Roberto Sanchez - Aramark A/M I b EAC H
City Of Miami Beach Office of the City Clerk
bd� �
1700 Convention Center Drive, Miami Beach, FL 33139 �o
r
LOBBYIST REGISTRATION FORM M
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. Pleaa-sa refer to Ordinance 2004-3435.
5 4- A e �� z �G�.f�'
NAME OF LOBBYIST: (Last) (First) (M.I)�
es ZfC 5c4
BUSINESS NAME AND ADDRESS -(Ntrmber and Street) (City) (State) (Zip Code)
In 71. � 07 76)
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAIN D BY: `.
/'� A �
NAME OF PRINCIPAUCLIENT:
BUSINESS Nr AND DR S (Number and Street) (City) (State) (Zip Code)
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:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:
II.SPECIFIC:LOBBY ISSUE-
Issue to be lobbied(Describe in detail):
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (,�cc -
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 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
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.
�Jy i C 9` E
Sec 2-482(g)An Fi anc' I,Familial or Professional Relationship " �' `.�
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc
A�\A, I s:'
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.
SAN C H E 2 ,QosE,gTb
NAME OF LOBBYIST: (Last) (First) (M.1)
1080 H1C*64^) 4119.15t 1l'q, M�AM/�E.4cy, �L 33/3q
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
3d5. -7 q41. 0703
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
/4 n
14 14-4 oe k—
NAME OF PRINCIPAUCLIENT:
A &A MM-K 110 6 a,K�,T ST P H IL-A 0 6.L fH eA PA (ei 10°7
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
_2, U M , [ Ci :t/1144,- C 6�X)
TE EPHON 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:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION,PARTNERSHIP OR TRUST:
II.SPECIFIC LOBBY ISSUE:
FOOP AAID l3E I/E.4fA6'E FAG141 r10s MA�A('FiyE�JT sE��11CI a MBGG
Issue to be lobbied(Describe in detail):
III. CITY AGENCIES/INDIVIDUALS .TO BE LOBBIED: (Pursuant to City Code Section 2-482(8)
include a statement of the extent of any business,financial,familial, professional or other relationship,giving raise to an
appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the
commencement of service of City personnel to be lobbied.)
A Full Name of Individual Title B)Any Financial,Familial or Professional Relationship
Gity,' G'o rliss�o� A10
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):
(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 ❑ No: Are you lobbvinq 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 [5'*No: Are you lobbvinq 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 2-484 (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 L7 No• Are you representing a not-for-profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1sT 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 Lobbyist
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 it Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client: is,—�,/L-
VI. LOBBYIST IDENTIFICATI N: PRINCIPAL IDENTIFICATION:
❑ Produced ID 0 Produced ID
Form of Identification Form of Identification
rs I Personally known(Principal)
VII. T I �FBF�10 RY:
® My Commission EE 158984 tFennS_ v��i�t; �lIM
State f� C810450M64"ODade State of-F+e°ids, County of
Swo Sworn anj1-subscf-,bed be re m
This 5 Aay of MY' 20/z This ay of gibm
Al
Signature of blic Notary-State of FI rida Signature-of-Public`.No.Wy.--T tale of-I�a ida-� e-OnS�
9
Notarization of Lobbyist's signature Notarization-.of Princi ai9ss.signature
TO BE COMPLETED BY CITY CLERK'S-STAFF.ONL''` /
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR* 3,� Y Z.. Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\LOBBYIST\Lobbyist Registration Form 32708.doc Revised 03/27/2008
F:�CLEI iistration Form.doc Revised 04/27/2012
'MIANAIBEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk @miam1beachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: !" 5T/"C
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
automaticallyAjspended from lobbying until all fines are paid, unless the fine has been
appeale o the iami-Dade my Commission on Ethics and Public Trust
ign dire: Date:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc