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John Thomas - Renovate America, Inc. /Y\ IAM I City of Miami Beach Office of the City Clerk 2016 is!i; I 1'd i 12. 16 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. Thomas John NAME OF LOBBYIST: (Last) (First) (M.I) Renovate America, Inc. do 2350 Kerner Blvd.,Ste.250 San Rafael CA . 94901 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (415) 389-6800 (415) 388-6874 renovateamerica @nmgovlaw.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: Renovate America, Inc. NAME OF PRINCIPAUCLIENT: Renovate America, Inc. c/o 2350 Kerner Blvd., Ste. 250 San Rafael CA 94901 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (415) 389-6800 (415) 388-6874 renovateamerica @nmgovlaw.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: J.P. McNeill • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: N/A u.SPEC,IFIC LOBBY ISSUE: Matters_pertamingto-energy-and_water efficiency-fmancing-- Issue to be lobbied(Describe in detail): III.CITY:AGENCIESIIIND;IIV DUALS 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 9eneral 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 All'eem- commissioners and personnel N/A 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 1 • • N/A IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) $400.00 hourly B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). $400.00 hourly 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 iKNo: 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. _Yess(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. 1: 1 O ' X Sig u 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: �. ' _ - T i/ X Signature of Principal/At: ,j ." . VI. LOBBYIST IDENTIFIC• 1.r : PRINCIPAL IDENTIFICATION:( 'Produced ID 41(3'6 —_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 rArsi cpvtai 11oG/1R11AC11(1RRVICT Gl1RMC11 nhhsncf Ponicfrohnn l r rm rinr. CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE §8202 �`A.c�!-`.c�CSC•A. .w..a-_�._v. a-_at!�._ t.At.at/.c,.v .a,t.at.at.a'.�t!a •.at.a .•.a •_a✓�Y�t!:� ✓� .•!� N�tiNwt!s�<!s�t. OrSee Attached Document (Notary to cross out lines 1-6 below) . ❑See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) 2 3 4 5 6 Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn tamed)- before me County of Mac■C\ on this `S day of Uwe- , 20 by Date Month Year (1) --Sesm e? U R " i`-Lkk'o() TYLER WILLIAM KLEINMAN Commission#2137003 -( )' Notar Public- z ? y California Marin County Name(s}of SigneF(e)— iN Comm.Expires Dec 15 2019 proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature 7 g-ter Signature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Pr i n Cilatk reteXAskPt-caV(tAN Document Date: PM Number of Pages: ' Signer(s)Other Than Named Above: )• /4 Gc�c�'��c\e',-• c.__ -�c�c�.c�✓c`.c�c�c�, ei{C%.�c�_!.�✓,c�✓,c�.c�4�c�.c�.tic`%c�-.c�.c�✓c�.c�.c�✓''.c�.c�✓ti✓c�✓c�✓L�✓.�✓ti✓6�✓,c�✓s�✓,c. ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5910 Thi day ' 21:610:74A. SUSAN SCHANS / Commission#FF 240701 This day of 01 _s / • a Expires July 19,2019 ' - Bonded Thou Troy Fern Maumee 8063857 ign. ure of P • lc Notary-State of Florida:. nature of Public • a '- ' • • 'da Notarization of Lobbyist's signature Notarization •rincipal's signature TO BE COMPLETED BY CITY CLERK'S ST F ONLY Annual Registration fee: [ ]Yes[y]No Amount Paid$ Cl ) MCR#4 1 CE0 0 0 Date Paid e)(9-011- Lobbyist Registration Form receiveed'"and verified by OU tC. :\CLEF.\BALL\aFORMS\LOl tSY5ST FORMS\Lcb byist Amittill Reg st-ration Forrrr.doe Revised 01/22/2014 City of Miami Beath, 1700 Convention Center Drive,Miami Beach,Florida 33139,www_miamibeachfl.gov CHI CLERK Office Rafael E.Granodo,City Clerk CityClerk@miamibeochfl.gov Tel:305.673741 l , Fax:305.6717254 LOBBYIST NAME: John Thomas I understand that no later than February a 6f 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 Cd), the tuty Clerk Shall notify any lobbyist Qor principal) Who fails to timely file a Statement and in addition to any Other penalties Which may [be imposed as #rovided in Section 2-485.1, *fine Of$50.00 a day Shall be assessed for all Statement(s) filed after th& dug dat1. The City dierkihall rft tify the Mid mi-I de County Commission on Ethic1 aNd P-ubtic TRust of fhe faiRir ee ofa lobb1st3(6r princiPal)Gto file the Stiten enAr pay theiisiessced des afterciotifidatiorfi Any lobbyist, Who fails to file the Fequired Statement t 4ril th coach year, shall I automatically gus ended icom lobbying tines ke hid, Liiiless tfle fine this ten appealed to the Miami-Dade •unty tmmission oit ethics Slid public gust. ///-1/P-016 Signature: Date: i-lri Fi eai I loFr'PfACll('RRVICT Ff1RMC\I nhhwief Ranictratinn Fnrrn rin,' i\t‘ NO BEACH City of Miami Beach 2016 .11k 2 1 Pi7 12: 1 6 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov City Clerk's Office Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Name: John Thomas Business Name: Renovate America, Inc. Address: c/o 2350 Kerner Blvd., Ste. 250 Office Telephone Number: (415) 389-6800 Cellular Telephone Number: (877) 747-4889 Email Address: renovateamerica @nmgovlaw.com If more than one lobbyist, please list: • 1) 2) 3) 4) 5) 6) 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. j Q p,p� For.City Clerk's Office Use Only MCR#: O C` t l 1 Amount paid: 5 00 ,0 Date paid: 06-a-1- 16 Processed by: -,,> o►.) Al Date: 19& F:\CLER\$ALL\aFORMS\LOBBYIST FORMS ANNUAL LOBBYIST REGISTRATION FORM reg_docx Miscellaneous Cash Receipt - CITY OF MIAMI BEACH • No. 409 '99 • ❑ Cash ❑Credit Card ©kCheck# 1 3o $ 6 o0 • . . 6- 91 • 20 City of Miarr Wed Of --i n k-' 11.4')M AD MiscellaneouAaFiS82016IN `•=-./ cr4.rx':.,L i 3 t`t:s'� j ; I, r, .:�-;./ f ' :.. •.• ( f- d)f:16 k 000214-0049 Jenel ff...06/21/2016 12:08PM MCR OPEN FOr I '''''H\-1''')'"c.4 L i4-G -. t n hi Payment Amount: 500.00 MCR409999 (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director By -3°1 '_ Account Number: Oil- C000 • '3 b ri 'f� L# - 00 ° ".gv 3 f' ' - (7t? y _ Preparers ---11 1.. i,v r r Dept: .a a 1 I o • D CD ---.O 3f� � eaa a ii Cr CD • C7`. R� a s a d cr o cD a o i C oo mQ _ p o CD C z c aa. a ail m I m O•• i-i z CD p L0 V - rife - r CD z O r-f —. C S O e6 - CD -• Cn L ' O C7 CD o - a i z °o 3 a co rt — - Q I� 3 3 x M O I -- O l.0 T rD U'I pi = *-i- -.< ' Q1 C) .G 3 �J - Cl) (0 LC) C) .J �,O co a i s MI - __'. N r CD co p., i �� i _N O = CD r-r L-c - aCI \ W co n rt Ei: lD D f.. .1 0 cri 0(xi Ln o u, c.n N c 0 o 0 o -. O CD O O O O 3 Miscellaneous Cash Receipt .w CITY OF MIAMI BEACH 4' 0 0 0 0 No. • k# .7-7 3`B $ �5o , C:-0 Cash ❑Credit Card Check _. OG' R 20 16 .. 014^a � ►•4-..) ,k, City of MiantllN�Of � ! ! Miscellaneou�l7 d? ss201 ..3 5O kg.r'- €:'t ch sue. 2 Sb S4- k-•-4-ch-€�i.. CA- q LI ri 0 000214-0050 Jenel F.#. 06/21/2016 1 2:10 1 MCR OPEN For ! 1)3‘•46, - t•-) �(i'� LVIR-". F_tt Payment Amount: 350.00 •MCR410000 4 (THIS INFORMATION MUST BE COMPLETED) • Office of Finance Director (f. [,.�t� ?� y i +y By Account Number: �` �`^ r EXT:� i , Preparers �`°► :� v. °ter t Dept: `� 1 1 0 E O 1 C. O O O O e ° o ; c) c) O c 3 .:.• t11 i C=7 Ll U LO i I --CV C*7 C") C') C`"7 �-, L lD !I; c OJ 0 Cr. '-- --- L- , � I ' I,. a�i coo N = la a m� U v iO ' o r1 °' ° — " _ c� b _ o ' ' U o w = r �•. w al C a) ■ ES C*7 Cn 'I al Ln O » O v O r"— [r 3 1 4 O C C") Lr C, W • 9 U -' O . C C✓ -. O 3 'e CO O t--I O W f E O Z O Z a I gi pi -- 1 a) O Cam") U U 4J .L] s 9 w 0) Q 1 ) S O CD m 1 N C..1 CU O •9 O C/) CU f CV •— -0 +-c-c w C� CO ti 1 1 ,e O F--4 CC 0 0 S L cc I — O g Cn )- Ci C3 0_ Salvatore, Jason From: Kyle Hoffman <KHoffman @nmgovlaw.com> Sent: Tuesday,June 21, 2016 4:24 PM To: Salvatore,Jason Subject: Lobbyist Registration -John Thomas Dear Mr. Salvatore, It was nice speaking with you earlier, thank you for confirming receipt of the payment for John Thomas' lobbyist registration. Per our conversation, I am confirming that Section III for Mr. Thomas' registration should read "All commissioners and personnel." Thank you for bringing this to my attention and I apologize for any inconvenience. Please respond to this correspondence as confirmation of receipt. • Please do not hesitate to contact me directly at (415) 634-6846 if you have any further questions. Thank you, Kyle Kyle Hoffman, National Compliance Coordinator NIELSEN MERKSAMER PARRINELLO GROSS & LEONI LLP 2350 Kerner Boulevard, Suite 250 San Rafael, California 94901 t: 415.389.6800 •f: 415.388.6874 e: khoffman(S nmgovlaw.com • NIELSEN MERKSAMER: Please visit www.nmgovlaw.com for more information about our firm Join Us on Linkedln •Join Us on Facebook CONFIDENTIAL COMMUNICATION: This e-mail, including any attached files, is confidential and is meant for only the intended recipient of the transmission,and may be a communication privileged by law. If you received this e-mail in error, any review, use,dissemination,distribution, or copying of this e-mail is strictly prohibited. Please notify us immediately of the error by return e-mail and please delete this message from your system. Thank you in advance for your cooperation. 1