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Neal Sklar - New National, LLC MIAMI BEAC City f Miami Beach Office of the City Clerk Y Y 1700 Convention Center Drive, Miami Beach, FL 33139 �b 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. klar Neal NAME OF LOBBYIST (Last) (First) (M.1) One S .E. 3rd Ave -#3100, Miami F1 . 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) . (305) 358-2600 nsklar @pecklaw.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: New National, LLC. NAME OF PRINCIPAUCLIENT: 1677 Collins Ave Miami Beach F1 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip,Code) (305) 532-2311 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: Delphine DRAY • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSUE: Building Zoning & Fire Prevention issues at National Hotel 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 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 City Manager, Building Official, Fire Marshall, Planning Director, City -Attorney, Code Compliance 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 'A Oft _. _ d e e _.. L Ch � l C:\Users\clerhatl\AppData\Local\Microsoftoij f,v� , en por '31nternet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc l \ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) 4 L-rl 0 @ 6 ) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): /y(® (REQUIRED). °[ l "clo 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 Alo: Are you lobbyinq 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 li�o: 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 item, shall register with the clerk as required by this section but, shall not be required to pay any registration fees. _Yes-lo: 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 CLE A SIGNED ST MENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION RECEIVE04N THE CITY O,MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF_j#RAF HAVE BEENAWO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. at,jrp I do solemnly swear that all of the foregoing a true and corr nd that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City e d portin uirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFIC PRINCIPAL IDENTIFICATION: Produced ID /Personally duced ID Form of Identification Form of Identification Personally known(Lobbyist) known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: .uuu,, KAREN DENIS State of FI r a, County of Mi ml-D �; y" titi State of Florida, County of Miami-Dade Notary public-State of Florida Sworn ubscrib b fo a i? Comm.Expires Nov 19,2016 Sworn nd s scribed before me 0.hi ys 'C ommission, EE 852889 This 1 ay of 2015__L�iUo Y__ft0e\ T)j •'% ,�...;vr- Bonded'Through National No Assn Signa re 8FPublic Notary- on a Signature of Pub ary-State of Florida Notarization of Lobbyist's s' na ure Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes( ]No Amount Paid$ IIQCR# tl ZZ:5 4L a _%V 25 w to4�ry-publkState of Florida Lobbyist Registration Form received and verified by: +� r io Fernandez t M ssion EE712059 C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83 o Formrevised 5-30-2012.doc IRFW � ' � f3 F:\CLEI listration Form.doc Revised 04/27/2012 AAIAMIBEA-CH City of Miami Beath, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado,City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 , Fax: 305.673.7254 �c f� LOBBYIST NAME: �T I understand that no later than February 23 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 2-435 (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 2-435.1, 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 failsAg file the required Statement by April 30th, 2012, shall be automatically suspend® from lobbyi until all fines are paid, unless the fine has been appealed to the ade Coun ommission on Ethics and Public Trust. Si a u Date: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc 1 C 4 � l � CL a. N ® a E C.. Xw W YI i C a Im '1 rot- w ,,� _ ,---m may. r - - Cf kv.` .OS ' 0