Andrew G. Suarez - Guy Max Malul ILI2—(lb
;tL� - c BEACH ae.m)MIAMIBEACH
City of Miami Beach Office of the City Clerk , ` �, a `-
1700 Convention Center Drive, Miami Beach, FL 33139
2015 jLH':12 6 PH 2: 2 f,
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage thet asse e,i defeat lor I r.:F
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.
Su A DTZ.ZZO �-.
NAME OF LOBBYIST: (Last) (First) t4t' (MI)
LEA:id uu S Z SO I u I /1 1 ‘u f4 o Y e
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
1 .315. c i3 AIS,SUM.*2 Li so fitickb.(.1)14
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
(pis/NI MA)e flAP WL
NAME OF PRINCIPAL/CLIENT:
ArLGYA1' D IL }-{-c11 E L 5225 townie A16' IAA I Anal i -t 331 O
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
YIN. 173. n37-
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: 60.4 y i A-X 14 A L U L ' b I CA 'Pair CO kV N
•. IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: •Uy MAY 4 A L ` (c_A voeit T C,o({EN
II.SPECIFIC LOBBY ISSUE:
5e .i- c It- ►q 2- 110 5 Cp E L's) a Lit $14111.4. u rr4-tN A 4E61 t x1144-IIoN -Mk AND (,612A1
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
Moslo(. illIuP Liut ( COMM. 1411(404 SZIN
tM4• b4 ales L IM I ��AD'1 rsAktik(at
Mt'S w ir2aJ (ANA.> t reA N
Co eN�N pc,
FC s�uahf tcARCege o )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 No.
F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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ty, DISCLOSURE OF TERMS AND AMOUN1S OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
Al :...3BSY ST DISCLOSURE:(Required) in
_.___ _ iv f 06! 431::Apexril
. -
3I PRINCtr2ALS DISCLOSURE OF LOBBYIST COMPENSATION): i„
(REQUIRED _ —1-.40.0_2A—tifiliLrff
The following information must be answered:
Pursuant to Miarn:Eeact City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
51.;eS itiV.
_Yes,s4o: Are you lobbvkg on a .resent or •endin• bid_figrag2Lis,equipmenLormulces or or,__,,,_ja.p_mea__p-e-it or ndino
award for goods,equipment or service?
Pt,rsJan;..0 Miami Beach C Cede Section 2-490 Entifled"Prohibited Campaign Contributions By Lobbyists On Real Estate
De, .c wren!is7:...e3
/
—Yes 2.,;(lo: Areyou lobbyin or_a_u_apscligs_agplisagimfaraggyelgsment A reerent with 2.a_the City or a lication for
chanee of zonin. ma. d si.nation or chan.e to theSityllyture Land Use Map?
:.:7 Pi,gsuant 10 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 remoursernent for the appearance. whether direct, or indirect, to express support of or opposition to any
item,shalt register■.vith the clear as required by this section but,shall not be required to pay any registration fees,
......Yesio:- Are .0 re.resentin. a not-for refit cor.oration or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 2/3 OF EACH YEAR,EACH LO=BYIST SHALL SUBMIT TO THE CITY CLERK A SI NE* STAT MENT UNDER
OATH, LISTING LOBBYING EXPENDITUR S.AS WELL AS COMPENSATION RECEIVED IN THE CITY 0 F MIA I BE.4_C H FOR
1 THE PREC40iNG CALENDAR YEAR. A STATEMENT SHALL BE FILED E EN F THERE HAVE BEEN AIRT7 NDITURES 0"
COMPENSATION DURING THE REPORTING PERIOD.
Parliar"
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Signature of Lo ici,L r
i co soierrniy sk.vear l!io1 al:of the foregoin* fa 0 are true and corrf gif d It . d v e re 4 or any farni FA.i 40.vi .co .ined
in Ssotfan 2-482 of the t-,ilarri Beach City .t e rd all reportin_ ril,/xments,
S"a‘,we of Locbyi8t: A ''Ar If
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VI. LOBBYIST IDENTIFICATION: 41.1 PRINC AL IDENTIFICATION:
1 '
Produced 10 RO Fl jefia' 1 g i-z,,,- Produced ID 4010129.3.311. q 714
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Form of Identlficatio *Z.:f--:_, Form of identification
—I Li-s'•.y
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Personally known(Principal)
Personall./known(Lobbyist) 12<'A —
•••••101.11. =... .•Z _
VU. SIGNATURE AND STAMP OF NOTA ‘,&8 E-t
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State of Fionda.County of Miami-Dade
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2 LLI. State of- I>itrda,County of Itamt:Dade.-
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Swom to and bscebed before ma / I Sworn and subscribed before me
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of FLoN2 -2 D
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%,;3,.......ilky .....,/ This 2-1 day of of.
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Sioaturiof Public Notary— tate of I-.orida ",,,t,a‘.. si.n_. re of Public Notary—State of gleoida
Notarization of Lobbyist's signature Notarization of Erinsigals signature
,.
TO BE COMPLETEDBY etTY CLERK'S ST_ F ONLY /.
Annual Ragisbation lea: ( 3 Yes I No Amount Patif$ ....../.15*" MCR$1 dim i._ _Date Paid ... ingill
Lobbyist Ragiatration Form rawly ' nd verified by:
Vi Revis-til 01/Ar/2014
Ft'CLER ALL\aFORMSILOBBYIST FORMSlobbyist Reli5tration Form,doc
M1Atv\ BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: AVOka.) r ai/W Z
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 of each year, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the iami-3 de County Commission on Ethics and Public Trust.
Signature: /7 Da :
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