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Adrian Raymond - Raymond Adrian AA I A NA BEAC Vc. Giestutir" 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.--ase refer to Ordinance 2004-3435. NAME OF LOBBYIST: (Last) (Firs (M.I) v, ► .�. . A . 1 CO lbw .Je BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 6, e Ma Awl,► 3aS' �o"� -�o os"! 3 O S' .PC9 ?--o o r 2. 3�i f f TELE HONE N BER: FAX NUMBER: EMAIL: GAD Q 2d.001 60.4 Please notify this office if your contact information_changes:address,phone, ore-mail address: '_ I. LOBBYIST RETAINED BY: a �►.�, .� k ),tiA' NAME OF PRINCIPAL/CLIENT: ''7 2—Z1 C4tt,N1 kvto_. I�tlum L QeAc� b�l- 33 f ( -t BUSINESS NAME AND ADDRESS (Number and Stre- (City) St- e) (Zip Code) • " . C o ..d• l , , .-o P - k R.t A&l t"o(..• o 0 1 TELEPHONE NUMBER: FAX NU : R:(Op tonal) 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: /tc.ro d n- 4 44 e.14 e-ae. • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II.SPECIFIC-LOBBYIS,SUE_ ,t V L•Q d-roo e.A. �C 7 o V 2.0 1 S — Z o 1 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) `DES NO title of person to be lobbied L4 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 NO 6-)`e- F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc f i IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) ,tO N Q-- B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST C�Of�1P6I��ATJ): (REQUIRED). ��V f��+ `` 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_VNo: Are ou Iobb in. on a .resent or •endin. bid for .00ds e•ui•ment or services,or on a •resent or .endin. 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_'No: Are ou lobb in• on a .endin. a••lication for a Develo•ment A•reement with the Cit or a••lication for chan•e of zonin• ma• desi•nation or chan•e to the Cit 's Future Land Use Ma.? 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. v Yes No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. — — V p q p p V p p 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 COM' SA_ON RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHAL =E FIL ;VEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. I Signature of L.-•yist I do solemnly swear that all of the . eg." ,, facts are true and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami B=:ch City •c•e and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: fy1 VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ,:- Produced ID Produced ID Form of Identification Form of Identification- {/ Personally known(Lobbyist) . Personally known(Principal)_ : VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade State• lorida,County of Miami-Dade -' Sworn tssaryl subscribed A,fore - %ter - d _ •scribed before me This TV day . ,' 201 S ,, y 20 àAIIià RLYDIA A MENDEZ=o`..� -'�% ...Ai ? '^ MY COMMISSION OF137064 0 MY COMMI , .� -�►. Signature of P . • a , -State •"Florida SSION .. ■ - ±;r,,o ••lic Notary-State of .■•? EXPIRES:JUN 29,2018 Notarization o�obbyis 's signature % EXPIRES:JUN 2�l. eriza'ion if Principal's signature 14OfR' Bonded through 1st State Insurance Bonded through 1st State Insurance TO BE COMPLETED BY CITY CLEKK'a AF' ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$. MCR# Date Paid - Lobbyist Registration Form received ived and.verified by - :\CLER\ j3 \G��3:tsa,NS\L OaBYLS T.FOR;AS~Lobbyist Annual Re_istra icon Form.doc Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc I c ilV I To 3-4 t 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: 305.673.741 1 , Fax:305.673.7254 LOBBYIST NAME: 44 ,1•At.) '�J�(U. &v J 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 app= ed t Miami-Dade County Commission on Ethics and Public Trust. q ! S� Sign. _ ='! D te: C.T, c= y= i N „. F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc Detail by Entity Name Page 1 of 3 e� r x FLORIDA DEPARTMENT OP STATE DIVISION OF CORPORATIONS Detail by Entity Name Florida Not For Profit Corporation UNIDAD OF MIAMI BEACH, INC. Filing Information Document Number N93000005603 FEI/EIN Number 650584874 Date Filed 12/14/1993 State FL Status ACTIVE Last Event REINSTATEMENT Event Date Filed 10/21/2003 Principal Address 1701 NORMANDY DRIVE MIAMI BEACH, FL 33141 Changed: 07/12/1999 Mailing Address 1701 NORMANDY DRIVE MIAMI BEACH, FL 33141 Changed: 07/12/1999 Registered Agent Name &Address DIAZ, VICTOR MJR. 119 WASHINGTON AVENUE SUITE 402 MIAMI BEACH, FL 33139 Name Changed: 08/04/2000 Address Changed: 03/20/2012 Officer/Director Detail Name &Address Title PD SABOYA, MARIA 1329 71 STREET MIAMI BEACH, FL 33141 Title TD http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 7/10/2015 Detail by Entity Name Page 2 of 3 RODRIGUEZ, JORGE 4755 ALTON ROAD MIAMI BEACH, FL 33141 Title SD MANNY, FERNANDEZ 4090 SW 2ND AVENUE MIAMI BEACH, FL 33145 Annual Reports Report Year Filed Date 2013 01/31/2013 2014 05/13/2014 2015 04/27/2015 Document Images 04/27/2015 --ANNUAL REPORT View image in PDF format 05/13/2014 --ANNUAL REPORT View image in PDF format 01/31/2013 --ANNUAL REPORT View image in PDF format 03/20/2012 -- ANNUAL REPORT View image in PDF format 05/10/2011 --ANNUAL REPORT View image in PDF format 04/19/2010 --ANNUAL REPORT View image in PDF format 03/25/2009 --ANNUAL REPORT View image in PDF format 03/10/2008 --ANNUAL REPORT View image in PDF format 02/13/2007 -- ANNUAL REPORT View image in PDF format 03/28/2006 --ANNUAL REPORT View image in PDF format 01/20/2005 -- ANNUAL REPORT View image in PDF format 01/26/2004 --ANNUAL REPORT View image in PDF format 01/08/2004 --ANNUAL REPORT View image in PDF format 10/21/2003 -- REINSTATEMENT View image in PDF format 04/10/2002 --ANNUAL REPORT View image in PDF format 11/28/2001 -- REINSTATEMENT View image in PDF format 08/04/2000 --ANNUAL REPORT View image in PDF format 07/12/1999 -- REINSTATEMENT View image in PDF format 04/14/1997 --ANNUAL REPORT View image in PDF format 03/18/1996 --ANNUAL REPORT View image in PDF format Copyright©and Privacy Policies State of Florida,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 7/10/2015