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Bob De La Fuente - South Beach Ocean Parcel II, LTCr o I o MIA�Al BEACH 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. DE LA FUENTE BOB NAME OF LOBBYIST: (Last) (First) (M.I) TEW CARDENAS LLP,1441 BRICKELL AVENUE,15TH FLOOR,MIAMI FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-536-1112 305-536-1116 BDF @TEWLAW.COM TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone,or a-mail address. I. LOBBYIST RETAINED BY: SOUTH BEACH OCEAN PARCEL II,LTD NAME OF PRINCIPAL/CLIENT: 100 SOUTH POINTE DRIVE MIAMI BEACH FL 33139 n �� BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-695-1111 - C-`' y TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) �} :'*7 ; { r- Fill out this section If principal is a Corporation,Partnership or Trust[Section 2-482(c)] 00 • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: IAN BRUCE EICHNER ° • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCHUORPTIO;Nr; PARTNERSHIP OR TRUST: t II.SPECIFIC LOBBY ISSUE: r� _�j DEVELOPMENT ISSUES RELATED TO 100 SOUTH POINTE DRIVE Issue to be lobbied(Describe in detail): III. CITY-AGENCIESIINDIVIDUALS 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 general 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 PLANNING AND ZONING DEPARTMENT X X PUBLIC WORKS DEPARTMENT CITY MANAGER'S OFFICE X CITY COMMISSION X NTAV0__R PARKING DEPARTMENT I X 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 N/A C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc r � l . � z IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $410.00 PER HOUR B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). 4t0 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 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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes_XNo: 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 XNo• 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 CLERK A SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION RECE ED IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF ERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of tobbyist I do solemnly swear that all of the foregoing f is are true and correct and that I have 01or am familiar with the provisions contained in Section 2-482 of the Miami Beach City a and all rep rting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification 4Personally known(Lobbyist) Personally known(Principal) VII. SIGNATURE AND STAMP O ,titi ELIZABETH BERNARDO r � ::z Commission#EE 070972 State of Florida,County of Miami-Dade _ - X116,X15 State of Florida,County of Miami-Dade Sworn to and subscribed before rn emmT=Tmyfefilnsvrm�e80a3�7m Sworn and subscribed before me This _day of , 20 This day of , 2012 igr a of Public Notary—State of Florida Signature of Public Notary—State of Florida Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED kY CITY CLERK'S STAF ONLY Lq Is Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# 62 ate,Paid Lobbyist Registration Form received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc I IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $410.00 PER HOUR 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_XNo•-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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes_XNo 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 XNo 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 CLERK A SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION RECEWED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF 2HERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature ob yist true afid c ect and t a r am familiar with the provisions contained I do solemnly swear that all of the foregoing f is � in Section 2-482 of the Miami Beach City e d al rcep' require e / ,! Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification 7� Personal) known Prin�ON H.McCULLOCH Personally known(Lobbyist) Y ( Public.State of New York No.01 MC6224121 VII. SIGNATURE AND STAMP O T y EL17�ETH BERNARDO Qual"led in New York County ' . Commission Expires:June 28,2014 r .,,,� Commission#EE 070972 State of Florida,County of Miami-Dade State of Florida,County of Miami-Dade _ E*�Ali 16,2015 tY Sworn to and subscribed before me �„�Th,,,T,�,�r, axir»s Sworn and subscribed before me This'_day o 201 This day of ,201 igna a of Public Notary—State of Florida S natur Public Notary—State of Florida Notarization of Lobbyist's signature Notar ation of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid Lobbyist Registration Form received and verified by: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc is ` m C a Poll dim OD A o0 0 A _ n is CL F Z a 0 y - s Y` �a W to S �I - - � _ .._ � i\\ � • --__. _ � +ter •�