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Bruno Lopes - Bruno Lopes �G 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"Lobbts"has specific exclusion VQ ease refer to Ordinance 2004-3435. yis C5 V'1 d NAME OF LOBBYIST: (Last) (First) (M.I) A' ai5 c o 0(5 _ �- 4W! NiMi(AAA 51v 5U;h ' 1_ 3 m► BUSINESS NAME AND ADDR SS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: EMAIL Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: rp a VV\C GS a h X�, NAME OF PRINCIPAUCLIENT: BUSINESS NAME AND ADDRESS (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: Ter-69. k1' h I'1 P CEO • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATIO , PARTNERSHIP OR TRUST: II.SPECIFIC LOBBY ISSU Vf fiafe. —q Issue to be lobbied(Describe in detail): III.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 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 eneral nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES I NO title of pers n to be lobbied � c ec 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 t . F:\CLER\$ALL\aF0RMS\L013BYIST FORMS\Lobbyist Registration Form.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) J/© 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�.No: 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": _Y4W: 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—No: 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 O_ATH, 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. 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: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification "Personally known(Lobbyist) Personally known(Principal) VI1. SIGNATURE AND STAMP OF NOTARY: State of Florida, County ami-Dade State of Florida, County of Miami-Dade rn t and su= Sworn and sub f ERd hi c i dRIDA This F LORIDA 151 53 184353 ig 6 tig�n tur o IL 23,2016 No rization of Lobbyist's signature Nota 'zation of Principal's signature TO BE COMPLET Y CITY CLERK'S ST FF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# d / Date Paid Lobbyist Registration Form received and verified by: 4 ikevised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk@mia.mibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: k-U VV C) I 0 n-es 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 301'of each year, 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. W j� Signature: Date: FACLER\$ALL\aF0RlVlS\L0BBYIST FORMS\Lobbyist Registration Form.doc Internal Revenue Service \ Department of the Treasury EP/EO Division: CSB P. 0. Box 1055 Atlanta, Georgia 30370 / U)� E0105 G N 0 W O C G ate° m DDD Person to Contact: Q G. Hawk/dm Cr Miami Board of Realtors w o `f Contact Telephone Number: 2050 Coral Way @� o (305) 536-5991 i Miami, FL 33145 E go CD Reply to: 3• o E0: 7207: GH o = �' W Employer Identification CD Number: _ ( w M c 0 59-0359750 � N = 0 00 Qw N� ass -gEp25 1W6 O • CD 3 co (0 W Dear Sir or Madam: Our examination of your Form 990 & 990-T for the year ended August 31, 1984 disclosed that you continue to qualify for exemption from Federal income tax. E: We will continue to recognize your exemption under Internal Revenue'Code section 501(a) as' an organization described in section 501(c)(6). There is no change in your liability for. the unrelated business income tax imposed by Code section 511. During the examination we noted certain aspects of your operation and/or reporting inadequacies which, if expanded or not corrected in subsequent years, may jeopardize your exempt status or subject you to applicable penalties. More Specifically: _ Our examination disclosed that your organization failed to furnish the names and addresses of 'all your officers, directors, and trustees and the compensation paid to each of them as required by section 1.6033-2(a)2(ii)(g) of the Income Tax Regulations. This information must be provided with your Form u in future years. Revenue Ruling 59-959 Cumula tive Bulletin 1959-1, page 627,• prescribes that failure to comply with the provisions of section 6033 of the Code and regulations which implement it.. may result in the termination of the exempt status of an organization on the grounds that the organization has not established that it is observing the conditions required for the continuation of its exempt status. Your return Form 990 included Schedule A Form 990. This schedule applied only to organizations exempt under Section 501(c)(3) of the Code and should not be ` : filed by your organization which 'is exempt under IRC 501(c)(6).