Regina B. Moore - Miami Light Project, Inc. CAC GAnwr
MIAMI BEACH Office of the City Clerk RECE! V ED
1700 Convention Center Drive
Miami Beach, FL 33139 2018 MAY 23 PH 2: 36
305.673.7411
11 EACH
LOBBYIST REGISTRATION FORM C.,1 CLEF
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 "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:
Moore, RQ-3(nA , f e++1
NAME OF LOBBYIST (Last) (First) (Middle Name)
V'awN, P�leo* n\c �lOH Ow 2.6 9 Y1 cu FL 33123
LOBBYIST
�'BUSINESS NAME AND ADESS (Number and Street) (ay) (S,tat(e)) (Zip 99Code)
3LOBBYIST BUSINESSM6PHON NUMBER CES! 9t/L �MBER-reit wk.@wtt EMA DORk-l-PaESS e'1
II. PRINCIPAL NFORMATION: `f
YLL Eli i.52-
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Miami Ligh+ Project ,�+tc. q0`( Nu) 26 #- Mkau4 33123
PRINCIPAL BUSIN S NAME A DDRESS (Number and Street) / (City) (State) (Zip Code)
205 '5 6- 43 so 305-cno-350 •R 52J-t @ /utut+.«1 k-t Pfbi
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADIDIREBS
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): 11179r (�,
&CI'Zq-66frit boor.)c-
• 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 1
Pic
Pagel of 5
M. 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.
\ are Cit SEe('! nc3 4s LoLkUsa -}o re wok GgA,r cy' F'i'j`°4 e,
o 44. ciktie# M.i,avAn, ttGCIA CA-t. (}v&. -PN5 f 5 Catoetc l 3 Yq44-1-
Pa vet, l i s kS . I4.e f°,v n l w,e.e '"-c w i I t 4R-k- ?Cate rad
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and 11-1- tot 8 .
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
X1.1 14()Ta( A f f r5 Council Vh %t lies V
Brqnok. Re-olylick, I(um( {flaw Wtmlr V
Qxfkt-rir-t Aou,iri.n,3 rwA.ts tvunawkro..4orV
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):
Ik
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):
k
Page 2 of 5
The following six(6)questions MUST be answered:
1) PursuanttoCity Code Section 2-488, entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
_Yes1LNo: Are you lobbying on a present or pending bid for goods, eauioment 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 o: 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.
Wes_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
reimburserpent 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 post election cycle. See Section 2-491 for more information.
_
Yes.�_M/a: 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(s) whom you provided campaign
consulting services was sworn in?
6) Pursuant to City Code Section 2382(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 bet a 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 CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes( ]No Amount Paid E ,..1 MICR# -Data Paid l
Lobbyist Registration Form received and verified by: -. t5 J - ica'29CLL Q
Revised 01/01/2018
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTING 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 COMPENSATION DURING THE REPORTING PERIOD.-
Signature of Lobbyist: I -� v -TDate 05-' I$ f (Ff
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 reporting
e. g.requirements
.
Signature of Lobbyist: �F f `^'—r"" Date 05 I 1g (
5.
Signature of Principal. (.# i A Date 05 ( 1 g 116
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST:n
PRINCIPALL14State of State of ,�/�i/ L _'`'County oCounty of: / v�ani— ,� /
Sworn J (or affirmed) a b cribed before me Swor (or affir e•) d subscribed before •.
this 41 day of 20 by this/fday of di24 , by
ina —F• Ai ore , a1' 'roon2
�NAM LOBBVIST� fi • NAME •y PRINCIPAL
/
l�Produced ID A • / % �'.�14 o _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personall Known/ K Personally Kno
ignature of Notary Public / Signature of No ry Publi
6016# �U< „Patna' - �Ud/
Name of Notary, Ty.-• •r -• •r S /).-d ame of Notary, Typed. Printed or Sta d
ifir Notary Public State of Florida
Darnads Suarez �.e
(NOTARY SEAL) ', M.cod,ml•swn oc+zi4e0 (NOTARY SEAL) ♦ Notary Public State of Florida
Exgrq OBlzsrza]t T DYmads Suarez
II` Expir 08ie•imr??''4"
�an� E+Prrea a9Ryzp]t
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.
Page 4 of 5
vA ' AM. BEACH
City of Miami Beath, 1700 Convention Center Drive,Miami Beach, Florida 33739,www.miambeachll.goy
Office of the Cly Clerk
Rafael E. Granada, City Clerk CiyClerk@miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673�j7254 �, I
NAME OF LOBBYIST: I ,Q- ( YVN. t4000—
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.
hoar �, 051 /SO&
Signatu of Lobbyist Date
F‘cLEMEALL aFORMSLose Vlsr FORMsroboyia Registrant-Form monad ] -JI 18 REG:loc.
Page 5 of 5
Salvatore, Jason
From: Beth Boone <beth@miamilightproject.com>
Sent: Wednesday, May 23, 2018 3:28 PM
To: Salvatore,Jason
Cc: Regina@miamilightproject.com
Subject: Corrected form
Hello Jason,
It was a pleasure to speak with you this afternoon.
As discussed, I am to be noted as the chief officer on the lobbyist form that was submitted by us and received by the city
of Miami Beach today.
My name will go in lieu of the note that says not applicable.
Thank you very much, Beth
Sent from my iPhone
1
WO IRS „n:en, one
In4mn1 Revenue Service
P.D. Box 2508 In reply refer to : 0248205661
Cincinnati OH 45201 Feb. 05, 2018 LTR 4168C 0
65-0107810 000000 00
o• 00012928
BODC: TE
MIAMI LIGHT PROJECT INC
'/. ELIZABETH BOONE DIRECTOR
PO BOX 531385
fivAty MIAMI FL 33153
018301
Employer ID Number : 65-0107810
Form 990 required : Yes
Dear Taxpayer :
This is in response to your request dated Jan . 25, 2018 , regarding
your tax-exempt status .
We issued you a determination letter in August 1989 , recognizing
you as tax-exempt under Internal Revenue Code ( IRC) Section 501 (c)
(3) .
Our records also indicate you' re not a private foundation as defined
under IRC Section 509(a) because you' re described in IRC Sections
509(a) ( 1 ) and 170 (b) ( 1 ) (A) (vi) .
Donors can deduct contributions they make to you as provided in IRC
Section 170 . You're also qualified to receive tax deductible bequests ,
legacies , devises , transfers , or gifts under IRC Sections 2055 , 2106 ,
and 2522.
In the heading of this letter , we indicated whether you must file an
annual information return . If a return is required , you must file Form
990 , 990-EZ, 990-N, or 990-PF by the 15th day of the fifth month after
the end of your annual accounting period. IRC Section 6033(j ) provides
that , if you don't file a required annual information return or notice
for three consecutive years , your exempt status will be automatically
revoked on the filing due date of the third required return or notice.
For tax forms , instructions , and publications , visit www. irs .gov or
call 1-800-TAX-FORM ( 1-800-829-3676) .
If you have questions , call 1-877-829-5500 between 8 a .m. and 5 p.m. ,
local time , Monday through Friday (Alaska and Hawaii follow Pacific
Time) .
0248205661
Feb . 05 , 2018 LTR 4168C 0
65-0107810 000000 00
00012929
MIAMI LIGHT PROJECT INC
% ELIZABETH BOONE DIRECTOR
PO BOX 531385
MIAMI FL 33153
Sincerely yours .�/
Kim A. Billups . Operations Manager
Accounts Management Operations 1