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Juan C. David - Anthony Manganaro MIAMIBEACH City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 ?Q I Q J1S-1 -6 PM 4: 39 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. David Juan C. NAME OF LOBBYIST: (Last) (First) (M.l) JCD Architect, Inc. 1385 Coral Way, #207, Miami FL 33145 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip) (305) 285-4343 mariad @jcdarchitect.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: Manganaro, Anthony NAME OF PRINCIPAUCLIENT: 8221 Snowden River Parkway, Columbia MD 21044 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Zip Code) (410) 923-1306 amanganaro@sienafarm.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: N/A • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: N/A n.SPECIFIC LOBBY ISSUE: Development approvals and permitting issues related to the property located at 2179 Meridian-Avenue,,Miami Beach: 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 Planning Staff, City Commission, Development None. X Boards, Land Use Development Committee None. X and Commission 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 N/A F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) k J D �B) PRINCIPALS DISCLOSURE(OF LOBBYIST COMPENSATIO/-fict : (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 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 101o: 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 SUB IT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COM' SAT N R- EIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL ' ED VEN THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 4111^ Signatu a of •bbyist I do solemnly swear that all of •- f arego/g fact- are true and c• dRU hid +have read or am familiar with the provisions contained in Section 2-482 of the Mia : • City Code ( d all reporting requirements. Signature of Lobbyist: � Signature of Principal/Client:1 • VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: _Produced ID _Produced ID Form of Identification Form of Identification XPersonally known(Lobbyist) _Personally known (Principal) VII. SIGNATURE AND STAMP OF NOTARY: State of Florid. _` A ECHAGARRUA State of Florida, County of Miami-Dade q•, Sworn to and bg :• fore - ` Sworn and subscribed before me ' Notary - fate of Florida This f Z �1�,�11�, �• This day of ,201 5 , :" 'sig � AblyComlayxplresJul7.2019 P g '' "r"�'`'�' `'Notary Assn. Signature of Public Notary—State of Florida Signature of P I� ���=1����r-��=��iY���=1 ur- Notarization .` ..:yr s I. a r- Notarization of Principal's,signature TO BE COMPLE E 1.BY CITY CLERK' ,T•FF O LY ff ' Annual Registration fee: NYes[ ]No Amount Paid$ 't s ICR# I o"td' `CYgt[Date Paid O6'v6"/b Lobbyist Registration Form eceived and verified by: J ' Li ''r G F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMP r O 1 (REQUIRED). , 1S-r—1S 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 Xlo: 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. 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: Signature of Principal/Client: X �tlunuf� W%_ 71°■••∎/■•"- \\``\ VTY III/,, VI. LOBBYIST IDENTIFICATIO . PRINCIPAL IDENTIFICATION: \`���` o ......4 M 4' �,� Produced ID Produced ID :� • NOr.q "p' Form of Identification Form of Identif§ n '� " -vBtIC %�� 06 _Personally known (Lobbyist) _Personally known (Principal) %�p •.9J•2Q\G.. P``�.` VII. SIGNATURE AND STAMP OF NOTARY: '// 0cOUN`` `\\\``� State of Florida, County of Miami-Dade State of-Ronda", County of Miami-96de Sworn to and subscribed before me Sworn and subscribed before me This day of ,201_ This day of ,Svne_ ,201 b Signature of Public Notary—State of Florida Signature of Pu lic Notary—State of F4erde- Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid Lobbyist Registration Form received and verified by:. F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc . • MIAMIBEACH • City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granado, City Clerk CiyClerk @miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673.7254 LOBBYIST NAME: Juan David 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 o th Ma! i-Dade County Commission on Ethics and Public Trust. • - (;/5 // Sig .t ire: . Date: F:\CLER\$ALL\a FORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc Miscellaneous Cash Receipt CITY OF MIAMI BEACH 409964 ❑ Cash ❑Credit Card ®-Check# ) ) 7 0 $ 500-w C76 20 l b ; City of MianR@ ed of —\1,L for N C. -'A b ! ; MiscellaneouAdd 01j6.7 3 C.nr L Wkv-M• d 01 ,A1 f A-P-b: .C. 3 31 1/5 000159-0011 Lidia C. 06/06/2016 04:34PM (OCR OPENFOr . AA-I'M - i it 6. G- Payment Amount: 500.00 MCR409964 (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director 3(cf By •r Account Number 01 I - 00 0 0 • us LI Ll L . OQ• 3 Or7. 2 b S- 00- 0 p..a • ':. Preparer• . ° .547, t Dept: L-C- Exr:-714• a - = 0 Cr; 70 . . o _ tr{ ' 0 i ? O O D O o C Z cT G E- " I CD CD C-) ~ C — cp ng j __ Z O I-1- O C p t - 6 i.-i :.-=') O c-� o ,-+ C I H O C--) a O a7 G C7 O 0 0 F rte, o z CD c� - c n Cu 0 r+ -h C) p i ; 1 O a. 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