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Freddy J Balsera - Portofino / South Pointe Master Association, Inc.
PSP St-et' �l-i3 i RECEIVED AAI A/ V 1 I B EACISI Office of the City Clerk OCT 2 3 2020 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI BEACH 305.673.7411 OFFICE 01=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 "Lobbyist"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 aril 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: Balsera Freddy J NAME OF LOBBYIST (Last) (First) (Middle Name) Balsera Communications 2199 Ponce de Leon Blvd Coral Gables FL 33134 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-441-1272 freddy@balserapr.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: c31�G��r 16 i vIA ¶ /.i — �/1�, r,,-; r ' s c-;0 NAME OF PRIN IPAL' (Last) (First) (Middle Name) . v & 95-1-NA-c_ ' M; cncti 22t 33(3i PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) .rcr , 51:4 - ri Al et e�at�o tr.' TdJ-'rs, PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER MAIL ADDRES Co•. PEEttEtifi ib j 3221 S=etio &MN= ,11 Inc pal OW corporation, partnership,CI?latiO 1119 nD ":. thio"la -t a -Ira withou sowlet cpu"e' i la.bursem t can aooeara ce,ca2a20 direct indir at ^_ j., , COMA E? ositlontl° taki iatl lii he CM g3 re0uiredl 7tni'#bfilifonze o l fa #L e'uiredt 1E9zihijEffnital If the principal is a Corporation, partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): A\ 1/4./ (),..) • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR,A,MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): A) Pagel of �/� 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. I v 11A ?6i MC- 1. V.JM`� Sl 0,3 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 CTitle of Person to be.Lobbied ,/ , t/ C.-V\( Cr)K.µ,ss,d.,J 4-\(`6? Mehyc C.,1-- `I t O ne-J S Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extent of any business, financial, familial or pilofessional relationship, or other relationship giving rise to an appearance of an impropriety, withany current City Commissioner or City personnel who is sought to be lobbied as identified on the lobbyist registration form filed. I List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): A-)/ /1 • 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): 4/ 000/ ,,,,,, 7)-e---:-/I-i Nre., 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": UYes1 : 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 ues' Yesb 4io: 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 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 e ci94c as required by this section,but shall not be required to pay any registration fees. LYes Vo: 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 Lmb ent for the appearance. yes o: 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 hin 6 ast election cycle.See Section 2-491 for more information. llYes v 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: I . _ -Yes[ lo: f as has it .een ess .htian 12 month since the elected official s whom ou 'rov dad cam•a •n onsultinq a-7:•es"T',-s.`,worn int 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 -,Acrvic " re 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: ['Yes /Jo: f yes, we e vs promised or did you eceive economic considers ion in e a,an,ge for campaiq onsultinq sea Joust' TO BE COMPLETED BY CITY CLERK'S STAFF ONLY •i 1 Annuali�Registrahomfee [ it Yes[rIiNo / mount1P,aid 3..,, — Cep MM„CR# "7 O. 3 ;Date Patdc __ Lobbyyist,Registration4Formrreceived and vedified1 y+ ✓ —k • .3 .. ,_ ,•, _•. 1,11- �,©aUErtt A1�L 0.0. !.10101 k 13T:F0iPord<l \��idl�,b�7 60. is i?54.iiik F�aW34,104103.�S�.t,' 0,(I E a ,Ro lseakt$/_lE 2020)... 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 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 COMPEN N DURING THE REPORTING PERIOD.1 Signature of Lobbyist: 7.5-7,tr Date / &/ii/ '-20 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 th provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code a r: all reporting requirements. Signature of Lobbyist: ..a, / Date lbVZ 2/7 U Signature of Principal: Date /-0/2Z/Z4:2 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL JJ State of A/G __ R! !%�' State of iefonccl�l County of: /1249"7/ -Z County of: L1lV ( ' Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of 0 physical presence by means of physical presence or 0 online notarizatign, L 2 or 0 online notarizatiop ' _ / this_day of UaTL0e ,2Q,' , by this V--day of 61CJ VW ,20Z0by PI'eado�G 0 6) ifr/se,Ga- M9stm r✓M4ican NAME OF LOBBYIST NAME OF PrINCIPAL Produced ID rive to- /CoJA_ _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Known Perso nown Signature of Notary Public Sign ur of Notary Public ,thy A Edith R.Fortuna „, , 4941 tri,l iso, NOTARY PUBLIC /tel/ Name c J'. '•,, t td�Fnttdtamped Nam of Notary,Typed, Printed or Stamped • `��-'-1-:ter i Comm#GG053238 (NOTARY'/'.. ' .) Expires 12/7/2020 (NOTARY SEAL) �:� ,; r , _Commission YOANROCHE#GG 088284 G,,, Expires July 29,2021 The term lobbyist specifically excludes the following persons: ;,, B .LINToyFanlaswance66048Sii 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 suppot 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 MIAMIBEACH City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachf.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: A `\ t-D;)7 t f t 5,(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 J 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 Ito 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 lobby1 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. 07.2 Z /2c., Signatur of'Lobby st Date F:ICLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 TM Miscellaneous Cash Receipt CITY OF MIAMI BEACH No 427043 , CICash °Credit Card '.l Check# C-",0 (-) $ / C o iscF" wAid.a,. - � .., � .. 1)..'. (a,, t .^A) , C (, e aneou -t (utas-Ll� n a9 hieT(raC as). . 1 `l .z.s t �f! '15'5=4,5 3 �✓ a f i)„,„ Payment Amount: - 1,200.00' ) :1 wFORMAT)ON MUST BE COMPLETED) � GRIc�of FManc�Director Account Nurablr: ? t. t?.)t7 ,`!" (-1 .g ) , £` C perOn r. = N>71-1,_ .Dep . . ( EXT'._„ i t