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Timothy Riera-Gomez - Social Bicyles, LLC. MIAMI BEACH Office of the City Clerk RECEIVED 1700 Convention Center Drive Miami Beach, FL 33139 OCT 3 0 2019 305.673.7411 LOBBYIST REGISTRATION FORM CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 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 decisionof any commissioner, any action, decision, recommendation of the City Manager or any City board or committee:or any action.decision or recommendation of arty 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: RIERA-GOMEZ TIMOTHY NAME OF LOBBYIST (Last) (First) (Middle Name) Floridian Partners, 235 Catalonia Avenue Coral Gables FL 33134 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-461-4260 305-790-3998 d timgomez3@gmail,com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS • •a • IL PRINCIPAL INFORMATION: . . • . CORREOSO " JAVI NAME OF PRINCIPAL (Last) (First) i (Middle Name) Social Bicyles,LLC, 80 SW 8th Street, Suite 1830 . Miami FL 33130 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (ZIP Code) 305495-1101 jcorreoso@uber.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS If the principalis 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 WA): StR hn an Reran Repecki,CEO • 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):. Social Bicyles, LC is owned by Uber Technologies. Inc. - 51z,MAARIve,c1 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. Transportation matters, including bike-sharing and scooter regulations IV. CITY AGENCIESANDIVIDUALS 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 monthspreceding such commencement of service with the City to the present date,stating the general nature of the subject contractual relationship. Fun Name of Individual and Contractual Relationship(If yes,explain) YES NO Title of Person to be Lobbied CITY OF MIAMI BEACH NONE . 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 flied. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write NIA): 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): $5,000 monthly Page2of5 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 XNo: Are you lobbying on a present or pending bid for goods,equipment or services,or on a present or pending award far goods,equipment or service? 2) Pursuant to City Code Section 2490,entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yes XNo: Are voulobbvincl 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 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 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)(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 members)of the City Commission: Yes XNo:• If yes, has it been less than 12 months since the elected official(s)whom you provided campaign consultin" services was swam 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 ata public meeting. Yes AO: 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 members)of the City Commission: _Yes No: =,TriC, 17i TLI. • :d r•7?rf11 ■ . eive economic c• id-ra on in ex -r C I3,. _m,�. ,n consulting servic ? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY- , - - _ ' Annual Registration fee .1. .1 Yes i 1 t!lo Amount Paid.; MCR ' t - flafe Paid Lobbyist Registration Fermireceivedtandverifiedby -- , � ;°� _ • 3: a-f# Y ",, i F..1Cl:ER\sA licaFliemikLOenyte Forim- Lobby;st Reyrstrati i Form Reviled i O1=01-t8 REG:doc' _ _ Revised 01/01/,2018 Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 26 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 LOBE A STA -MINT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPEN TION DURI G HE RE-4. ING PERIO 1 7 Signature of Lobbyist: -411 t Date /0/z q b_l 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_contain;; in Chapter 2, Art.VII, Division 3, entitled'Lobbyists" of the Miami Beach City Code an. all re r„rti•g r-U. meets: ' / � . /I Signature of Lobbyist: I`b / '��/,r�. �'- e l n rLC� III Signature of Principal: - Date I b 4°1 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of )'-'L(A D4 State of 7-Loai f'- County of: i)0i14.1 -.)i E County of: ,VVl I tiffl i- LMMM-D Sworn to(or affirmsst}an ,?iipscribeci before me Swaim t (or affirm )an¢spbscribed before me this gal day of Uc TULrZ ,2Q0;by this day of 1 Dit'_4' .207 , by 1 /,i'io -/ i Alm 66,2_ 3-"',„ier- ..co,rreOJ-b NAME OF LOBBYI T NAME OF PRINCIPAL A Produced ID ,LPeoduced ID r. i, 'fii! FORM OF IDENTIFICATION FORM OF ItIIENTI ICATION -ersonaliy ., n - -ersonally K wn rii, e 1 �lictitdia, .... lIr ://f// ,tc, �'�- of -ture if =i= Publi Sig ture of N Public Feet., MIREYACARBALLOSA Name . 'tit.! i. ,t`• . - T_. Name of Notary, Typed,Printed or Stamped "%,gtr ito Bonded ThNN PublicUndenvrilers ! Vi ;iR ,� MIREYACARBALLOSA . � � �� MY(;OL+IMISSION#GG28384T (NOTARY SEAL) (NOTAR 1=' ,i7€ SORES:February 22 2023 "t ;„0.0''Bonded"Mu Wary Public Underwriters 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 AA I AiM I BEACH City of Miami Beath, 1700 Convention Center Drive,Miami Beach,Florida 33139,ww.w.rriiamibeach8.gov Office of the City Clerk Rafael E.Granada,City Clerk CiyClerk@miamibeachll.gov Tel:305.673.741 1, Fox:305.673.7254 NAMEOF LOBBYIST: Timothy Riera-Gomez '. 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. OF Az>Zit: Signature of Lo yist/ZA I Date F 1CLEMSAU pFORMSILOBBYIST FORMSILobbytit R•gistretion Form Revised 01-01-16 REO doc Page 5 of 5 DIVISION OF CORPORATIONS an official Note gf Awk4 S e ;Siii Department of State / Division of Corporations / Search Records / Detail By Document Number/ Detail by Entity Name Foreign Limited Liability Company SOCIAL BICYCLES LLC Filing Information Document Number M18000009704 FEI/EIN Number N/A Date Filed 10/26/2018 State • DE Status ACTIVE Principal Address 55 PROSPECT ST STE 410 BROOKLYN, NY 11201-1497 Changed: 04/19/2019 Mailing Address 55 PROSPECT ST STE 410 BROOKLYN, NY 11201-1497 Changed: 04/19/2019 Registered Agent Name&Address C T CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Authorized Person(s)Detail Name &Address Title Manager Chadwick, Francois 55 PROSPECT ST STE 410 BROOKLYN, NY 11201-1497 Title Manager Gumbs, Keir 55 PROSPECT ST " STE 410 BROOKLYN, NY 11201-1497 Annual Reports Report Year Filed Date 2019 04/19/2019 • Document Images 04/19/2019--ANNUAL REPORT: View image in PDF format Ti 10/26/2018--Foreign Limited View image in PDF format nofiwa Department of Sate,Division of Corporations DIVISION OF CORPORATIONS t� M YEICIPI offidal Num of Florida wrtinlit Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Foreign Profit Corporation UBER TECHNOLOGIES', INC. Filing Information Document Number F13000004719 FEI/EIN Number 45-2647441 Date Filed 10/30/2013 State DE Status ACTIVE Principal Address 1455 Market Street 4th Floor San Francisco, CA 94103 Changed: 04/03/2018 Mailing Address 1455 Market Street 4th Floor San Francisco, CA 94103 Changed: 04/03/2018 Registered Agent Name&Address CT CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Name Changed: 02/03/2016 Officer/Director Detail Name&Address Title CEO, Director Khosrowshahi, Dara 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Camp, Garrett 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Cohler, Matt 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Trujillo, David 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Martello,Wan Ling 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Al-Rumayyan,Yasir bin Othman 1455 Market Street 4th Floor , San Francisco, CA 94103 Title Director Huffington,Arianna 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Kalanick, Travis 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Graves, Ryan 1455 Market Street 4th Floor San Francisco, CA 94103 Title VP Manik, Gupta 1455 Market Street 4th Floor San Francisco, CA 94103 Title Secretary West, Tony 1455 Market Street 4th Floor San Francisco, CA 94103 Title CFO Chai, Nelson 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Burns, Ursula 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Sugar, Ronald 1455 Market Street 4th Floor San Francisco, CA 94103 Title Director Thain,John 1455 Market Street 4th Floor San Francisco, CA 94103 Annual Reports Report Year Filed Date 2017 04/12/2017 2018 04/03/2018 2019 03/23/2019 Document Images 03/23/2019--ANNUAL REPORT View image in PDF format J 04/03/2018--ANNUAL REPORT View image in PDF format 04/12/2017--ANNUAL REPORT View image in PDF format 04/04/2016--ANNUAL REPORT View image in PDF format 02/03/2016--Reg.Agent Change View image in PDF format 02/24/2015--ANNUAL REPORT View image in PDF format I 04/30/2014--ANNUAL REPORT View image in PDF format 10/30/2013—Foreign Profit View image in PDF format r iai:(a Depat'tme-t of State, ii.is oo a1 Corp oi'alars L 1 i Miscellaneous Cash Receipt r. CITY OF MI) IVIIBEACH } . 1 No. 425104 [ 0 Cash El Credit Card dChedk# 04c.A. I '‘ $ —7 00-00 I' 1. i 0 '-'(::,( i 20 rl i,), _ Roved of ,,,,,, Nr ,,,,.„.,, iv\ (t1 a ii , A I 11.., 4- I- ,.. (...),- '4 k 4 -2 1 Ayiiiicellaneous-•MCR-2020 ) -',7i:: -4 r 1,., 1 I e.,... ....„, -, i , ,, k 1 [ ',74SM010 Ad,ian ... t0/36/ 014-112CAPer' n ' ' 111 i Q• , C r'-,,, cfr I, 'S ) '-')—'I ) , ) I- FeirR OPEN(MCR) .). f '''„'),,,.( '-, ' tf f k _ . ,„ , 1 , r [ Payment Amount: 700.00 1 [ MCR125101 1 r - ,... • 1 i (THIS INFORMATION MUST BE COMPLETED) 1, Office of Finance Director By 1 Account Number: 0 I 1•"c'sr C(1, -3(,--1(.41,114 (-0 3-1 5 1 1 r.-0 Preparer: —)R,r'Nn,..) ),A-1. v'4-'7 ' N-; Dept r , EXT -7'i ( ( 1 [ i