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Michael Llorente - Collins Park Partners, LLC CCM%/Asp arki,, S‘..- MIAMI BEAc City of Miami Beach Office of the City Clerk . 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM 2016 ` i' -� Pi Z O 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. 11 c cm-e_t -� NAME OF LOBBYIST: (La�)�.. � (Fi t (M.I) Lai� �r I"� -fir, LSti Paf-4-r a rs i\ Prc�tx...,,� hoc N.(c�►-ci 1 ei e ( P 3 14 Q BUSINESS NAME AND ADDRE4 (Number and Street) (City) sk,qdr (State) (Zip Code) 3 (913—a sus 3c6-cal 3 -2-5Y . Il creri_k l snp 6', c� TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: l -QA— -ih / Dan i e to T2 Kde NAM l AaCo /M S rE ales I LL t I ooc Kane CnnCQkrit ,Skilx O! 64y & hof lds,P- BUSINESS NAME ADDRESS (Number an Street) (City) (State) (Zip Code) 305-8(do- 7555 305'-8bb- in c 33)sy 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: -- t \V \VWt • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ( (� /0 C/ n.SPECIFIC LOBBY ISSUE:] -N_111Y6YaX=\L— Clritt 69176-Ar- Issue to be lobbied(Describe in detail): Ill.;CITY AGENCIES/INDIVIDUALS TO BE LOBBIED': • :.Pursuai*to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered Into aiiy`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 /Y:- CYYl Si o\f/ WC- 15 Pursuant to City Code Section 2-4:- e)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 Iv • 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) 1-t0 B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (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": t Yes_No: 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 lgevelopment Issues": _Yes_No: 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 co pensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any i m,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 BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of •bbyist / I do solemnly swear that all of the foregoing facts are true and correc and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach City C•'e and all re•ortin• requirements. Signature of Lobbyist: ��� Signature of Principal/Client: „� VA 1.,� 1..t..._ • _, to VI. LOBBYIST IDENTIFICATION: ' Z 1`5 %s' . PRINCIPAL IDENTIFICATION: a�a"n',,, _Produced ID ''°:,,;,,,'•;0�` <. _Produced ID =�-��=�! �- 7 c• cl c, IL Form of Identification o o Form of Identification '%,, y• Personally known(Lobbyist) . H Q „ ■ ✓ Personally known (Principal) Q� 1 X O n z C ffl VII. SIGNATURE AND STAMP OF NOTARY: ' =H- �„ x rn w` 5"`. ,� co' v i X T Z O y 7 Z = State of Florida, County of Miami-Dade ' s Q ;' State of Florida, County of Miami-Dade ?F Sworn to and subscribed before me d.- N e,s " Sworn and subscribed before me This (b}' day of J IA , 201 ;e ° N n This day of 3 u ,201 4,0 •,,, Signature of Public Notary—State of Florida Signature of Publ c Notary—State of Florida =:t' Notarization of Lobbyist's signature Notarization of Principal's signature �'4,. I V aw nom TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes ]No Amount Paid$ `0.(- 7 i C' # 0 e 1 ( Date Paid O� Off'lb Lobbyist Registration Form receive and verified by: __jr N • ..•,:L! g'P F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised O1/22/21p cI 0 r C- F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc 31, -.41 x t •o = 1 Z ®sN. MIAMIBEACH 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: H.uCkOLet ��cFen- 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. c, Signat e: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc ,i Miscellaneous Cash Receipt CITY OF MIAMI_BEACH No 409971 ❑ Cash ❑Credit Card OCheok# O& O 20 /6 Received of ��'t c,,Lc ! L.1,,,,e:/.,4 Address , d I A'kLtA- (7 o d =,; gA . 5k.-- 1101 l3 rz 5/L/e) For / .'5> c-it- / (THIS INFORMATION MUST BE COMPLETED) - Office of Finance Director By ''' Account Number: 0/1 ° O(J 3(.7C1 L/L/t; co - 307- 3(S- 4Q -( O _r-'a f,4.;e4 - Preparer. . -V > tL t�� �p EXT: 71/// / " Dept: • 14,2+ l c,rr, c c ar ---3 - 'R - 0 -_.. N 3rD CO O _� log�° c — rn CD ^ rn cse Cl)r m iz tWi i i— v C7 'y _ -v - Z O O rn b O o 12_ Cr mo za, m Cl) �: - b z o ,+ O rn 3 '' Q: '3S ° co cCn 3 •0 3 0 = .SS� - - z N -- m a r-n m 0 3 C7 n o I C -_ n W = <C -oc in T m a(D CD Q Lb "'.4-:1 \ tkr I. ____--- rte+ _ \ .yT _ ; o CD r-- 0 i CD '_ e ° to � i � � lD O o C.J W , p� D O , Ul t.J 1 cz, cp O � O O , O O O O O O• i O O i O 3 Col 1,,A /1 „5 P ` - ,� E. Salvatore, Jason v 4 , L� �� 'u5e From: Erin Hendrix <ehendrix @Isnpartners.com> Sent: Thursday, August 18, 2016 5:11 PM To: Salvatore, Jason Subject: Final Version, please review: Requested Lobbyist Registration Information Good afternoon Jason, I hope you are well. Below are the responses to the information you requested in your letters to Alex Heckler, Diana Mendez and Michael Llorente dated August 1, 2016. Please let me know if you need any additional information. Have a great day! Erin 1. Security Alliance = In 2015, the monthly fee was$2,500; however, there is no fee for the City of Miami Beach matter. 2. Ashbritt, Inc. = No additional compensation for the City of Miami Beach over our national agreement fee. 3. Clark Construction Group, LLC = $9,000 per month 4. Lincoln Road Business Improvement District = $50,000 fee in 2015. $10,000 per month fee in 2016 for legal services. 5. 1052, LLC = $10,000 per month; however, no longer a client 6. Serco/Daria Van Engelen = $6,000 per month 7. Yachting Promotions = $5,000 per month 8. 1 Hotel South Beach = $7,500 per month 9. Greater Miami Tramlink Partners = $20,000 per month, including other jurisdictions 10. 1681 West Ventures = $3,000 per month 11. Setai Hotel Acquisitions = $15,000 one-time pay ment agreement 12. Fort Partners = $20,000 per month 13. Harris Corporation = No agreement in place 14. Collins Park Partners = No agreement in place Erin Hendrix Director of Client Relations LSN Partners 801 Arthur Godfrey Road,Suite 401 Miami Beach, Florida 33140 (305)673-2585, Ext. 315-Office (561)358-1289-Mobile (305)673-2588-Fax www.lsnpartners.com IMPORTANT-The information in this e-mail is confidential and may be legally privileged. It is intended solely for the addressee. Access to this e-mail by anyone else is unauthorized. If you are not the intended recipient,you are notified that any disclosing, copying,distributing or taking any action in reliance on the contents of this information is strictly prohibited. Any views,opinions 1 1