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Wesley J. Hevia - Publix Super Markets, Inc. RECEWED MIAMI B Office of the City ClerkT 2:20EACH 1700 Convention Center Drive Miami.Beach, FL 33139 . CITY OOCF MIAMI 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 "Lobbyist has specific exclusions. Please refer to City Code Chapter 2,Article VII, Division 3, entitled"Lobbyists," for additional information. tnstructlons: 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: Hevia Wesley J. NAME OF LOBBYIST ' (Last) (First) (Middle Name) Akerman LLP .' 98 SE 7th ST,Suite 1100 Miami FL 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-982-5525 wesley.hevia@akerman:com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS IL PRINCIPAL INFORMATION: do Robert J. McGarrity,Vice President of Facilities NAME OF PRINCIPAL (Last) (First) (Middle Name) Publix Super Markets, Inc. 3300 Publix Corporate Parkway Lakeland FL 33811 PRINCIPAL BUSINESS NAME AND,ADDRESS; . (Number and Street) (City) (State), . :(Zip Code) 863-688-1188 eric.lieder . . .. .. ,. @publix.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULARTELEPHONE NUMBER • EMAIL ADDRESS Py[s4atioKoili ode Sector 2 de2(h (1) A p► Arf .ny rP�C n P 1 �sb1R, oz of a who oQPears as tobbbns�Ton b ba neat ent( 'yVitti6uwoal atn Ian ifl t o- I�nts r ernenttortfi`a�ploviee eth dlGc"t, 1rQ q`c o g nt�to a ess-�u Pott ofao topPasi_on to a t 1r1 4'dll 7egl tel v i 4f1t orEi., ,tfwexl sse-A rssuhse ttotilt5-it sh Irnot btreyulred f -paY- n5 9SaiFattan 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 NIA): See attached. ▪ 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): See attached. Page 1 of 5 r /i it 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. DRB Approval for modifications to customer circulation system at Sunset Harbor Park located at 1920 West Avenue. 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 Members of the City Boards and Committees None X Members of the City Commission None X Planning Director and StaffNone 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 filed. 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): $375.00 per hour 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 X No: 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 x No: 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 the city clerk as required by this section,but shall not be required to pay any registration fees. _Yes x 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 reimbursement for the appearance. _Yes X No: Are you providing-only scientific, technical or other specialized information; appearing as a representative of 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 X 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,LNo: if..Vetv,liasiilt,3been lass then 12-months since.the.elected`oificial(s) whomwyou.,p ovidedacampaign .,consuilttngser3>_pes wasAsworn in3 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 membero'f 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 CommisiCiTefa'public meeting. _Yes x No: Have you provided campaign consulting services to an incumbent member of the City Commission �g� ' 'within the,past electionfcycle?7lf'Yes,.please list the incumbent member(s)of the City Commission: :,(VAI i}9 21 I r `x.:> Ic X- 'r'`"''"".�y, '+'.,e,. ••" ,;,. '�' =c °G': T3C ;V , 4: . .;Zti 1.w,aC, ., ,. Yes1 ,>, Noy! F„ 7 If:yesti vsrere troa�'wprotrti§ed.or'.'=iird you:receJve..economrs�consnstderatrowrti.exatiange.forgcampaifiln FF @i l ), et , l cdns��t�11 tr ices? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee [ ]Yes[ No Amount Paid$ MCR#` Date Paid "Y '' i rd -"a Lobbyist Registration 1=onn received and verified by � F,\CLER\,$ALL\FORMS\LOeGYIST FORM6\Lobbyist Re9istrationFor n Revised t)3 11-20 REG.doc f,,.;` Revised 03/1 /2030., 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 ' •LENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGE i 0 LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENS •N DURING THE REPORTING PERIOD.' Signature of Lobbyist: Date 10" 21 w W 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 th the provisions contained In Chapter2,Art.VII, Division 3,entitled"Lobbyists"of the Miami Beach City Code and : porting requirements. Signature of Lobbyist Date /Q.2)1 242 Signature of Principal: 4>P o/� 1201 Date 1v Robert J.McGarrity, resident of Fadllties ViI. NOTARY SIGNATURE AND SEAL: LOBBYIST: J PRINCIPAL - State of t'f Oft a State of CL County of: 11 I IQ/'Y)f'(��L�E' County of: PC), Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me,. by means of Lhysical presence by means of,X physical presence or 0 online notarizatio% LL!!--__ or Ctopline notarization, this day of Ve./7011Der 2020,by this day of a(,t 20 by Wesley � A.v� Robert J.McGarrity,Vice President of Facilities NAME OF LOB MIST NAME OF PRINCIPAL Produced ID Produced ID ./ FORM OF IDENTIFICATION FORM OF IDENTIFICATION r Personally Known ,,Personally Known Dcuu,fr Signature of Notary P 2ture ' ' tic � r�mrIo ��on7QlPZ S t„ �c v 1 S Name of Notary,Typed,Printed or Stamped Name of Notary, ped,Printed or Stamped (NOTARY SEAL) t` " MARIAGONZALEZ (NOTARY SEAL) ,0�;:`:P.N, SHELBY L.DAVIS * * Commission A 00348492 di • s Commbsbn#GG 335,052 9,2023 ,. y%f fl,o*��e sorondti uihd tneialysmbll..Expires October 22,2023Expires tot' vine ttt.y.l tHam strrtal '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 dr 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 1 MIAMIBEACH City of Miami Beath, 1700 Convention Center Drive,Miami Beach,Florida'33139,www.miamibeochff.gov Office of the City Clerk Rafael E. Granath),City Clerk • City.Clerk@miamibeachfl.gov Tel: 305.6737411,Fax:305.673.7254 NAME OF LOBBYIST: Wesley J.Hevia 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 $500.0 ursuant to Section 2-482 of the Miami Beach City Code. 10-21 — ?� Signature of Lobbyist Date F:,CLEROLL1aFORMSILOBBYIST FORMStobbylst Registration Form Revised 03.11.20 REG.doc Page 5 of 5 DISCLOSURE OF INTEREST (City of Miami Beach) There are only three shareholders that own or control more than five percent (5%) of the company's outstanding common stock as of February 4,2020: • Tina P. Johnson—6.15%* • Employee Stock Ownership Plan—25.57% • 401(k)Plan- 10.21% *Ms.Johnson has sole voting and investment power over a portion of this stock and shared voting and shared investment power over a portion of this stock, and Ms. Johnson serves as the trustee or co-trustee of several trusts over which she has either sole voting and investment power or shared voting and shared investment power. For more information, refer to the proxy statement filed March 2, 2020 with the Securities and Exchange Commission by Publix Super Markets, Inc., available at: https://www.publixstockholder.com/financial-information-and-filings/sec-filings. [ - PAISCellaneous Cash Receipt . CITY OF MIAMI BEACH. 6, . . NO42 Check# 1 1 ) L-7 $ >. • Q Casio E • JCreditCard Q ,, , , . .1 / • .a -,%-•„ 0 . avid of _ _ N tsce aneous- d 7� ••f �1,., ,�. 1 I Li t�-.1 ,�,� (-( )' t r• } () �_.?,):' ,- rr ashler(mcrcas} , - �t> ,, ;' a �'Rayment Amount: 35�.0� . • A�7042 F i F --,-: . INORMATION. M• UST BE COMPLETED) B N t it St�X) t• 1 Li f t •QC.) • 3 ,, . � , ., �• ` ' • ` EXT. ti