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Daniel Diaz Leyva - Miller Nuttle 13t:ke• � • 4 Office of the City Clerk j1�}A 1700 Convention Center Drive fi� 2� 2I Miami Beach, FL 33139 E~! C)f=k'` ;f;; l (;fir•�!T 305.673.7411 ` ' ' = i3r l s, Gil� CLERK 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:wilt 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 shallbe required for each principal represented on each speoific issue. I. LOBBYIST INFORMATION: Diaz Leyva Daniel .. NAME OF LOBBYIST (Last) -(First) (Middle Name) Diaz Leyva:&-Gil PLLC •999 Ponce De Leon Boulevard, PH-1120 Coral Gables, FL 33134 LOBBYIST BUSINESS NAME AND ADDRESS- :(Number and Street) - (City) (State) (Zip Code) 305-203-0673 305-846-268:1 DDL@DLGPLLC.COM LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER z EMAIL ADDRESS II-PRINCIPAL INFORMATION: Nuttle.. Miller NAME OF PRINCIPAL (Last) (Flirt) - (Middle Name) - 548 Market.Street;:'Suite 68514 San Francisco, CA 94104 PRINCIPAL BUSINESS NAME.AND ADDRESS (Number and Street) (City)- (State) (Zip Code) 855-946-7433 607-592-9500 mnuifletc7r lvft:com PRINCIPAL BUSINESS TELEPHONE NUMBER: - :CELLULAR.TELEPHONE:NUMBER EMAIL ADDRESS- . 'ursuant tlb l Node Sectio 2 2(h)I a! A principal t71Qi/corporation,partnership a'of er entity Ii•j Egimeit ®1156byist C.)behalf of tha •ntity.t El compensation CP reimbursement for flki2 appearance,tZIGIftwarga mdi act,Cii'contingent Q7( C+Ii o+•es'tio to n EtIMEriElftregIste tliptE3@te-apcklikag by MO s bsection Meilen iitCa i re•uirea l gy any ga istration f : If the principal is a Corporation, Partnership orTrust,=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): t.fjC�CA C L- VAN" z, • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): k,J I v'—6,52/110e % cr l e7t. l- AIL4 v . fi 'Loc. 1 e, 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 applicable of a pending request for:proposal, invitation to bid, or public hearing,number. Scooter/Bike Share 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 intoany 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 i:. Contractual Relationship(If yes,explain) YES NO Title of Person to be Lobbied Mayor N/A X City Commissioners N/A 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 other relationship giving rise to an appearance of an impropriety;:with any:current:City Commissioner or City personnel who is sought to be lobbied asidentified 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): N/A 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): $2,500.00 r10. Page 2of5 • • 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 2-490, entitled"Prohibited Campaign.Contributions By Lobbyists On Real Estate Development Issues": _Yes-XNo: Are you lobbying on a-pending application for a Development Agreement with the City or application for change of zoning map.desiqnation 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 spedial-compensationor reimbursement for the appearance;whether director indirect to express support of oropposition 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 XNO: 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 orreimbursement 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 not4or-profit community based. organization for the purpose .of -requesting a grant without special compensation or reimbursement for the appearance. _Yes XNo: 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 CityCommission 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?If yes;please:list the incumbent member(s)of the-City Commission: YesX.No:. ... tf s fres it been less than 12 months since thr$elected official lli whom you provided campaign, onsulting 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 before lobbying the City'Commission at a public meeting. _YesX 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(s1 of the CitvCommission: liummo_Yes No: f yes were you romised or slid you ecsiv economic consid ration in exchan•e for cam'ai consulting services? • • TO•BE COMPLETED BY CITY CLERK'S STAFF ONLY. • • ;Annual Registration fee::[ J Yes[Y1 No Amount-Paid$_ ✓S° -�'O MCR# � O 1 Date Paid C7.Z'(S- IT -Lobbyist Reglstration.Form received and verified by: . Rl;ioA.)' _ - . . F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc: j 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 AR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOB= : 4 STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMP ' . • 'Uri G-T. -EPORTING PERIOD:' Signature of Lobbyist: Date .Q\ O:a tai I do solemnly swear or affirm that all of the foregoi 0 -cts, statements, and disclosures in this form are true and correct, and that I:have read or am.f ili:r ,ith:the v - contained in Chapter 2, Art VII, Division 3, entitled"Lobbyists" of the Miami Beach City:Cod and:- -i•• 1:,r `- ts. r - Signature of Lobbyist ` Date �\ _C>,. a-Q\ - Signature of Principal: r Date 'Q \ Q a .ma c VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL y State of Florida State of . 11 G S 5 OM U S'V 15 County of: Miami-Dade County of: M I Ul(A It S Swornto(or affirmed)and subscribed before me Sworn to(Or affirmed)and subscribed before me this c\ day of January : i 2019, by this l ay of January .2019 ,by eir MI Hu Nvi-nit NAME OF LOBBYIST : NAME OF PRINCIPAL Produced.ID. ProducedlDTRIO S Ir1rlV"C/1' VIV/145"`'' ' x FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personally Known- ..- Personally Known , I c I I Lit,c �[ 1 �.�1Lr�11- k Signiate*a;ef.Nbtary _ublic a'gnature of otary Public Diana L. Villares G r Q Oi 1 ` - Da lei r Name of Notary, Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped _ '' - ;,Ah<gn AOAAAw.r.�AM✓.I.A�AAAAA An AA AAA.AtAA� 1 s„ozr,VQTARY SeltruiARES. I (NOTARY SEAL) S ,p 4,,; AMANDA M. DeANGELO ?a°,'.. `�'; Notary Public-State of Florida I 1) 1 Notary Public. _ 4 • ,': -•: ' ._. 'GuinmisSion'N:SG:055568 Commonwealth'of Massachusetts y -°� ti t�= My Comm Expires Apr 9:2021'r > 'r • My Commission Expires May 17,2024 1.440:11,4,4140=m3440,�' � f. the:following persons: Expert witnesses who,provide only scientific,technical or other specialized information or testimony in public-meetings;any personwho only appears as a representative.of a.neighborhood association withoutcompensation 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 requestingz a grant without special.compensation or reimbursement for the appearance. Page 4 of 5 MiAMI EACH 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: Daniel Diaz Leyva 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 a 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•ursuant to Se tion 2-482 of the Miami Beach City Code. .� ,17110) Signature of obbyist Date F:ICLER\$ALL1aFORMSILOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Page 5 of 5 • F04 CS ,q /fir ND ,a► 7► AG ;i . . .j � . 17 410 Si' • 4444` gr, • is 1M�.oaaE °°J� Certificate of Completion This is to certify that Daniel Diaz Leyva has satisfactotiyfai filled the requirements for lobbyist refresher training under Section 2-11.1(s),Miami-Dade County Code, bj►participating.in "Ethics. Refresher °Course for Lobbyists" conducted by the Miami-Dade Commission on Ethics and Public.Trust on January 31, 2019 Jose Arrojo, xecutive arrector. Miami-Dade Commission on Ethics & Public Trust — , . . ., . : . ,: .•:-.:"7:::=.'"},,,,, ,;,,,,T,' ,.,,,,,,,:,..,.,..,...,,,:,„-;,,,,,,,,,-„,,-„,..,_,„-itsp,-,:,,,--7,77:7 ,-,,,,.,-,,,,-.7..-,,,,,,:,, .] Miscellaneous Cash Receipt :_i ..,, CITY OrMIAMI BEACH .- No. 423'107 ----, ,1,,c ,.• I:1 Cash 0 Credit Card 6 Check# ' d''' $ j ) 2011 ,,,.. P'..: I ReaKred of \'41..)it,il,,4• \ 1'...'") i r.., -,.-.-:-. 1...,.., 1,../k Arg"‘"^-ilarteous-MCR-2010 ,-, ) , ,.......__ ______ __ ria----#4*' ''CI 1:4 (I- II')1 ,., 0 in Ci 0 /7 r 1 "-"n n 0056 Adrian ...02115120 I 02: 5r-co . ' , '.-(-- - --(' •-• ' 4 f • --' '- ,-------7! r — -- ',-, ..... polVICR OPEN(MCR) r I P) .1,, c I \ ,-; k ,, :),,,,,,k.... , :, c co-. . „i i, 1.:..•• • Payment Amount: 350.00 ..1 N1CR423107 ..: ,,..., (THIS INFORMATION MUST BE COMPLETED) Office of Finance Director _ By !' .,› , L Account Number: 011 . ciboo '..) ‘-_-,'I (-1P-I- fk.i.)(9 1107- 3'iSci ' ''''''0 (r- i --, C C.-- .., Preparer: r• ) A-1 n,y.t.-/,. ,,,,.. .',,,,,,:-1,,,,s, Dept: EXT: , '