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Rene Gonzalez - Ferrado Lido, LLC 40 I s kr..4 Arvt, MIAMIBEACH {a . City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 331796 F��l� 0 PM i { { LOBBYIST REGISTRATION FORM CITY ;' ;,.'` 0;1: I ; 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. Gonzalez Rene NAME OF LOBBYIST: (Last) (First) (M.I) Rene Gonzalez Architect 670 NE 50th Terrace, Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-762-5895 Rene(a?reneaozalezarchitect.corn TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone, or e-mail address.' I. LOBBYIST RETAINED BY: Jose Tena, Vice President NAME OF PRINCIPAL/CLIENT: Ferrado Lido, LLC 20411 SW Birch Street, Suite 360 Newport Beach Calif. 92660 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (949)474-9884 c/o meredithlakeWerrado-us.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:See Attached. • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNFRSHIP OR TRI1ST• II.SPECIFIC LOBBY ISSUE: clDevelopmen`t Approvals and Permitting Issues, including, but not limited to the Design Review Board,Planning Board, Board of Adjustment,—Land-Use Deueloprrient-Commi"ee, City Commission, and any City Workshops or Committees, if necessary, relating to the property located atF40 Island Avenue.Miami Beach.Florida 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 Staff for the Planning Department, Building Department, None. X 'b 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 • C:\Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Formrevised 5-30-2012.doc ffr IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required)$ 4e719/h✓• B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): $ '1OO / f 1 IC" (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 nendina bid for Goods.eauinment or services.or on a present or pending award for goods.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 lobbying on a pending application for a Development Aareement with the City or application for chanae of zonina map designation or chanae to the City's Future Land Use Mao? 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 X No; Are you reoresentina 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 UNDFA OATH. LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION RECEIVED. IN THE CITY OF MIAMI BEACH FQR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FLED EVEN IF THERE HAVE BEEN NO (PENDITURES OR •u'_► _ • I ► •_ :_ t _.�:c:�J�: •/� Signatu • obbyist I do solemnly swear that all of the f. -• •• acts are true a d correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Mi-- =•ach City Co.• and - re'•rti • requirements. Signature of Lobbyist: A _ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ties ao.,, r WNNA X Produced ID 1)LO�_ ��-1•� a' , _Produced ID i ::441,.a Form of Identification 1 :'4•,.•0�,; Form of Identification 4 _Personally known(Lobbyist) c, o Personally known(Principal) 4,; o 0a 77 it VII. SIGNATURE AND STAMP OF NOTARY: 3 3 m 1 State of Florida,County of Miami-Dade a. 4 State of Florida, County of Miami-Dade Sworn to and subscrib before , y y Sworn and subscribed before me This •r ;y of��016 T m This 1°1 day ofq 2016 ° J • SF a u -y�J•ubic Notary—State of Florida ^ o n Signature of Public Notary—State of Florida r •tariza;7J of Lobbyist's signature °D ' Notarization of principal's signature 12 TO BE COMPLETED BY CITY CLERK'S STAFF ONLY ,/ Annual RPgistratinn far, [ )Yea I.p)Nn Amnunt Paid$ 3•i0• t MCR it `( ( ' natl.Paid °s"�0 7 Lobbyist Registration Form received and verified by S0,-1 Sl4."A't0(L6.- MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139, www.miamibeachll.gov CITY CLERK Office Rafael E.Granado, City Clerk CityClerk @miamibeachfl.gov Tel:305.673.7411 , Fax:305.673.7254 LOBBYIST NAME: Rene Gonzalez 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 ba4is 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, 2012, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed • - . -Dade County Commission on Ethics and Public Trust. Signat ate: • C:\Users\clerhat AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration Form revised 5-30-2012.doc 7 CITY OF MIAMI BEACH DEVELOPMENT REVIEW BOARD APPLICATION DISCLOSURE OF INTEREST 1. CORPORATION, PARTNERSHIP, OR LIMITED LIABILITY COMPANY If the property that is the subject of the application is owned or leased by a corporation, partnership, or limited liability company, list ALL of the owners, shareholders, partners, managers, and/or members, and the percentage of ownership held by each. If the owners consist of one or more corporations, partnerships, trusts, partnerships, or other corporate entities, the applicant shall further disclose the identity of the individual(s) (natural persons) having the ultimate ownership interest in the entity.* Ferrado Lido, LLC -20411 SW Birch Street, Suite 360, Newport Beach, Calif 92660 NAME OF CORPORATE ENTITY NAME AND ADDRESS %OF OWNERSHIP Ferrado Inmuebles SL 100% Plaza Maria Pita 17 La Coruna 15001 Spain Ferrado Inmuebles SL-c/o Plaza Maria Pita 17, La Coruna 15001 Spain NAME OF CORPORATE ENTITY NAME AND ADDRESS %OF OWNERSHIP Rosp Corruna SL 100% Plaza Maria Pita 17 La Coruna 15001 Spain Rosp Corruna SL-Plaza Maria Pita 17, La Coruna 15001 Spain NAME OF CORPORATE ENTITY NAME AND ADDRESS %OF OWNERSHIP Sandra Ortega Mera 89.24% Plaza Maria Pita 17 La Coruna 15001 Spain Marcos Ortega Mera 10.76% Plaza Maria Pita 17 La Coruna 15001 Spain IF THERE ARE ADDITIONAL CORPORATE OWNERS, LIST ALL SUCH OWNERS, INCLUNG CORPORATE NAMES AND THE NAME, ADDRESS, AND PERCENTAGE OF OWNERSHIP OF EACH ADDITIONAL OWNER, ON A SEPARATE PAGE. NOTE:Notarized signature required on page 9 FILE NO. Miscellaneous Cash Receipt . • . CITY OF MIAMI BEACH . 1 • 4 1 1 9 48 No - - ,.,.. .. ,.. . .: .. - 5 ,) 5 . ..4 - - $ / ,,.....6,_ , c- 0 Cash 0 Credit Card 0.Check# . . i ,., oe...i 0-76 , 20 - -: City of ivliarlitgaftiVell Of NI 1.• (,\1 EA I. \ L,,F Lel , /VI MA t It..r., C"-..A i .", 1".. ''.-1Q- G :1,17.(11).' 1.. .c. - -- MiscellaneouAdViss2:9)16 0 __-.) 0,s.,: c,,i, ,( (3 t... C.,0 , ekr.ls ,, , c-., ..,)3 1,:::,1 , 6-7() 000512-0039 Irma-Ro.. 09/08/2016 19:444M' _„ i , N .'47J-"rc-,rC i-ivl IA-1/41; r L. ., Ac,T ) Payment Amount: 1,050.00 411948 -- . (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director • • By •,--sr-I . 7.--^ .11.• Account Number: 0? 1 - 0 w.-.7-- 3 ci LI qt./ - 00 - Jo --) . 3 (,).5" .. 0 ...„ , ,,•,,, ,,.,,,,,,...:: Foreparer: '_......\r..-elc)p•-,)- _SA-L-VI'l---7f.--,[4'(,.' - Dept: EXT: -IL/ i 1 . • . ! . 7.---__ :=7 : .ei -- . , . 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