Juan Espinosa - Fort Partners LLC MIAMI iT )
City of Miami Beach Office of the City ClerLII \,
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1700 Convention Center Drive, Miami Beach, FL 3 f_ )139 PH 12: 09
LOBBYIST REGISTRATION FORM
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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.
Espinosa Juan
NAME OF LOBBYIST: (Last) (First) (M.I)
David Plummer and Associates, 1750 Ponce de Leon Blvd. Coral Gables, FL
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State)
(305)447-0900 (305) 305-444-4986 Juan.Espinosa @dplummer.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:
Fort Partners LLC
NAME OF PRINCIPAL/CLIENT:
Fort Partners LLC 176 NE 43 Street Miami FL 33137
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 865-4181
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: Michael Conaghan
U IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Nadim Ashi 100%
u.SPECIFIC LOBBY ISSUE:
%'L5-nd7:l7s eland=zoning'issues srelatedsto 300 Alton4CREIR
Issue to be lobbied(Describe in detail):
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
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:ICLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPE ATION(DISCLOSE WHETHER HOUR LAT RATE OR OTHER):rikjaimiC4
A) LOBBYIST DISCLOSURE:(Required) L% (I�(�(,I
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION) /L
1 n
(REQUIRED).
/J 1
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 - CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSAT % "ECEIVED 01 THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILE S IF TH AVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
(-
Signature of L•.byist
I do solemnly swear that all of the foregoing facts are tru- an. corr- - d that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all epo• ng . ements.
Signature of Lobbyist: CI--
Signature of Principal/Client: S- 4Q.JXi- r e
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
_Produced ID —Produced ID .--
Form of Identification Form of Identification r'
_At.-- T_
3/Personally known(Lobbyist) —Personally known(Principal) t` -
.
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, Coun. of Miami-Dade ..,.y, ;f'•,,, tate of Florida, County of Miami-Dade; � ,
Sworn o aJ�d subscrib••• ,,e .r: , e ='�' R�'OP...BERUf,OES '..worn and subscribed before me N) �i
�V// r MY COR Ni
T• day of 201 + . ''`:: SSIONtFf?249 his day of ,201 _- O
. / l � f+�- BorniadlRThm Nptmy Pi November L4Mte.'mitars C '' t�
A L- !M.iil
ig f a ure of Public otary-St:a of Florida ig- of Public Notary-State of Florida
N• arization 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$ SOM.) MCR# 1 ► 1, 1 Date Paid 06-3o-lb
Lobbyist Registration Form received and verified by: __Via,■ :a ':rLi_
F:\CLER\$ALL\a FORMS\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 COMPE ATION(DISCLOSE WHETHER HOU LATTRATEE OR OTHER):
/-4,0 A) LOBBYIST DISCLOSURE:(Required) •N 1.7Y(}
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION)
(REQUIRED). p� � /� L'�/�
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 XPIo: Are you lobbying on a pending application for a Development Agreement with the Citv;or application for
change of zoning may designation or change to the ClWs 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.compensatlon or,reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR,EACH LOBBYIST SHALL SUBMIT TO.TH .CITY CLERK A.SIGNED STATEMENT UNDER,
OATH. LISTIOG LOBBYING EXPENDITURES,AS WELL AS.COMPENSA 101..xeCEiVED W.THE..CITY OF MIAMI BEAC}I FOR
Tip PRECEDING CALENDAR YEAR A STATEMENT SHALL BE FILE I N IF TH AVE BEEN NO EXPENDITURES OR
COMPENSATION.DURING THE REPORTING PERIOD.
Signature of L..byist
I do solemnly swear that all.of the foregoing facts are tru- an•corr d that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach City Code and all epo'epo 44 ng =, =ments.
Signature of Lobbyist: CI--
•
Signature of Principal/Client: '44 4•
VI. LOBBYIST IDENTIFICATION: 11 PRINCIPAL IDENTIFICATION:
Produced ID /Personally Produced ID
Form of Identification Form of identification
a� .••• VANESSAVIRGIUO
!Personally known(Lobbyist) known(Principiri MY COMMISSION t FF 022448
* EXPIRES:May 29,2017
"rE
VII. SIGNATURE AND STAMP OF NOTARY:
OFF�o BandedThruBudgetNotaryServices
State of Florida,Coun► of.Miami-Dade ^"gt� "�—� Late of Florida,County of ,'aml-Dade
l ;Tit,. IOR.BERut 1.wprn'and subscri • before •e
Sworn�fo}(8 sdaycif d e •r-. e .� xowAIMI OHpFFp ,� his day of o 1�0
T �( ((J day cif 20.1 �? �� t• EXPIFIES:November 21 20 • • ,
ig r a u of Public otary-.St''a of Florida • 4 ; • -ublic Notary-State-of •
N• atIzatlon of J.obbyjst's.signature Notar zatlon • Principal's signatur W
TO BE COMPLETED BY CITY CLERK'S . NLY
Annual Registration flee: f •)Yes( ]-No Amount:Paid'$. . MCR Date Feld ' '
Lobbyist Registration Form.received and verified by;
t=s1CLlRI$ALLwORA9s\LABBYSST FORms Lobbyist Annum!RegtsfraYion.Form.doc Revised 01/22/2014
F:ICLERI$ALL1aFORMSILOBBYIST FORMS\Lobbyist Registration Form.doc
•
•
MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov - •
CITY CLERK Office 2OI' �IU,= -3 +`� �.
Rafael E. Granado,City Clerk CityClerk @miami eachfl.gov � J 1
Tel:305.673.7411 ,Fox:305.673.7254
•
LORI::.YOST NAME: .(Jct Sp/ ), D5 GL.,
understand that no later than February 28 of each year, I must file the following form,
pursuant to Section_2-485 of the iami Beach City Code, with the City Clerk's Office for
all active lobbying issues. •
1) x.01-,1:VOST EXPENDITURE AND COMPENSATOI N FOR i
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 kliami-Diode
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-Dad County Commission on Ethics bind Public Trust.
,- /- Zb76,,
Signs re: Date:
•
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
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CHECK 350.00 c -.
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Change due 0.00 ^ c
Paid by: david plumbing .r. 0 - ;1
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