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Martin Scasserra - Setai Resort & Residences Condominium Association, Inc (2). 5 )c4: `7 ,r % t frAe s( MIA City of Miami Beach Office of the,. ity Clerk 1700 Convention Center Drive, Miami Bt 3ch, FL 33139 LOBBYIST REGISTRATION FORI1 Lobbyist means all persons employed or retained, whether paid or not, by a principa who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissional.; a' y action, decision, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation o' any city personnel during the time period of the entire decision-making process on such action, decision or recommendation that foi aeeably will be heard or reviewed by the city commission, or a city board or committee. The term specifically includes the principa as well as any employee engaged in lobbying activities. The term"Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Scasserra Martin NAME OF LOBBYIST: (Last) (First) (M l) 101 20th Street Miami Beach Florida 331. 9 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305 962-8550 305 520-6515 ms;,asserra • setaiassn.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: Setai Resort & Residences Condominum Association, Inc., A Florida Non Profit Corporation NAME OF PRINCIPAL/CLIENT: 101 20th Street Miami, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) r _. 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: Dr. Stephen Soloway, President • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: N/A II.SPECIFIC LOBBY ISSUE: Impacts related to Setai Resort&Residences Condominum Association,Inc.,concerning HPB File No.7515 and related matters. Issue to be lobbied(Describe in detail): Ill.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 .erson to be lobbied Planning Board None X Land Use Board None X • Planning Staff one X Maynr X Pursuant to City Code Section 2-482(g)Every registrant shall be requiredito 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 City Agencies/Individuals To Be Lobbied: Cite Manacles Office None X City Attorney's Office None X Historic Preservation Board None X • • IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A)NoBBspeDclial compensaltion for representation; salaried manager. B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (Required). No Compensation 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": ❑Yes ® 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 2-484(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 El No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: ON FEBRUARY 28th 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 SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. ii , -1,011.111P'4 Signat•re o Loi.ist I do solemnly swear that all of the foregoing facts are tru- a correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and z.-ft , .•rting re•uire ents. 7 ;i/ , � Signature of Lobbyist: R ∎'�i�//A � t/ Signature of Principal/Client: `'.�.�1 VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: m, ) ProducedID tL ,')RtY& g LIC • .' „ *4. 0 Produced ID r`� ,- Form of Identification s o A^�4� Form of Identification co 3--Lo m 4 0 z 0Z x— Personally known(Lobbyist) CO y T v w o y ( y ) $:'_� Personally known(Principal) m*m o"' i j 4i�`..--;Q 2m z C.•V) VII. SIGNATURE AND STAMP OF NOTARY: �'`'',g W.�°-�cn.-r If of `.c..'r =v' ` State of Florida, County of Miami-Dade ,' _° c. a State off eriri&, ounty of ' m Ez,0 0 Sworn t nd subscribe• efore me `,,��,�„ o-c Sworn and subscribed before me oa'e,,� This •: of 'A, , 21 . r, ;�,,,, . b�: This ' •09)./,..' t ,201g c.),.� ■P . !__AR 'a . � i 4,5. Signatur'�•lic Notary tate of Florida • 511.-c''..-' Signature Signature of Public ':-- ate of Z Notarization • Lobbyist's signature """�� Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF N}Y /,��_� Annual Registration fee: [ Yes[ ]No Amount Paid$ CR# �/ Date Paid �O�e�JV� Lobbyist Registration Fo received and verified by: r :IC R\$A L\a Ci�3�l '�L Y T FORMS\Lobta*i Annual l d i tr io .do Revised 1/11/2011 ( r - * f i f�a 5 ( z s _ Y - r City,of Miami Beach, 1.700 Convention Center Drive,Miami'Beach,Fiorida,33139 www:miamibeachfl.gov CITY CLERK Office CityClerk @miamibeachfl gov T&:.305 673:741 1 ,Fax:305:673.7254 = LORYhST �� is I understand that'no idter than February 28th of each year, I must file the following I - L form, pursuant to Section 2-485..of the N[iamii 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_tirriely,Ibasis will result`in my name being transmitted to the __ Mi-ami-Dade;County Commission..on Ethics and for code violation evaluation:: In-addition 'once a`n issu(I.-•''have= g're' isteired to lobb y :ha's on been resolved .1''am;re wired q to immediately notify the`City',Clerk's Office of lobbyist withdrawal in writing. Adi(giggigor. , , Signature: ate ` • • • • • • • • 1