William W. Riley, Jr. - CG Florida Properties, LLC 9
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.
RILEY WILLIAM W. Jr..
NAME OF LOBBYIST: (Last) (First) (M.I)
Bilzin Sumberg Baena Price & Axelrod LLP . 1450 Brickell Avenue, Suite 2300, Miami 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code)
305 - 375 -6139 305 -351 -2285 wriley @bilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
CG Florida Properties, LLC
NAME OF PRINCIPAUCLIENT:
404 Fifth Avenue, Suite 600 New York NY 10018
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
646- 230 -9360
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: Joseph Chetrit
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP
• INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
•
11. SPECIFIC LOBBY ISSUE:
All land use /zoning matters regarding application for property at 1220 Ocean Drive, Miami Beach, FL
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Historic Preservation Board and staff n/a
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER)
A) LOBBYIST DISCLOSURE: (Required) $435/hr
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $435/hr
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 ''JNo: 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 '\iNo: 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?
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3) Pursuant to Miami Beach City Code 2 -484 (h) Any person (except those exempt from the definition "lob�,#grist "` set
forth in Section 2 -481 above) who only appears as a representative of a not - for - profit corporation4pr eotfty wwtfibut
special compensation or reimbursement for the appearance, whether direct, or indirect, to express sort of)or
opposition to any item, shall register with the clerk as required by this section but, shall not be recOred la- pay;ty
registration fees.. --.1) ,
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❑ Yes 'N/No: Are you representing a not - for - profit corporation or entity without special conens'Sron`" +i ,
reimbursement? -,,, N
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V. SIGNATURE UNDER OATH:
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ON FEBRUARY 28 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. e/
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Si ture of Lobbyis
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions
contained in Section 2 -482 of the Miami Beach City a and all reporting requirements.
Signature of Lobbyist: / ‘ ‘ i Lt
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Signature of Principal /Client:
VI. LOBBYIST IDENTIFICATION: PRINCIP , A EN FICATION:
❑ Produced ID D Produced ID
Nta Form of Identification Form of Identification
Personally known (Lobbyist o cox;P49 EUZABETHORTIZ ' Personally known (Principal)
i * MY COMMISSION # EE 043223 LOIS HUTTER SANCHEZ
VII. SIGNATURE AND STAMP OF 1i1'(; ',; : EXPIRES: December 17, 2014 Notary Public, State of New York
, ,:', r No. 01HU5042516
Nor F,00 Banded Tduu Budget Notary Services 1040 trap%' Oviti4vt
State of Florida, Q
County of Miami -Dade State of Fdo ,County of Atli; a mi ssion ualified in Queens County Expires April 24, 2bf
Sworn to and subscribed before me Sworn and subscr" • ed before me
his - day of 0 et"" 20 /1 This IX. d y of 201
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Signature ublic Notary — tate of F , ida Signature of Public Notary — Stat- of Florida
Notariza % of Lobbyist's signature Notarization of Principal's signature
FOR CLERK'S USE ONLY /
Annual Registration fee: [ ] Yes [ ] No Amount Paid 3 5 () --- MCR # Date Paid / A
Lobbyist Registration Form received and verified by: % owl A 1 ` yr ' Revised 05 05/, 010
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MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,
www.miamibeachfl.gov
LOBBYIST NAME: William W. Riley, Jr.
I understand that no later than October 1st of each near, I must file the following 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 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— �c
Sign re: Date:
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MIAMI 2666385.1 7000060139
8/18/11