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Tony Recio - Crown Castle /vV1 I B EAC H COPY 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. Recio Tony NAME OF LOBBYIST: (Last) (First) (M.1) Weiss Serota Helfman Pastoriza Cole&Boniske, P.L.2525 Ponce de Leon Blvd.,700,Coral Gables, FL 33134 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)854-0800 (305)854-2323 trecio @wsh-law.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes: address, phone, or e-mail address. 1. LOBBYIST RETAINED BY: Crown Castle NG East LLC NAME OF PRINCIPAL/CLIENT: 1220 Augusta Drive,Suite 600 Houston TX 77057 BUSINESS NAME AND ADDRESS (Number and Street) (Ci (713)570-3000 h') (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: • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH QRPORATION, PARTNERSHIP OR TRUST: =_ Ii.SPECIFIC LOBBY ISSUE: Approvals for several wireless facilities located in the public-right-of-way t` Issue to be lobbied(Describe in detail): m.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the loGUyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months precedirig such person's commencement of service with the city to the present date,stating the general nature of the subject contractual relatiohshi .- Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) , YES NO title of person to be lobbied 'See attached Exhibit"A" None (as to all) X 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. None F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc s , IV. DISCLOSURE OF TERMS AN r ' OF I_(1I313YIST COMPENSATION(DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Rcgiiii Hourly rate Oi)-,.ii'. B) PRINCIPAL'S DISCLOSURI:(()i I 1', CONiPI:NSATION): (REQUIRED).Hourly rate o1 1LiO t _ The iollowinginfomiation niuSi. I �:red: 1) Pursuant to Miami Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": Yes X No: Are you lohhviII!, r,111 Pt•nclin,• hid for Uoods. ctauinment or services,or on it m-cscm or i)cndinW , -ard f s,c, (1;. 2) Pursuant to Miami t RL.h ! Scctlon 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development ISSUC;" _ Yes X No: Are you lohl2vill� ,• ,lim: nrg lication for a i7evelonment Agree nient with the City or annlic,rtion for c:hanee t_�1 IL-`ir_Tnatioti or change to the City's Future Land Use Mar)? 3) Pursuant to Mian-ti ScL'tion 24$2 (h;) Any person(except those exempt from the definition of"lobbyist"as set forth in Section 2-1,>I :d ojil)! appears its it representative of a not-tor-profit corporation or Cntity \%ithout special compensation or rcin,l,m- C1, ,or the appeal-ance, whether direct, or indirect, to express support Ot' (W opposition to and iiem,shall register •.•.'tilt ih rCcl i ll'�1 bV ibis Section but, shall not be required to pay any re-istration I'ec.. _ 1'cs X No: Are you rcrrt•:;•j itcorpornion or entity without sr)ecial coninensalion or reinlburscnicrit. V. SIGNATURE UNDER: ().V]1 ON ITBRUARY 28 Oi= I .\t !!_' '11 1 i`r IRYIST BRIM 1. SUBMIT TO THE CITY CLERK A SIGNED S_I_ATI=:A91=N"I" OATH. LISTING L0BRY1\(I 1 � __! !:ti. AS \VFI I_ \S COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENII�); ', _ 1 NTFMFNT SIIALL BE FILED EVEN IF THERE HAVE BEEN NO FNPI=NDI'rttRFS OR CONIIIENSATION DURIN(I I I S-nature ot'Lobbvist I do solemnly swear that Sill d t.- :ire true :inkl correct atid—that I have read or am familiar\%-ith thr provisions contained in Section 2-452 of the Miamm i ents. Si_tInature of Lobbyist: _ Signature of PrincipaUClient: \'I. LOBBYIST IDEN 1 1 PRINCIPAL IDENTIFICATION: Produced ID if. Produced ID �1����f' D e Ji4, I it Forin ol'Idcntilic.ttiort Personally known i!`.k Personally known (Principal) VII. SIGNATURE AND S State of Florida.County of State of Florida.C r • S%�orn jig aid subscd ,.•• tPIRY P e Sworn and subsc • ,�% MARILYN SOMODEVIlLA AL7<N This day of * * MY COMMISSION#EE 116532 flis duty of Eft! EXPIRES:September 13,2015 �IFOF FLO Bonded Thru Budget Notary fiiervlcetr , Signature of Public tary - . :. Signature of Public Notary -State of Florida Notarization of Lobbyist'-, Notarization of Princir)al's silgnature ! ''ONIPLI:'I'FI) 131'CITi'CLERK'S STAFF O Annual Registration fee: ( ] 1 i 11,nuit Paid$ MCR# Date Paid _ Lobbyist Registration Fonn t . !I, _t[:..e;f,LC',S�GI;r15\LnBEt -a! ._r t ,,o F,';rr'`,,joc k-;rze) Revised 01/22/2014 1=:,.CLER\SALL\aFOR;\1S`.L(}!:'� : Form.doe i • 0 i Exhibit"A" " Mayor& Commissioners: Mayor Philip Levine Vice-Mayor Micky Steinberg Commissioner Michael Griec Commissioner Joy Malakoff Commissioner Jonah Wolfson Commissioner Ed L. Tobin Commissioner Deede Weithorn City Manager: Jimmy L. Morales Joe Jimenez, Assistant City Manager Planning Board: Historic Preservation Board: Jean-Francois Lejeune David Wieder Frank Kruszewski Dominique Bailleul Jonathan Beloff Herb Sosa Brian Elias Jane Gross Jeffrey Feldman John Stuart Jack Johnson Josephine Manning Randolph Gumenick Wyn Bradley Design review Board: Board of Adiustment: Annabel Delgado-Harrington Barton Goldberg Carol Housen Bryan Rosenfeld Edgar Sarli Heidi Tandy Elizabeth Camargo Larry Colin John Turchin Noah Fox Kathleen Phang Richard Baron Vincent Filigenzi Richard Preira Gary Held Thomas Mooney Acting Planning& Zoning Director: Thomas Mooney Planning Staff Public Works Staff • M] A Ml B E A( H City®¢Miami Beach, 1700 Conventioi Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov h' . ov C 9 Tel:305.673.741 1 ,Fax:305.673.725 LOBBYIST NAME: I understand that no late than February 28 of each year, I must file the following form, pursuant to Section 2-48 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues 1) LOBBYIST EXPENDI--URE AND COMPENSATION FORM Failure to file these form 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 2-48 (d),the City Clerk shall notify any lobbyist(or principal)who fails to timely file a Stat meat and In addition to any other penalties which may be Imposed as provided in S ction 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after a due date. The City Clerk shall notify the Miami-Dade County Commission on E ics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or p y the assessed fines after notification. Any lobbyist, who falls to le the required Statement by April 30t'of each year, shall be automatically suspended rom lobbying until all fines are paid, unless the fine has been appealed to the Miami-Da a County Commission on Ethics and Public Trust. Signature: EiateK. FACLERULUaFORMS\LOBBYIST FORMS\ obbyist Registration Form.doc r r _ o -- c °fin °' samom 3 r Q some �_Sm f to Vlei *r-z llt;z, 1'f1 CD ® •y_ i _ -f I .n ��