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Greg Togel - Deco Capital Group P\Ar, t\'\1 r City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach,.FL 33139 V LOBBYIST REGISTRATION FORM 2016 J id" 2 )('7 L. if 5 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, recommendationh of itlje 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. Toael Grea NAME OF LOBBYIST: (Last) (First) (M.I) Deco Capital Group, LLC 119 Washington Avenue Suite 505 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786) 360-0541 TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone,or e-mail address. I. LOBBYIST RETAINED BY: Bradleu W. Colmer NAME OF PRINCIPAUCLIENT: Deco Capital Group 119 Washington Avenue, Suite 505 Miami Beach Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786)360-0541 _ bradleu•colmer(aydecocapital.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: co_ \ • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORc OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Please see attached S&€ ILSPECIFIC LOBBY ISSUE Development Approvals and Permitting Issues, including, but not limited to the Historic Preservation Board, Design Review Board, Planning Board, Board of Adjustment, Land Use Development Committee, City_Commission,and any City Workshops or Committees,if necessary, relating to the property located atg733-1759 Purdy Avenue and 1724, 1738, 1 752 Bay Road;Miami (Beac 4 ssueto .e o•:ie• 'escri•e in .etai : Ill.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 Staff for the Planning Department, Building Department, None. X Public Works and City administration, PB, HPB, BOA, None. V X City Commission, and Mayor as necessary None. 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 Alone, Alone. _None, C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDII\Lobbyist Regis .tion Formrevised 5-30-2012.doc 1 , IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): I A) LOBBYIST DISCLOSURE:(Required)$ D per hour • B).PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $0 per hour (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": • Yes)\,ISO: -[ •• 1• •1 : •t:;:.:1 • ...1,••p,• •",. I." ••..... __• 11:11 • =a 4...:; e 41;1 •1:.:.:11 e •;:1;.•ate 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.,XPIo: Ll: ••• 1. •I •.:••.1,• •i•, ,: i.1 I• : 3 :l .••11 =1I ,.•1: :11 =-si ■.I1 .1 : 401.1\ •.x:11.1 1• change •, .•1'1• II: • •::._-,.1,: !'„.1 •, ,L:a•: • l•, l\ II l 1• . ,, • 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 J\. No" .,l: 1 •is .:-111 It• : ••1..0. .-•l6111 y•1..• :al•1 • =1•I\ ,.1 a:' I =•.=:•: •:•11•::1.=7: !;.I • 1=•11• II=1 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, 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: a �,_ /� Signature of Principal/Client: r g P -- � VI. LOBBYIST IDENTIFICATION: PRINCIPAL 40.40 •fir e it Produced ID ca Produced ID 14• Form of Identification 4i Form of Identification gz x302 /Personally mR Personall known(Lobbyist) i 3' 2 known Princi I 3 Y ( r ) ��ao� (Principal) $3 �c VII. SIGNATURE AND STAMP OF NOTARY: m 3 y g g 0 CA 5� State of lorida;' ount of Miami-Dade I- State,•f Florida, County of Miami-Dade ' o sa, Swc�n1tf.,-nd su crib o me �' \ orth�S :-�d subscriged befor me _ s This t 'd of , 2016 ; T is day of ��U1 , 2016 IIT O. Signatur'=Y•f Public Notary—State of Florida Signature of '11 blic Notary—State of Florida Notarization of Lobbyist's signature Notarization of principal's signature TO BE COMPLETED BY C TY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# _Date Paid 'L.AI,-(b Lobbyist Registration Form received and verified by: _ ®N1 SA1-1.11I oR. , MIAMI 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 LOBBYIST NAME: Greg Togel 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, 2012, 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. 411 jik") /2, /46 - Date C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc r C m N m 1.... ,--1 > e-1 "5.Q V I to >- V c � � Ad Z = m O o r1 o >, . 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