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Arthur Marcus - Ronald J. Finvarb • -- jt,u5 w Lslgl ,, x ' • M AMI BEACH Office of the City Clerk E rI t.' S. 1700 Convention Center Drive 7m CE° 17 pm 9: 144 Miami Beach, FL 33139 305.673.7411 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 lime 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 Offtrce 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: /� igniarr M are v ] A r+1,1 V r NAME OF LOBBYIST (Last) I (First) (Middle Name) iR'(tkoR J. m AKO S kek[rOsc-c Y.A . Soo fj..4a3vars&5 k) 7f— LOBBYIST tLOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) J (City) (State) (Zip Code) rt--( � }vf7���ACtCT''' -`I67 -to/c-F LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS -r II. PRINCIPAL INFORMATION: h1 r � � JA(2�3 dLoon�( ct �. NAME OF PRINCIPAL (Last) (First) (Middle Name) SO ISEer ) LLC to 6 C ( Csr.ccrta.;.e._ Sty Zoo- PRINCIPAL BUSINESS NAME AND ADDRESS (Numbef and Street) (City) (State) (Zip Code TSa 4kr `"st cls EL 33(4 Go\ St (— Sb 7 PRI AL BUS ESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS r '‘-v,Acr C•Yu� 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): lar • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATIONtePARTNERSHIP OR TRR�UST(if none,write NIA): m°Atl IA'.I P — �r I�lck �clv �ti ` " Page 1 of 5 III. ISSUE TO BE LOBBIED: 2616 SEP 17 AM 4: 44 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 publics heeatrh'Ifulnber. li ' Q �/f lo C9✓�1S V-",�,r "'V .� (nlF31/I//mac /Ih J 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 HPt3 PB Cf3y ConnM'SJIan Ar 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 NIA): A/ a /L-4 V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contin ency fee is prohibited pursuant to City Code Sec. 2-485.3): Page 2 of 5 The following six(6)questions MUST be answered: ?lig rp 7 �yf o• 1) Pursuant toto/City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobt�lsts4 AfocaE2ment Issues": _Yes ✓No: Are you lobbying on a present or pending bid for goods eouipmeAt W ffeWldes. 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 vNo: 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. _Yes t/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 reimbursernent 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 thq 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 yr4o: 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 2482(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 service b 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 member(s)of the City Commission: _Yes,Io: 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 ,Q�� �/ Annual Registration fee: [ IYes o Amount Paid S7 J , nL2O OMCRR Lid-/ 3r� Date Paid .7/, 7/AY-- Lobbyist /A� Lobbyist Registration Form received and verified by: (" W12f�-S /) 14[/3 519 n F:\CLER\$ALL\aFORMG\LOBBYIST FORMS\Lobbyist Registration Fon Revised 01-01-18 REG.tlR Revised 01/01/2018 Page 3 of 5 • nl l.PI 7 i L` , VI. SIGNATURES UNDER OATH: q��q"� �M qq ((,,SS ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT T6�T155I�,E�'1O1$FF11IyyCE OF THE CITY CLERK A SIGNED ION RECEIVED. FORNTHE PRECEDING CALENDAR YEAR WIT UNDER OATH. LISTING TH REGI iD TTO TG HE SPECIFIC ISSUE ON WHICHELL AS THE LOBBYIST HAS BEEN ENGAG O LOBBY. A(ASTATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR CO��MM/PEN TION DURIN T REPORTING PERIOD.' q Signature of Lobbyist: /� u'" Date I f I do solemnly swear or affirm that all of the regoing facts, statements, and disclosures in this form are true and correct, and that I have read or am familia with the provisiok contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and . eporting re..'r:'ents. `t-•-✓L� Date7 ( Signature of Lobbyist: y` � � 7 I era' Signature of Principal: a e��C Date 9(( '1/ VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL/,, State of se 7 ' State of FYU" f(/4- County of: a Sad — I i -- County of: Ai.A714, Sworq}a)(or affirmed) :nd subscrib-d before me„.. Swoyp4(or affir d) and subspribed before me this / / day of _' /0. 20/.6 by this/ / day of 7.2^2+L 20/1,--by Fh ,tti a S( Li S EO'/A-m F AA0zwzg NOF LOBBYIST \ NAMOF PRINCIPAL / AMJroduced ID Urf fj / ( CF:OS�- VME Produced ID ��'(n l^-f CG'S Se FORM OF IDENTIFICATION FORM OF IDENTIFICATION Per nally Known _Personally Known Alpe 12 a n • Sig ure ototary PublicSig ure�Jrotary Publi Zi le i) �0, 0sr,` .// f 13 h � .2s�r.✓ Name of Notary, Typed, Prints or Stamped Name of Notary, Typed, Printedd Stamped Charts J.[Agustin citilli NOTARY PUBLIC Charles J.DAgostin (NOTARY SEAL) ?.ir L STATE OF FLORIDA (NOTARY SEAL) NOTARY PUBLIC av Comms 06168171 F � STATE OF FLORIDA ' Expires 12/14/2021 °. _\. Comm#GG166171 °jn' - Expires 12/142021 ' 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 10IANAIBEACH 7019 SEP 17 AM9: 45 City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www mamibeachf goq Office of the City Clerk Rafael E. Granado, City Clerk CiyClerk@miamibeachfl.gov Tel: 305.673.7411, Fax: 305.673.7254 7 NAME OF LOBBYIST: /'1 r v r r\i\(h.rC U , 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. pursuant to ection 2-482 of the Miami Beach City Code. AWAAAA- fl 7 e l 8 Sign ure of Lor. .t Date F.1CLERIEALL\aFORMS LOBBnST FORMSLobbms,Registration Form Revised 01-01-1e REG disc Page 5 of 5 - > " > z El3 City Nllall E to a - p w T �'m o , ON Ilu0Iunve it Ion fcnter Ur . 2 3 _ 02 mo ; 7 Miami Beach , El. 33139 'iv M - 9 ' y m30b-613-l4Z17 i D : n 3 c Welcome F H _ ' 2 CO Mn z 2 to . atM15Lf i IANEOIIfi 4 i - �. _ , .%. �' Dieser 1pt fon MLI: OPEN m ❑ N (MCP) ? A m P fei ewe 1 . M( I 4P130tf O E = .p MGR OPEN (MCk to .� -i• ! m — 20'tl Item; MUR m n i' x 1 h 350.00 --i MSR OPEN (NUN; nil lIiC v o 4:I,y 9m 350.00 nt, Sublotal 350 00 Total 350.00 ti 1�� - AMtf AA"! riNPIIINS 1:lu 00 �--. k'f Number 5074 cJ oSG ^� -.4 0 -€A Change due 0.007 �� _ oz m m Pill L9 Mtiildtl i <tRn . Ii[P W. PALE-1 , R : h' LEENTr > jj^l s m W CO Ihanl: yin, to icur pi IIFai'. o A I- CISIOMI}+ I:fr