Juan C. David - 551-557 Michigan Avenue City of Miami Beach Office of the City ClerM SEP -I AM 9= 56
1700 Convention Center Drive, Miami Beach, FL 33139 C,�.
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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.
DAVID JUAN C
NAME OF LOBBYIST: (Last) (First) (M.I)
1385 CORAL WAY MIAMI FL 33145
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)285-4343 mariad@jcdarchitect.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office it your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
551&557 MICHIGAN LLC
NAME OF PRINCIPAUCLIENT: i
551&557 MICHIGAN LLC .2601 S.BAYSHORE DR#725 MIAMI FL 33133
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305.859.6050 305.859.6051 pieroconsoli.1 @9mail.com
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TELEPHONE NUMBER: FAX NUMBER:(Optional) "EMAIL:(Optional)
Fill out this section If principal is a Corporation,Partnership be Trust[Section 2.4.82(c))
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: PIETRO CONSOLI -MANAGER I
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IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:CARLO BIANCO 25% PIETRO CONSOLI 25% MARIO GIUSTI 25% WILLIAM SISTI 25%
II.SPECIFIC LOBBY ISSUE:
PLANNING DEPARTMENT-BOARD OF ADJUSTMENT-FLOOD PLAIN MANAGEMENT ORDINANCE REQUIREMENTS
Issue to be lobbied(Describe in detail): S(—SCE ,, AVE ,
ni.CITY GENCIESANDIVIDUALS 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 enerai nature of the subject contractual relationship.
Sec 2-482(x)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO I
.title of person to be lobbied
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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) N/A
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). NONE(PROFESSIONAL OF RECORD-REGISTERED ARCHITECT)
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":
Yet X_No: 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 X No: Are you lobbying on a pending application for a Development Agreement with the City or application for j
change of zoning map designation or change to the City's Future Land Use Map? i
3) Pursuant to Miami Beach.City Code Section 2482(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 i
compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any
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item,shall register with the clerk as required.by this section but,shall not be required to pay any registration fees.
_YesX_No• Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
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 R CEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE vfLeb MIN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
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Signature of obb st
I do solemnly swear that ail of t g ng f is are true and correc at I have read or am familiar with the provisions contained
in Section 2=482 of the Miami ac it Cod and all reporting requirements.
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Signature of Lobbyist: —
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
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Produced ID Produced ID r
® Form of Identification. Form of Identification
X.Personally known(Lobbyist) Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:.
S t ka I f State of Florida,County of Miami-Dade
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Notariza
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ Yes[ ]No Amount P 'd$ MCR# Date Paid
Lobbyist Registration Form received and.verifed by:
F:\CLER\$ALL\aFORMS\LOBBYIST.FORMS\Lobbyist Annual_Registra ' n Form.rloc Revised 04/27/2012
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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City of Midmi Beath, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miomibeachil.gov
CITY CLERK Office
Rafael E. Granado; City Clerk CityClerWrniamibeachfi.gov
Tel:305.673.74.1 1 ,Fax: 305.673.7254
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LOBBYIST NAME: JUAN CARLOS DAVID
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I understand that no later than February 28 of each year, I must file the following form,
pursuant to Section 2-455 of the Miami Beach City Code, with the City Clerk's Office for
all active lobbying.issues..
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1) LOBBYIST EXPENDITURE AND COMPENSATION FORM
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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.
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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 ar>n required to immediately notify i
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 1
falls 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) Bled 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 l' y a 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 the Miami-Dade County Commission on Ethics and Public_Trust.
S na Cate:
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CADocuments and SettingslclermarmlLocal Settings\Temporary Internet Files\OLK1 1\Lobbyist Registration Formrevised 5-30-2012.doc