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Francisco Javier Ruiz - Life Time S RECEIVED t'/\11Atv\I. BEACH Office of the City Clerk OCT 2 5 2019 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI BEACH 305.673.7411 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. LOBBYISTINFORMATION: 12 ,-4Li£ co "]-6( v)`c-r NAME.OF LOBBYIST (Last) (First) (Middle Name) �.I - ker7 °7 SivJ / ' / Si- / 1 /t9-rn LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 7 , ,Y6�� 0.1-14 it '.S 3/ • e / F iiel /Z Q62L-/`�. . LOBBYIST BUS ESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: /eV/2 --cq. ci SC o kG Vie 1- NAME OF PRINCIPAL (Last) (First) (Middle Name) / / ke29 sG%) 7 3/ -S'� 41/lj- -3 /74 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 3 os' en06r 3n� ��/` gAT- -Fre.4! e L •• L, .� PRINCIPAL SINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to City Code Section 2!482(h)(1)(55): A principaloof 0V corporation, partnership,cp other,pe itity who 01X201B0a0 lobbyist on behalf of tha entity,&Rog special compensation CiF reimbursement for appearance,0022 direct, indirect,for contingent,lbtamGtm su••ort of or o••osition't• an item shall register with the Clerk;as required b 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): Egli f"G frill kiroI • 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): #6 I (' '' 4/e-r`cl/ Page 1 of 5 f • III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable ofraending request for proposal, invitation to bid, or public hearing number. C/Ct /(Y)7 42'1^ fiLor,f 14,-1 ,a028 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 /a / UC' - 7� 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): 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): Sq /Cf/ije /M;D g� Pte, �-, te�1 S 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 1:104:: 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 o: 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 orentity 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 _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 reimburs ment 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 t ast election cycle.See Section 2-491.for more information. _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: "rd �":a��; �'�-�.;. �_o-,L�� `t _ d'a� I U i :vs`^ ,. ;.. r'38`�'" li��i�.` _Yes o: Ifyes; hatEtbeen iless�than124monthssetth e�lectedEoff"icial(s) whom you providetl;.cMampaign oc Hain Ifing erv'�01tias ws ornth`iin? 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 servicee ore lobbying the City Commission at a public meeting. _Yes 1ZQNo: 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:• [[ g �;�.p p .ate :.AK'v 2'i k'4 ri.... 7( rel . f; F.:. -.. 23,..4 =F. '..� fir. a f�' 'e�.i4. a- "- �'� ekY ftp', _Yes o: Y ves,�werecvoa promisedi.or didEruouF,receive conomic consideration exchangel.for campaign Consulting servi'c' `til TO BE COMPLETED BY CITY CLERK'S STAFF ONNLCYY Annual Registration fee: [+r]Yes[ ]No Amount Paid$ itf` ° MCR# -(-� .7 Date Paid la' 1-5 1 '1 Lobbyist Registration Formll`received and verified by: � .3c4-6�_� _ $-n,, • F: CLER\$ALL'áFORMStO35YIST=FORMS\'Lobbyist Registration Form Revised 09-20-18REG.doc Revised 09/20/2018 Page 3 of 5 f , 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.1 Signature of Lobbyist: `" s Date /P-"r/ 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 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 (0/a3/9 Signature of Principal: 9 _ " Date /'Q caf / VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL • State of. FL_ State of '9- County of: /vi tarni�-NAL: County of: ivirej ' 1.." Sworn to or affirmed)and subscribed before me Sworn.tojor affirmed)and subscribed before me this .7 ) day of C9cArftbe r • , 20n, by this 25day of_ OCdo b er , 20)e, by ilAte1Ci SC® h(A Z. - Fr ikinet SC6, p,(,.,i Z: NAME OF LOBBYIST NAME OF PRINCIPAL Produced.ID Produced ID FORM OF IDENTIFICATION / FORMnon OF IDENTIFICATION _Perso 1`y Known Personal w Sign./re of Notary.P M's- Signa a of Notary Pu ig 11-riTA.- C1),, C vv' . W r.c L P• C •-ti,^- . Name of Notary,Typed, Printed or Stamped Name of Notary, Typed, Printed or Stamped (NOTARY SE°,lr fi••,, PATRICK D.CAMM MY COMMISSION#GG 209247 (NOTARY SEAL) �4, ��.PA�a EXPIRES April 19,2022 MY COMMISSION#GG 209247 „li k° Bonded Thru Notary Public UnAerwriters_ : . �=w _ .i •o`,? EXPIRES:Apnl 19,2022 1 The term"lobbyist"specifically excludes the following persons: ''SPR ;°'' gO—ThNtfpuMictlnde"v�iters 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; 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. Page 4 of 5 MIAMIBEACH 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@miarnibeachfl.gov Tel:305.673.7411, Fax:305.673.7254 ,1- NAME OF LOBBYIST: 1-0 y1/6 ! X C A/ 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 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. (0/?.._ Sig ureof Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS1Lobbyist Registration Form Revised 09-20-18 REG.doc Page 5 of 5 ire: -, 7 W 7 � f 1 h.s l p .�;:. 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