Ralph Choeff - Jeff Menzel MIAMIBEACH
a •
City of Miami Beach Office of the City Clerk frk
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 spedflc exclusions.
Please refer to Ordinance 2004 -3435.
Choeff Ralph
NAME OF LOBBYIST: (Last) (First) (M.I)
Ralph Choeff Architect, P.A. 8425 Biscayne Blvd. # 201 Miami FL 33138
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 892 -6262 x 11 (305) 613 -4516 rchoeff@choeffarchitect.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact inforntation changes: address, phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Jill Menzel
NAME OF PRINCIPAL/CLIENT:
49 Palm Avenue _Miami Beach FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305 -588 -1616 •
TELEPHONE NUMBER: FAX NUMBER: (Optional) 6rMIE: (00301MI)
Fill out this section if prindpal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
•
II. SWIM LOBBY I551,
Historic preievalian and design review approval.
Issue to be lothled (Describe in detail):
III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2- 482(a)(4) include the commissioner of personnel sought to be lobbied, and whether the lobbyist
has entered Into contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding
such person's commencement of service with the dty to the present date, stating the general nature of the subject contractual
relationship.
Sec 2482(0(4) Full Name of Individual and Contractual Relationship (Explain) YES NO
title of person to be lobbied
William Cary & planning staff, HPB, DRB, City �q x
Commission i140 $tSi431
80 :Z Wd 8- dVN
Cl3AIJ3
L
Pursuant hall be required to state the extent of any business, financial, familial or
pur to city Code Section 2- 482(g) Every registrant s req
professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current ci ty commissioner
or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed.
Sec 2.482(g) Any Financial, Familial or Professional Relationship
None.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) X25.000
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $25,000
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 ":
0 Yes X No Are you lobbying on a present orpendina 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':
■ X 0: i1' • _ ... 1.. • .n. ,.,i .1 . • • • . e _7C,: 1 • 1 i1 .% • • .•I.5'.
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..
U Yes X No: Are you representing a not - for -profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL S ' , . • TH _CITY CLERK A SIGNED STATEMENT
UNDER OATH. LISTING LOBBYING EXPENDITURES. AS WEL ( • PENSATION JtECEIYED, IN THE�ITY OF
MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A _t �'1 I- _ : g L _ • , : _ , . l ' _ ■
NO ,.P • i .E: • •MP 1 .: 1 • 1 • L. _L ' • r - 1 - h.•,
ill -t
Signature of • . • - ...-A
I do solemnly swear that all of : for ring f- • i - rue and correct and that have read or am familiar with the
provisions contained in Secti• 4 '; 2 . 1i l o : rau • . • City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal /Client: a. , , '•'
. LOBBYIST IDENTIFICATION: 1 eRI NCIPAL IDENTIFICATI N:
n Produced ID Produced ID Ft. OIL- 64 SA-Y- Y 7 -4 /i r'sP -o
I I 1 Form of Identification Form of Identification
i Personally known (Lobbyist) 0 Personally known (Principal)
17.11' c • . SIGNATURE AND STAMP OF NOTARY:
to Pv
: of Florida, County of Miami -Dade State of Florida, County of Miami -Dade r° A na Nota Public State of Florida emandez
rx . n to nd subscrib efore me Swom and su •- ri • •before me tl y ' a My C omm i s o n DD668383 +
T s 1 da 20 This y . r ' �_ i '+ o
__ Y � o, •° Ex. Tres 04 /29/2011
4 •), ■ , 'r; tate of Florida Signature .f • • •lic Notary — • -te of Flori w
it :., .. ,... , rl atlon o - f byist's signature Notarization of Prindpal's ', nature i
`°"'°°`' FOR CLE 'S USE Orgy
Annual Registration fee: [ ] Yes [ ] No Amount Paid
CR # ��� /Q. pa �/
Lobbyist Registration Form received and verified by: Entered By:
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1" - ie Revised 1/11/2011
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
LOBBYIST NAME: R'ii p it Cf o1i?
1
I understand that no later than October 1st of each year, 1 must file the following J
forms, pursuant to Section 2 -485 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami -Dade County Commission on Ethics and for code violation evaluation.
In additio. once an issue I have registered to lobby on has been resolved, I am required
to i r ed e ely notify the City Clerk's Office of lobbyist withdrawal in writing.
1
t g atur 1 Date:
F:ICLERILOBBYISTILobbyist Registration Form 32708.doc