Elizabeth Hernandez- Morabito Properties, LLC (,mot/ C /
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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 xclusions. Please refer to Ordinance 2004 -3435.
N ME OF LOBBYIST (Last) (First) (M.I)
SENT t �rr �. Sf 3►1I 9vQ . 1 F1 oor, M rim I FL. 3h 31
BU SS NA 5 1 Bz- sq E AND ADD S /( er and Street) (City) / (State (Zfp Code)
S S 31- 1 5QQQS EI i ZA-IdT1-1. Hemnnndea -E.
TELEPHONE NUMBER: FAX NUMBER. EMAIL.
A-Aermin .601V1
Please notify this office if your contact information changes: address, phone, or e-mail address.
LOBBYIST RETAINED H O R4e ITO PrOP n I es �
NAME OF P r AL/ LIENT: ^ � r � l �i� S NC'w
q o(K (J D 2
BU E A tDDD ,, S \J (Number Street) (City) (State) (Zip Code)
TELEPHONE NUMBER FAX NUMBER: (Optional) EMAIL: (Optional)
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Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] .—
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: C-, rn
�
r f �. i
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH'ORP9.RtATIOI1,
PARTNERSHIP OR TRUST: ---
C!
n.SPECIFI LOBBY ISSUE: i rn
vMue - 1-11sior �' PrOCiall •
SI Collins
C �� � P- S
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
lAY c S e r VPT1o1i RO/ rd
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 P P 9 9 pp o 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
Vv
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR
OTHER): (rl
A) LOBBYIST DISCLOSURE: (Required) \ C n H/'�, I/
„JJ J V QJ�f 1
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION) c2 S vvll( 7 Ho v / l
(Required). ��// �S/
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"
❑ Yes NZ: Are you Iobbyinq 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
Deve opment Issues
❑ Yes 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 register with the clerk as required by this section but, shall not be required to pay any registration fees.
❑ Yes No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of L... is
I do solemnly swear that all of the foregoing facts are true and correct : nd that have read or am familiar with the provisions contained
in Section 2 -482 of the Miami Be— c ity Code and all reporting require -
1
Signature of Lobbyist
Signature of Principal /CIi= t:
VI. LOBBYIST IDENTIFICATIO . PRINCIPAL IDENTIFICATION:
❑ Produced ID ❑ Produced ID
Form of Identification Form of Identification
NI
• Personally known (Lobbyist) ❑ Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
+ 0 0 ,:.!; 1 . 4, 0, DEBRA ATKINSON
State of Florida, County of Miami -Dade MY COMMISSION #DD948018 State of Florida, County of Miami -Dade
* -c_)-
Sworn ,4o ap subscribek.D9fore me i EXPIRES: April 15, 2014 Sworn and subscribed before me
This L / dd of �� // 44 Y 2011 J. � ' ",.' B o etNola Services This day of 2011
to
Signature of Public ��Notary _ State of Florida Signature of Public Notary – State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY V7111 Annual Registration fee: [ ] Yes [ ] No Amount Paid $ 3o MCR # 370 � 3' Date Paid
Lobbyist Registration Form received and verified by:
\CLER\5ALL \aFORMS\LOBBYIST FORMS \Lobbyist Annual Registration Form.cloc // Revised 1/11/2011
.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION iDISCLOSE WHETHER HOURLY. FLAT RATE OR
OTHER): A) LOBBYIST DISCLOSURE (Required) s-2 S 0 H
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION} c2 l `\ Hai( J( lu
(Required). _�
The following information must be answered:
1 ) Pursuant. to Miami Beach City Code Section 2-488 Entitled' Prohibited Campaign Contnbutions By Lobbyists On Procurement
Issues'
!/
❑ Yes 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"
❑ Yes r.9410: 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, register with the clerk as required by this section but. shall not be required to pay any registration fees
❑ Yes ,.., No: Are you representing a not - for - profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH
ON FEBRUARY 28th OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Ldbbyis
i do solemnly swear that all of the foregoing facts are true and correct nd that have read or am familiar with the provisions contained
in Section 2-482 of the Miami Be Cdy Code and all reporting requ ren ts
°'
Signature of Lobbyist -- / it
Signature of Principal /Cli /f
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
❑ Produced ID ° ® Produced ID EL t r w iAi. II( •
Form of Identification Form of Identification
❑ Personally known (Lobbyist) ❑ Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
r P„ e w as
,� DEBF?AAIIQNSON N ,,`, NZw
State of Ftohda, County of Miami -Dade µy is fpD94g018 State of Pieede. County of LL..,,,, -Dude
Sworr o ap¢- subscribekpe ! me * 4 EXPIRES: Aprit 15,2014 Sworn and subscribed before me
This ,? 1 da of If,' 2011 *n,r r t,.. Bon* - nraBudgetNotary &was This ' day of iii V r'e 2011
41 .r " ' 0 Signature of Public Notary - State of Florida Si n ture of Public ary - State of i.lorie r /Ve wyn.0
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annu Re fee: [ J Yes 1 J No Amount Paid $ MCR # Date Paid
Lobbyist Registration Form received and verified by:
zt• Revised 1/11/2011
MICHAEL SENZ .
Notary Public - State of New York
J
No. 01 SE6114952
Qualified in New York County r ,.- .
Commission Expires August 30, 2012 ' ,. ";p° - !. ..`
ter , ,
Ora ' ,,
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl gov
CITY CLERK Office CityClerk @miamibeachfl gov
Tel 305.673.741 1 , Fax 305.673.7254
LOBBYIST NAME: ' GQ � rid el
1 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.
5 3
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