Tracy Slavens - 032W@DILIDO, LLC coif-
RECEIVED
CRECEIVED
M I ANI I B EACH Office of the City Clerk JUL -8 2019
1700 Convention Center Drive
Miami Beach, 33139
305.673.7411 CITY OF MIAMI BEACH
OFFICE OF THE CITY 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 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:
Slavers - - Tracy_ _ - - -
NAME OF LOBBYIST (Last) (Middle Name -
Holland&Knight,LLP - 701 Brickell Avenue,Ste.3300 Miami .__ .._ FL 33133 _ _
LOBBYIST BUSINESS NAME AND ADDRESS " - (Number and Street) (City) - (State) - (Zip Code)
305-374-8500 tracy.slavens@hklaw.com
LOBBYIST BUSINESS TELEPHONE NUMBER - - CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Masson Lionel
NAME OF PRINCIPAL (Last) (First) (Middle Name)
do Mr..Jim Agard,Barnes Miami
302W@DILIDO,LLC 1150 S.W.22nd Street Miami FL 33129
PRINCIPAL BUSINESS NAME AND ADDRESS' (Number and Street) (City) (State) (Zip Code)
jagard@barns-international.com
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):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(If none,write NIA): . Lionel Masson
• 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): .-N/A _
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, invitation to bid, or public hearing number.
Approvals required for constructionof a single-family residence located at 302 West Dilido Drive in Miami
Beach.,
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.--- .___
Design Review Board members X
Board of Adjustment members ' X
Mayor X
City Commissioners. X
Planning Department staff - X
City Attorney and City Manager : '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 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): _
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):
$590.00 r 1
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 Mo: ;Are_vou'iobbving.on a:'presentor pendinst..bid for:goods,:equipment or.services;or on a:present or
:pendingaward for qoods equipment service?
2) Pursuant to City Code Section 2-490, entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":
_Yes x No: Arevou-rObbYing on a pending application:for-a Deveioprnent-Agreement.with'.the.Citv.or application
for ofzoninti map desienation'tor'change.to the Cltv"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 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 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.
Yes xNo:• 'Are you providing only. scientific, •technical or other' specialized information; appearing.as: a
representative of a'neighborhood`association without"siiecial compensation:or rein bursenrent'or`
•ttepresenting a not=for4trotit based• organization.'.for the purpose-of requesting acgrant 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 1No: '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'yes, has it.been less than'12 months since the elected official(si whom.vou provided campalun
.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 disclase:Such particular
:service•barite labbyihO the CityCoinmission'.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 incurnbentmember(s)of.the CityCommisslon:,
Yes No: If yes. were You-promised or did you receive economic consideration in exchange-'for campaign
_ _
consuitinQservices?
TO BE-COMPLETED BY CITY..CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes 13 No Amount Paid$ SCO, MCR iR l Z' Yo( Date Paid 01 055" lel
Lobbyist Registration Form received and verified by: a,Se-t yu.
F:\CLER\$ALL\eFORMS\LOBBYIST_FORMS‘Lobbylst 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 PRECEDING CALENDAR.YEAR WITH REGARD:TO THESPECIFIC ISSUE ON WHICH THE
LOBBYISTHAS'BEEN'ENGAGED TO-LOBBY. A STATEMENT SHALL BE.FILED.EVEN IF THERE HAS.BEEN NO
-EXPENDITUREOR COMP TION:DURRIING.THE REPORTING PERIOD.' j' '
Signature of Lobbyist:;` air-64-4-7_777 - - Date i q -- -
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and that I have read or am f-. iliar with the provisions contained in Chapter 2,Art. VII, Division 3, entitled"Lobbyists" of '
the Miami Beach City C•.: -nd all repv'n! requirements. //7
Signature of Lobbyist: It� e..� Date 7(Y
mo '% I2� ) i
Signature of Principal:; : . �i�r�� Date
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of 1-L1GF-i cl A- _ State of =K� �
- " —
County of: N1;ALAI•-• Abe County of: '.Mon,--‘% - 4491✓
Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before me
this g day of 3 L' ,201i, by' this *7"day of. �cr-e_ _ ,20k°N, by
1T;Ac � S L AM G.NS l.'o,",` - Ac aSf-
NAME OF LOBBI1'IST NAME OF PRINCIPAL
_Produced ID _Produced ID.--
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
°--"Personally Know 441 sop Iy I nown
- ---*--------3
Sig ature of No 7PCtb1r - Signatur 'Notary Public
Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped
(NOTARY , PAMELA JACKSON f
? 0,1,:' MY COMMISSION#GG 160789 (NOTARY SEAL) t,PY Poe VICTOR ALEXIS RECONDO
.0: MY COMMISSION#GG 039B13
'-?-.:;•4L.:g EXPIRES:December 17,2021 ,
..<r.or F�°p' Bonded Thru Notary Public Underwriters u„ !N "',= EXPIRES:November 19,2020
l'eorr Fvog. Bonded Thru Budget Notary Services
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
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: Tracy Slavens.
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
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
/I/OV '24A-M4---- R-C2://7
Signa re of Lo•• Dat
F:ICLERl$ALL1eFORMSILOBBYIST FORMS1Lobbylet Registration Form Revised 09-20.16 REG.doc
Page 5 of 5
, ~
.4'
MOF '
City Hall
1700 Convention Cent8r Dr.
`
Miami BeOCh73-, FL 33l39
' •
315-�@742O ^
�lCOm8
0U3678'UO4� Adrian V l9 O4�04PN
�
_/
;� MISCELLANEOUS` Description: NCR OPEN
(NCA)
R�f8[0�C� l � NCR424381
NC� UPE@ (ACR)
7019 It�N: MCR
1 d 1.050.00
NCR OPEN (MCR)
1 '050.00
_______
1.85U.O0
Subtotal
1`050.00
Total• l,U5U.DU
.
l'050.00
CHECK
. Check NUNb8[O080O3O32
'— -----
Change due
0.00
Paid h»� UU8U �� 0NLLP
U01�1 ',-'.;'-'--;:-'.. ;-`,-,:s'-.::1'....-- .-----i::'--'•.',3..--;.:::::.-.,-- e--i,"z---:-. ....'(..-:--'_''... .*y•';_.,.•-•:- .._13:-'40'-i---,,-„,,,:.--..,::..-.. .,:-, -:.-..:;-':::,...;,,,--.:?..:
. KNIGHT
•
.���� „��1111�� 1110NU!1�1@1��N11U �
' — [ ���
-�•
~~-
.~�.
,..,,,,,___,,„,..w....., .
�5�~ = ~�~~—^�
' .'.*,.::-..:.:...'::".,::.:,7'', .1.:-'''.: 1: J-.1:::4D1';-;V'"...- .::::'- ' ,,,'----':-,.::::',--.: -1.'1'..-f.:'77, ,::•,:',..-A,':-,-:.:.'.,T,;.ts.:.:- ::...-.:'.::.-...,,.
Thank you for your payment
.