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Clifford A. Schulman - Spear Bros. Consulting, LLC 40 ,� . MIAMI ao t.7 Ivy 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" h s pecifc exclusions. Please refer to Ordinance 2004-3435.lkq P? t-�0,4a A. NAME OF LOBBYIST: (Last) (First) (M.1) 454 CCVf'b+q Otj m n I. 5a5 P#Aw 012 Leon 9/4• Suif 700- Co ra e4 Z/ L 3313 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 3C6 85q- os co 30s> 3 5 y-a•3a 3 c 6C)I vJma4 6'ws A-IqW.c o TEL PHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: 00A501f1AVI 4 Im nS. LL C ° NAME OF PRINCIPAUC TENT: -�_ SW f4 ✓ �► �JfQ 013 or�Lquo�Pi�Kle FL 333 c BUSINESS NA E A D DDRESS (Number n Str et) ( ity) (State) Zip Code) 95`I 8 - D0p 5 79a- a6 je r? es e�r� -ov o„j.I TELEPHONE NUMBER: FAX UMBER:(Optional) EMAIL:(Optional) �r - Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] -- C__ t v • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: --� Ln • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: 014 s fQS be n 4 ve I o 4 z o4 �d✓ S Issue to be lobbied(Describe in detail): III.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 prcceding such person's commencement of service with the city to the present date,stating the eneral 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 ?J(-1-VAt9;V - i3LLILDIP�fa._ 6ftctArt.- P--000 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( Any Financial,Familial or Professional Relationship C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\83LGQDDH\Lobbyist Registration V Formrevised 5-30-2012.doc r. IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) 45-00 nnuk B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): ,� Ou (REQUIRED). 1b S N 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_VNo: 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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes VNo: 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 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 7oAre shall register with the clerk as required by this section but, shall not be required to pay any registration fees. Yes 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 FILEIREVENAF TH RE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. AZj Signature o Lobbyist I do solemnly swear that all of the foregoin cts are true d correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami a ch City d and I re rting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally known(Lobbyist) Personally known(Principal) VII. SIGNATURE AND STAMP OF NOT IUE�VELO State of Florida, County of Miami-Dade ; Wy #.5EeV167 S to of Florida, County of Miami-Dade Sworn to nd subscnb d before me = EXPIRES: r21,2014 S orn and subscribed before me This k , 2012. ''� '„�" se�Aed �'Inc u �T s day of '2012 Signatur — tate of Florida Signature of Public Notary—State of Florida iza ' b ist signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual.Regis ion fee:,[ ]Yes[� No Amount Paid -251) MCR# Date Paid t2, Lobbyist Registration Font receive and verified by: C-\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc 1 1 ,l l I IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) Sbd A o* B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (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 VNo: 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 Section 2-490 Entitled'Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes VNo: Are you lobbying on a pending application for a Development Agree I ment with the City or application for change of zoning man designation 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 ite 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 FILE07EVENAF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Ae'—' Signature oT Lobbyist do solemnly swear that all of the foregoin0flact are true d correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami e c City d and I re orting requirements. Signature of Lobbyist Signature of Principal/Client VI. LOBBYIST IDENTIFICATION. PRINCIPAL IDENTIFICATION: Produced ID Produced ID Farm of identification Form of Identification Personally known(Lobbyist) /Personally know a EORGIA SANCHEZ MY COMMISSION#DD834803 VII. SIGNATURE AND STAMP OF NOT � F. .TRES:Novmba 16,2012 �,"%y MONKV1E S I Ay� NOTMY R.Notary Discount Assoc.Co. State of Florida,County of Miami-Dade `�N#IcE(i3216T S to of Florida,Coun Sworn to An,d subscrib d before me EXI�PFIES:MPYKAer 21,2014 S om and before me This ,2012. Aa., - �'"'! �+�T s O ay of U t6V 0 2 Signatur —State of Florida Signature of Pu otary—State of Florida Izat' b Ist signature Notarizati Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Regis on fee: I ]Yes[ ]No' Amount Paid$ MCR# Date Paid Lobbyist Registration Form received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc I i l i F:\CLEI listration Form.doc Revised 04/27/2012 ' . ' BEAC H . \ City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov CITY CLERK Office Rafael E. Granado,City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 ,Fax:305.673.7254 sc n LOBBYIST NAME. Cilf ora 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 automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to th Miami-Dade County Commission on Ethics and Public Trust. Signature: Date: C:\Users\clerhatlWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc