Lee B Schrager - Florida International University V
MIAMI
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.
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NAME OF LOBBYIST: (L s) (First) (M.1)
il R IBDYIA(A A MI t/° 0 SW I r9 M*j L 551
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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TELEPHONE NUMBER: FAX NUMBER: AIL:
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 PRINCIPAUCLIENT:
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BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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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: -�)t. r 'a nL+k II
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: 1V1,4
ii.SPECIPIC LOBBY ISSUE:
1221 S t_ od vC4 1
Issue to be lobbied(Describ 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 general nature of the subject contractual relationship.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES I NO
title of person to be lobbied
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Pursuant to City Code Section 2-482(8)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(g)Any Financial,Familial or Professional Relationship c
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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): 11
(REQUIRED). #09 010,*7;?eo0,S4,7"7 dh
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":
_Yes x 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.
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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
OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENSATION RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT HALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Sigr toe of Lobbyist
I do solemnly swear that a I 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 Mia i Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Clie :
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known( n i a
ao Y p e4^ Notary Public State of Florida
VII. SIGNATURE AND STAMP OF NO F1?fi�t a Patricia M Tully
P& Notary Public State of Florida ,, �Q My Commission FF 031258
Patricia M Tui!y �CF F o Expires 08/29/2017
State of Florida, County of Miami-Dade 4` rely Commission FF 03'!258 St of Florida,County
Sworn to and subscribed b fore meoF F� Expires 08/29/2017 S rna�,n�,d�subscribed efore me
This , 4''day of 0 ,201 day of 0* . ,201q
e
.Signature of Public Notary State of Florida Signature of Public Notary rY– g –State of Florida
Notarization of Lobbyist's tgnature Notarization of Principal's signature
TO BE COMPLETE BY CITY CLERK'S STAFF ONLY in ISO 6V
Annual Registration fee: [']Yes[ ]No Amount Paid$ CZ MCR# " O - l to Pai
Lobbyist Registration Form received and verified by:
F:\CLLR\$ALL\a FORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.dot 0AS d 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
AVAI I A IM I B E A C H
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeochA,gov
CITY CLERK Office
Rafael E.Granada,City Clerk CityClerk @miamibeachfl.gov
Tel:305.673.741 1 ,Fax_305.673.7254
LOBBYIST NAME:
1 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 30u'of each year,shall be
automatically suspended from lobbying until all fines are paid, unless the me has been
appeal to the Miami-Dade County Commission on Ethics an Publi7Tr s .
/0 g / 4
Signatu : D te:
FACLERISALLIaFORMS10813YIST FORMSlobbyist Registration Form.doc
Prieto, Silvia
From: Cancino,Julia <JuliaCancino @southernwine.com>
Sent: Friday, October 31, 2014 2:40 PM
To: Prieto, Silvia
Subject: Lobbyist Expenditure &Compensation Form
Attachments: Lobbyist Expenditure &Compensation Form.pdf
Hi Silvia,
Pleasure meeting you yesterday. Please see attached our Lobbyist Expenditure &Compensation form I was missing with
the paperwork from yesterday.Thank you for accepting it via email.
Have a great weekend!
Julia Cancino
Accounting&Compliance Manager
Florida International University
Food Network&Cooking Channel South Beach Wine & Food Festival presented by FOOD &WINE
P: 305-627-1266
SOBEWS ��
r•rcn y.TC4 L;YRPM�NAKC
This message is the 17r-oper1y oaf Soitlhern I'V ine & Spirits or ils affiliates. It is intended only for the use of the
individual or entity to i,ti.hich it is addressed and may,contain inforrrration that is n.on-public, proprietar j,,
privileged, confidential, and e-vcn pt ftom disclosure under al.)[kcable or may comtitute a.s attorney, uwrk
product. ff),,ou care not the intended recrpren.t, you are herehj,notrfr.ed that anv use, dis.sen7rnatror7, distribution,
or copyingr Of this communication is strictly prohibiter .If yon have received this con"Inunication in error, noto
tt;S' rr'anediately by tele1.7hone and(i) destro ill this rne:s:soge rf a f icsimde or (ii) delete this rnessa 'e iminediaiel)- tf
this is an electronic cornmunicazion.
Thank you.
i
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/ c x-
Prieto, Silvia ✓
From: Cancino,Julia <JuliaCancino @southernwine.com>
Sent: Tuesday, November 04, 2014 2:41 PM
To: Prieto, Silvia
Cc: Clay, Brittany
Subject: RE: Lobbyist Expenditure &Compensation Form
Attachments: Lobbyist Expenditure &Compensation Form.pdf
Hi Silvia,
I just wanted to follow up and verify you received the 3rd page. Please reply to this email for confirmation.
Thank you in advance,
Julia Cancino
Accounting&Compliance Manager
Florida International University
Food Network&Cooking Channel South Beach Wine & Food Festival presented by FOOD&WINE
P: 305-627-1266
SOBEWFF
From: Cancino, Julia
Sent: Friday, October 31, 2014 2:40 PM
To: 'silviaprieto @miamibeachfl.gov'
Subject: Lobbyist Expenditure &Compensation Form
Hi Silvia,
Pleasure meeting you yesterday. Please see attached our Lobbyist Expenditure &Compensation form I was missing with
the paperwork from yesterday.Thank you for accepting it via email.
Have a great weekend!
Julia Cancino
Accounting&Compliance Manager
Florida International University
Food Network&Cooking Channel South Beach Wine & Food Festival presented by FOOD&WINE
P: 305-627-1266
.Gi7Cl.�lk3�t5
SOBEWFF
This message is the pro pel�t) cif.S'ozrtherl� line Spirits or il.s ciffiliutes. .It is intended only fvr the u.se of the
indivi(2ial or entili, to 1•L'hich it is addressed and ma),contain infor ination that is nvn-public, proprietary,
privileged colgfidential, and eXempt,frorn dis'closur'e under applicable kar or mcf)-const'lute as attorney iv-ork
product. If you are not the intended recil)ient, You are hereh)-notified that any use, dissemination, distribution,
or colt v,ing of this communication is .strictly prohibited. .If.yon have received this coinnninication in error. notifl'
1
a
O
Prieto, Silvia
From: Prieto, Silvia
Sent: Tuesday, November 04, 2014 4:34 PM
To: 'Cancino,Julia'
Subject: RE: Lobbyist Expenditure &Compensation Form
I got it,
Thank you so much.
Silvia Prieto,Administrative Aide I
CITY CLERK'S OFFICE
1700 Convention Center Drive,Miami Beach, FL 33139
Phone: 305-673-7000 ext.6269/ Fax: 305-673-7254
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.
From: Cancino,Julia [ma i Ito:JuIiaCancino @southernwine.com]
Sent: Tuesday, November 04, 2014 2:41 PM
To: Prieto, Silvia
Cc: Clay, Brittany
Subject: RE: Lobbyist Expenditure&Compensation Form
Hi Silvia,
I just wanted to follow up and verify you received the P page. Please reply to this email for confirmation.
Thank you in advance,
Julia Cancino
Accounting&Compliance Manager
Florida International University
Food Network&Cooking Channel South Beach Wine& Food Festival presented by FOOD&WINE
P: 305-627-1266
5 :
SOBEWF'F
From: Cancino, Julia
Sent: Friday, October 31, 2014 2:40 PM
To: 'silviaprieto @miamibeachfl.gov'
Subject: Lobbyist Expenditure &Compensation Form
Hi Silvia,
Pleasure meeting you yesterday. Please see attached our Lobbyist Expenditure &Compensation form I was missing with
the paperwork from yesterday.Thank you for accepting it via email.
1
a
Have a great weekend!
Julia Cancino
Accounting&Compliance Manager
Florida International University
Food Network&Cooking Channel South Beach Wine& Food Festival presented by FOOD&WINE
P: 305-627-1266
SOBEWFF
This inessagoe is the propertil,of'Southern [Fine &, V-)irit ' or lls afflliales. Il is intended onlj' n-the 14Se Of the
individual or entity,to lf,,hic-h it hs, addressed and inav,contain infUrination that is non public, proprielarv.
Privilc�(4red, confidential, and exempl.fi-oin disclosure tinder applicable lay oi-wa"v conslilule (is allor"ney ivork.
1)1"ULl1.GC'l. .If;y,on (ire, not the intended reclpienl; 'yo21 are hC'i"ebv iiolif led that anj' tile, (1isseminal7.On, dish"ij7Lf1701�,
or copying(?/'/his, con?rniinlc(ation is str'lctly prohibileel. Y you have r'ereived this communication in error, noti1j'
its immediately by telephone and(i) desir"oy this ines;sage if a f ie;simile or (ii) delete lhi:s me;ssatie inimediately if
this is(in electronic coinini.inrcation..
I hank vou.
2
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