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Rafael E. Andrade - ISC Miami, LLC. ... , „_l_ , 1)11-1-r-k1 PlItlit(r.k. . , .. , . . • I . • • . . . . . . , • .• . . ..„ . . . _ , . RECEIVEIV A'\A :),'i • i BEAC'.- ' ' , l'--'' - Office of the City Clerk • : SEP 01 20201 . . •. ,.. 1700 Convention Center Drive •f• : '.. . • Miami Beach, FL 33139: j CITY OF MIAMI B- ACII •:,, ......:. :. ' . 305673.1411OFFICE• r-37 THF 7577( LER .. • ' - ' '' •''''l''''''' LOBBYIST REGISTRATION FORM . Lobbyist means'all persons employed Or„retained, whether paidt or not, by a principal who seeks to encourage the.pessage, defeat or modification of any Ordinance,-resolutlen, acti)n or decision of any;commissioner;'any action decision,recOmrnenifation of the City Manager or any City board or con irnittee:i or,iliyactien; deciaion•or:-:rCcorrirnendatiOn-of any City personnel during the kinie period of the entire,decialon-making process on spOtfaCtioni,decision•or-recommendation-that foreseeably will be heard or reviewed by the City Commission,.or a Cityboard or cOnimittee. 7.-::.1e terM:Specifically,inCludea the principal.as well as any employee engaged in lobbying activities, The term "Lobbyist has SitieCifiCar. ,.i.31ttins. Please refer tp City Code chapter 2, Article VII, Division 3, entitled "Lobbyists," for additional information, I ' I , • . Instructions: Please:ccrnplete all sections of ',,h'iS kJ/tin-arid submit the completed form, With the applicable fee, to thei Office of the City Clerk. if you'need more space to complete an:answer, use a separate sheet(s) of.paper...lf you have-nothing to repOrt In a particular sedtion, ytv, must write. '!none" or !'n/e7.1n. that' section. Any change to,any information originally filed, or an additional City CoMmissioher or personnel who arealSaeought to be lobbied shall require-that thelobbyist file an amendment to the registration form. The lobbyist has a.Continuing,duty to supply information and amend the forms,filed tnrciughout the period that the lobbying occurs. ' Separate registration forms Shall be required for each principarepresented on each specificissue. , ..,-,- • I •LOBBYIST INFORMATION: 1 0 . Andrade. Rafael E. NAME OF LOBBN 1ST . --(Leat). . • (Ft): 'Middle NaMe) I . . . . WIBSOCh-COriBtlitii-Ot:.'SCIU.V011S- lei 1688 Meridian AVenue, 7th Floor, Miami Beach, FL, i 33139 . • - - - . . . . • -, LOBBYIST.BUSINESS.NAME AND ADpRESS. .'.• ' (NtiMberend.Street) ' ' .(City) (State) i gip Code) , (30021.6 . • • •2028 ralph@MbeaChtonsulting.com . , . . 3 . —..,....— LOBBYIST.BijSINESS.TVE'PHONE NUMBER • *---- ' CELLULAR TELEPHONE NUMBER . . EMAIL ADDRESS "• . '' i - . . . , . , i • U PRINCIOALINFORMATION:: ."'. . .• • . . .,, . . :;:,...._... . .. ...._ ,,,4. ....._ee:77. . .. i -. . NAMEOFPRINC:PAL • '•. '- ':• (Last) '' - " ' .''' '• (Fleet) (Middle Name) i IS.0.Miami,.Lir, ' f.•.-.. ..' -:- '''' '-'250. NJ...Hartford Avenue Columbus Ohio i 43222 PRINCIPAL BLISINESS.NAMEAND:ADDRESS:::',. ' (NOMIldrand.Street) . -• '• (pito (state) i (Zip Code) • 1, , • . (6.14) 205-9108. . , -••, • , : ,poantlanci©orangebarrqilmedia.com PRINCIPAL ELJSPNESp TELkP1-19NE:NUivl6gR: CELLULAR TELEPHONE NUMBER. E 'AIL ADDRESS ROStortt;t0;;Oltt 009**004:44462ogyot woiir*:itOf'*j*IrfitiOri; pioi)oitaK-:*oitieii:iooty.:**.-*j.poj*Aik:j'o1*i,isOP'.behalr Of that enttty';***0000(0060600:0*-iefriihOOkiientf0,-**00orii:to;.***AlreCt .:Indire4;or tbritingent,-1(keiiPteisa0PriCrt.: f:dr opposition to ior;0iii**Tt--;0416ter(*b: h07,010***,,r4060,i.0.016.':oogooloitaifi611..fiii.00010i604,06*Eiki6.6140iliiit(ii*. :1 • •4 , .• Partoerehip or:Trps. . If the :principal Is a Corporation,- t. the following information'MUST tie provided .. 1 pursuant to City Code:Se0thea:2482( ): ...„... I , NAME-OF CHIEF OFFICER, PARTNEFI,OR BENEFICIARYfif pone,write N/A):.- Pe_kAL Seco 1.-lui-0., 1 . •0 NAME'OF•ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH I . ' CORPORATION, PARTNERSHIP OR'CRUST(If none,write N/A): IKE•Smart City, LLC,_First Arnericani _ _ _„ i • . . ,. . , Telecommunitations,COePorattiOn; The .-Liquid Group, LLC i - • , Page 1 of 5 i . I • i 1 , iii. ISSUE TO BE LOBBIED:. Describe with as much detailas:is �rractical, including but not limited to a specific description where applicable of a pending request fol proposal, invitation to bid, or public hearing number. interactive digitai media kiosks on ;public right-of-way • 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 Citypersonnel 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 Mayor and City Commission • X City Manager and all City staff,' ; ;_ X • Pursuant to City Code Section 2 4 i2(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 NiA): Not applicable. 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): $5000.00 per month, plus $350 lobbyist registration fee • Page 2 of 5 i The following six(6)questions MUSTbe:answered: 1) Pursuant to City Code 5ection'.`2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurerr ent Issues": Yes XNo: Are you —lobbying q a present or p ndina bid for goods, equipment or services, ort on a present or .pending award,for goods,equipment or service? 2) Pursuant to City Code Saction,,2.490;entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": .'Yes XNa: Are you lobbying on a pending application fere 1]eveloprnent:Agreemenf with the CIL or Application for change>of zoning map designation or change to the City's Future Land Use Map?1 3) Pursuant to City Code Secticrlx,'2 48;t(h), any person (except those exempt from the definition of "lobbyi t" 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 appearan*whether direct or indirect to express support of or opposition to any item, hall register with the city clerk as required by th'rs'section,but shall not be required to pay any registration fees. _Yes XNo: Are'you .representing a noWor profit corporation or entity without special cdmpensation or reimbursement?;' 4) Pursuant to City Code Section;`2-481; the term "fobbyisr specifically excludes the following persons: Expert witnesses who provide only scientific, technical or other specialized information or testimony in public meetings; any person uyho only appears as a representative of a neighboi'hood.association without compensation or reimbursement for the appearanc ,whether direct, Indirect or contingent,to express support of or opposition to any item;and any person who only appears as a leepresentative 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 provicfiig manly scientific, technic'ai or other specialized information; dppearinq as a repressritafiye`of'; ';net hborhood association ithoiit's acral corn.ensation or rei(nbursement or representing: a'•not-for-profit based organization for the purpose of requesting . grant without special compensation or reimbursement? 5) Pursuant to City Code Section:2491(1), no campaign consultant shall lobby the City Commission for a peri d of 12 months following the swearing in of any'elected official(s)for whom the campaign consultant provided campaign co ulting services within the past election cycle. See=Section 2-491 for more information, • "Yes XNo: 'Have ou,provided eam ai n:consultin services to.an incumbent member of the CI Commission within the past election cycle?if yes,please listthe incumbent member(s)of the City commission: • —Yes`No: If vas, has it beerg;,a„�,s than 12 months since:the:electeds official(s)'-whom•you preydted campaign 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 I),y Cade section 2-491) shall disclose such particular:service on his/her lobbyist registration form and shall orally disclosel$uch• particular service'before lobbying the City Cori mission at a public.meetinq, _Yes XNo: Have. ou ,,rdvided.cam,ai•n.consultint services to an incumbent member of the Ci Commission within the bast election cycle?If yes,please list.the Incumbent member(s)of the City commission: i —Yes_No: If yes were you promised or�'did You-receive economics°Consideration in exchange for'campaign c n uitino-servtces? ".TO SE COMPLETED BY CITY-CLERICS STAFF.ONLY ... 3Annual Registration fee: [ ]Yes( jNo Amount Paid S.. MCR# V26 Sb Date Paid 0 c,•0 (" le Lobbyist Registration Form received:and verified by 'a FACl.Fi21 A.CI 1nr'b1;M5% p0RYd5Y F6Rile‘Le littris(4 IStr lkioo Form Revised 03 G..1c?r_ _ Revise 03/3,1/2020 Page 3 of 5 • VI. SIGNATURES UNDER'OATII: .. ON FEBRUARY 28 OF EACRIEAREACH LOBBYIST SHALL SUBMIT TO THE.OFFICE:OF THE CITY CLERK A SIGNED :STATEMENT UNDER .:OATH, LISTING LOBBYING EXPENDITURES... AS WELL .AS.:COMPENSATION RECEIV D :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 C.MPENS t TI • "tIRING T REPORTING PER100.1 Signature of Lobbyist: X ''' .7--.--: ,.....„...-.--C Date- . ., . . I do solemnly swear or affirm that all of the foregoing faCts, statements, and diSclosures in this form are true and correct, and thatt have read or am famllial*ith ha•provisions contained in Chapter 2, Art, VII, Division 3, entitled "Lobbyists" of the Miami,Beach City Code and'. . ,:•ortiriVequirernents. ..._„_ . -"L.----‹ Signature of Lobbyist: . : . I, :. :::- - ... Date . . 1.,) ,._ ,r,,(......-. 2_-.41.2,..0 Signatute-OtPiaricipal:- ..., :-.--..--- ..- --: .'--'---,-.."1 ::- '. . ' -riaI ...-—.. . .--• ' 2-° • - . VII NOTARY SIGNATURE AND.SEAL: LOBBYIST: PRINCIPAIL• State of .7-qo r, L)°-, ,:,----. , ' State of , . . (---: County of /1c;,1,, 10,6./e..,- ,-i- :-. County-of .t r"11-' ,\-.\ Sworn tolorgirmed)arid subscribed before me, ' Sworn to(oraffirmed)and subscribed before me, by means of physical presence by means of,/physical presence or 0.online notarizatioN , . or 0 online"riOtaki -tion-, ..t this So day of ftrocia- -- - 202d by thisll,-day of ,20-40„ by ...,...........,.......,.....,..,..............,,,..4 ......._,.1 ............ ...... ri 4 ' , k: /?c-c4 fieidicde- . . . , NAME OF LOBBYISTNAME Or PRINCIPAL . Produced ID - . ._Produced ID Com OP IDENT1lc,INT100--- " FORM OF IDENTIFICATION , /. Personally Kt›Wri, X Person.. '<AO i • . , . „., ., . , , .., • ; .eit ..,,,...,., . .,„......;,..,.. ."'M 01 % .,', .: C: err''' Signature of Notary PUblic• ' - - ,, es" Signature,fritary Public -4,e)e°,* Al4--- , -7 .s.c$'ft., - OteliJ C - 'T.14.4-1.1• 1 , ,e..10Y70/0 tat I C,,.. ,q 0. Name.orNotary,Typed, Printed o- - ° NarmdfltiVtaw Typed, Printed or Stamped .4 +ye tgtRit+ JOHN C. 1RUITT (NOTARY SEAL) ') Notary Pu'lpild ill) zie ...',- State sof Ohlo my CommIssidn Explies ,V--'" , ,4Z.2.-z-- 5:aptembet '1?2. 2022 1 The terriiiobbylsr specifically excludes't--,• -Hewing persons: r.0.7-0...,,,:,' -*.-,er 'l'1:C)Z. 41.11..? ‘fA,4,,0?"PC. Expert wilnesseswho provide only scientific,technical or other spedialitiVf-• '`:!-Wai;ialAteirriciny-in pubito meetings;any person who only appears asa representative of a neighborhood association Without,C6644, 014eirnbUrSement for the appearance, whether direct i indirect or contingent, to express SUPPOrt of or opposition to any itern;:brin'A person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant withOut specialcompensation or reimbursement for the appearance, Page 4 of 5 - , . " tv\ IAMi FE:A r City of Miami beach, 1700 Convanticm Center Drive,Miami Beach, Florida 33139, www.miamibeachft.gov 6ffice of the City.Clerk ' Rafael E. Granada, City Clerk CltyClerk@rniarnibeacll.gay Tel: 305473.7411, Fax: 305.673,7254 NAME OF LOBBYIST:,Rafael E. Andrade • 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City :CodeSection 2-485(d), the City Clerk shall notify any, lobbyist (or principal) Who fails4o.file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). in addition to any other penalties that may be imposed asprovided in Section 2-485.1, 'a fine cf $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 TrustI . 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 annualregistration 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. _ . Signature of Lobbyist Date F:1CLERt$ALL1aFORt!ASIOBSYIST FORMS1146!?ilstRogictrollonForm Revlsod 03-11-20 REG.doc Page 5 of 5 • • MBF L City Hall 1700 Convention Center Dr. 1 , � Miami Beach , FL 33139 o © = CV , 305-673-7420 � Welcome co ) ; c. 7-1/4") 4,,,i, 2 ' 8 - 004556-0039 Maria A. 09/01/2020 03:11 PM N �" MISCELLANEOUS Z � . 1 E Description: NCR OPEN -� (NCR) f. _ .. j Reference 1: 426366 NCR OPEN (MCR) m 2020 Item: MCR 1 @ 350.00 MCR OPEN (NCR) 350,00 . 350.00 . ) ( o Subtotal 350.00 --.� e Total 350.00 t,> CASH 1 360,00 'v a : U , — •.4.," '` ,� CASH 10,00 v: v c--- Change due - - -10.00 r y" GC ,,. c, ` m -...•• :. r = g Paid by: RAFAEL ANDRADE 0 m ., Z . 111111 11111 IIIIIIIIIiIIIIIlIIIIIIIIIIII111111111111IIIIIIIIII!!!1111 (._` o Q 1. Thank you for your payment 'c o ��` " w 2 0 co ,>v 4`.O aci N t"4 rr CUSTOMER COPY r