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Jonathan W. Cardello - 1747 Bay Road Properties, LLC IA M IAMIBEACH I ftKI 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 2004 -3435. Cardello Jonathan W. NAME OF LOBBYIST: (Last) (First) (M.I.) c/o ADD, Inc. One Biscayne Tower, Suite 1670, Two South Biscayne Boulevard, Miami , FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 482 -8700 (305) 482 -8770 jardello @addinc.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: LOBBYIST RETAINED BY: 1747 Bay Road Properties, LLC NAME OF PRINCIPAL/CLIENT: 1747 Bay Road Properties, LLC 2200 Biscayne Blvd. Miami Beach FL 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374 -5700 (305) 847 -3354 mkramer @crescentheights.com TELEPHONE NUMBER: FAX NUMBER: (Optional) 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: Sharon Mirmelli • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: See attached Disclosures of Interest. II. SPECIFIC LOBBY ISSUE: Application for Design Review Approval for design modifications to an existing structure and the reconfiguration of the surface parking lot for the property located at 1747 -1759 Bay Road. 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 the commencement of service of City personnel to be lobbied.) A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship City of Miami Beach Design Review Board None City of Miami Beach Planning Staff None AI /0 City of Miami Beach Mayor /Commissioners None 19 :Z, City of Miami Beach Committees None 444 30 o `-f IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $ CrEr0 B) PRINCIPAL'S DISCLOSURE OF LOBBYIST COMPENSATION): (Required). $ ' (p D 0 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 ": nYes II No: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending 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 ": nYes M No: Are you lobbying on a pending 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 a not - 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.. nYes RI No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON OCTOBER 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPEND • ' ES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECE • G C LENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURE OR CO PENSATION DURING THE REPORTING PERIOD. Sig •f Lobbyist – Jonath I do solemnly swear that all of t fo egoing facts are true and c• • ct and that I have read or am familiar with the provisions contained in Section -48 of the Miami Beach City Cod • and all reporting requirements. Signature of Lobbyist: of Principal /Client: / 4 4 _ aron Mirmelli, Mana ing Member, 1747 Bay Road Properties, LLC VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ❑ Produced ID ❑ Produced ID Form of Identification Form of Identification • — • Personally known (Lobbyist) Personally known (Principal) I F I o SIGNATURE AND STAMP OF NOTARY: o , •,- ]� W O z ° - of Florida, County of Miami -Dade State of Florida, County of Miami -Dade I o Z n to and subs ribed before me Sworn t and sub cribed before me I y x 0 o i l k 21 •a of ',' , , 20010 This' day of , 2010 1 a W z ,I ature of Pu Notary – ,�.te of Florida Sig nature of FILb ry – State of Florida v , v o JV • • rization o,obbyist's s gnature Notarization of Principal's signature I z 4 ' �= TO BE COMPLETED BY CITY CLERK'S USE ONLY , /.,/, a I _ a 0 `� %,t,,; ual Registration fee: [ ] Yes [ ] No Amount Paid $ 'WV MCR # f4'I Date Paid L/ byist Registration Form received and verified by: i i / • F: \CLER \LOBBYIST\Lobbyist Registration Form 32708.doc hr / 'W' p Revised 03/27/2008 ,,;,,,os. MINOIBEAC City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax 305.673.7254 Acknowledgement of fines /suspension from lobbying for failure to comply with City of Miami Beach lobbying Laws LOBBYIST NAME: 'ITh/A CARtpf.uo 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, cis 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. 20 s 20 /o Signature: / Date: 1 _ = a n. 4W z z i D �y 0 ac 2 73 lfrac � i r m 0 ,..- ' : i ' -,'--, 1- sl r.:,,,,,' oCE9- 1:: t - I \ .9, \-, , - i i w ' u O k i 3 ' - . 2 13: ,',=', , t , 8 2 t o c i sk c"