Hamed Rodriguez - RC Lincoln Holdings I
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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.
Rodriguez Hamed
NAME OF LOBBYIST: (Last) (First) (M.1)
Hamed Rodriguez Architects, Inc. 3250 Mary Street, #305, Coconut Grove, FL 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-244-5626 ham.edLhr-architects-inc.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:
RC Lincoln Holdings
NAME OF PRINCIPAUCLIENT:
c/o Crown Acquisitions, 767 Fifth Avenue, 24th Floor, NY NY 10153
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(212) 563-6400
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: Richard Chera cam.. 7
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: See Attached
II.SPECIFIC LOBBY ISSUE:
Development Approvals and Permitting Issues, including, but not limited to Historic Preservation Board, PlannW and Board of
Adiustment approvals for the properties located at 846 Lincoln Road, Miami Beach. FL.
Issue to be lobbied(Describe in detail):
III. CITY AGENCIESANDIVIDUALS 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 Department and Building Department Staff None
PB, DRB, HPB, BOA, City Commission, and Land Use None
Development Committee, as necessary None
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(g)Any Financial, Familial or Professional Relationship
None-
lVone
None
r
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
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":
'1/
_Yes No: obb in on a resent or endin bid for oods a ui ment or services or on a resent or endin
a r or 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 i(o: lobb in on a endin application for a Development A reement with the City or application for
ge of zoning map designation or chance 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 VNo• ou 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 COMANSATION RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL LED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Sign of Lobbyist
I do solemnly swear that all of the foregoing facts are tru nd co t and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all reporti uirements.
Signature of Lobbyist:
Signature of Principal/Clien .
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Personally known(Lobbyist) .2L Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
Cr
U)
State of FlondA County of ami-Dad State of Florida,County of Miami-Dade
Sworn t �and ss bscrib efore �'R :`e JESSICA ACMA Sworn and subscribed before me
This ay of +/ �', * MY COMMISSION#FF 010901 This �`�day of 'fie c ,20i,� � �•��;
EXPIRES:May 13,2017
Bonded Thru Budget Notary Services � co
WA li Nota —State of Florida Si nature o Public Notary—State of-Ffmt&.r C
Sign ure of b c 9 ® �
Nota 'zation o Lobb ist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF AN Y 6'
Annual Registration fee: ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\a FORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 11118/2013
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
MIAMIBEACH
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: L(AMgO
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 30, shall be automatically
suspended fr m lobbying until all fines are paid, unless the fine has been appealed to
the Miami-D de County Commission on Ethics and Public Trust.
12 ;o 3
Signet Date
FACLER\$ALL\aF0RMS\L013BYIST FORMS\Lobbyist Registration Form.doc
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