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Mario S. Vieira - Frederic Marq 13( (1)L U • L A ,e r � R Fl • '�\` I I Office of the City Clerk 1700 Convention Center Drive MI! OCT I A. I I: 20 Miami Beach, FL 33139 _ 305.673.7411 L r' _.c .. _ i.l I at.;'. 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 "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: , : cQf} Mw:o oeeGvo NAME OF LOBBYIST (Last) (First) (Middle Name) °it!I Ss CA, At, it K 33\E 1 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) a 8G M aGZ�I c( � rAi.o hlkr))+wL eootw± . LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPH NE NUMBER EMAIL'ADDRESS II. PRINCIPAL INFORMATION: / AA-it6. 4€-oF2lC- NAME OF PRINCIPAL (Last) (First) (Middle Name) f-"42Ntir,a_ VYrkkv.. s e-c¢ p y'$3S Cn�-L.+t ewe 1-u t&t2 . CL 33M.IJ \ PRINCIPAL BUSINESS NAM�ND ADDRESS (Number and Street) (City) (State) (Zip Code) 3os- 12S - '- 615 PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to City Code Section 2-482(h)(1)(a): A principal of any corporation, partnership,or other entity who appears as a lobbyist on behalf of that entity,without special compensation or reimbursement for the appearance,whether direct, indirect,or contingent,to express support of or opposition to an item shall register with the Clerk as required by this subsection but shall not be required to pay any registration fees. If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): yew. .c��s 54\o PARTNER,OR BENEFICIARY if none,write N/A W qa o.ee��«l sc� • NAME OF CHIEF OFFICER, ( ): • 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): ��c.\\.— o'Crc c .,c L as y,a jy;\C` tk Page 1 of 5 I III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where appli able of a pending request for proposal, invitation to((bid, or public hearing number. .� a heli-•� �• 4eer. . cos, r. hc.v CZe.S�clenre c\ 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 \ \ e 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 1 appearance of impropriety(if none,write N/A): W// V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fee 's prohibited pursuant to City Code Sec. 2485.3): Page 2 of 5 • The following six(6)questions MUST be answered: 1) Pursuant t 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 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 Map? 3) Pursuant to City Cade 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 cl rk as required by this section,but shall not be required to pay any registration fees. _Yes_ O: 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-profi community based organization for the purpose of requesting a grant without special compensation or r burs nl for the appearance. o: prep you provitli a neig seihoodc technical or other s ecializinto appearas a 9Ck�y eel representative of a neighborhood association without special ofcompensation or reimbursement or f��� 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 thyast 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 ves, 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 2491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular servicebefore 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 memberls)of the City Commission: —Yes No: If res, 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 tee: [ 'Yes[7]No Amount Paid$ -- MCR N _ Date Paid Lobbyist Registration Form received and verified by. N )^k IT � I�'� ..situ . ... 1OI NIti oean?r F,xtis r.nrrcucy� r,.�,a.v r zo ra so:,.no. Revised 09/20/2018 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: Date (-0 /oil l8 I do solemnly swear or affirm that all Oflite- f s, 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 d all reporting requirements. Signature of Lobbyist: Date l O 'O I I Signature of Principal: Date t p`.`irre VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of F Ie . .Xe� State of W-- ovt.../ata--- County of: r-\t County of:t--1 t (7c.aa-Q Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before meJ this \ day of n 4-7..-4-1..e .. 20\ by this 1 day of O t, 20 by NAME F LOBBYIST NAME OF PRINCIPAL Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION /Personally Known Personally Known Signature of Notary P c Signature o Notary Publ. Nalt7 Not ry,Typed, Prince or St9 ed ItlNa - .f Mary, Typed, Printed or ',tam.-. ?xM'F'' MEGAN LAUREN MOFFET1 (NOTARY SEAL) ��•,fj MY COMMISSIONEFF9HE82 (NOTARY SEAL) v "7T e 0.0-.0 MEGAN LAUREN MOFFETT si4D(PIRES.APM 12,2020 ,d a�peee MY COMMISSION N2,FE901502 20 7wn°°8aMr9TMu19dgMNeWYSrMw ►`fYr{ EXPIRES:AO 72.2020 'T orn°a Bohai Tvu Budget Nowy SeMem 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. Page 4 of 5 City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfi.gov Office of the City Clerk Rafael E.Granada,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411, Fax:305.673.7254 NAME OF LOBBYIST: YW&,O \ l te- • k �' 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. k % Signature Signature of Lobbyist � Date 11111) 111 F]CLER\SALE\aFORMSLLOBBVIST FORMSLobbyis(Registration Form Revised 09@0.18 REG doe Page 5 of 5 Beneficial Ownership Declaration; Arbor Holdings Corp. Section C: Entities S/7/18 Jean-Jacques Murray and Jean-Pierre Murray as Equal Beneficiaries 100% Hotel and Property Trust(GO;Trustees Jean-Jacques Murray,Jean-Pierre Murray, Marie-Claire Leon,Xavier Mignolet,Baudoin Terlinden 100% Tristar Properties Investments Corporation (Pan).Directors/Officers;Jacques-Gaston Murray, Jean-Jacques Murray, Marie-Claire Leon,Xavier Mignolet 100% EOI Property Sarl(Lux). Directors/Officers; Jacques Gaston Murray, Sophia Gury,Salim Bourekba 100% EOI European&Overseas Investments Sari(Luz). Directors/Officers;Jacques Gaston Murray, Francis Parisis, Salim Bourekba 100% EOI US Property Inc(DE). Directors/Officers; Jacques Gaston Murray,Marie-Claire Leon, Xavier Mignolet 100% MB Florida Holdings,Inc(DE). Directors/Officers;Jacques Gaston Murray, Marie-Claire Leon,Xavier Mignolet 100% Arbor Holdings Corp(DE). Directors/Officers;Jacques Gaston Murray, Marie-Claire Leon, Joel Simmonds, Frederic Marq Salvatore, Jason From: Mario Viera <mario@mbdevelopment.net> Sent Monday, October 1, 2018 11:14 AM To: Salvatore,Jason Cc: John Carino Subject: RE: amendment to application Jason, I authorize you to amend my answer on question 4 of page 3 to YES Regards, MARIO VIEIRA u * i 1 leorrl�nl.rlel G 2r 195 iC Coffins H4C11119 So?!S Ure FL 33154 From:Salvatore,Jason [mailto:JasonSalvatore@miamibeachfl.gov] Sent: Monday,October 1,2018 11:12 AM To: Mario Viera<mario@mbdevelopment.net> Cc:John Carino<jcarino@mbdevelopment.net> Subject: RE:amendment to application Good morning Mario, I need you to authorize me in writing which specific part I am able to amend. Please confirm that I am able to change your answer on Question 4 of Page 3 to YES. ( BEACH Jason Salvatore - Office Associate 111 Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411 www.miamibeachfl.gov We are committed to providing excellent public service and safety tool!who live, work and play in our vibrant, tropical, historic community. From: Mario Viera<mario@mbdevelopment.net> Sent: Monday,October 1, 2018 11:06 AM To:Salvatore,Jason dasonSalvatore(olmiamibeachfl.Rov> Cc:John Carino<jcarino@mbdevelopment.net> Subject:amendment to application 1 Jason, I authorize you to amend my application. Regards, MARIO VIEIRA rrairiocroropmerit.net 2.195 la h ,s A✓eami farts F( 33154 2