Rafael E. Andrade - BMG Money, Inc. 01/15/2013 14:41 8502224457 ADAMS ST PAGE 0' '32' '
i N
City of Miami Beach Office of the City Clerk q-
1.700 Center Drive Miami Beach FL 33139
1.700 Convention _
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seems 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"i_obbyists"has specific exclusions. Please refer to Ordinance 20043435.
Andrade Ra.fae l E.
NAME OF LOBBYIST: (Last) (First) (M.I)
Law Offices of Rafael E. Andrade, P.A., 11. 11 Lincoln Road, Suite 400, M.iarni Beach, Florida 331.39
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 531-951.1 (305) 673-5734 ralpli.@raildradela.w.com
TELEPHONE NUMBER: FAX NUMBER: • EMAIL:
Please notify this office if jrour contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
BMG Money, Inc.
NAME OF PRINCIPAUCLIENT:
1221. BrIckel.l Avenue, Suite 1000, Miami, Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) _ (State) (Zip Code)
(305) 851-6134
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: Marion (J. Matlles, CEO
• IDENTIFY ALI.PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST iN SUCH CORPORATION,
PARTNERSHIP OR TRUST:90%,owned by ECTI. F..mprcrid.imcntos Gerais Ltda.(Brazil); 10%owned b BCp Securities
Ii.SPECIFIC LOBBY ISSUE:
Pavrol). Deduction.Plan AT4reement(.Loans At Work)
Issue to be lobbied(Describe In detall):
Ill.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 preceding such person's
commancomont of service with the city to the eracent date,Stating the eneral nature of the subject contractual relationship-
Sec 2-482(a)(4)Fuil Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Mayor&City Commission,City Manager's Office, X
City Attor'ney's Once, PTOCUrCnlCnt Division,and X
[All City Boards and Committee,; X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,fitlanclo-,jamlPl or professional
relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioneq.r cl"ersonnel who is
sought to be lobbied as Identified on the lobbyist registration form filed. - �
Sac 2-482 An Financial,Familial or Professional Relationshi p rTn
None
Cn
,
_T1 ~F 6
-1
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\LGbbbyl Registration
Formrevlsed 5-30-2012.doc ;
01/15/2013 14:41 8502224457 ADAMS ST PAGE 02/02
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLQ$E WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE,(Required) $5000 per month
B) PRINCIPAL'S DISCLOSURE_(OF LOBBYIST COMPENSATION): $5000 per month
(REQUIRED).__ - —
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
Yes XNo: Are You Iobbyinc on a resent or endin bid for oods a ui rnisnt or senrlces or on a resent or pending
award for S1<oodLs1 equipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobbying_on a pending application fvr a Development Agreement with the City or application four
c an a of zoning map designation or change to the CitMs Future Land Use Mab?
3) Pursuant to Miami Beach City Code Section 2-482(h)Any person(except those exempt from the deflnition of"lobbyist"as set
forth In Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without special
compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any
item,shall register with the clerk as required by this section but, shall not be required to pay any registration fees.
YesXNo: Are ou re resentinst_a QQt for profit corporation or ent`i without special co�pansation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FIE,13RUARY 28 QE-F, I YEAR, EACH_LQI3BYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH L_STING LOBBYING IEXP NDITURES A$WELL AS COMPENSATION RECEIVED THE CITY OF MI MI BEACH FOR
THE PRECEDING CALENDAR( YEAR, 6 STATEIMQIT SMALL 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 Beach City Code and all reporting req ' ments.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced 10 Produced ID -_
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known(Principal)
VII. SIGNATURE AND STAMP Notary Public scale of Florira
Maria Maharaj
State of Florida,County of Miami-Dad My Commission EE 827602 State of Florida, County of Miami-Dade
Sworn to and subscribe efore me ss Expires 08/16/2016 Swo[V and subscribed before me
This j _day of z0 s d , 201
MIUSSA IgAACS
t--� + PubNG BIate of Roma
Sr f Public Nola –St:�tc o lorida Signature f Public Notary ri 0
Notarization of Lobbyist's sigins re Notarisation of Princl al' si re ��m��July�,2d1�.
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fea: [ ]Yes[ j No Amount Paid$ � MCR# Date Id '
Lobbyist Registration Form received and verified by:
C;1 Usersl clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet FIIeslContent,0utlook183LGQDDH1Lobbylst Registration
Formrovised 5-30-2012,doc
listration Form.doc Revised 04/27/2012
/M I A M B"AC 2
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granado, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: AVZ) 2A;6 re_— s- v,
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 the Miami-Dade County Commission on Ethics and Public Trust
..........
_X// 5112-
Signature: 6ate:
C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration
Formrevised 5-30-2012.doc