Jack Seiler - Eric Poms PEor;v''n
MIAMI BEACH Office cif the City Clerk nie MAR 2g P!! 2: 32
1700 Convention Center Drive
Miami Beach,FL 33139
3056737411 �- - YCLER:i
LOBBYIST REGISTRATION FORM
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 City Code Chapter 2,Article VII,Division 3,entitled'Lobbyists;
for additional information.
Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s)of paper. If you have nothing to report in a particular
section, you must write 'none' or Wa" in that section. Any change to any information originally filed, or any additional City
Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form.
The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs
Separate registration forms shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
SEILER JACK
NAME OF LOBBYIST (Last) (First) (Middle Name)
33311
SEILER SAUTTER 7ADEN RIMES ETC 2850 N ANDREWS AVFNUE WILTON MANORS FL
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) Rip Cade)
954-568-7000 954-562-0958 JSEILER@SSZRLAW.COM
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
POMS ERIC
NAME OF PRINCIPAL (Last) (First) (Middle Name)
SOUTH FLORIDA CFPNCG HOST COMMITTEE, INC., 14360 NW 77 COURT,MIAMI LAKES FL 33016
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (Cay) (State) (Zip Cade)
305-341-4700 305-773-4288 ERICPOMS@ORANGEBOWL.ORG
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
If the principal is a Corporation, Partnership or Trust, the following Information MUST be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): SL h
A --f t-Aek}C-n
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST fid none,write WA): N/A-A NON PROFIT
Page 1 of 5
III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
COLLEGE FOOTBALL PLAYOFF NATIONAL CHAMPIONSHIP GAME
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date,stating the general nature of the subject contractual relationship.
Full Name of Individual and Contractual Relationship(If yes,explain) YES NO
Title of Person to be Lobbied
CITY OF MIAMI BEACH 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.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write N/A):
NONE
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3):
NONE - $0.00
Page 2 of 5
The following six(6)questions MUST he answered:
r d Sdatt d:City Code Setlion 2408 entitled 'Pronrmled Corr Aaiun Contrloupoue Hy lobbyists On Prowremem twee'
_Yes XNo-. Are you lobbying on a present or pending bid For goods equipment or services,or on a present or
pending award for gouda,equipment or service?
art to City[ode Leff:hen 2490 sntibvq rftrulilbithe ama :g i Contrbu tioris Hy Louuy clr On Real Estate Deva bpmom.
_Yea 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,Future Land Use Map?
Pursuant to City Code Seal,oi z482th), any per firm leaccep! Ih05e exempt from the aeration of (Lobbyist off Set forth in
Section 2-481)who only appears ab a reptesent tiVe ul a not-for-profit cnlpamlron Of entry without special compensation e,
reirubtirmnenl 101 the appearance.Whether direct or indirect to express support olor apposition to any item,shall rcg,3tar will
tl e arty ch-+rk as require(by this sertien,hut shall not he rel.:lied to pay any registration leen.
res No: Are you representing a notAOPpronl corporation or entity without special compensation or
reimbursement?
41 Pursuant :o City Cooe Secbun 2401 Iha iron "lobby sr seeclircaily exd'hdes the labowing persons. E pen wrriessns who
prcvine only scientific,technical or other specialsed Information or testimony in puboc meetings:any person who only appear
ina representative of a neighborhood association without compensation or reimbursement for the appearance,whether direst,
direct or contingent,lir express support of or 0opesrtion to ens item and any person who only appears as a representama of
not-for- role anminonify based organizaLor or Ire pumasa of reuuoShn9 a pupil withom special compe+sating or
rolmbdrsemert for the appnnran✓e
Xyes No: Are you providing Univ scientific, technical or other specialized Information: appearing as
representative of a neighborhood association without special compensation or reim0ursement or
representing a not-for-Profit Cased organization for the DatPpse of ..questing a wan( without
special compensation or reimbursement?
Pursuant to City Code Section 2-491(1), r p'1ra ,:arsur'a 11 f 11311 lobby the coy t _ n for ' period of 12 nlcnbls
following file swearing in d any es. '.t&Harts) lo' whom trio .I-911 conctnt t F I.lsamp I 11ont1 saviors
w Ih,n the past election cycle See Sedan 249i lot more udormatmn.
_Yes XNo: Have you provided cempaign consulting services to an incumbent member of the City Commission
within the past election cycle?If yes please list the Incumbent momberls)of the City Commission'
Yen No: $yes.his It been less than 12 months since Use elected offrcielld whom you provided camwion
consoWn services was sworn int
o, Pursuant to Cqy Cede Section 2482(a)(4)a.. a lobbyist prim has within the past ekcliun cycle provided oampagn censusing
services to an mcumlxnl met Of Ina City Commission(which lobbying adrvity Is net oOmwse prohibited by Code section
24Y I) shall disclose such particular service on his/her Sty's' regielrsrn0 farm and shall orally disclose such particular
service beforelobbyrne the City Cr/mmrssron et a public meeting
Yes XNo: Have you provided campaign consulting services to an Incumbent member of the City Commiselon
Within the Past election cycle?It Yes,please Ilse the incumbent member(*)of the city Commission'
Yes Not It yaw.were you promised or did you receive economic consideration In withalmo tor campaign
consult/pa services?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Anneal Reglntmilon l e [ J Yes 9Q No Amount Paid f _MORD NET Data Paid
Lobbyist as M1tmt _ c1—_ � 34 Avt'it
o F received_and verified by: ae'. r Revised01/01/2018 - f
Pape]of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OFFICE DF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION,
RECEIVED. FOR THE PRECEDING CALENDAR YEAR WITH REGARO TO THE SPECIFIC ISSUE ON WHICH THE
h: : • a O LOBBY. A . _a?.. .1 < ALL ;E F • . x . HAS : •
EXPENDITURE OR COM 1{$pT10!/((/�1RIN TME REPORTING PERIOD.
Sgnature Of Lobbyist: (//1rX`/17rJ(/�/� M Date t3 / 23/ 1 8
I do solemnly swear or amim that all of the foregoing facts, statements, and disclosures In this form are true and correct,
and that I have read or am familiar with the Pr• ,.Ions contained In Chapter 2,Art. VB. Division 3, entitled 'Lobbyists'of
the Miami Beach City Code an ,•..,zI . r-.rements, O •
Signature of Lobbyist: _/.:g/a_(r,�.. . pale 031131 I0
/ti 'c-
' J %
Signature of Principal. cit.. Date 315.111 l
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL p
State of f logs I'I
State of /1K-In.<
County of: Drowocd_ countyoC VllkjitI -DADFi
Sworn to jor affirmed)and subscribed before me Swo o(or effirrofidi pilo pubscrlbed before me
this a 1 day of Mo.tck 20.1 by this jado.day of Itikii_ ,2811k by
Iohn ? Seller ERIC Polls
NAME Or LOBBYIST NAME OF PRINCIPAL
Produced ID _ Produced ID
FORM OF IDENTIFICATION FORM Of IOENTIFICAT.0
icP)erKyonally Known �I roon*Knovq
atue ?C
Signature of Notary Public Signator of Not- Pub'
Ifil,i iS-4.i/Lou rikc-Cnrkle_ Asul .IM "INLol:. n1AtaE
Name of Notary,Typed,Printed or Stamped Name of Notary,TOO, Printed Or Stamped
r" , KRISTINA MCCOR KLE
(NOTARY SEAL) #' , „x rr kions NOTARY SEAL)
xSFlBsxlaYLaerxucERE
.� MyCninunvsa,, Ho,.es �- xCbtyNwrsmv4lrlMa
\�„-we Aceu:t lv. iota - Krame90Lfsr kb9,201
r The term"labb arec caly esduds Incthe following persona: 44.1.”' raftlwereleseiwrexre
_
Expert wilnessea who provide only aelenlitic,technical or other totalized intonation or testimony In public rneelegs,any person who
only appears as a representative M a neghlsorhood association*Pivot compenaesm or reimbursement for Ow appearance,whether
direct Indirect or contingent to eNsrass support of or opposition to any item:and any person who only appears as a represenlative of
not-tor-profit community based organizalior for the purpose of requesting a grant without special compensation or reimbursement for
the appearance
Page 4 of 5
I
City of Miami Eeach, 1100 Ctifififfiltfififi �nm,p nm,li.fifili flo, 1119'),r:.,-x i;ffl q:.,
OOf e of iho Cir,fiefif
Rafael E.Cruorvin. ' Cled I ierW.r,o dmock yoe
Iry
rel J05 til,-ili ice. JOif,)9754
NAME OF LOBBYIST: JACK SEILER
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or
principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements 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 30'' 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.
I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist expenditures. as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
commencing October I of each year, and the fee for such annual registration shall be
$5 p/u s nl to Ghon 2-482 of the Miami Beach City Code.
//\//' en ___ 031 23118
L `
Si pre of L byist Date
PJIjL 5 Qf 5
Salvatore, Jason
From: Mireya Carballosa <mcarballosa@flapartners.com>
Sent: Tuesday, March 27, 2018 11:37 AM
To: Salvatore,Jason
Subject: Lobbyist registrations confirmation email
Hi Jason,
Per your request, below is an email confirming the CEO to South Florida CPNCG Host Committee, Inc.
Thank you,
Mireya Carballosa
235 Catalonia Avenue
Coral Gables, FL 33134
305-461-4260 Office
mcarballosa@flapartners.com
www.flapartners.com <http://www.flapartners.com/>
On 3/27/18, 11:31 AM, "Licursi, Maureen'<MLicursi@OrangeBowl.org>wrote:
>Hi Mireya,
>From Eric:
>Eric Poms is the CEO of the corporation as it currently exists, with
>the following three designated officers:
>-Michael Chavies, President
>-Brad Houser,Secretary
>-Frank Gonzalez, Treasurer
>They are in the process of making changes, but as of now the
>information above is correct.
>Let me know what I can do to assist in making any updates to the
>paperwork.
>Thank you!
>Maureen Licursi
>Orange Bowl Committee
>mlicursi@orangebowl.org<mailto:mlicursi@ora ngebowl.org>
1