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Joseph Z. Fleming - La Gorce Island code/flags Q MIAMI BEACH 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 pas sage,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 foresesably 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. Fleming Joseph Z NAME OF LOBBYIST: (Last) (First) (M.1) Greenberg Traurig, P.A 333 Avenue or the Americas,44th FI Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-579-0517 305-951-5517 flemingj(Qgtlaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: P/ease•rlotiTy fhls•�fflce Il.yourC6'tact,Ir formaltibn,changes;:address,;phone,.ore-mail address{ t. LOBBYIST RETAINED BY: Dr. M. Lee Pearce r NAME OF PRINCIPALICLIENT: BUSINESS NAME AND ADDRESS (Number and Street) (city) (State) (Zip Code) c!o 305-579 4517 TELEPHONE NUMBER: FAX NUMBER:(Optional) 'EMAIL:(Optional) Fill out this section If principal Is a Corporation,Partnership or Trust[Section 2-M(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., "~ N II n C Le Gorce Island Issues relating to Code Enforcement and temporary flags for C:!;fy ften Issue to be lobbied(Describe In detail): f J -e M r-0 Pursuant to City Code Section 2.482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lob yls an into any contractual relationship (paid or unpaid) with saW city commissioner or personnel from '12 months p arpcommencement of service with the ci to the resent date stati the eneral nature of the sub ect contractual relatlonshi Sec 2.482(a)(4)Full Name of Individual and Contractuar Relationship(Explain) -r, IN W tide of person to be lobbied — W Cit '"kana er Planning Staff Planningrn Board, City Attorney, City Commissioner Pursuant to City Code Section 2482(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 forth filed. Sec 2-482 Any Financial Familial or Professional Relationshlip { ;. 1 A0 j n y 7 F:ICLERI3ALLIa FORM SILOBBYIST FORMS1Lobbyist Registration Form.doc LL '01 I V IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): < 1 (REQUIRED). 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!J/No: Are you lobbyina 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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate D pment Issues": _ 7 Yes %No: Are you lobbying on a pending application for a Development Agreement with the City or application for chanae of zoning map desianation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2-482(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. Yes o: 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 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 Lo byi f t 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 2482 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: c r ( � Signature of Principal/Client: Vi. LOBBYIST IDENTIFICATION: — PRINCIPAL IDENTIFICATION: F-ri •,- „unu,, S Cn =O a _Produced ID c,�� "O _Produced ID Form of Identification ° �;= Form of Identifica i'o_ -'�rY,;,,,.•�`�, Personally known known(Lobbyist) o z _Personally known(Principa('F W 3 VII. SIGNATURE AND STAMP OF NOTARY: a 3 a m y 3 ° H D 43a ,oa z =° OLD a ca o y 3 State of Florida, County of Miami-Dade o n State of Florida, County of Miami-Dade c m Sworn to and subscribed before me d ° ° , o Sworn and subscribed before me Ca cn) This C1\ 2012 d v o This ` ,,_%Lday of 110. 2012 m H O 42 d 47 w T r. ur o AL=-State of Florida N o a ° SI ature State of Florida Notarization of Lo byist's signature ° �, ° Notarization of Pri ipal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$'�5�� MCR# 4, Date Paid / Lobbyist Registration Form received and verified by: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 04/27/2012 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc IM MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granada, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 , Fax:305.673.7254 LOBBYIST NAME: Joseph Z. Fleming I understand that no later than February 28 of each year, 1 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. Pursuant to Section 2-486(d),the City Clerk shall notify any lobbyist(or principal)who fails to timely file a Statement and in addition to any other penalties which may be Imposed as provided In Section 2-486.1, a fine of$60.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. C-, �, Any lobbyist, who falls to file the required Statement by April 80th, 2012,�haNJbe automatically suspended from lobbying until all fines are paid, unless the the&s i on appealed to the Miami-Dade County Commission on Ethics and Public TrLV*_L � x :-r1 � N Signature: Date: w `D v� F:\CLER\$ALL\a FOR MS\LOB BYI ST FORMS\Lobbyist Registration Form.doc