Adrienne R. Grandolfo - Sixt Rent A Car, LLC 'l 19.s A- 0 -
\ LAL 2016 Ji-\i,[1 I 2. 23
City of Miami Beach Office of the City Clerk i_f0. _ E
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. Please refer to Ordinance 2004-3435.
C,RANT)OT,FO AfRTFNNF R
NAME OF LOBBYIST: (Last) (First) (M.I)
1601 WASHINGTON AVENUE SUITE 300 MIAMI BEACH FLORIDA 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-602-8245 305-448-5566 ADRIENNE.GRANDOLFO @GMLAW.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:
SIXT RENT A CAR, LLC
NAME OF PRINCIPAUCLIENT:
SIXT RENT A CAR, LLC 1850 S.E. 17TH STREET, UNIT 207 FT. LAUDERDALE, FL 33316
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(786) 547-9005 CRISTIAN.LAVIN @SIXT.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:
JOHANNES A. BOEINGHOFF, PRESIDENT
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: SEE EXHIBIT "B"
.
11 SPECIFIC.,LOBBY:ISSUE
CONDITIONAL TIONAL USE PERMIT FOR VEHICLES FOR RENT OR—LEASE?UTILIZED IN CONNECTION WITH
THE—OPERATION—OF AN AUTOMOBIL`E—RENTAL—AGENCY—NOT—LOCATED WITHIN A SUBSTANTIALLY
Issue_to be lobbied_(Describe_in detaii):EN_CLOSED,_P_ERMANENT B.UILD.ING—AND, ANY LAND USE DEVELOP_MEN
[ZONING DESIGN OR LICENSING ISSUES :RELATED TO THE'SUBJECT PROPERTY. ' ---
Ill.CITY AG.ENCIES%IN DIVIDUALS TOTBE a_OBB'UED-: --- 145_ Ids .�
Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has enteredt ?
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
PLANNING DIRECTOR AND STAFF • X
PLANNING BOARD X
MAYOR AND COMMISSIONERS 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
NONE
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
i .
•
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375/HOUR
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375/HOUR
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 XNo: 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 XNo: 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.
YesXNo: 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
AlA
444 %-,1 km1464
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 iami Beach i Code and II reporting requirements.
Signature of Lobbyist: k. I ..
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID Produced ID
to,'' ' Form of Identification Form of Identification '
Fl i •off •.
•.°,;,,,,,. ' 113ersonally known(Lobbyist) Personally known(Principal) •
MOtoz0
SIGNATURE AND STAMP OF NOTARY: W 3 -4 -O xi
N r
o 5!. e of Florida,County of Miami-Dade State of Florida,County of Miami-Dade rm O - z
Q ..,,rn to and subscribed before me Sworn -nd subscrbed before me S -n 2
`p
T ,•A�� day of �Qn. ,201 This �1 day of _�.��._ 201 r- C
I� OOnN
8 ['r" 'lade
0 • € ig ature of Public Notary-State of Florida Signature of Public Notary-State of Flori43
No rization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S ST AFF ONLY
Annual Registration fee: [ ]Yes E" 1 No Amount Paid$ 50.0O MCR# s Date Paid
• Lobbyist Registration Form received and verified by: a
F:\CLUR\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014
•
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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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: ADRIENNE R_ GRANDOLFO
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.
4kLulittu Va0 01I lt/ OIL,
Signature: Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
EXHIBIT "B"
DISCLOSURE OF INTEREST
1. CORPORATION
If the property which is the subject of the application is owned or leased by a CORPORATION,
list ALL of the stockholders, and the percentage of stock owned by each. Where the
stockholders consist of another corporation(s), trustee(s), partnership(s) or other similar entity,
further disclosure shall be required which discloses the identity of the individual(s) (natural
persons) having the ultimate ownership interest in the entity.*
Sixt Rent A Car,LLC
CORPORATION NAME
Disclosure shall not be required of this entity, as the equity interest is regularly traded on an
established securities market in the United States or other country.
•
Miscellaneous Cash Receipt 1,,:,,,,--:„..,J-I !1,,u;,---., f i., t +- F e, tio s 121
CITY OF MIAMI BEACH ff 11
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a Cash Credit Card Check# ; $
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Received of
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Address fc,t A31.-;t NC-1014:_ Av4 Sic 'c)c) irt1 far. L .5.?( 3Ct
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- _For / -.ICS. t' .
- (THIS INFORMATION MUST BE-COMPLETED) - - --------,-� : -"Office of:Finance Director `:
' ? /2—
, By
:::._;z---,.410:",_,,i,.- . Account Number 0 i 1' ''00 6,c,q i
r x is Preparers SA L VA--171,:-‘:.it . Dept: C f =C. . K : 7 4 -
. _ CITY HALL CASHIER OFFI
,- _., :
1700 CONVENTION CNTR DR
MIAMI BEACH, FL 33139
- 01/26/2016 12:28:43
CREDIT CARD
IlzonsWPWINIEZEINEVIRAIARVIV VISA SALE
..._......_... .. XX( • '1 4,5682
...m..01,- CARD#
Chip Card AID: A0000000031010
ATC: 000A
City of Miami Beach-Florida TC: C469354723EEB978 0012
Finance Department INVOICE 0011
SEQ#:
1 City Hall Batch#: 001341
1602620-1 01/26/2016 BR1 T121 Approval Code: 026568
Tue Jan26,2016 12:29PM Trans#27-27 Entry Method: Chip Read
27 $350.00 MCRCLERK - MCR-City Clerk Mode: Issuer
* MCR#: 408646 Tax Amount: $0.00
1 ITEM(S): TOTAL: $350.00 �NT 350,00
Credit Car PAID $350.00 SALE AM
0
Have a nice day!
CUSTOMER COPY
Detail by Entity Name Page 1 of 3
FLORIDA DEPARTMENT OP STATE
DIVISION OF CORPORA IONS ..01/ j
Detail by Entity Name
Foreign Limited Liability Company
SIXT RENT A CAR LLC
Filing Information
Document Number M11000000034
FEI/EIN Number 27-4394382
Date Filed 01/05/2011
State DE
Status ACTIVE
Last Event LC AMENDMENT
Event Date Filed 02/18/2011
Event Effective Date NONE
Principal Address
1850 SE 17th St
Unit 207
Fort lauderdale, FL 33316
Changed: 03/20/2015
Mailing Address
PO Box 460967
FORT LAUDERDALE, FL 33346
Changed: 03/20/2015
Registered Agent Name &Address
CORPORATE CREATIONS NETWORK INC.
11380 PROSPERITY FARMS ROAD
#221 E
PALM BEACH GARDENS, FL 33410
Name Changed: 02/21/2013
Address Changed: 02/21/2013
Authorized Person(s) Detail
Name &Address
Title MGRV
SAZERA, VINCENT TODD
1489 SE 17th Street
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/27/2016
Detail by Entity Name Page 2 of 3
Unit 2A
FORT LAUDERDALE, FL 33316
itle MGRP
BOEINGHOFF, JOHANNES A
1489 SE 17th Street
Unit 2A
FORT LAUDERDALE, FL 33316
• nnual Re•orts
Report Year Filed Date
2014 01/13/2014
2014 02/13/2014
2015 03/20/2015
Document Ima•es
03/20/2015 --ANNUAL REPORT View image in PDF format
02/13/2014 --AMENDED ANNUAL REPORT View image in PDF format
01/13/2014 --ANNUAL REPORT View image in PDF format
02/21/2013 --ANNUAL REPORT View image in PDF format
02/14/2013 -- Reg. Agent Change View image in PDF format
01/16/2012 --ANNUAL REPORT View image in PDF format
02/18/2011 -- LC Amendment View image in PDF format
01/21/2011 --Amendment View image in PDF format
01/05/2011 -- Foreign Limited View image in PDF format •
Copyright CO and Privacy Policies
State of Florida,Department of State
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/27/2016
Detail by Entity Name Page 3 of 3
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/27/2016