Cesar Molina - 1826 W. 23 St LLC 2
-- MIAMI 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.
Molina Cesar
NAME OF LOBBYIST: (Last) (First) (M.1)
CMA Design Studio Inc. 232 Andalusia Avenue, Suite 101, Coral Gables, FL 33134
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)448-4200 cmolina(c�cmadsi.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:
1826 W 23 St LLC
NAME OF PRINCIPAUCLIENT:
999 Brickell Avenue, Suite 600 Miami FL 3-,3 131 f
BUSINESS NAME AND ADDRESS(Number and Street) (City) (State) (Zip�Code) '
(786) 552-3262 polansku(a_-�yolansku-law.coin. �i
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL:(Optional)
Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] < r
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Christian Massa
C IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Christian Massa
II.SPECIFIC LOBBY ISSUE:
Development Approvals and Permitting Issues, including, but not limited to Design Review Board, Historic Preservation Board,
Planning Board, Board of Adjustment, Land Use Development Committee, and City Commission, if necessary, relating to the
propertu located at 1826 West 23rd Street, Miami Beach, Florida.
Issue to be lobbied(Describe in detail):
III. CITY a 4GENCIES/11NDIVIDUALS 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, HPB, BOA, City Commission, and Land Use one
Develo ment Committee, as necessary
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
None
None
None
V
d
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required): $ 0�
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 X No: Are you Inbbvina can a present or nendina bid for goods.equipment or services.or on a present or
°ending award for goods,gauioment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes X No: Are you lobbying on a oendina aonlication for a Development AgLgement with the City or aoolication
fgC change of 12 designation or change to the City's Futuie Land Use Mao?
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 X o• Are you represpntil3g a 13ot-for-12rofmt
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
MI THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client: Jro?.
VI. LOBBYIST IDENTIFICA ION: PRINCIPAL IDENTIFICATION: Z:n
0 W ZL 0
Produced ID Produced ID LU W w
Form of Identification Form of Identification O
q N
c T O
N F
L
Personally known(Lobbyist) Personally known(Principal) H T o E
U
VII. SIGNATURE AND STAMP OF NOTARY: r4 U
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn to and subscribed before me Sworn and subscribed before me
This day of ,2014 This J 4 day of M A, ,2014
Signature of Public Notary—State of Florida Signature of Public NotaryK State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITy CLERK'S STAF ONLY 0
Annual Registration fee: [ ]Yes No Amount Paid �.. MCR# �Date Paid y
Lobbyist Registration Form receiJed and v
Y 9 erified by:
i
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":
_Yes X No: Are you lobbvina on a present or pendina bid for aoods. eauigment or services, or on a present or
pendina award for aoods. eauigment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes_X No: Are You lobbvina on a pendina application for a Development Agreement with the City or application
fQC change of zoning mpg designation or chanae 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 X o: Are you representina 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 QF MIAMI BEACH
F_QB THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE ^DTIK 1-_.s0C01r%n
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beac City Code and reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICA ION: PRINCIPAL IDENTIFICATION: Z y
000 ao
Produced ID Produced ID M w C
Form of Identification ^H Form of Identification O
Personally known (Lobbyist) o y Personally known (Principal) N o y
O F5 &Q- Q i > m
VII. SIGNATURE AND STAMP OF NOTARY: V N a-0 N
CO�
L 2
`•p• Y i
State of Florida, County of Miami-Dade a State of Florida, County of Miami-Dade
Swornitq,�i subscribed before me ��
�" _` g Sworn and subscribed before me =�
This ` day of CI , 2014 m This 14 day of M►Ary . 2014 S �,c�,•r
Sign r f ublic No State of Florida L: Signature of Public Notary State of Florida
Notariz ion of Lobbyist s signature Notarization 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:
I
i
Istration Form.doc Revised 04/27/2012
r'
&AIAMIBEACH
C11y of Miami Reach, 1700 Convention Center Drive, Miami Beach, Florida'33139, www.niiamibea6h0:gov
CITY CLERK Office
Rafael E. Granado, City Clerk COClerkCiniamibeach(l.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: Cesar Molina
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 30th, 2012, 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.
Signature Date
ge
e of CaL&A
SwLzn rrU
-rh s q4A' del M l y 2 o'N
-pLzbli< Sfi v�-Y7v
MAGIY C.RODRIGUEZ
4 = MY COMMi
EXPIRES,:Augl-•;i 1;_;017
,017
7.RF... Bonded Thru Notar,4•u`.;i,i ft,! writers
a
I
Miscellaneous Cash
Receipt
CITY OF MIAMI .BEACH
-
r
No. �' �
Cash EI Credit Card heck#
T
r ( 2p .
Received of
Address
For � }�� .�`� �� � ��s • ;'�"�
_.:d E"':•V4,. r ii j:a�*r.'..f: 7" 3;:'i�' t"t i f
(THIS INFORMATION MUST.BE COMPLETED) Office of Finance Director
By
Account Number:
arer:
P Dept:
Pre EXT: ,
i