William A. Lai - Capital One Financial CorporationI
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City of Miami Beach Office of the City Clerk ` ? aY :_ , , ,.. 1
1700 Convention Center Drive, Miami Beach, FL 33139 2016 'A 114 n4 3: 5?
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage tJJ e y passage,e,'defeat'or ��'-
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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.
Lai William A.
NAME OF LOBBYIST: (Last) (First) •(M.I)
Dynamica Architecture and Design, 888 Biscayne Boulevard, Suite 201, Miami, FL 33132
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305)376-8889 wlai(ddunamicastudio.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:
Capital One Financial Corporation
NAME OF PRINCIPAUCLIENT:
Capital One Financial Corporation, 15000 Capital One Drive, Richmond, VA 23238
BUSINESS NAME AND ADUKESS (Number and Street) (city) (State) (Lip Code)
(661) 466-6910 (312)260-2728 ruth.newell(aIcapitalone.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,PARTNE OR BENEFICIARY: Capital One Financial Corporation is publicly traded corporation on the
New York Stock Exchange(NYSE). �-G� a &.r 7
1 • IDENTIFY ALL PERSONS HOLD G.DIRECTLY OR INDIRECTLY.A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION.
PARTNERSHIP OR TRUST: v‘b1 0 C_ `
II.SPECIFIC LOBBY ISSUE: Y
Development Approvals an'd Permitting Issues1 including, but not limited to the Historic Preservation Board, Design Review
Board, Planning Board, Board of Adjustment;Land Use Development Committee, City Commission, and any City Workshops or
Committee's, if necessaru, relatina to the propertu located dt_1_029-1031 Lincoln Road,Miami BeachT Florida
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 •
Staff for the Planning Department, Building Department, None. X
Public Works and City administration, PB, HPB, BOA, None. X
DRB, City Commission, and Mayor 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
None.
None.
None.
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Formrevised 5-30-2012.doc / �►
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)$ 30 0 Dvitt Y
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $ 0 11 Oi.'t'
(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 lobbvina on a present or oendina bid for goods.eauioment or services.or on a present or nendina
award for aoods.eauioment 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 lobbvina on a oendina application for a Development Aareement with the City or application for
chanae of zonina map desianation or chanae 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 aC 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,
f.QB THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO
EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD.
od016.09011111
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
Y 9 9
in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist: .i��d•®
Signature of Principal/Client: (L
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
4Produced ID t•-• ^ Produced ID CA 0
Form of Identification Form of Identification
Personally known(Lobbyist) Personally known(Principal) ;; _o`=_(_
VII. SIGNATURE AND STAMP OF NOTARY: .°,;,SI;,��.•• r
I +�unt of Miami-Dace JAIME NAVARRO State of Florida, County of Miami-Dade Z (f
S ate •f Florida, y � ,, y
S or' to and s •scribe before me �4. « i Notary Public,Stated Florida Sworn nd subsc ibed before me ° o
T'i: 1 S d= of ��, 2(1 '�� Commission#EE 192996 This n da Q� ,?.6.1� H B Q -+
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4) M eomm.expires Apr.25,2t'`
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"'ignature of Pubic Notary—State of Florida Signature o Pu:1' • ry—State of Florida ' .�
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otarization of Lobbyist's signature Notarization of c:... rnal's signature o d o a
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY rn
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Annual Registration fee:[y]Yes[ ]No Amount Paid$ S.00•O° MCR# b I Date Paid 0 `[II`I • 0.
•
Lobbyist Registration Fo received and verified by: Ck) v( J•
NAJAMI BEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.mianibeachfl,gov
CITY CLERK Office
Rafael E,Granado,City Clerk CityClcrk@miamiboachfl,gov
Tel: 305.673.7411 ,Fax: 305.673.7254
LOBBYIST NAME: William A. Lai
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.
An y lobbyist,ist, who fails to file the required Statement by April 30th, 2012, 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.
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Signature: Date.:
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Formrevised 5-30-2012.doc
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DYNAMICA ARCHITECTURE&INTERIOR DESIGN CORP. BarikofAnterica4,t 2223
888 BISCAYNE BOULEVARD,SUITE 201 1 SE 3rd Ave
MIAMI,FLORIDA 33132 Miami,FL 33131
63-27/631 12/17/2015
950
PAY TO THE City of Miami Beach
ORDER OF t $ **2,400.00
Two Thousand Four Hundred and 00/i 00*************************************************************************************************************
DOLLARS
Security teaiures
1700 Convention Center Drive °6e ed5 0�beck.
Miami Beach, FL 33139
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DYNAMICA ARCHITECTURE&INTERIOR DESIGN CORP. BankofAnierice 2226
888 BISCAYNE BOULEVARD,SUITE 201 1 SE 3rd Ave.
MIAMI,FLORIDA 33132 Miami,FL 33131
63-27/631 12/21/2015
950
ORDER of City of Miami Beach
$ **350.00
Three Hundred Fifty an d 00/100*********, t*****************************************************************************************k******************
DOLLARS
r, Security features
1700 Convention Center Drive ° a a�back
Miami Beach,FL 33139
VOID AFTER 60 DAYS
( en)MEMO 1508.02 Capital One-Lincoln Rd-Additional Lobbyist Registraw AUTHORIZED SIGNATURE
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M I AM I BEACH
City of Miami Beach, 1700 Convention Center Drive,
Miami Beach, Florida 33139 www.miamibeachfl.gov
City Clerk' Office
Tel: 305/673 - 7411 Fax: 305/673 - 7254
ANNUAL LOBBYIST REGISTRATION FORM
Name: William A. Lai
Business Name: Dynamica Architecture and Interior Design
Address: 888 Biscayne Boulevard, Suite 201, Miami, FL 33132
Phone: 305-376-8889
Email: wlai a, ynamicastudio.com
If more than one Lobbyist,please list:
1)
2)
3)
4)
5)
MCR#: LI n ba_i
Amount paid: 46d°.O1) Date paid: 01—/L� - /6
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Processed by: --)ASSOM CNAJ MOQE Date: 01 -14. IL,
Send this form with a check for $500 payable to
the City of Miami Beach for each lobbyist
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM.docx
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