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MIAMI BEACH Office of the City Clerk 2010 APR 10 AM 10 36
1700 Convention Center Drive
Miami Beach, FL 33139
305.673.7411 °({
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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, Divis.on 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 fomes shall be required for each principal represented on each specific issue.
I. LOBBYIST INFORMATION:
Grimm Carly
NAME OF LOBBYIST (Last) (First) (Middle Name)
BILZIN SUMBERG BAENA PRICE & AXELROD 1450 BRICKELL AVE. , #2300,MIAMI, FL33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Cade)
305-350-2352 cgrimm@bilz in.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
GCEA LLC -Gerardo Cea
NAME OF PRINCIPAL (Last) (First) (Middle Name)
414 71 Street, Miami Beach, FL 33141
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
ceagerardo@gmail .com
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): Gerardo Cea
• 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): Gerardo Cea
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.
Proposed land swap between City of Miami Beach and North Town Center
15eAc M
Development, LLC
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
Planning Department/Staff & Planning Board x
Building Department/Staff
Mayor,Commissioners and City Manager
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):
$380/hour
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
_Yes )01o: 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 Nb: 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 director 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 So: 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
reimbursement for 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-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 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 vet has it been less than 12 months since the elected off cialls)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 YNo: 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, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF�FONLY
lr1'N
Annual Registration lee: [ IYes[ o Amount Pald$ JS\ •Cr-)MCRa t/ 7AJO5 ) Data Paid OLI-JO' If
Lobbyist Registration Form received and verified by: —JA 'i
F:\LEER\BALL\aFORMS\LOBBYLST FORMS\Lobbyist Registration Form Revised 01-01-18 REGAoc Revised 01/01/2018
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH I OBBYIST SHAI L SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH I ISTING I ORBYING EXPENDITURES AS WEI L AS COMPENSATION
RECEIVED FOR THE PRECEDING CALENDAR YEAR WITH RFGARD TO THE SPECIFIC ISSUE ON WHICH THF
J ORRYIST HAS RFFN ENGAGED TO I ORRY A STATEMENT SHAT I RF RI FO FVFN IF THFRF HAS RFFN NO
EXPENDITURE OR COMPENSATION DURING THF REPORTING PERIOD 1-
Signature of Lobbyist: Date 4 / sit 8
Carly Grimm
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, entitled "Lobbyists" of
the Miami Beach City Code/ and all g requirements.
Signature of Lobbyist. ( repo Date 4/ $/ I B
Carly Gr m ff
Signature of Principal: Date
GERARDO CEA
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of rt0f0;0` State of
DJCounty of: A 10.1411— e- County of:
Sworn to(or affirmed) and subscribed before me Sworn to (or affirmed)and subscribed before me
this ...grs day of glPri\ 2018, by this day of 2018, by
Carly Grimm GERARDO CEA
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
KP -silly Known 9 //� Personally Known
Signature of Notary Pu lic Signature of Notary Public
LAM( Ill (WVC-
Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
sof" Dia R CASANOVA
(NOTAR * Ccomirmt GG109091 (NOTARY SEAL)
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14 new myfwrypriTpiiF COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR fi Date Paid
Lobbyist Registration Fomi received and verified by:
F:\CLER\SALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 08-18-16 REG.doc Revised 08/18/2016
1 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 reimbursement for
the appearance.
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 2R OF FACH YEAR. EACH LOBBYIST CHAT L SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH I (STING I ORBYING EXPENDITURES AS WELL AS COMPENSATION
RECEIVED FOR THE PRECEDING CALFNDAR YFAR WITH REGARD TO THE SPECIFIC ISSIIE ON WHICH THE
ORRYIST HAS REFN ENGAGED TO LORRY A STATEMENT SHAT L RF f Eli Fr) FVFN IF THERE HAS RFFN NO
EXPFNDITI IRE OR COMPENSATION DURING THE REPORTING PERIOD -
Signature of Lobbyist: J,�'v/ '✓ — L'Z-- Date 4 / �/ f 8
Carly Grimm
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, entitled "Lobbyists" of
the Miami Beach City Code and all reporjmg requirements.
/ j/
Signature of Lobbyist. c� I .. "LLQ -L, Date 4 3/ I G
rr Signature of Principal ary Alinn Date o (/oy / i?
GER, De F •.
VII. NOTARY SIGNAT - . AN a SEAL:
LOBBYIST: PRINCIPAL
State of 4 CLtGU State of ue"'1 loiL4
County of r•t 1t- i C.L0f County of 11,..d
Sworn to(or affirmed)and subscribed before me Sworn to (or affirme )and subscribed before me
this ,bra day of heti i\ 2018. by this `1 day of Y\( ° 1 . 2018, by
Carly Grimm GERARDO CEA
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID ✓ Produced ID �'p1-
VFORM OF IDENTIFICATION FORM OF IDENTIFICATION
Persorfally Known _Pe e• Kn..r
tark
Signature of Notary Public Signs 3''":j �ublici
Name of Notary.Typed, Printed or Stamped Name of Notary,T JESUS EFERNANoIiz
este cm.o R CASANOVA Notary Public-State of New York
(NOTARY, 3- Caaeiwan#GGI00096 (NOTARY SEAL) NO.O1FE6364nsg
Ia balms YtryJD.MI Mycomm,ianin Erores Sep it 2021
g." pinnas .MlikBfc COMPLETED BY CITY CLERK'S STAFF ONL
Annual Registration fee: [ I Yes[ I No Amount Paid', MCR# Date Paid
Lobbyist Registration Form received and verified by:
A L.4FC:+M<_\LOBBYIST FORMS\Lcbhyict Registration Fong Revised O8-18-16 PEG.dnC Revised 08/18/2016
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
directindirect 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.
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,wwwmiamibeach l.gov
Office of the City Clerk
Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673 7411, Fax: 305.673.7254
NAME OF LOBBYIST: Carly Grimm
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
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
All
413118
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