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Samuel J Dubbin - Fisher Island Club, Inc. • 1,710 PALARAlajtCA`tiSCw.4 RECEIVED FEB 26 2021 Otte ep the City Cleric 170D CornerAterCenterE"ivetrrY t) MIAMI BEACH Mena Jl ,8 331 ' r C CITY CLERK 361374It LOBBYIST REGISTRATION FORM Lokbpst means ail parsons ins agapik yid or ista odl,whether pad c.a*Ito a pargipril sae 1111011010.0111111.0 mow.IMPS al moddcoiro d arty ald dram 1,seedelkok atria at deS siita al raw oarnamissierrafr. amgr ariert,d Iron df V idly Maen'o coram OF bawd or OhleddreC air sltYa1 de+mailml6 et armormendtallom aft NV a'perszooml M Erne panel d lhar ental dariaisisisdav peen Oa see ace"dedslan an neemrtarmnenrlliti an,ttnanftaresdeatetto',wih to hood of footoose hobs its Consissatkm ora City roam or em adloo.lbls boot R akti,aiss the,Onto*as twat as mg amplipso cowl*111dotrd acttt+oBrs; The term labs y/riti'has TNTC Wallow Pitose rem lm C31y Coat C alptor Z Aittalk Y111 !lam 3.NOON ILOh NS" for additiora intbartaticri. tmstrrartherar IPtteaena a.IgJM1!Racism oft xtne tat aid saving tte=misted hstmsl,a ttk.apsyptiinaltaa tk tr.it.taw Oafs*ad Ctt Cierle, If y€'a nowe mama Nem basergras amt aaowlr,RIO$sipesse sttteet(-s))adt paper Ift gymw Masa=thing it,newest ie at:puntfuwart section ylow roast ants 'ie ` art War ilm asalsaL 11'r done nre to, arty it timadc,m m tors tv !back, an alma and 0114 Commissioner arryanarnand sae am alis eashrd le he Marled Ind mom that the IdtbOn em onernitmedt1m the er tifinficrn term The Ibtscrycits011sa a aaniLm i ngt Rai 11,1g14*iinitammorkis aid a tttat forms.Sint tarvnttrtmWC 11111 peed Barri * kiterypl.rii moms Separate regilladiam!Imams lead tlsr froodhesdt ltrr 4SeiM ertitld r dl amu sasssp>.dtl¢Oxon, IS 1_ LOBBYIST "" N' SAWA! S. noottE OF L'O8SY1tri Cl rsa) (Fin* iPeNddlu Muer*" f i n � 4► t j 1611Is�'la Avg, �4e Soo Lod M cL 31/.?y1 LOES'ImS1TBUS1mi SSAWtD.1AiCi�SS pihmlteearrdSareet0 lathy}; 5 ' ,PP Ogle (3°S)SS 7-9004 (Ps) 81S Soho $da6t4bItinit k.AwN tOse^nisT earSin ESS sap Iso itanagul Cirri 1lload ri ITEILE *01,tleE;gRltedf e R EVAil ACCIRESS 1L PRINCIPAL INFORMATION: WA NAME OF WsriilDPPA t I �SL36rb T Oast pad -M .7 temm r iSIW T4044 04, ] L. Otte V'1f�tr J� Fair 144.1/ TL Riot IP13il iCWdYL taiSIN[ :KANE AND. `S5 piton terr Ind SibadQ) 40tg.;) ;f- 'tZ+t s4360 (3bS1604-437o (3oc- gas-oils parvo upwa. maismeLENcwiluislat mixt"IRE3LEFRI^ME 14l1161EIGAILACOMEISS MNrrl lla O1y COON ldlml 24Mihrdlit Apai ed 11air.gimareiq.aistairsiip,a aWsredgy aahm aj is s a itc,ttpyirt w tow of oft aslanir>f al rlNp laij�1rn , ilial elf rrapairr11ra11io ■�. southanion pdoeipsl is a Corporation, Parbee ship or Tad.the tloilorrig irdarrnaliall MUST ba prsMd.d puwwntSo ClIy Cod.Section 2-4112Cc3 p " 1. NNW OF off.PARTNER,CR pr ems.Auto oarSLo�� oi�11P, E .v P, C col coo • NAME O ALL PERS ROL0014,QRECTLY OR$NI C1M.V.,A 3%Olt mar clanagaSialP ROI Si.w SOON CORPORADOk PARTMEEtiaP OR TRUST(l waft meta 11t1Ag:-- N/A Papa 1 d 3 III. ISSUE TO BE LOSIIIED: Describe with as much detail as is practicaL including but not imbed to a specific description whin applicable of a pending request toe prOprollal,SedlialiOn to bid,or public hearing number. u,c_Aftlit041.0. cticomit_JA,1_6041441 offal Lulls al- Io Mg417.44. LcAseway_, DrBa-0-053o . IV.CITY AGENCIES/INDIVIDUALS TO BE LOBBED: Pursuant to City Code Section 2-4112(a)(4),list the City Commissioner or City personnea sought to be lobbied, and whether the lobbyist has aniseed into any coatrachal relationship(surd or unpaid)with said City Commissioner or City personnel from 12 months preceding such commencemmenk al service with the City to the present date,slating the general nature of the subject contractual relationship. IRA Name of imAviniat and Ccastractuall RiMationisihitp Ppm.eipladoi Vial ISO 'Tilled Person to be Lobbied f * k1jJ .th tuNt V4 A • Apilk_a_CANR 1).6.t lid. tidy v I kill , ovit )r. Pursuant to City Code Section 2-4112(g)„every registrant shall be required to steer the intent at any business, financial. (=Mal or professional reladonship, or other relationship giving use to an appearance of an hapeopriety.milt way current City Commissioner or City personnel who is sougtd to be lobbied as identilled an the lobbyist registration fawn fled. List wig flusineen Finandai. Familial or Prollassional Relational*. or Misr rolationship gliring rise to an sepeararce iiipeqpifilliv(11 nom,vain 1111101): NOW_ V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION—Be Sumac.(Note that a contingency fee is prohibited pursuant to City Cede Sec..2-4115.3): Goo, V\r Page 2 of 5 The isdowinyg six IR questiorys MUST be answered 6.,Cti Ce Sect 2-44W c.trettleel IPmciettrated Campaign Coaitikortoos Loalarynar Om Pirrowenment tk$Licat,5,' 'V as Ate: Aryi you lobby nag ani a program or tvarlarQbdlot qaoria oanioororrit sorrirkoa, or c a of es.ent pestering swami for awed*nouleammeit csocOrail 2) Pvu.arrt t C Cana Smarm 2-411111.brOMINI Protritillat Carnprogn Coraribtoms B4.Izettvats Ort goat Esdate W4,03' Xiikr: Are row botatnieeet on a torolliaso arannina Pot al Dondoefonnt Mawaorritergarr tar cinorsq*ciarroilara woo dosiarroarra or dawn to the COe'S IFNI**Land Illoo Sop? 3) Pursuante City Cade Soden 2-113114,ary person illsucst*Lass exempt tarn Sae delloiliar rif Intittsys:1`as set fbiltt, Section 24611)\de inti appals as a ouprononotsa da 11014o-piellt corprirahrafa ar ad*ovituut 3wariaration cyr witioduseenesse flat the appaanwok wham dimeltOf SWIM asaaiaa af or aproodien asp drum Sind frIggiattt WWI 11110 ON dart as neWrot lby ostaan bat sae ratios sorplood bps.say moildniao loss. Ifinglioc At, 11,110 onornsialor soldonoullt atinamitoL or mita gips* aisOr* Mernitenliatitte. cv reirnievementsall 4) Parsosat to Ow Cods Swam 1411,11*rsom apardliord,en:Wm as dalkonrw bosom Loeb awarbote*Irbo, radio aidi ocaradiz,tocaricoll Wald imIldnallma or tordfranny park areseilmwk any,person vete cyr14,applasiiti Asa omposernan of a inthotroadasindidoo ailhantommormadon Or Iliossarrerit to Ike altreererve,leteAber dnet. Want arOortfogeoll,, eaponsaipport alfarroppoikm to ow bin arid ant won Who writs swarm an poorosentatirar oft imallarkpollt barrourrally bond aundslom for Ito gowns rog000ltai a graft 'rutin= sprout compensation cr ooloaebard into appora vwas, Øi ono araoldhoo oft sew soecialeted tribmwakaink agc«wag al. a larovomilina at a • amoodidnai demi jamsiat coorpoosaaloo cemi frorrnborrontoot arootosillaa a intdaikarallt bond anarrnarkon %Lira MMITC410 at 1,MWatitkhg' a Walt ''‘Itheut mod*oratoorfnattem err reksetinatation 5) Pursuant*tDay Coale Section 241101,a aregaica aornalard*tail nitsbi Oho Cilr Carrialovirm for a warn elf 12 oronfite Milbaang Ito snowing Flt1 Mt gay itided clicittpd tor alma Oa caommoVo aonoultatt padded cuipap ater akin oarocas Orin ire post eietion cyzto Soo Seats 24911 ler owe bilmonsillow Yes Xilkt •••• •.Z 'Its dia. d ralL baiting lin Ina la SWIM sehha Ow chiseled Cdklattioi ation yow prostidist cuppmatian cosidoilloisureleas etas seam ala 6) Rosana lo otyC dina 2-raltnina.,a lomit ono Ms nen itn oIn cyMit)pormilot=mow orroollirg taincas to aa rtebn ad*a CINIY Caddraliallaa*Oath ititins actailt,do matt elltertutes pretriOdieti 11 ©ti motion 241913 shall Adore ft*asairulor 0111 Haw arbbfist roastriescon'arm SIMahI trak, troikas surtti sanAola lay Comaiosiso atimaidloralltam YesIlituatimilidamismamiuminumbessmadeugamsaggssern — • imp In sag ilardion andol Ituan sionallofkillor inuodmora WIt!* ?1M eV*COO Corgorilmilao _ It .los ware WU 11111111MiseW oi 4dyou reoerye econizens canstiderahasom roo carAgotclill cons.uftwiil services? Ci at IXIIIMIAINID int CIMUNIKS MVP Milt Annual Registration tee: Ni Yes[ No Amount Paid SSSO.:CY') OM 42,19, j Darr POO 61-4 Li Lobbyist Registration Fenn received and verified,by, _ cLE111,,SALLkaFofilms\wean:sr FORMSVLabtrose awersetion Form asthma 01-21-101Magre. wed 03/11/202o Page 3 of 5 VL SIGNATURES UNDER OATH_ ON FEBRUARY 2S OF EACH YEAR EACH L.oeBmsr SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A. SIGNED STATEMENT UNDER OATH. LISTING LOBBYING EIR'oeB RURE , AS WELL AS CONI'EAiSaATtCat RECEIVED= FOR THEINIECEDINB CALISid1R YEJITt lAl1D1 REGARD TO THE SPECIFIC ISSUE Oen BCH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL.BE FLED EVEN IF WERE 144•54, 4 NO EXPENDITURE OR 1041 114 •REPORTP1ea PERIOD.' Sgmatare of Lobbyist - — awe R 6- 1$ soil t do steamily serer or arms that al©1!t^e!brewing ta,StaieffnaltS,and disclosures in des lam are 3 re ard axcnraem and wan h have reed or ane twiner mien rte proms cartaitred;in Cheaper 2,Art Vlh„Division 3,entitled'lam`ail the Daamw Beech City Gale • -- • • repor9i . ,its, Signature at ._. _ _ ����w____ a» • 2S 7+31 Simanna d Prinban L taa1 r.4a, 1.2 tel VII. NOTARY SIGNATURE AND SEAL_ LOBBYIST: PAS, Slate Bra Fi__Oi1 d N-- I Staat.o� 1'1pv+ 6 a' i C vi r i 1 OM k T IU W.- Cate a+r��at 1-1►Ayv►+ t,d t Swore to(bi alis aadl and saibscibed bistros the, Sawa to lar a1Nim'aaad4 Bred swbscsb,l beam molk ibyr mewls o f pith piasince W means dIlt physical prreasaaance oraiEi waked, ra, K dycn r sd.LY�r�__.2y ..„,_,..y., S Cb 1 JA .201.1„by tirY►,lL.;.1 D �to .SC kt c V co.as nTS1 t* �c _ Pheatuaed Praduted C ,� foist a*it>3H1MFeCAINOW tow or it tiA'rosi _ `,a , ty Keeton �; Es/ e f ' I mame--- � ►ri�C J r4 "_� � r�. ,.. 7.03,10m6WITARy'31(27"pla".‘:EAL3E-91r";"‘3 ,Phiairt9z •t tonmhsmn M#M 1113316i,(74OT*R1( r„ ow�.mm..i aD s Fre)3..2e3b W $Baena<dtrtrpuli�'Mieaanwi',waryflym. ..,,,'"7"----------:::**;. - SHIRLEY BRIONES MY COMMISSION tt GGO76904 i The ae i m'b "apetelt}railti Beal the goiloa+in9 persons. ""`,' EXPIRES Aprd 24, 2021 I Evan witnesses mer:,pewee ant),au»eradi4.1ednniese reedier sperustitristl intannatien err Iesteneny to tu;ibic.'meeengs;any ltersan sadly agars as a nspreseintalwe ad a treigttbartiond Breslau tion mitnmui ti nrmpens tine•to**enamored!Tsar itirta appaarasea,Whether ail,is Fired mr amfbneard,Ito aaxpases&Berri O a r: 'to any disrn;and ardy person'atm only spews as s is pn+segftIibm et ea ti-tint-emsia:arnnununhy tweed orgairiteatimit'krr 1tte papaw Of s:Wing,a vent wittratit enema!,asnwe,neetion or a+eirrtbursemertl ter tie apziwarinnie. ,Page 4i f s S jO S abed '44 Baa ar i vis ,,:aoaenriane ie�aaomsraoy lsu ea:,nsvaio47nt,a31a, , / ,1 ! , • � l 'WOO O Nam eta p z8tr-z 0047PeS 011146616Ed®O t;i eq ley.s unale4s406a parnaue Lpnes 1.04 eel eWt pure %les& 4aea la L. memo 5143USUSLIXXI POI!i Z fi IPela 101 mei a6Itssls4441101 PR i0 u €e !WOW PuelssaPtin 333 NO(1Va1S!93211 iS$A68011VnNNV (£ A.rO ine$+ago eke via PERVe424471M IP e a an ittele530116111 Ms 1`eras trees —titotaqp iut1 Cautintl.10 peporpoao Sag tiggp crt perimpPelli t ue aouo -r w►vactuva ismA9801 (z "Aqqot o pa6B6ue uaaa alteu ltipeiet uo west woods aI of patios gam mot lepoaleo 6upeoeld eta Jo,`Paat,oaa uottesuedlulao se am se 6satragruathe aRstgaot Bugsa Valeo Awn anumeets paid5is B Vag fan 041 el Puttee Me I P 9 eKie3 I t e6PeleolVe Agexel I `efei arvnd Pva StIM3 u0 UOiegiuk0100 AIU003 a,11601Lue1111 at4 at Paleadde uesq sem euq eta sawn `pled ale sew we pun aupttigui tuoa parsuadsos Anemeurayne eq r>leup`JesA tpesAmot pidv Ag luguramS Pao i bee ete 414 al s W+t Is!tggol dud voge3agou Saw 1 pass se e4 Ansi Patkillian ust a ct 611100. t l ro) > ! a 10 eniti to 1%111 Akind pue 3 up J u Veq1 .et+ep e0P sql Peill 611661116MS.Pam=eq !OEMs Lep a WOGS 10 a `1.94-.1 uc ua peptimaxl se peeod1a11 eq Aeur seta sesaeued regp kin at uvulae up "ilu tuatelS) leeelegen UngeSIMIXMOO Pee emeguerle31 ea3 PlAeciert s Ala"st 818 et SIM a (ledP0PCI Am VulD AID av1 1p)) p-z impas apo Asj nt teemed 1lt3MB1V1S NOLL11SN3edNO3 ONV 3anWION3dX3 33J ISIA8901 (t %I ry :13 PVII4S 1114#f" :ISIAA9o1 JO MINN rczeftei MC mai 41-ELME lq Vala"""J79! •�8 u0vwv ',0i rt°421401i 0 DCI Vase!wow t° J • E" Miscellaneous Cash Receipt CITY OF MIAMI BEACH • No, 427464 0 Cash DCradft Card 0 Check# • 20 CSJVidof tkil7c7a7eous 04140110, 34L'Ci4—; For Payment Amount: 850.00 (THIS INFORMATION MUST SE COMPLETED) Office of Finance Director By Account Number: 1 preparsr: Dept: EXT: