Eduardo Vazquez - Solid Builders, Inc. (w�
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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. Pleaase refer to Ordinance 2004-3435.
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NAME OF LOBBYIST: (Last) (First) (M.I)
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
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NAME OF PRINYAL/C eINT:
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BUSINESS NAME AND ADDRESS �(NVm rand Street) (City) (State) (Zip Code)Mir,
TELEPHONE NUMBER: iJq.. FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)]
C-1 N
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH COFtt3ORAT,,ION,
PARTNERSHIP OR TRUST: r�
ii.SPECIFIC LOBBY ISSUE:
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Issue to be lobbied(Describe in detail): ' I
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CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: w
Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether thi25obb, ' t has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months precedingch person's
commencement of service with the city to the present date,stating the eneral nature of the subject contractual relationship. " ;
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) �. -�Y ES'°° NO
Ln `,"title of person to be lobbied
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Pursuant toWAy Code Section 2-482(8)Every registrant shall be required to state the extent of any business,financial,familiaFor professional
relat d6shipLw other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is
sought°to be 1pbbied"as identified on the lobbyist registration form filed.
Sec 2-482 n `Financial,Familial or Professional Relationship
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1.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) ,t S 00 Q
B) PRINCIPAL'S DISCLOSURE(OF LO ISTT CCOMP�[�1SATIQf�)_
(REQUIRED). M��Yt��'�J
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 No: Are you lobbying on a present or pending bid for goods equipment or services or on a present or pending
award for Qoods,equipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
D elopment 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 vNo: Are you re resentin 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 SU IT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH LISTING LOBBYING EXPENDITURES AS WELL AS 4of TION RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. STATEMENT SHA EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REP TING PERIOD.
a. Signatur
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I do solemnly swear that all of the for g ng fa is are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach`i it C and all repo ing requirements.
Signature of Lobbyist:
Signature of Principal/Client: MI/
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known(Principal)
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VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida,County of Miami-Dade State of Florida,County of Miami-Dade
Sworn to and subscribed befo Sworn and subscribed before me
This ay of Notary Public State of Florida This _day of Rteo 201
�' Aldric€:Diaz
EE _ Zirc Public State of Florida
My Commission EE 184152
Signa re° f"Public Not — ate orida'"'gyres 03/28/2016 Signatur of Public Notary—S k Diaz
Notarization of Lobbyist's s Notarization of Principal's si mmission EE 184152
s U3;28/20 16
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ M C R# Date Paid 67 1
Lobbyist Registration Form received and verified by:
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/\AIAMIBEA.CH
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: ODON" V
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) LOESY18T 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 2485(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 State .®nt or pay the assessed fines after notification.
Any lobbyist, Who falls to file the required Statement by April 30th, 20129 shall be
automatically s spended from lobbying until all fines are paid,unless the fine has been
appealed to -Dade County Commission on Ethics and Public Trust.
Signature: Date:
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