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W. Tucker Gibbs - Il Villaggio Condominium Association (2) `, 1\A1Atv\ LI. AC £ City of Miami Beach Office of the City Clerk 1:' F,y. ,T_,, , ; 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM 2015 OCT L I P 1 2: 54 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. C/B8f WI 71/ . NAME OF LOBBYIST: (Last) (First) (M.I) w.nr c ma AA .3e 3s- viiloo cr c_ ektldr 6.14411 r- 33i33 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 34C' WI-SIM. 3O 9W!'07 73 f e k-er, 14) eh. �bbzr • Gen, TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: V1Li j 4/v Gnaa v/14 YM 4-1s b `NAME OF PRINCIPAUCLIENT: / _ BUSAJESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) g -1` r"(14, ��s-vjYj-a)73 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: ` - `bk- t / L-4j 1 • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II sPkteiRCIDEOWIS$OV ft,e2ied alf cif / Jh an, (u//mi Ave, - a//c l N fc� JJj Issue to be lobbied(Describe in detail): v III. `mss y � ID �... T �f tx � . .1:... 'F.. Sn a..<.:.. Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to the present date,stating the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be lobbied ahf /4#0/4 t 47 te G rnon41e- P/ann, ,0//, rS "v J x Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2-482(g)Any Financial, Familial or Professional Relationship Nd/tie" F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc , W. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) B) PRINCIPAL'S DISCLOSURE(OF LOBBJ$c PM_PENSATION): (REQUIRED). (JU//V 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)c.No: Are ou lobb in. on a •resent or •endin. bid for .oods 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 1No: 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 resister with the clerk as required by this section but, shall not be required to pay any registration fees. Yes,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 SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Yfr 6 411d6 Signature*bbyis 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: .I .J� r, ,_• Signature of Principal/Clie i —_ VI. • LOBBYIST IDENTIFICATION: 4PRINCIPAL IDENTIFICATION: • CN7 +�, ' Produced ID FLOQ_tIl-S 1 IWN (I C � Produced ID— a N= Form of Identification Form of Identification ti J 1L1-N chi <Z L ki r �Q� Personally known (Lobbyist) Personally known (Principal) Woill o_ `SIGNATURE AND STAMP OF NOTA 2Y,o��►Y.4N>, JAVIER TOVAR Ill #-..4 MY COMMISSION#FFt .!tc¢Stated" c.Florida, County of Miami-Dade '� lorida, County of Miami-Dade =�,`�.��.�Q; y ^I/ - _,',�.F',-0�?' EXPIRESNovemb-r7.-• , 1. an• .ubscribed before me , gF�,.. - '`an and subscribed before me °. l-li A_/ da . Q -k e'i , 2011`1 (407)398-0153 FloridallotaryServi•-..• ' day of jO , 201,D■ Signature of Public Notary–State of Florida Signat ti f Public Notary–State of Florida Notarization of Lobbyist's signature Notariz• on of Principal's signature TO BE COMPLETED BY CITY CLERK'S 4,•El O Annual Registration fee: [ ]Yes-( No .Amount Pa' MCR# � �: .:. Date.Paid I Lobbyist Registration Form receive and verified by i__, F:\CLER\$ALL\aFORMS\LOBBYIST FO MS\Lobbyist Annual •<-gi r-tion Forrn.doc Revised 01/2 /2014 I F:\CLERI$ALL1aFORMSILOBBYIST FORMS\Lobbyist Registration Form.doc M I A. (VIBE Ar City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139,wvwv.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.7411 , Fax: 305.673.7254 LOBBYIST NAME: [Al. "Nekae. 4itJS 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 Miami-Dade County Commission on Ethics and Public Trust. )4(,,DiAk4144 Signature: Date: F:\CLER\$ALLIaFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 1 - --_-_-•,,,, ' '..-- :- e_: , ------,,-..„,_ _ i, - HAl 4 ti.; o-ri _ = ,mot r 2) CI —ft......- `� __L. 3 ; n .� Q "- =; _ ;y City of Miami Beach-Florida Finance Department � p c \_- n cn tu 0 H : '''''::- 7:t:, i g 1 City Hall �. to , 1529413-1 10/21/2015 BR1 1137 8 _ -- w n CD _ 28 2 1 44ed Oct21 ,2015 02;53Ph1 Trans# ; c N _ 0 _.. 28 $700.00 MCRCLERK - MCR-City Clerk E '0 * MCR#: 408058 _ m 1 ITEM(S): TOTAL: $700.00 `� nn �* Check (006957) PAID $700.00 `I : _-__:._ . Have a nice day! (-- -- ) i ..,.- - w r 0. 1 t.= .. \VVJ i. m -, o La-: t. o