMBER: j FAX NUMBER: EMAIL: .. - ._ ,. Pleasenofify this office i your contact information hanges: address, phone, ore-mail addlress. I. LOBBYIST ~ETAINE BY: ~I I PESTANA„MIA1~.1 I NAME OF PRINCIPAL/CLIENT: Grupo Pestana, a Jau,' 54, 1300~~-314 .Lisboa., Portugal I BUSI~~~B-I~'~E~~ J i e~ ~ (Number and Street) (City) (State) (Zip Code) I TELEPHONE NUMBIE i : FAX NUMBER: (O tional) EMAIL: (Optional) Fill out this section ifl p i incipal s a Corporation, Partnership or T ust [Section 2-482 (c)] ~. • NAME OF Jose C HI Ro EF OFF ctue CER, PARTNER, OR BENEFICIAR • IDENTIFY SUCH C I i i A P i LLI i i PERS RATlO NS HOLDING, DIRECTLY OR INDI ,PARTNERSHIP OR TRUST: ECTLY, A 5% OR MORE OWNERSHIP INTEREST IN n.SPECIFIC LOBBY I SUE: Renovation of pr rty a l j t 181735 J s Avenue Issue to be lobbied Describe in et ~(~ f I ail): ul. ,CITY. AGENCIES/I DIVIDUALS TO BE LO BIED: Pursuant to City Code Section 2-482(g) include a statement of the extent o any business, financial, famili I, professional or other relationship, giving rise to an appearance of an impropriety with any City personnel sought o be lobbied -- further, pursuant to City Code Section 2- 482(a)(4) include la statement of any contractual relationship (paid or unpaid) from 12 months recedin said. Ci p g ty personnel commencement o service with the City to the resent date, stating the general nature of the subject contractual relation. i II A Full Name of Individual Ti e B Financial, Familial or Professional Relationship Historic Prleservat'on Board None IIII Board of None ~~ ~~ I' IV. DISCLOSURE OF TE MS AND AMOUNTS OF LOBBYIS COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER) A) LOBBYIST DISCLOSURE: (R quired) $395 per hour B) PRINCIPAL'S D IS CIL I ©~ OSURE O,F LOBBYIST COMPENSATION): ~~~ (Required). I I ~ s • The following in o rm I ation ust be answered: 1) Pursuan t to M ~ iami B ach City Code Section 2-488 E titled "Prohibited Campaign Contributions By Lobbyists On Proc u ~e m ent Iss es": ^ Yes ®No: A re ou to b in on a resent or endin bid for oods a ui ment or services or on a res ent or a din award for oods a ui ent or service? ~~ 2) Pursuant it Real Esta I ' oi Miami B ach City Code 2-490 Entitled " rohibited Campaign Contributions By Lobbyists On te Develo ment Issues": ^ Yes No: A re , ou to b in on a endin a licati n for a Develo ment A reement with the Ci or a ' 'li cation fo chan a of zonin ma desi ation or chan a to the Ci 's Future Land Use Ma p? I 3) Pursua t t o Miami each City Code 2-484 h An erson exce t those exem t from h () P ( p p t o definition of "lobbyist " a s set fo h' in Section 2-481 above) wh only appears as a representative of anot-for-profit corporat indirect ion to or entity without special compensation o reimbursement for the appearance, whether direct, or express support of or o osition to an it h ll i t i , pp em, s a reg s er w th the clerk as required by this section b ut, slhall no b,'e required to pay any registrat on fees. ~p`''~ I I vec~ A 11-Iw. / ~I w . Iw.. ~w wow .-a: _~ 1_- _ri ... ... _ _ . i -. ~~ . .i V. SIGNATURE UNDER ATH: KEGEIVED IN TINE CITY O MIAMI BEACH FOR THE PR CEDING CALENDAR YEAR. STATEMENT SHALL BE FILED EVEN IFI THERE AVE BEEN NO EXPENDITU ES OR COMPENSATION D ING THE REPORTING PERIOD. ,. I Q ~^" Signat of Lobbyist Y , I do solemn) swear that all f, the foregoing facts. are true a d c rect and that I have read or am familiar with the provisions contaii ed in Secti n th~ i~ ~ each Cit ~ e and ail reporting requirements. 1 A / l /1 Signature of Lob i yiit: ' ~- ~l~ E Signature of Princ ipal/Client: I t„` ~a,c~ VI. LOBBYI i S i IDENTI ICATION:; PRINCIPAL IDENTIFICATION: ^ P d ( I d ro uc ID ~ Produced ID F rm of Identification Form of Identification j ~ Person I ly known ( obbyist) Personally known (Principal) VII. SIGNA IRE AND TAMP OF NOTARY: _ State of Florida, Sworn to ands t~s I I l ~ ,,~~ ,"•,•• J061115 N. DEWEY o f Mi mta~ State of Florida y, MY COMMISSION # DD 606162 y State of Florida, County of Miami- e $r' e ~~I~ms 2010 - `r EXPIRES: October 17 Swor d b T c~' , . n a su scrib d fore me 20 BondedThru Notary PubNc Underwrites ' Co,r>~~i0n DD663520 This ~ Of ( ~ I , x fires 0611512011 .. Signature of Pubi Notarization of c Notary - tate of Florida S' n ture of Publi o ry -State of Florida otib` fist's ignature ~ ' Notarization rinciual s signature ~ . I~ ' TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registrati r Lobbyist Registra i ~ i fee: [ - j es [' ) No Amount Paid- D -' MCR # '.Date Paid on Form,re elved and verified by --'-' F:pct.ii*RI~ALt.laFO t ws~t_oi~i~Ya T FoaMS~Lobbyisfi Registrat€on t~or 2010.doc wised 05/0 /2010, I ~ f~ 'P i ~{ ,. 1 I I' I I i City of Miami Beach, 1700 C nyention Ceinter Drive, Miami Beach Florida 33139, www:miamibeachfl.gov I~ CITY CLERK Offic f j CityClerk@miamibeachfl.gov Tel: 305.673.7411 ,Fix: 305.6 3'.7254 ~~ i ~ ~ ~ . E ~~ ~ ~ f i ' 4 j i LOBBYIST ~E: ~ ~s M~-P ~ s, EsQ. {, I~~ I I~ understand that; no I -ter than ~ Februa 2 of each ear, I must file the following form, pursua ~t Ito Sec ion 2-485 of the Mia i Beach City. Code, with the City Clerk's Office for all a ~tive to hying issues. l) LobbyistlExpen iture and Compensation Form . I j Failure to fil ~ these fo ms on a~timely basis will result in my name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. ~~ ~ j ~ j In addition, once an i sue I have registered to obby on has been resolved, I am required to immediatelynotify t e City Clerk's Office of obbyist withdrawal in writing. i i . ~ v g ~~ ,, Signatur ~ ~ ~ ~~ Date: c i i i