Jose M. Jimenez - Reta Ocean Drive, LLC _,) O r4
m MIAMI
s
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.
Jimenez Jose M.
NAME OF LOBBYIST: (Last) (First) (M.I)
Stearns Weaver Miller Weissler Alhadeff & Sitterson, P.A., 150 W. Flagler St., Ste. 2200, Miami FL 33130
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305- 789 -3341 305- 789 -2682 jjimenez @stearnsweaver.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes: address, phone, or e-mail address.
LOBBYIST RETAINED BY:
Reta Ocean Drive, LLC
NAME OF PRINCIPAL/CLIENT:
1236 Ocean Drive, Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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: _
o
Refik Cevik; Tacettin Yildirim
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SU47KCOSWRA N,
•
PARTNERSHIP OR TRUST: Refik Cevik; Tacettin Yildirim
.r- ""
u.SPECIFIC LOBBY ISSUE: Cl;
Conditional Use Modification - 1236 Ocean ° ..
Issue to be lobbied (Describe in detail):
M. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED: `
Pursuant to City Code Section 2- 482(a)(4) include the commissioner or personnel sought to be lobbied, and whether the lobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date, stating the general nature of the subject contractual relationship.
Sec 2- 482(a)(4) Full Name of Individual and Contractual Relationship (Explain) YES NO
title of person to be lobbied
Planning Board None x
Pursuant to City Code Section 2- 482(g) Every registrant shall be required to state the extent of any business, financial, familial or professional
relationship, or other relationship giving rise to an appearance of an impropriety, with any current city 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
5r
x
IV. DISCLOSURE: OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR
OTHER»
A) LOBBYIST DISCLOSURE: (Re $225 / i ir.
8) PRINCIPAL'S DISCLOSURE (OP L.O8BYIST,QM SATION):
(H.quIrad). r
The following Information must be answered:
1) Pursuant to Miami Beech City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement
Issues':
Yes f into: Are Nap lobbvina nt qr send ea or n a t resent:Qr i endin
award fo f geode. eoutamettf or ee MCa4
2) pursuant to Miami Beach Clty Code 2-40o Entitled 'Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues": • NI . P N. • • • . . : ,:t. I. ....11 i • r: •m -n As -. :m: .t i . a.' •, f.r
h.nre • • Inn ma. •e•I!natl•, • t an : - t. h: Oft - . Jo -n.. .eMe.
3) Pursuant to Miami Beath City Code 2 -484 (h) Any person (except Moue exempt from the definition of 'lobbyist" as set forth in
Section 2-481 above) who only appears ee a representative of a not - for -profit corporation or entity without spools)
compensation or reimbureeMent for the appearance, whether direct, or Indirect, to expre9s support of or opposition to eny
Rem, shall regieter with the clerk as required by this section but, shall not be required to pay any registration fees.
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V. SIGNATURE UNDER OATH: •
• N FEB • - 28 h O EACH • c ACM • :: 1ST 8.: _ ; 8MI • THE a LERK ;, ; _D = - ; EME T . • _R
• La LI..i 1. OB: . PEN! II L = • -- .ELL •8 •. •...:AT •. R °CEI • T.H a •1= ,, • t, :EA. , •
THE PRECEDJt'G CALENDAR YEAR..: - • T ME = .: L B - -D E A 1-1 - _ - _ B A ■ • PIP >, • 1 C E; OR
COMPENSAT!9 .PUKING THE REPOftjl�r3 PEiIISLD_-
i ?I4( L
S •n. u . of •b.ytsl
1 do solemnly swear that ell of the foregoing facts are true and correct and that Have read or am familiar with the provislons contained
in Section 2-482 of the Miami Beach City Code end all reporting requirements.
Signature of Lobbyist:
Signature of Principal /Gllent: . .i � ,..!...2" VI. LOBBYIST WENT! > � PRIM OPAL IDENTIFICATION:
El Produced ID - g Produced ID
Form of Identification Form of Identification
P. Personally known (Lobbyist) ❑ Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
\ a ,
State of Florida, County of Mlaml -Dade ztOTARY PuBLIC - STATL OF FLORIDA State of Florida. County of Misml -Dade .
Sworn to 4nd subetxibed before Me "� `1'a laml t;a ]atY:O gyno a�¢ subsc b efor e me .,« Cp ?� '
` c , ,
This 17th day of March . 2011 Commission #DD949634 This 17tllday of MarJ1 , 2011 9�s'i0�� 0
( . D _ _ - . ,,' *,,, Expires: JAN.03, 2014 c��fr� r,+� A c
Boon THRg 4/11., sizoixa rd.erc c cr....._ ^r. (7 a:4A).640
$Ignature of Public Notary — State of Florida Signature of Public ary —State of Fi tr des 0
NotatlxaUon of ,Lobbylst'e signatory Notarization of Eripswes.. signature • ? 0
g TO BE COMPLETED BY CITY CLERK'S STAFF ONLY •
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MIAMIBEACH
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
LOBBYIST NAME:
Jose M. Jimenez
O
I understand that no later than February 28th of each year, I must file the following
form, 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 and Compensation 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 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.
3/17/11
at e Date:
�9