Michael R. Band - Michael Festa W\ jG eruuk, �
MIAMI BEACHR F: ''
Otfce of the City Clerk
1700 Convention Center Drive ?Alt OCT 16 AM 8: 52
Miami Beach, FL 33139
305.673.7411 - s` &'A Y l =`
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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, 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: //
BAUD Mlc }�41 � ( oe'
NAME OF LOBBYIST (Last) (First) (Middle Name)
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LOBBYIST BUSINESS NAME AND ADDRESS (Number nd Street) (9ity) ' (State) / (Zip Code)
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LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
+At( s. Part MtcU4E L.
NAME OF PRINCIPAL (Last) (First) (Middle Name)
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PRINCIPAL BUSINESS N ME AND ADDRESS (Number and Street) (City) (Slat) (Zip Code)
3u5 511-4 ZI 2_' 7) L:5 6?,y ZI ZY) tJ/A
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Pursuant to City Code Section 2J82(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): _
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A):h( ci`G,• E' I {-Q 54 Cti
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,r,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): N(4
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, i vitation to bid, or public hearing number.
OIAJinh FP/vy1r�S Q rd. Pc I'V\c. P�
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
M2 J r 6 � .-1 cuvv,%A I S 4 r-S ✓
Cc11 A4-1ur rtiatA ✓
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):
hen
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):
¢S oo rc�o, le
tvs' -I-410001 Yin D,AJ k+-e 2/ (>-m- es
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 VNo: 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 V4): 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 Cl 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-profit community based organization for the purpose of requesting a grant without special compensation or
reimburse
ent for the appearance.
_Yes Ao: 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 thepast election cycle. See Section 2-491 for more information.
-
_Yes �T(o: 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 yes, has it been less than 12 months since the elected officially) 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 bef re lobbying the City Commission at a public meeting.
—Yes_ o: 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 yes, were you promised or did you receive economic consideration in exchange for campaign
consulting services?
TO BE COMPLETEDETBY CITY CLERK'S STAFF ONLY
Annual Registration fee: [NO Yes[ ]No Amount Paid$ 0�- MCRO 1232 Date Paid f0 . 1e9 ' I,
Lobbyist Registration Form received and settled by: J O-50.& C. (v in tIv.
'
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc 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 PR • ` , •A' •R WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BE Egiey, • r • : : ATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE O M' :pike, s f. :Fr -EPORTING PERIOD'
Signature of Lobbyist: I'eytI —.4 _ Date (4OCI 7-V16
i
I do solemnly swear or affirm t • - - • t• r, sta -menu, and disclosures in this form are true and correct,
and that I have read or fa ovisi• ntai•ed in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City od a a +••• P�g requtr is
•,7 •` . l s UC 120 l iSignature of Lobbyist: (.l Date
Signature of Principal: • , Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of h r21 P A- State of
County of: 1•11 A-Nt— CAD County of:
Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before me
this I S{% day of (rTDISR _ 20A,, by this day of 20_, by
N OF OFL P-A NJ d •
NAME LOBBYIST NAME OF PRINCIPAL
_Produced ID Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
N Personally Known Personally Known
Signature of Notary Public R
Signature of Notary Public
Name of Notary,Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped
NictNotary Public State of Flora
(NOTARY 5r• • y : Susan Cavanagh (NOTARY SEAL)
•� p My Commissioncote2tos
lywJ Expires 01072022
I 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
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 21 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, LISTIN LOBBYING EXPENDITURES. AS WELL AS COMPENSATION
RECEIVED. FOR THE PR a `(- P ' C 2 - WITH GARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BE E 11` - r - t r s a ATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
LXPENDITURE • '�• �, -EPOR7ING PERIOD.{
gr
414i1 .
Signature of Lobbyist -Aye_ a Date f 4 G 4 l 2-1,7I t
I do solemnly swear or affirm it), -2 -- a t tg. statements, and disclosures in this fop+ are true and correct,
and that I have reed or fa ar ' th:,provls! �'.ntareed in Chapter 2, Art VII, Division 3. entitled "Lobbyists' of
the Miami Beach City od a a'N4 •fi g raga �y f5.----
lit
•tt. , �. at t 0( I 2c I Signature of Lobbyist V ( ., J � '. ) _ Date
Ili
Signature of Principal . _.. G/ ' Date iS o._+ 2c.
/
VII. NOTARY SIGNATURE AND S-AL:
LOBBYIST: ' PRINCIPAL
State of ;t ' iii - A State of
County of Mi th'th ')'-L-.- Caunty of
Sworn to(or affirmed)and subscribed Defore me Sworn to(Or affirmed)and subscribed before me
this day of C`:S'1Q)&i AZ 20S,,by tmss�j day of ' r �o 2C_, by
tilts-sett. (>7Ai;� . /'4chrne( As+fl
NAME OF LOBBYIST NAME OF PFJNCIPAL
_Produced ID Produced ID _
% FORM OF IDENTIFICATION j FORM OE IDEFINFICATION
/
iv/Personally Known ;_Personally Known
Signature of Notary Public Signature of Notary Publte-
I
Name of Notary.Typed, Printed or Stamped '.. Name of Notary Typed, Printed or Stamped
eowy PUNIC Sera of home
Susan Crean SHANE SONNENFELD
(NOTARY si • agn (NOTARY SEAL°'r'^'•.
/ W CcmmawPt ogi MOB ' State of FbnOa-Notary Public
Nod
Ewes carovtJS: _ ' Commission il GG 190396
"s A My Commission Expires
February 36, zon
The term lobbyist'specifica.ly excludes the following persons, s
Expert witnesses who provide only scientific.technical or other specie ized intormatloh or testimony In public meetings:any person who
only appears as a representative of a neighbomood association wthout compensation or reimbursement far the appearance, whetner
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 base° organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
M AMIBEACH
city Otatitirlfireath7171.XJLonvention-enler Drive,Miami Beach,Florida 33139,www.miomibeachfl.gov
Office of the City Clerk
Rafael E.Granada,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.7411, Fax:305.673.7254 n
NAME OF LOBBYIST:i C1-1-Are-1- Q, PJ_D
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
- •derstand an - -Yistration of all lobbyists shall be required for each 12-month period
o -•ting 0 tober of each year, and the fee for such annual registration shall be
71 1$501 10,ip y'to -ction 2-482 of the Miami Beach City Code.
/ it043 ISOC(241V
Sig af,of obby'- Date
F:\OLERI3ALL\eFORM5LLOBBYIS1 FORMS\Lobtyis1 Registration Form Revised 09-20-18 REG doe
Page 5 of 5
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