Alexander P. Heckler - Terra Group L<hSC_ C--%7C-N_) ,ra
REC.7P1En
13E±1 � Office athe City Clerk 2J uiuR28 n1111: 51
1700 Convention Center Drive �..
Miami Beach, FL 33139 � RACH
305.673.7411 '" 1,0L 7
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 ell 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 "Na' 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 en 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:
fleck-lei M-QaundeY P.
NAME OF LOBBYIST (last) (First) (Middle Name)
G" `IS I A Si . Si- 7 4C. A it '. .t =-- - (-L- 14.D
LOBBYIST BUSINESS NAME AND ADDRESS (Num.:1.nd Street) (City) (State) (Zip Code)
( 305)ro73—esus nWc'Ocr@ tsyg(f tmtxs• ccvA
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER E ADDRESS
II. PRINCIPAL INFORMATION:
tACIt 1Y\ David
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Tefra�f C-into 2(OC-,S S ealysW-c-O4vc '#1020 CrC(MLA-C-wwMC et. 3133
PRINCIP^'�USINESS NAME AND ADDRESS (Ndmber and Street) (City) (State) (Zip Code)
Y
2Us' 41I _4S5� � av1C10-kerva {1,a . rcav
P INCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER (JEMAIL 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): 17a\1 IqGVtIY\
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MOREJJ `OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(H none,write N/A): L• •Vl U I`1U,V4 n.
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.
4/7`o-n ,477-ed-v1F -li s fifitldiis,74(
L-tAe 0A-eYtsLty'
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(N yes,explain) YES NO
Title of Person to be Lobbied
CGarvasslncs r s+aU-
r L41_ S-(-G cc-
-
� n . .
x
Pursuant to City Code Section 2482(9), 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):
1\1 CA
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):
zo l 2 = lD, mro fr.- mar'
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 No: 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 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 cipr 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 parson 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.
_VesJNo: 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 bass 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 ofcial(s)for whom the campaign consultant provided campaign consulting services
within the
past election cycle.See Section 2491 for more information.
_Yes Ano: Have you provided campaign consulting services to an Incumbent member of the City Commission
within the past election cycle?H yes,please list the incumbent memberisl of the City Commission:
_Yes Mp: 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 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
servic4before 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?H yes,please list the incumbent membertsl of the City Commission:
_Yeo: H yes, were you promised or did you receive economic consideration In exchange for campaign
(/'(1 consulting services?
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY r p �
Annual Registration ba: I (Yea�1No Amount PabS _c MCRf
`$ �1 Oa � L✓'33 Dab Pald 0 't
Lobbyist Registration Form received and verified byR-G-
F \CLER‘$ALL`,aFORMS\LOesYIsr FORMS',Lobbyist Registration Form Revised 01-01-18 REGdot 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 PRECED CALEND Y WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGA TO OBS . A ATEMENT SHALL BF! FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COM' a re Ni' REPORTING PERIOD.
Signature of Lobbyist Date al 211 1g
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 faml 1- with o: pro Ions contained in Chapter 2,Art.VII, Division 3, entitled'Lobbyists'of
the Miami Beach City Code an• LIE, iiri requi e ts.
Signature of Lobbyist: .:..e_ , Date 3 121 f 1 $
rir
Signature of Principal: "Iiinsof Date 3 12-i f Of
•
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Stateof Ftrn\Acn Stateof ilbrl aft
Countyot N am I —17nr1.r County of: RIO PAI . Dade
Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)an ubscribed before rge
this ,.7 day of o411rrn 20s,by this 21 day of 1/1/A20(Y by
A 1 txahrlly P. NcdCFe- Ja''it( M a of ✓l
NAME OF LOBBYIST NAME OF PRINCIPAL
_Produced ID Produced ID
FORM OF IDENTIFICATIONFORM OF IDENTIFICATION
✓Personally ✓ Pers/o1'nnall(y.I�KKnown
Signature otary Public Sgnatu O Nota li `tlNuouuNgepi
Vlvltm Q-tve✓D 5iPoin f znwS411'034 S ...oro "4+
Name of Notary,Typed, Printed or Stamped Name of Notary,Typed,Printed of zo,, 0%% i
��i� +: H•
(NOTARY SEAL) j`1aV Went Miro (NOTARY SEAL) o'., Irf%6912 f•a
Li CDnnYnimt(Ki785827 '>giq'rSfra o e!"&s
vet f"%fv� ?'s Bonded flu Alml Expert Mem Notary 4,2022 ,/�r�a iiiiTNi �I.�`
The term'lobbyist'specifically excludes the following persons:
Expert witnesses who provide only scientific,technical or other specialized Intonation or test*nany in public meetings:any person who
only appears as a representative of a neighbodaod 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 commonly based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
fvi"� ' A ^�✓1I3E.ACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Fbrida 33139,www.miamibeochffgov
Office of the City Clerk
Rafael E. Granada, City Clerk CityClerk@miamibeachfl.gov
Tel: 305.673.741 1, Fax: 305.6733..7254
NAME OF LOBBYIST: A1e. Vr{QI( P. 3 ec 4-cr
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 n.erstand annual registration of all lobbyists shall be required for each 12-month period
tom 'encin. Octob- 1 of each year, and the fee for such annual registration shall be
',500.'10 pur.uant to +•ection 2-482 of the Miami Beach City Code.
A A 317g11g
Signature o'Lobb Date
FCLERWLLaFORMSLOBJVIST FORMStoM)iet Registralion Form Rein 0101.19 REG Ea
Page 5 of 5
a = m =�° :=m m O
n 0 A . .z-- ❑ 3 C
_ O �
z - Q
0 0 Al
N S S
- In p
y X
CD
m '0 f!
m illet
o
m x
i
m - ,
0
a TTh
w
\ d
EA Z
n
0
m
N
g O
m
p O
P
c