Symeria Hudson - Chapman Partnership 1.,,,\0.,142,)e)3,5 4- ).-)•c'04 Ut b ,c4
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Office of the City Clerk a —5 j l t"4
1700 Convention Center Drive . � � �
Miami Beach, FL 33139 ni Y � " i `V1 ?i, C1�
305:673.741.1 . ;i;c:it 71'1. CITY CLFrr
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 periodof 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 completedform,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 informationand amend the forms filed throughout the period that the lobbying occurs.
Separate registrationforms shall be required for each principal represented on each specific issue..
I. LOBBYIST INFORMATION:
Hudson Symeria
NAME OF LOBBYIST (Last) (First) (Middle Name)
Chapman Partnership 1550 North Miami Avenue Miami Florida 33136
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
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305-329-3026 shudson@chapmanpartnership.org"
LOBBYIST BUSINESS TELEPHONE.NUMBER CELLULAR TELEPHONE NUMBER. EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Hudson Symeria
NAME OF PRINCIPAL (Last) - (First) (Middle Name)
P p 1550 North Miami Avenue Miami Florida 33136
Chapman
PRINCIPAL.BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-329-3026o p
shuds n@cha manpartnership.org
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
u a t to City Code Section 21482(h)(11)(a): A principal of Egg corporation, partnership,C7 other entity who(:LtTglid OD p lobbyist(.Til behalf of that
entity,data special compensation a4 reimbursement for MID appearance,Eagit2P direct,indirect,a!contingent,WO eliDEM sue•ort o .osition 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): Symeria Hudson
• NAME.OF ALL PERSONS.HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA):. not-for-profit organization ( MIA
Pagel of 5
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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.
Homeless and domesticviolence assistance funding.
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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
Staff X.
Mayor X
Commission X
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 otherrelationship 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):
None.
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):
-0=.
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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 x 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 2-49.0, entitled "Prohibited Campaign Contributions By Lobbyists.On Real Estate Development_.
Issues":
_Yes x No: Are you lobbying on a pendingapplicationfor 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 2482(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 forthe 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 berequired to pay any registration fees.
xYes 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
reimbursement for the appearance..
xYes_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 past election cycle. See Section 2-491 for more information.
Yes xNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the past election cycle?Ifyes,.pleaselist the incumbent member(s)of the City Commission:
Yes xNo: If yes, has it been less than-12',months since the elected official(s) whom you provided campaign
consulting services was sworn_ini
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 otherwiseprohibitedby Code section
2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular.
service before lobbying the City Commission at a public meeting.
_Yes xNo: 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 xNo: 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[I]No Amount Paid$ ' MCR# Date P id r
Lobbyist Registration Form received and verified by: 2/017.:).1`.1 So t � _ ``.� COC . . -
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Revised 09/20/2018
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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 3/1/2019
I dosolemnly swear or affirm that all of the foregoing.facts, statements, anddisclosures 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 requirements.
Signature of Lobbyist:: . . . Date 3/1 : .
/2019
Signature of Principal: Date 3/1/2019
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of F6 r-r cLct, State of 1
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County of: t-h'I.tM . , cbe : County of: [/1(141/1 1 -�G(��. :
Sworn to(or affirmed and subsc ibed before me Sworn to(or affi a �an�dsO scribed before me
this l day of . and
, 20n by this I day of L , 204 by
u ntile.rta_ _So n�e- c� 64 sr
NAME+OF LOBBYIST NAME O .PRINCIPAL .
Produced ID
Produced_ ID . •
FORM OF IDENTIFICATION / FORM OF IDENTIFICATION
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Signa u - . • ary.'u• c _ Signature of Notary Public
Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped
+ MIOSO1YSALBERTO MIOSOTYSALBERTO..
(NOTAFI', (NOTAR" •1 •_.
*; ,., ;*. MY COMMISSION#FF 988742 � ••, MY COMMISSION#FF 986142
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:.•l''' EXPIRES:Juno 27,2020 ^`.o= . MIRES:June 27,2020
"7,-Fc�,p, Bolded Thru Notary Public UndefwTNers ,ebr.01;• Bonded Thru Notary Public Underwriters
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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 orcontingent, to express support of or opposition to any item; andany 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. .
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MIAMI BEACH
City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
Office of the City Clerk
Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.7411, Fax:305.673.7254
NAME OF LOBBYIST: Symeria Hudson
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 2-4.85.1, 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 ofthe 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 Clerka
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar yearwith 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.
3/1/2019
Sig ure of Lobbyist Date
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