Tony Leon - 411 Aqua, LLC MIAMI BEACH
Office
City of Miami Beac h O ce of the City J
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.
Leon Anthony
NAME OF LOBBYIST: (Last) (First) (M.1)
3 Design Architecture 4300 Biscayne Blvd. Suite G-04 Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)438-9377 (305)438-9379 3dtony(o-)bellsouth.net
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
411 Aqua LLC
NAME OF PRINCIPAUCLIENT:
411 Michigan Ave Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)469-1657 aquabluedesi-griammail.com
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:Philippe Harari
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:Philippe Harari
ii.SPECIFIC LOBBY ISSUE:
Design approval for the property located at 411 Michigan Ave
Issue to be lobbied(Describe in detail):
Ill. CITY AGENCIES/INDIVIDUAL'S 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 I NO
title of person to be lobbied
Planning Department and Building Department Staff None X
B, HPB, BOA, City Commission, as necessary* 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 2482(g)Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$445
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $445
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 X No: Are you lobby'na on a present or nendina bid for mods.eauioment or services,or on a present or
oendena award for aoods.eauioment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Arp you lobbvina on a gentling anolication for a Development Agreement with the City or aoolication
&change of zoning map desianation or change to the Citv's Future Land Use Man?
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 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 SUB T TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COM . IN THE CITY OF MIAMI BEACH
E4B THE PRECEDING CALENDAR YEAR. A STATEMENT SH BE F1 D EVENJIF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIQ
Signature of Lo yist
I do solemnly swear that all of the for oing fa s are tr and correct a that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Be h ty o and a r orting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
_Produced ID _Produced ID
Form of Identification s Form of Identification
/
to
LL
-Personally known(Lobbyist) q W o Personally P in i t
y c v P JUAN CARLOS MACEDO
VII. SIGNATURE AND STAMP OF NOTARY: ; E o Notary Public-State of Florida
CL • •e My Comm.Expires May 9,2014
State of Florida, County of Miami-Dade A; State of Florida iar06WIliglon#r DD 989785
Sworn to and subscribed 4efore me Z i5 m w Sworn and sub ri re BUM Through National Notary Assn.
This day of J_, 2012 •� t This da
0
Signal e o ubl c Notary—State of Florida a'071d. Si o — ate of F
Notarization of Lobbyist's signature rization of signature
TO BE COMPLETED BY CITY CLERK'S STAFF 0 LY —7 P
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# 3 Date Pai l
Lobbyist Registration Form received and verified y:
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F.\&E istration Form.doc Revised 04/27/2012
MIAMBEACM
City of Miami Beach, 1700 Convention Center Drive, Miami Beach. Florida 33139. w•ww.miamibeachn.gov
CITY CLERK Office
Ral'ael G. Granado, City Clerk CityClerkCA,trtiamibeachll.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Anthony Leon
I understand that no later than February 28 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, or I am no longer
lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's
Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (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 2-485.1, a fine of $50.00 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.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatical suspended from lobbying until all fines are paid, unless the fine has been
appealed t the Mia i-Dade County Commission on Ethics and Public Trust.
7. 7.12
Signa ur : Date:
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