Giovanni Ramon Castro - Verizon Uitpt,k535 c-r.,<,‘' 1 t 41(3
RECEIVED
Office of the City Clerk OCT 22 2019
1700_Convention Center Dow
miami Beach, FL 33139 CITY OF MIAMI BEACH
305673.7411 OFFICE OF THE CITY CLERK
LOBBYIST REGISTRATION FORM
Lobbyist means ail 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
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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 thislorm: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 flied throughout the period that the lobbying occurs:
Separate registration forms shall be required for each prinoipal represented on each specific issue.
I. LOBBYIST INFORMATION: -
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NAME OF LOBBYIST (Last) (First) (Middle Name)
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LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) - - (City) (State) (Zip Code)
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LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
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NAME OF PRINCIPAL (Last) (First) (Middle Name)
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PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) . (State) (Zip Code)
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PRINCIPAL BUSINESS TELEPHONE NUMBER- CELLULAR TELEPHONE NUMBER - EMAIL ADDRESS
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If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c):
•
o NAME OF CHIEF OFFICER,PARTNER,-OR BENEFICIARY(if none,write N/A):
14a 11 e -9:)e9 CPO
o NAME OF ALL PERSONS HOLDING,DIRECTLY OR INETRECTLY,A 5%OR MORE OWNERS IP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(If none,write N/A): RADII CIl "%et d
Page 1 Of 6
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III. ISSUE TO BE LOBBIED:
Describe with ass much detail as is.practical, including:but notlimited to a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
1\)000 Q.plot,neryt po\t`c_y Pop oscil
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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
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Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extent cif 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):
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V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION —Be Specific. (Note that a
contingency fee is prohibilt?d pursuant to City Code Sec. 2-485.3):
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Page 2 of 5
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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 4o: -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"No: Are you lobbyingona 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 yko: 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 organizationfor the purpose -ofrequesting a .grant without special compensation or
reimbursement 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 ofany elected official(s)for whom the campaign consultant provided campaign consultingservices
within the.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 _No: 4Mia as It been less than 1.)mo Its inoe the :fe:ted •ffl :l s' o ou acow oed a x +at*
era sal n_• -0 f to was s torn to":
6) Pursuant to City Code Section 2.482(a)(4)a.,a lobbyist who has within the past election cycle providedcampaignconsulting
services to an incumbent memberr of the City Commission(which lobbying activity is not otherwise prohibited by Code section
2-491) shall disclose such particular service on his/herlobbyist registration form and shall orally'disclose such particular
service bgfore 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:
• p,ti r •,'1 ie:•rd^4;5}ir :.a�R:n,,,
Yes No: f it :-LonYsed .r did o; eeelveoco o •I- co : ion i1 e�--ha ? " t c<'"`4a1.
.co usual a •errvices�i' •
TO BE COMPLETED.BY CITY CLERK'S STAFF ONLY -
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Annual Registration fee: [�.]Yes[ ]No AmountPald$• ` MCR# 1-a A- ° I Date Paid f ± ' t`-
Lobbyl'st'RegletretionFormreceiv-ed and.verified by: ek •
r\OLE:R\;ALL\aFORMSLOBBYIST FORMS\Lobbyist Registration Form Revised 01-01-18 REB.doc Revised 01%01,1,201&
Page-3 of 5:
VI. SIGNATURES UNDER OATH: -
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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 COMPE SATION.DURING THE REPORTING PERIOD.'
' Signature of Lobbyist: Date /4
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 a d all reporting requirements.
Signature of Lobbyist: Date (0/(-—V/(111
Signature of Principal: WO l Date IO/2.. / I q
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VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of 1 State of C4
County of: m}�11ti�t"NG,,Gi� County of: 77)(5-7,
:.� Sworn to(or affirmed)and subscribed before me Sworn to(or affirmed)and subscribed before me
`., this IX day.of UC-1 ,'., ,2001, by this, day of (C /xe . , 20_, by
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NAME OF LOBBYIST A/ME OF PRINCIPAL
produced ID 9ZdC s% —r—"/� f/ Produced ID n�C'r 7ec.5 Li cehS--e
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
_Personally Known _Personally Known
Signat --e ,. -`� -u•lic Sig ature of Notary Public
D Lis"S i 7e; ) Cu/y/41-Ni G Le e Mc,
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Name of Np ary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped
- Dianelys Garrido
j (NOTARY SEAT'? 'is . #GG221549 (NOTARY SEAL) ��0".‘2,,irk Lee 4",,0
EXPIRES:May 23,2022 am••. ..........niSSIO ••%
; y; Bottled Wu Near/ . . cP
;V:4% Notay• N', o� '
'The term"lobbyist"specifically excludes the following persons: s e s
Expert witnesses who provide only scientific,technical or other specialized information or testimony SALA, eetfngs,i any t�An who
only appears as a representative of a neighborhood association without compensation or reimbursertS94)1' 42 earan -whether'
direct, indirect or contingent,to express support of or opposition to any item; and any person who onlyitp car trihb`entative of
not-for-profit community based organization for the purpose of requesting a grant without special compen lj 4 X94�-�iM ursement for
the appearance.
Page4of5
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:305.673241 1, Fax: 305.673.7254
•
NAME OF LOBBYIST: A..or U( 1Y11 C,6.4(I
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_timelya 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 CommissiononEthics 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
$500.00pursuant to Section-2-482 of the Miami Beach City Code.
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Sign e of Lob yist Date.
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F:ICLER18ALL1aFORMS\LOBBYIST FORMS1Lobbyisl Regislia86n Form Revised 01.01-18 REG.doc -
Page 5of5 -
r Miscellaneous Cash Receipt
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CITY OF MIAMI BEACH
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No. 424887
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(THIS INFORMATION MUST BE COMPLETED) Office of Finance Director
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Account Number ()t 1- 5)00n- 31,-ILILit•-i, 00 • 30-7- 3ec•rf OC) ,,C*--•.-,C1 • :I
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