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James E. Rauh - Drunken Dragon, LLC ' � �= ~ ^ ~ `~ B ° ^ =~� " " City of Miami Beach Cffioa of the City Clerk 1700 Convention Center [}rk/e. Miami Baoch, FL 33139 LOBBYIST REGISTRATION FORM ' Lobbyist means all persons employed or reta|neu, whether paid or not, by a principal who seeks to encourage the possaga,defeat or modification of any oruinanme, rean|uuon, act/on or decision of any commissioner; any action, decision, recommendation of the City Manager or any city board or committee; or any ocmon, decision or recommendation of any city personnel during the time period of the entire decision-making process on such acdon, decision or recommendation that foreaeoab|y will be heard or reviewed by the city oomm/aaion, or city uoong or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The mvnn"Lobbyists" has apaumo oxu|um/unn Please refer to Ordinance 2004-3435. NAME OF LOBBYIST: (Last) (First) (M.1) T1 0/0 &4ccm/vi v0d, /Ow -1 &Ctt4k el'I"�4 e�ffO -P me 41 BUSINESS NAME AND ADDRESS (NuATer and Street) (City) (Statd) (Zip Code) % TELEPHONE NUMBER: FAX MB_' EMAIL:_ .= Pleas enotify this office/7 your contact information chengem/a' �hbn -mre-Myileddreog. ` ' 1. LOBBYIST RETAINED BY: D_ t4 D r 6 4 r" I !Lu, � 41 i-cpq ;�:G it i4eQ et., F( 3 3) 3z BUSINESS _AKin (Number and Street) (City) (State) (Zip Code) 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: lollp-1 Febrel • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLUA 9%G�R MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: E7yl-)Tj�,j ",40 cteo x.SF»EC|FlC LOBBY ISSUE: 1!;!�kof (elet (e 4-0, It'Folpo S.eD 9_0P,1 14e Issue to be lobbied(Describe in detaif): Lf 9 4- III.CITY AGENCIES/11NDIVIDUALS TO BE LOBB IED: Pursuant to cuv noua Section muua the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual mumunomn (paid or unnom) with said city commissioner or personnel from 1e 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 ri 4 r�T 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/n»mmo as identified on the lobbyist mu/ouaunn mnn n|ou. Sec 2-482(g)Any Financial,Familial or Professional Relationship 1,-5,rj � L F:vCLER\$ALuaFORNS\LDBBnST R]RK8S\Lobbyhst Registration Fomndoc ^� J IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) 375 e, B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): 7 (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_40: 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 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 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 44o: 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 RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. C_ Signature obb ist I do solemnly swear that all of the foregoing facts are true and orre and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach � ode and all reporti g r uirements. Signature of Lobbyist: Signature of Principal/Client: �1 bfes VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: s b y� Produced ID F� -�R�JeP_ LLC, „r Produced ID Form of Identification J� ��a Form of Identification am Personally known(Lobbyist) SS\'a ii� ° ersonall y known(Princi p al) Ca co �o VII. SIGNATURE AND STAMP OF NOTARY: °`a�� Co .o State of Florida County of Miami-Dade oc�` °°� State of Florida, County of Miami-Dade��LIC Sworn to and ubscrib d b fore me ;c .4•`; �aea Sworn And subscribe bcfore me o r This ay of 201 =0 a 0° h1 � day f �� 20�1� o` Q 0 D Q TATE �0 WC6I IIII', re Signs o Public No ary—State of Florida Signature f Public Notary—State of Flori a�JO�•°4abC ; Notarizati nh of Lobbyist's signature Notarizatich of Principal's signature %y ak TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No 'Amount Paid$ MCR#` Date P id Lobbyist.Registration Form received and verified by: ... F:\C LER11St ALL\aFOiZMS\L086YIST FCF;MS'5L obbyist Annual I1-21Cistraiie�s F�rr��.de� Z:�Revi,sed 11/18%2013 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc r' 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: 305.673.741 1 ,Fax:305.673.7254 LOBBYIST NAME: 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 g Y 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 from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. 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