Bernardo Fort-Brescia - CCCC Miami Beach, LLC . �
_ (v-is--) cot\‘,43 Ave-
BEACH
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. Please refer to Ordinance 2004-3435.
Fort-Brescia Bernardo
NAME OF LOBBYIST: (Last) (First) (M.I)
Arquitectonica 2900 Oak Avenue Miami Florida 33133
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-372-1812 bfort @arquitectonica.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:
CCCC Miami Beach, LLC
NAME OF PRINCIPAL/CLIENT:
1221 Brickell Avenue Suite 900 Miami Florida 33131
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)]
Haibo Pan
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Please see attached
ii.SPECIFIC LOBBY ISSUE:
Development-approvals for--6747 and_6757Collins_
Issue-to-be-lobbied-(Describe in detail):
III.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) YES NO
• title of person to be lobbied J
Board of Adjustment,Dept of Public Works,Historic Preservation Board X
City of Miami Beach Commissioners, City Manager, City Attorney X
Planning Board,Design Review Board,Building Dept., Planning Dept. c X
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial;"famili I r 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
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F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
•
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W. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE
^OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) S90" G o /i-ivvv (iw .t
ti �. 1 v/
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). / W OOVg.- CHOU
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✓1Go: 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'io: 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.
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 B LED EVEN IF TH RE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
/7414Lift‘A
Sign-lure of L..•st P
I do solemnly swear that all of the foregoing facts are true and correc and to have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all re,..rting uir :n
Signature of Lobbyist: e..[
Signature of Principal/Clie / v 41110111/
-
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID �,Produced ID
..� Form of Identification Form of Identification
i
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 t. -nd subs .• -: =-fore me Swom gad subscribed befgre me
T d= of_��.�,;�( ,201LE This 7 day of Msg4i• ,201
Ars •
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Nib
`ig ature of Public Notary–State of Florida Signat. - • -I.-7"'-=-" t•r e of Florida
Notarization of Lobbyist's signature Not- ization of pr cipal's si• ature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY q
Annual Registration fee: ( ]Yos[ ]No Amount Paid O-0_6 CR# S Date Paid 03-0 p
Lobbyist Registration Form receive and verified by:
F: CUR\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014
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F:ICLERI$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc — ° ° —
4 JuriGL A.JIMENEZ
P''•, MARiBELDIAZ ' • ra°, Notary Public-State of Florida
*, :� MY COMMISSION#FF205139 ► � =•• • My Comm.Expires Aug 9,2017,`
`•' EXPIRES:June 29,2019 ' "' '"' • = • Commission#FF 40669
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1V\ AM BEACH
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
Bernardo Fort-Brescia
LOBBYIST NAME:
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.
. /7VA/di( 70)
Si ature: Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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Ministry of Housing and Urban-Rural Development of
• the People's Republic of China
100%
China Real Estate Research Association
100% •
China City Development Academy Co., Ltd
100%
China City Operation Co., Ltd
100%
China City Construction Holding Group Xu Guangyue, Xu Guangyue,
Company Limited (CCCC) Individual Individual
100% 100%
100% 100% 100%
China City Construction Hang Zhou Tangqi Hang Zhou Well
Development Co., Ltd-., Investment Co. Limited Wishing Investment Xu Guangyue,
Individual
a Beijing company
Co. Limited
83% 4.773% 2.682% 9.545%
Zhejiang Joyon Real Estate Co.Limited,
A China company
100%
Hope Faith Holding Limited,
A BVI company
100%
CCCC Holdings II LLC
a Delaware limited liability company
100%
CCCC USA Holdings II Corporation, a
Delaware corporation
100%
CCCC Miami Beach LLC, a Delaware
limited liability company