Java Kader Zebede - Moone MB, LLC M I AM I BEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139 ‘Av\.\#\
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.
Kader Zebede Java
NAME OF LOBBYIST: (Last) (First) (M.I)
KZ Architecture 7580 NE 4th Court, Suite 116 Miami Florida 33138
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)865-9911 (305)865-0572 iavaOkzarchitecture.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:
Moone MB, LLC
NAME OF PRINCIPAL/CLIENT:
Moone MB, LLC 999 Brickell Avenue, Suite 600, Miami Florida 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)965-7882 (305) 396-2857
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:Mathieu Massa,Managing Member
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Christine Lombardi—99%;Mathieu Massa—1%
II.SPECIFIC LOBBY ISSUE:
Development Board Approvals and Permitting Issues for 4440 Prairie Avenue, Miami Beach, Florida
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 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 X
PB, DRB, BOA, City Commission, as necessary* None 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.
Sec 2-482(g)Any Financial, Familial or Professional Relationship
None
■
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
' A) LOBBYIST DISCLOSURE:(Required) 179, ' n0 D /o-- 'e _ „kilt
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): I ���
(REQUIRED). $ �r c' (
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 pendina bid for aoods.equipment or services.or on a present or
pending award for goods.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 lobbyina on a pendina application for a Development Agreement with the City or application
fa change of zoning map designation or change to the City's Future 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 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 BEACI-(
EQB THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING/PERIOD ___C___
/7.-----_______
Signature of Lobbyist
I do solemnly swear that all of the ` -•oing facts are tru nd correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami :-ach Ci y Code and --►► ••rting requir.-ments.
Signature of Lobbyist: AilakIlekl6Vi
Main Signature of Principal/Client: . ��,...
��ii■--u:: ✓„r Vi O .,):BYIST IDENTIFI"ATION: I' i PRINCIPAL IDENTIFICATION:
$i W ° -�'.�,)duced ID r L Jei%/ei ,�S L C~ Produc
�• °.° '' Form of Identification Form of Identification.2 jt to C9 � �
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a w :- W •.... -_.,
2 a E a 'c•rsonally known(Lobbyist) Personally known (Principal)
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- o E `- °�� Notary Public State of Florida
tI ° =C NATURE AND STAMP OF NO 4e Mitchell S Polansky
a°o .a o` My Commission EE 166431
,,, - F k rids, County of Miami-Dade of 0 Expires 04/02/2016 to of A • •a, Co • of Miami-Dad-
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ignat re o Public Nota • —State of Florida :ignature of ublic a — ate of Florida
Notarizati.n of Lobbyist's signature otarizatio i of P. cip. 's signature
TO BE.COMPLETED BY CI CLERK'S STAF ��NLY ;.; ��
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Annual Registration fee: [� es[ ]No Amount Paid$ Air.o MCR# 1?- • - Date Paid i�
Lobbyist Registration Form received and verified by: jIIII a _
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F:\CLE istration Form.doc. Revised'04/27/2012
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK 0 ffice
Rafael E. Granado, City Clerk CityClerkamiamibeachfl.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME Jaya Kader Zebede
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
appeale Miami-Dade County Commission on Ethics and Public Trust.
5- -
Signat e: Date:
•
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