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Julio Ramirez - Congress Hotel South Beach' d' 4 (6c-z Ocea.,Dr tte, (0,4,5ce55 l- }e-1 AAIANA1 E ,A•CH .• r i} City of Miami Beach Office of the City Clerk L 5 Liu I' p 2: 5 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM 1 t�.,T, I- L ;':. i . 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. Ramirez Julio NAME OF LOBBYIST: (Last) (First) (M.I) Congress Hotel South Beach 1052 Ocean Drive. Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-534-6820 ext.5204 305-534-6380 Iramirez @congresshotelsouthbeach.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: Julio Ramirez,General Manager NAME OF PRINCIPAL/CLIENT: Congress Hotel South Beach 1052 Ocean Drive Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-534-6820 ext.5204 305-534-6380 Irami rez @congresshotelsouthbeach,com 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: Julio Ramirez • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: N/A ILSPECIFI'C LOBBY ISSUE: Conditional Use Permit for Outdoor Entertainment Establishment for rooftop lounge of the Congress Hotel(1052 Ocean Drive) Issue to be lobbied(Describe in detail): 4 Ill.CITY AGENCIES/INDIVIDUALS TO:BE'LO:B BIED: 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 City of Miami Beach Committees and Boards None ✓ City of Miami Beach Attorneys Office and Administration None City of Miami Beach Mayor/Commissioners None V 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 Y p None 11280678 CPL__ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) i Ii�t�, L pi B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST QOMPEN$ATIQN): (REQUIRED), Data( loyee, 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✓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. Yea= Jo: 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 REC_VED IN THE ITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHAL s;E FILED EVEN I A RE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signatur: of Lobbyist ' ' I do solemnly swear that all of the foregoing facts - a and correct and that I have read o - amiliar with the p rovisions contained In Section 2-482 of the Miami :_- City Code - d : reporting requirements. Signature of Lobbyist: - -, Signature of Principal/Client: AV' .4, -4," VI. LOBBYIST IDENTIF CATION: PRINCIPAL IDENTIFICATION: Produced ID Produced ID Form of Identification Form of Identification # Personally known(Lobbyist) tersonally known(Principal) VII. SIGNATURE AND STAMP OF NOTARY: •1�"'"41 GiSELLE GARMENDIA Sta of Florida,County of Miami-Dade State of Florida, County of Miami-Dade ,,�t�RY°�,B��I Sworn t d subscribed before me = �° `� Notary Public-State of Flora+' and subscribed be ore me a �.1 a• Commission A►FF 18662f hi:, c9 lv day of 1( ,2aO1 s- This day of �1� My Comm.Expires Jan 1,2019 J //• _ ''''''''' through Natio►'I► /•. 1.:•.I 41- -! Bonded thr ��=� , Signature of P 11t-1I. ' b stary–State of Florida •1e�N•�,..ry–State of Flori•'. � •� , Notarizatlo. .f Lobbyist's signature Notarizatio .f Prci'al's signature TO BE COMPLETED BY CITY CLERK'S.STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ g ' MCR# L1 1 4 17� Date Paid [1) Lobbyist Registration Fo received and verified by: '� Revised 04/27/2012 F:\CLER\$ALL\aFORMS\I.OB YIST FORMS\Lohbyis-t Annual Reglstrntic I oc ��,aa"u • GISELLE GARMENDIA ,,a —��, Notary Public•S of • ,•- Commltyion•FF 1USZ2 -A My Comm.Who Jan 1,20 •''r Borakithra NftlondflolNy pr ,' City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CilyClerk@miamibeachfl.gov Tel:305.673.7411 ,Fax: 305.673.7254 LO YOS4 N, , 4,,E: Julio Ramirez I understand that no later than February 28 of each year, I must file the following form, pursuant to Section 2-485 of the IViiami 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 2485.1, 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-Dad 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 om lobb in until all fines are paid, unless the fine has been . appealed to the Miami-Dade County Commission on Ethics and Public Trust. Si ature: Date: • MAMBEACH City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov City Clerk's Office Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Julio Ramirez Name: Congress Hotel South Beach Business Name: 1052 Ocean Drive, Miami Beach, FL 33139 Address: Office Telephone Number: 305-534-6380 Cellular Telephone Number: jramirez @congresshotelsouthbeach.com Email Address: If more than one lobbyist, please list: 1) • 2) 3) 4) 5) 6) 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. For City Clerk's Office Use Only MCR#: Amount paid: Date paid: Processed by: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx '11 - - -7 Miscellaneous_Cash Receipt �� y�.^ . CITY OF MIAMI BEACH r . - - . . - - 4 - = Cft.d„r. C7 Cash ❑Credit.Card Check#(10H.9_. I 20 l; of, f' wq r c J, v►r , " ! 1 a : ` ; • Received k Address _ C • pe rn;± GJoo( e (ov (For (� ! -I (THIS INFORMATION MUST BE COMPLETED). - Office of Finance Director r 1,. a • ;t �� Account Number: II FOOD —7:4)1). (. `� - De t: _. Exr: 4 1 1: • Prepares. ,s • t. P , E • • • .- . . - am i..s� «.s.._, �._. r-., . ,z_. .. i :. .. •� .. �..?.. •.1i-.e�is•.-.:i,...,sxxbkuc*'",�.f3.Aa-� ... �'�.� .., .. ..„a.l.�, _,.. �._ .. t�. ...�, -... ... .. ^_-