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Wayne M. Pathman - Ricardo Navarez oi o( Lf3ra C4'. g:-.) AAIAmi BEAcH , , . S i City of Miami Beach pffice pf the;City. Irk Beach �� 3d't S.� � i city. I 1700 Convention Center Drive, Miami Beach, FL 33139 LOBBYIST REGISTRATION FORM P 1 . - 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. P• u. I ' NAME OF LOBBYIST: (Last) (Firs (M.I) pF4A4,u, 1--e to r, L-G.e ,.2 S'. 63f4 i'2 y� n 1. 3 3/3 ) BUSINESS NAME AND ADDRESS / (Number and Street) (C.y) l (State) (Zip Code ,� r 3o5- -51q- 2�f 2c -3 0 .. 3-7 c, 2L(2O LA)Pal-4 C tewrg_ /IA TELEPHONE NUMBER: FAX NUMBER: EMAIL: ,Please notify this office if your contact information changes:address,phone, or e-mail address. I. LOBBYIST RETAINED BY: le/Ca vda life i[r.p Z— NAME OF PRINCIPAL/CLIENT: 901 4 3r' Cv i)r+ / 11aiiM i i30 .c. FC--- 331 Li 1 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) `3 - 29c -q .(il 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: JJ/&.. • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRE,CTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: Al a-- II:SPECIFIC LO BBY ISSUE: ----„a.._.,O Pc' A- \0 '7 o I� : iv v�e�;\% r PLt0_I. - C =��I� mil('j ;t► Pt-i Issue o 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 4- a inm I ig-e(-s ./ ,,,,s,Comm 15.'c?67, + sfe,..o ,--- ,q),,yoliiisirttil 61&.— 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 /ID F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc I IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) 0/, B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): (REQUIRED). ) 5 Al 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.L./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 Development 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 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 VNo: 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 . EN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all the foreg.' _ ncts are true and correct anc that I have read or am familiar wi he provisions contained in Section 2-482 of the Miami ach City C o.- . -l - ' . - Signature of Lobbyist: L:m_._ Signature of Principal/Client. :' �'�yA iiir �_ VI. LOBBYIST IDENTIFIC' ION: PRINCIPAL IDENTIFICATION: _ProducedlD Produced ID Form of I ntification orrra en i Ica ion � 11,1"�°�' SYLVIA SNYDER ersonally known(Lobbyist) ✓Personally kn' )Notary Public-Stste of Flails ,.;►..:''••., DORINDA TRIPONEY "'- My Comm.Expires Jul 2l 01 VII. SIGNATURE AND STAMP OF N 'I� ;, . _ , ���' �• Commission.N FF 135546 ;, MY COMMISSION#FF 224382 � � •.,;,z y%7 o .°%ss- Bonded ThR Notary Public Underrwnters 1 State of Florida,County of Miami-Dade �`` to of Florida,County of Miami-Dade Sworn to and subscribed before me Sworn and subscribed before me This Or-day of /11 ek_ ,2014._ This '■\ day of ,201 L Sig a ure of Public Notary i.tate of Fl• 'da Signature of 'ub c Notary-State of londa Notarization of Lobbyist's signature Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes[1]No Amount Paid$ .S60- SCR v� Date Paid _t7`3at-(t. Lobbyist Registration Form receive and verified by: " F:\CLER\SALLIaFORMS\LOBBYIST FO°t 1.5%i abbyist Ann.ial Registration Form.cloc Revised 01/22/2014 F:ICLER\$ALL1aFORMS\LOBBYIST FORMS1Lobbyist Registration Form.doc \ 11 BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida, 3139,,Iww,w"iniamibe'achfl.go4 L131 1 t CITY CLERK Office Rafael E. Granado, City Clerk ti,■ 1 i' 1�z.. =Cit■Clerk @mi'amibeachfl.gov Tel: 305.673.741 1 ,Fax:305.673.7254 LOBBYIST NAME: f,R 111 Ci 11J' dt 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 aut. .1 . 'cally suspended from lobbying until all fines are paid, unless the fine has been appealed to t' mi-Dade County Commission on Ethics and Public Trust. �. Z - z 5- ZD/ • ignature: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc PATHMAN LEWIS LLP i_ ATTORNEYS AT LAW ern 6 NO 2 1 P[1 1: 7 L J I��4'7;.,,. a �i WAYNE M.PATHMAN,P.A. ONE BISCAYNE TOWER•SUITE 2400 HAROLD L.LEWIS,P.A. r 3 f 'i ;; . ;, ,; i_ 2 SOUTH BISCAYNE BOULEVARD DAVID E.SACKS ` MIAMI,FLORIDA 33131-1803 LOUIS P.ARCHAMBAULT* JOHN A.MOORE** TELEPHONE(305)379-2425 RICHARD N.SCHERMER FACSIMILE(305)379-2420 AARON W.TANDY*** www.pathmanlewis.com PETER L.MELTZER WAYNE M.PATH MAN wpathman@pathmanlewis.com •Board Certified Specialist in Real Estate Law March 16 2016 "also admitted to practice in Texas '"also admitted to practice in New York City of Miami Beach Lobbyist Registration 1700 Convention Center Drive, 1st Floor Miami Beach, FL 33139 Re: Lobbyist Registration —Wayne Pathman on behalf of Ricardo Nevarez 901 43rd Ct., Miami Beach, FL Dear Sir or Madam: Enclosed for processing please find a Lobbyist Registration form on behalf of our client, Ricardo Nevarez, along with a check in the amount of$350.00 for the registration fee. Please do not hesitate to contact us should you have any questions or comments. Very truly yours, PATHMAN LEWIS, LLP g3oIu '441 Dorinda Triponey • Legal Assistant 1 ' -,_,. , ,-.1.;i -,1).. 1--„,n1 . Ito Gs Miscellaneous Cash Receipt . it,,, ..1J.k. 1 -,,, , L- 1.*, ti 1,- I . ''''' '' ' - - 'C *fr--' ''' ' '-' i' 4tIct146,,-$15° , - - ... , , No , • ,.., .,,,, ',.- , , ITY OF MIAMI BEACH--:= • . q -'7 i 1 : tr• - - 0 •• °'0 '''' ' D Cash El Credit Card Check# f 10,,(.. 1 I . 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