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Jose Gelabert-Navia - Russell Galbut� X APO I B E AC H V City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM i 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. Gelabert-Navia Jose NAME OF LOBBYIST: (Last) (First) (M.1) Perkins +Will 806 Douglas Road, Suite 300 Coral Gables FL 33134 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 569-1385 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: Russell Galbut NAME OF PRINCIPAUCLIENT: Crescent Heights 2200 Biscayne Blvd. Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5700 rgalbut(a-)crescentheights.com 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:' • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH L&PORATION, PARTNERSHIP OR TRUST: n.SPECIFIC.LOBBY ISSUE_: Development Board Approvals and related ordinances for 709 Alton Road w Issue to be lobbied(Describe in detail): T' nl.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 Staff, PB, HPB, BOA, DRB, Commission None P110 Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,famili or professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner-or ci tmersonnel who is sought to be lobbied as identified on the lobbyist registration form filed. ' t� Sec 2-482(g)Any Financial, Familial or Professional Relationship = , NONE 'r s C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc 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": _Yes X No: Are you lobbying on a present or pending bid for goods.eguipment or services,or on a present or pending award for aoods.eauipment 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 oendina application for a Develooment Aareement with the City or application for change of zoning map 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 No: Are you reoresentina a not-for-orofiit 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 EM 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: A96elol_,�Ar_ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification Personally known(Lobbyist) _Z Personally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State of Florida, Co my of Miami-Dade Sworn t.Nd subscribed befog erne Sworn nd su This day o A14�aren Valdes This da f 2016AYAMI AGUTAR COMMISSION#EE 136824 ?0 *` otary Public-State of FI, '�.,��'• P EXPIRES: OCT.11,2015 mm.Expires Mar 15 _ Sign Lure f u lic Notary— F16n&RONNOTARY.com Signs ure Public No - l FlorMmission #EE 70,, Notarization of Lobbyjs�signature Nota r ati of PH 11 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 I 1=, t iW tion farnt doc - Revised 04/27/201.2 Ale t �•. , way qk 3 4 �a:2� 1 a s a-_.k.<. City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, wwwmiamibeachfl.gov CITY CLERK Office Rafael E.Granado, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax:305.673.7254 LOBBYIST NAME: Jose Gelabert-Navia 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: C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc • CN �- W UJ } IL .� ` tqV Co . mr LL u MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139 www.miamibeachfl.gov City Clerk'O flice Tel: 305/673 —7411 Fax: 305/673 -7254 ANNUAL LOBBYIST REGISTRATION FORM Name: Jose Gelabert-Navia Business Name: Perkins+Will Address: 806 Douglas Road,Suite 300 Coral Gables, FL 33134 Phone: (305) 569-1385 Email: If more than one Lobbyist,please list: 1) 2) 3) MCR#: Amount paid: Date paid: Processed by: Date: Send this form with a check for $500 payable to the City of Miami Beach for each lobbyist F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM.docx Salvatore, Jason From: Gelabert-Navia,Jose <Jose.Gelabert-Navia @perkinswill.com> Sent: Monday, August 15, 2016 3:35 PM To: Salvatore, Jason Cc: Bercow Radell & Fernandez, P.A. (gpenn @brzoninglaw.com); Snow, Kricket Subject: RE: City of Miami Beach Update of Lobbyist Registration Information Attachments: Scanned from a Xerox Multifunction Printer.pdf Jason I asked my office to scan the letter which you had sent. As I said in my earlier e mail, unfortunately architects do not work like attorneys, and our clients expect us to appear before Miami Beach however many times for NO COMPENSATION other than an ocassional dinner, if the time works out! SO for 709 Alton Road, I DID NOT PERSONALLY RECEIVE ANY COMPENSATION FOR MY APPEARANCE FOR MY PUBLIC APPEARANCE AND ASSISTANCE IN SECURING THE PUBLIC APPROVALS FOR THIS PROJECT. Please let me know if this suffices. Thank you for all of your assistance, and I apologize for the delay. As I said, I have been out because of surgery and am still out until the 26th of August that I return to the office. JOSE Jose Gelabert-Navia, LEED AP Regional Director, Principal t 305.569.1385 m 305.308.0773 Perkins+will From:Salvatore,Jason [mailto:JasonSalvatore @miamibeachfl.gov] Sent: Monday,August 15, 2016 10:26 AM Subject: City of Miami Beach Update of Lobbyist Registration Information Importance: High Good morning, On August 3, a letter was mailed to your business address of record requesting updated compensation amounts for certain issues that you have registered to lobby on with the City of Miami Beach. Our office has yet to receive a response to the letter. Please be advised that this information is a requirement of your registration and as such, if the information is not received then you will be suspended from lobbying the City until your registration is updated. Please respond by August 19,2016 to avoid a suspension status. If you have not received the letter, please respond and advise so we can provide you with a copy via email. The information can either be provided by a letter mailed to our office or by email. Miami Beach City Code Sec. 2-482(a)(6) states the following must be disclosed: The terms and amount of compensation to be paid by each principal to the lobbyist with regard to the specific issue on which the lobbyist has been engaged to lobby. Thank you, 1 AM BEACH Jason Salvatore Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411 www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. • 2