Reinaldo Borges - Philippe Harari (2) ..� v
MIAMIBEACH
�J
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.
Borges Reinaldo
NAME OF LOBBYIST: (Last) (First) (M.I)
Borges +Associates, P.A. 1200 Brickell Avenue, Suite 1525 Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)374-9216 rboraesnaboraesarchitects.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:
Philippe Harari
a
15 Palm Aqua,LLC 411 Michigan Ave Miami Beach Florida 33139
um er ana Street) i (State) (zip o e
(305)283-5151 aauabluedesian(aWmail.com
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:Philippe Harari
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:Philippe Harari
Ii.SPECIFIC LOBBY`°,ISStUE
Development board approvals for the propertu located at 15 Palm Avenue.
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
arson's commencement of service with the city to the present date,stating the general nature of the subject contractual relationshi .
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning Department and Building Department Staff None X
B, HPB, BOA, FP, City Commission, LUDC, and None X
Commission Committees, as necessary None X
Pursuant to City Code Section 2-482(8)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 t 7,
None 1.']
None
NoneV
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $ v5ioI•_
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 X No: Are you lobbvina on a present or nendina bid for aoods.ea r on a oresent or
pendina award for aoods.eauioment 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 lobbvina on a pendina application for a Development Aareement with the City or application
f2L change of zoning man designation or chanae 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 X Noy Are you rearesentina 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
FM THE PRECEDING CALENDAR YEAR, A ST HALL BE FILED EVEN IF THERE HAVE EEN NO
EXPENDITURES OR COMPENSATION DURING HE R
Si nature obbyis
I do solemnly swear that all of cts are true and co ect an that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami each ing r uirements.
Signature of Lobbyist:
Signature of Principal/Cli
VI. IDENTIFICATION: A v IDENTIFICATION:
Pry rte;F�tr. c �' ° a La4�y i S
Produced ID c ; Produced ID
Form of Identification oo Form of Identification p m
O N m %
ZPersonally known(Lobb ist) a •" �.° " Personally known(P el)
Y� () Z W
zZ
VII. SIGNATURE AND STAMP OF NOTA nW oC
o v H t
State of Florida, County of Miami-Dade z State of Florida, County of Miami-Dade Z N
"""'•� Sworn and subscrib d before me
Sworn to�subscribed efore a ..�;c •, �jG-ct�,T2013 •
This C_d of ,20 4� This L9day of
Signat o ate f F a Signature of Public Notary—State of Florida
Nota tion of signa ure Notarization of Principal's signature
TO BE COMPLE C CLERK'S STAFF L /
Annual Registration fee: Yes No Amount Paid S MCR# Date Paid
Lobbyist Registration Form received and verified by.
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F:\CLE is#ration Form:c oc ",'' `` 6tevised 04/27/2012
M!AIM I BE" E A
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139, www riamibeachfl.gov
CITY CLERK Office
Rafael E.Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: Reinaldo Borges
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-1n 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
:. ..., ,_appe d o t. mi-D ounty. Commission on Ethics.and.Public.Trust.
Signatu e: Date:
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