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Daniel Ciraldo - Jack Johnson Loot Oc.c p IJvF MIAMI BEACH1pie�pRFn�/�� Office of the City Clerk '1;? . 1700 Convention Center Drive ,`7 Miami Beach, FL 33139 ., r„ / /• 305.673.7411 `,^/ f-,^ i2B LOBBYIST REGISTRATION FORM ✓``F• Lobbyist means all naemployed olu or retained, whethercisipaid or not,o by i principalo ; who seeks. atencourage co the passage,defeat or modification any ordinance,rcommittee; any or decision ci of any commissioner; any action siorecommentme i the City Manager e cis any City or co an such or ion a sidecisionror reenrnmendthat of asen Cably willpersonnelhand ogr thetimeperiodyof 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'Lobbyits°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 "n/a" 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: Ciraldo Daniel c NAME OF LOBBYIST (Last) (First) (Middle Name) Miami Design Preservation League 1001 Ocean Drive Miami Beach FL 33139 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-672-2014 daniel@mdpL org LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORM NJi �� tsC"„5- \ 1 NAME OF PRINCIPAL (Last) (First) (Middle Name) Miami Design Preservation League 1001 Ocean Drive Miami Beach FL 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 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 2482(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(it none,write N/A): N/A • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): N/A Page 1 of 5 The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": YesXNo: 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 City Code Section 2490,entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues — Yes 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's Future Land Use Map? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist' as set forth in Section 2-481)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 city 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? 4) Pursuant to City Code Section 2-481, the tens "lobbyist" specifically excludes the following persons: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. VesX No: Are you providing only scientific. technical or other specialized Information: appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(1), no campaign consultant shalt lobby the City Commission for a period of 12 months following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services within the past election cycle.See Section 2-491 for more information. _Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the Incumbent member(s)of the City Commission: _Yes_No: If yes, has It been less than 12 months since the elected official(*)whom you provided campaign consulting services was sworn in? 6) Pursuant to City Code Section 2482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission(which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meetinq. _YesX_No: Have you provided campaign consulting services to an Incumbent member of the City Commission within the past election cycle?If yes.please list the incumbent member(s)of the City Commission: Yes_No: N yes, were YOU promised or did you receive economic consideration in exchange for campaign consulting services? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY � Annual Registration fee: I 1 Yes�I No Amount Paid$ MCR. Date Paid Lobbyist Registration Form recelfied and verified by: Revised 01/01/2018 F:\CLER\SALL\.FORMS\LOBBYIST FORMS\LObbyist Regl#rOtlon nn Revised 1-01-18 REG. Page 3 of 5 . wl' ( Ii City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeochtl.gav Office of the City Clerk Rafael E. Granado,City Clerk CityClerk@miamibeachf.gov Tel: 305.673 7411,Fax: 305.673.7254 NAME OF LOBBYIST: Daniel Ciraldo 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 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. 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 1 of each year, and the fee for such annual registration shall be 00.00 pursuant to Section 2-482 of the Miami Beach City Code. 7 Signature of Lobbyist Date F CLER1/45ALL aFORMBtOBBviST FORMELLCLbyist Rpistratm Femi Revised 01-01-18 REG dec Page 5 of 6 l00k OcEr/1/J 5±(2-) vc MIAMI BEACH I�%4,oa, Pi. Office of the City Clerk j '� 1700 Convention Center Drive "G").) C- �9 Miami Beach, FL 33139 r,j" � � 305.673.7411 ""';%. Of LOBBYIST REGISTRATION FORM • ��'Y Vic^ g C< ^' Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or 0' modification of any ordinance, resolution, action or decision of any comme ; any action, decision, recommendation of the City Manager orr 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 "n/a" 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: Ciraldo Daniel G NAME OF LOBBYIST (Last) (First) (Middle Name) Miami Design Preservation League 1001 Ocean Drive Miami Beach FL 33139 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-672-2010 daniel@imdpL ory LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORM N• \� NAME OF PRINCIPAL (Last) (First) (Middle Name) Miami Design Preservation League 1001 Ocean Drive Miami Beach FL 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 1 1 CELLULAR TELEPHONE NUMBER PRINCIPAL BUSINESS TELEPHONE NUMBER ii� dn/ EMAIL ADDRESS/ If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2482(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): N/A • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): N/A 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. ft I Col Oma- 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 Commission and Commission Committees City Administration/Staff City Boards(HPB, Planning, DRB) Pursuant to City Code Section 2482(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): n/a 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): N/A-No special compensation Page 2 of 5 The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2-488 entitled Prohibited Campaign Contributions By Lobbyists On Procurement Issues': _YesXNo: 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 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 Mao? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of lobbyist as set forth in Section 2-481)who only appears as a representative of a not-for-profd 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 city 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? 4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursementurfor the appearance. _Yes/(No: Are you providing only scientific, technical or other specialized information; appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profd based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected official(s)for whom the campaign consultant provided campaign consulting services within the past election cycle. See Section 2-491 for more information. _Yes %No: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: Yes No: If yes• has it been less than 12 months since the elected offciaffe)whom you provided campaign consulting services was sworn in? 6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. _Yes%No: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent members)of the City Commission: _Yes_No: If yes, were you promised or did you receive economic consideration in exchange for campaign consulting services? • TO BE COMPLETED BY CITY CLERICS STAFF ONLY Annual Registration fee: [ I Yes 'No Amount Paid$ MCR 9 Date Paid r(o ��' Lobbyist Regbgatlon Form raced and verified by: F\CLER\$AL \BFORMS\LOBBYIST FORMS\Lobbyist Registration m Revised 1-01-18 REG.ZZ'"snara...._ Revised 01/01/2018 Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY LISTINGLOBBYIST SHALL SUBMIT TO THE OFFICE SIGNED STATEMENT UNDER OATH, LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED. FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPSATION �G T REPORTING PERIOD.1 Signature of Lobbyist: / I do solemnly swear or affirm 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 provisions contained in Chapter 2, Art. VII, Division 3, eenntitled 'Lobbyist& of the Miami Beach City Co and all r portin require ents. et—q- /uX (/ Signature of Lobbyist: Date / Signature of Principal: 5?.,�-%1' "A���"�• �� v Date (-'1 7I% / VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State ofT �dState of Wt`1^a h/��.�Q County of M�V✓\I �'c- County of:�Q�l "- u'^' Sworn to(or affirmed)and sybscribed before Zme,/ by this orn rn (or ofaffixed)an;subscribed before itl, tm p thisday of _9(4 1O by NAME OF LOBBYIST.tcvt a^t �Np/M/�E OF PRINCIPALT)T eta._ �.o Produced ID'I) el•1•4 VS C i QQ✓1%C 1Lcroduced ID I)N J LYS n�• FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personally Known 'e o ally Known SiSia. atur of Notary Public Sir ature .f Notary Public JOA/ <-r leg S .1iitr 2e -i-ro-s Name of Notary,Typed,Printed or Stamped Name of Notary,Typed, Printed or Stamped t1/4 ,ARY SEJA4IFER S.REYES N9y;g1,FLY,SEAL)JENNIFER S.REYES Notary Public-Stale of Florida Notary Public -State of Flalta -� a My Comm.Expires Jun 9,2018 . �y4J My Comm.Expires Jun 9,2018 •• C•un .� • .1663 :ale 6Or itC �' Commission # FF 130663 I •...ILt,c. •, -- - - _ C, following persons: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings; any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance, whether direct, indirect or contingent,to express support of or opposition to any item; and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement tor the appearance. Page 4 of 5 • Hill !, ( I I City of Miomi Reach, 1700 Convention Center Drive,Miami Beoch, Fbrida 33139,www.miamibeachll.go, Office of the City Clerk Rafael E Granada,City Clerk CityClerk@miamibeachfl.gov fel: 305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Daniel Ciraldo 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 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. 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 1 of each year, and the fee for such annual registration shall be 07 00.00 pursuant to Section 2-482 of the Miami Beach City /�Code. Signature ofLobbyist Date ' �� F eLERSPLLaIOFMSLLOBBYIST FORMS'U obbysl Registration Farm Revnee 01.01-19 REG doc Page 5 of 5