Reinaldo J. Borges - Goram Ronstad and his LLC 6r)rn tine,Viet,Dctve�
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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
ac'vities. The In"Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
f2(4hIclv
ME F LOBBYIST: Lasj (First) (M.I)
/200 �J� � �. ��� ,. 33/
BUNESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
519 ?I 12,16 3/ 12- r d fa.��o .02
TELEPHONE NUMBER: FAX NUMBER:
EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST ETAINED izoliktiteL
bovw,NAME OF PR ICIIPAIL/'LIENp th , Nye./ tit 42)I
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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: 9:t ct \,> benc�‘
-• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PA"T► ''- - OR TRUST: 5111 Prairee IXIWz
SS
b• to MINFescribe i. .etail):
III C 4 IES/INDIVIDUALS TO BE LOBBIED:
Pursu:nt to I ity Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered
into .ny con ractual 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 eneral 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
h 12€ a 9 f /
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
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
9)
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) G�r„�„, f_v v. Ftviu
h(��1 f�tvi 15(b��11�UV”B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED)./
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":
VV_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.
Ye 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 BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SH• = II VEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD. /11117-- ►11����
1rp Sign
-of ,.rr4l11111111."--
I do solemnly swear •_=mu - ;3. acts are true and ,orrect a d that I have read or am familiar with the provisions contained
in Section 2-482 of e raffilitise and all reporting requirements.
Signature of Lo • ist: �,►1/[��,��
9 y `.�
Signature of Principal/Clie t:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
,
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Produced ID FL Rti/t'_R'S UCei.v't' Produced ID
—
Form of Identification a`u ^ Form of Identification
O.0 O y
Personally known (Lobbyist) ' �k o^`O Personally known(Principal)
C.) Q � ` .'v
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VII. SIGNATURE AND STAMP OF NOTARY: CQ`' hoc
my .oe .'' m
State of Florida,County of Miami-Dade ? cC 44-a State of Florida, County of Miami-Dade
Sworn to and subscribed b:f e me � F F ` Sworn and subscribed before me
This . _ �-y of .b€R.,2015 .4?c.' (3�F� This day of ,201
iliP‘ / 9 ' ') -,, ,
Signature of P blic Not.: —State of Flo a $ * • s: Signature of Public Notary—State of Florida
Notarization i f Lobb st's signature s I Notarization of Principal's signature
%•a• 0:
TO - i°L�`Ew D =Y C CLERK'S STAFOF ONLY`7 Date Paid )t) 6 I�
Annual Registration fee: [ es[ ]No Amount •ai _i.. _P MCR# Li
Lobbyist Registration For eived and verified by: I
F:\CLER\$ALL\aFO S\LOI"S,,YISTFORMS\Lobbyist Annual Registration «rtmd.f.: Revised 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
. NA IAM ; 3E/\Q
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
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LOBBYIST NAME: ►Y
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
ap•eale r. to 'e = •de County Commission on Ethics and Public Trust.A, Adts111/
110111' i
4
Ce C)
diiI � Date:
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F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
•
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
B PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED).
The following information must be answered:
Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign contributions By Lobbyists On Procurement
Issues":
Yes No: A ou tebb .-on"a resent•o •: din t bid Or•oods.e•ut.mentor service S'•or.on a r resent'-or.endin•
award for goods;eauipmet�t 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 fobb int .n:a •e d ,•.a+ tea'io o a Deveto•ue t.s,.erne Cwlth the Cif ,.or a..lication_for
c ai!eofzo in. Ia. .esisnAi• orch.n•etot eC ' u • Land Us. •.?
3) Pursuant to Miami Beach City'bode Section 2-.4820)Any person(except those exempt from the definition of'lobbyist'as SCI
forth in Section 2-481 above)who only appears as a representative of a not-for-profit corporation or entity without special
cOMpertfrsation 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 riot be required to pay any registration fees.
_Yes_No-: Are ou re.res•`tin. a:not•or••ro' ;•cor•o - 1.1 or entit ,w t ou<s• c al corn. _atidn or.ret ;<•urseme t
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28,OF EAC I YEAR,EACH LOBBYIST'SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
01,l L ISTIN L0=B : ,G ' . TU-ES AS ELL. •S COMPENS•TI•N REC VED` N THE CIT OF A I SE CH Fe e
E PRE E' NG CAL NDA` .EAR. STATE`'E SH•L 'BE<F LED EVEN'IF THERE H•VE BE N 10 EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.,.
Signature of Lobbyist
I do solemnly swear that all of the'foregoing facts are true and correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all reporting requirements,
Signature of Lobbyist:
Signature of Principal/Client, .-PWA
VI. LOBBYIST IDENTIFICATION PRINCIPAL IDENTIFICATION:
r
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 of Florida,County of Miami-Dade
Sworn to and subscribed before me Sworn and subscribed before me
This day of 201_ This____day of ____,,201 _
r ,
Signature of Public Notary-State of Florida Signature of Public Notary-State of Florida
Notarization of hobbyist's signature- •• Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S.STAFF ONLY
II
Annual Registration fee: ( I Yes j j No Amount Paid$ MCR# „ Date Paid
Lobbyist Registration Form received and verified by;,,
F:tiG emsALLta s8Lo !I sT r0/01SUAbbillit Annual RegiAtolicri Form.doc Revised 01/22/2014
F:\CLERtSALLtaFORMS1LOBBYIST FORMS1Lobbyist'Registration Form,doc ,
Under penalties of perjury, I declare that I have read the foregoing Form of Lobbyist
Compensation and that the facts stated in it are true.
6114g-r\I!
Goran ROstad
Camm, Patrick
From: Reinaldo Borges <rborges @borgesarchitects.com>
Sent: Tuesday, October 06, 2015 1:13 PM
To: Camm, Patrick; Marlene Lopez Allende
Subject: RE: Lobbyist Information
Patrick:thank you for your follow up on this. Owner is the following:
Goran Ronstad: Miami Waterfront development and retail, LLC / EIN 32-0455620
He is 100%owner.
Reinaldo Borges, R.A., AIA, NCARB Principal-CEO
brirgoom a,rchitects
4ae
architecture urban planning interior design
Email: rborges borgesarchitects.com
1200 Brickell Avenue, Suite 1525 I Miami, Florida, USA 33131
T 305 374 9216 x 100 F 305 374 9217 C 305 322 5956
www. borgesarchitects.com
AA26000765
The information contained in this email transmission is privileged and confidential. If you are not the intended recipient, nor the employee or
agent responsible for delivering it to the intended recipient, you are herby notified that any dissemination or copying of this transmission
(including any attachments)is strictly prohibited. If you have received this E-mail in error, please notify the sender by email reply.
From:Camm, Patrick [mailto:PatrickCamm @miamibeachfl.gov]
Sent:Tuesday, October 06, 2015 11:22 AM
To: Marlene Lopez Allende<mlopez @borgesarchitects.com>
Cc: Reinaldo Borges<rborges @borgesarchitects.com>
Subject: Lobbyist Information
Good afternoon,
I sent an email to Reinaldo earlier today,asking him to stop by the City Clerk's office before he leaves. I am not sure if he
will see this email before he leaves.
I need to confirm that Reinaldo is lobbying on behalf of Goran Ronstad, as an individual person or as a business.
MIAMI BEACH
Patrick Camm,Administrative Aide 1
OFFICE OF THE CITY CLERK
1700 Convention Center Drive, Miami Beach, FL 33139
Tel: 305-673-7411/ Fax: 305-673-7254/ www.miamibeachfl.gov
We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical,
historic community.
1
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CIT`i HALL CASHIER OFFI
1700 CONVENTION CNTR DR
trilk6r1 MIAMI BEACH, FL 33139
10/06/2015 09:05:38
CREDIT CARD
.- AMEX SALE
CARD# XXXXXXXXXXX6002
Chip Card: AMERICAN EXPRESS
City of Miami Beach-Florida Chip Card AID: A000000025010801
Finance Department ATC: 0005
TC: 9B8C567DB8957FBF
1 City Hall INVOICE 0003
1527920-1 10/06/2015 BR1 T131 SEQ#: 0003
Tue Oct06,2015 09:06AM Trans#19-19 Batch#: 00 00003
19 $850.00 MCRCLERK - MCR-City Clerk Approval Code: 845171
* MCR#: 408017 Entry Method: Chip Read
1 ITEM(S): TOTAL: $850.00 Mode: Issuer
Credit Car PAID $850.00
Have a nice day! SALE AMOUNT $850.00
M its cellan eons Cash Receipt ,__= 1 ,,-,,i.y Ili= `i l 2C 1 1,i 0i i 133
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(THIS INFORMATION MUST BE COMPLETED)
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