Javier F. Aviño - 1345 Pennsylvania LLC tOIAMIBEACH
City of Miami Beach Office of the City Clerk Yea t✓�
1700 Convention Center Drive, Miami Beach, FL 33139 1'
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.
Avin6 Javier F.
NAME OF LOBBYIST: (Last) (First) (M.1)
Bilzin Sumberg Baena Price&Axelrod LLP, 1450 Brickell Avenue, 23rd Floor, Miami, FL 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-350-7202 305-351-2275 javino @bilzin.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:
1345 Pennsylvania LLC
NAME OF PRINCIPAL/CLIENT:
888 Brickell Key Drive 17-12 Miami FL 33138
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-972-2869
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:Evergreen Overseas Holdings, Inc., Manager
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN RCH CORPORATION,
PARTNERSHIP OR TRUST:Victor Uzan C=
ILSPECIFIG LOBBY.ISSUE:
3 s ,Iv s z LV/.;
Zoning and Land Use information for prope rt EN
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issue to be lobbied(Describe in detail):
lll.'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-ifie lobbyist as entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preced DR such person's
commencement of service with the city to the present date,stating the eneral nature of the subject contractual relatGAshi .
Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning,land use,zoning n/a x
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MIAMI 3850793.1 80647/43365
Pursuant to City Code Section 2482(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.
Es:ec 2-482 Any Financial, Familial or Professional Relationship
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE: (Required)
Hourly/$475
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):(Required). Hourly/$475
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 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 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
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 X No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th 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 SHAkL BE FILED EVEN ILE THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Si ature o)LLr bbyist-
I do solemnly swear that all of the foregoing facts are ue and Cct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Be ch City Cod or ing irements.
Signature of Lobbyist:
Signature of Principal/Cli t:
VI. LOBBYIST IDENTIFICATION: PRI INIC
jp,AL IDENTIFICATION:
❑ produced It _
lkoroduced ID 0a, 06J?rS Ll CQ 001)e-
Form of Identification Form of Identification
Personally known (Lobbyist) ❑ Personally known (Principal)
VI 1. SIGNATURE AND STAMPj9F NOTARY:
°`.• •.e�%
CHRISTINE A.BOWEPs
State of Florida, County of Mi * MY COMMISSION#DD 959346 State of Florida, County of Miami-Dade
Swor to and subscri be re oP EXPIRES:February 20,2014 Sworn and subscri d be ore me
OF ` Bonded lVu Budget Notery Services
Th' f1o� day of ,213 This �'d 2013
ign ture f Public Notary-State of Florida 6Notariz n ture of ublic Notary-St a f�a ao rs
ation of Lobbyist's signature ' n of Principal's si� S3OOA
��A��#NOISSIWW00 AW
MOO V 3NLLSIHH0 °�•...•,��
TO BE COMPLET D BY CITY CLERK'S STAFF ONLY nd Aad
Annual Registration fee: [ ]Yes[ ]No Amount Paid SW MCR# Date aid. 3
Lobbyist Registration Form received and verified by: o
MIAMI 3850793.1 80647/43365
` Revised 4/27/2012
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office CityClerk @miamibeachfl.gov
Tel:305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Javier F. Avino
understand that no later than February 28th of each year, I must file the following forms, 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 Form 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, 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 301h of each year, 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.
Signaltj Date:
MIAMI 3850793.1 80647/43365
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MIAMI
City of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida 33139 www.miamibeachfl.gov
City Clerk' Office
Tel: 305/673 -7411 Fax: 305/673 -7254
ANNUAL LOBBYIST REGISTRATION FORM
Name:
Javier F. Avino
Business Name: Bilzin Stmberg Baena Price & Axelrod T.TP
Address: 1450 Brickell Avenue, Suite 2300, Miami, FL 33130
Phone: 305-350-7202
Email: 7 avirxrnbilzin.ccm
If more than on Lobbyist, please list:
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Amount paid: Date paid: 2-3 (1 3
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Send this form with a check for $500 payable to
the City of Miami Beach for each lobbyist
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