Matthew S Barnard - Mount Sinai Medical Center rilam--5tACt: At cc,
RECENED
I AAA.I ;'EdrAL. . Office of the City Clerk ^�AN 21
�6 2D 2
1700 Convention Center Drive
Miami Beach, FL 33139 CITY O MIAMI BEACI-{
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.
• 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:
Barnard, Matthew, S .
NAME OF LOBBYIST (Last) (First) (Middle Name)
Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) ' (State) ', (Zip Code)
305-674-2777, matthew.barnard@msrnc.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Santorio, Gino R.
NAME OF PRINCIPAL (Last) \ (First) (Middle Name)
Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-674-2777 gino.santorio@msmc.com
' . . . PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
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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:N/A): Gino R. Santorio
• 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):'N/A.
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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;proposak invitation to bid; or public hearing number:
All aspects of design, permiting and building of a parking gara9e and cancer center on Mount Sinai Medical
Center's Miami Beach Campus:'
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
Planning Department
Building Department
Administarion
Mayor and Commission :
•
•
Pursuant to City:Code Section 2=482(g), every registrant shall be: required :to state the extent'of any
1 . 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 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):. •
N/A . .' . . . .
•
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":
—Yes4No: 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":
Yeslo: 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.' .•
es 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_No: 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 fora 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 41o:. . .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 .No: . I^ s ' i, ,, u :;`; c€'1=1 12 m in:'s , c:' tth el: o j It ,,) ".e 11 it p 1 0 4:, e. e-Th
s , a o 1, •
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. : . .
Yesflo 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 CityCommission:
.Yes:. No: ei• ,oil p"om•sel1 cro d`, oT1 't:5-, : : , eo, - t`a in : en,nt, .-a. ,4-0
' . • • TO BE COMPLETED BY CITY CLERK'S STAFF O Y. ' • -
AnnuallReg,i'sfratl'onlfee3 [( ]Yes, ]]No) Amount�Paidl$1 MCR;#? Date�Pai'tli _ ,
• LLobbyist�Regisfrati'on7Formlrecelvedl add verifiedlby _ zJ..J • , •
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VI. SIGNATURES UNDER OAT
• ON:FEBRUARY 28 OF EACH'Y• R, 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 CO ENSATI •N DURING THE REPORTING PERIOD.' - : .
Signature of Lobbyist: Date January 24; 2022
.I do solemnly swear or affirm th- all of thz oregoing.facts,.statements, and disclosures.in this form are true and correct,
and that I have read:or am f-• iliar wit e provisions contained in Chapter 2; Art. VII, Division 3,.entitled "Lobbyists" of
- 'the Miami Beach City Code -nd all r-•orting.requirements. • •
Signature of Lobbyist: Date•January 24, 2022 -
Signature.of Principal: �' :ram'► `-i ..DateJanuary 24, 2022
VII. ,.NOTARY SIGNATURE:AND SEAL: : : • . : . . :
• • :LOBBYIST: . . . PRINCIPAL . ' . . .
State of A[>e-1 D A State of l 012;l
. County of: '11 1-r)1—DAcDe. County of: Hol-f�i---'DA D g •
Sworn to(or affpmed)and subscribed before me; Sworn to(or affirmed)and subscribed before me, '
by means of f physical presence. • ' • by means of•EB'physical presence - . .
: or 0 online.notarization, or❑online:notarization, : :
this: 24 day of'?V UFf.2C4 , 20nby this 211 dayooff � 4()U R-t'�dn , 201,?-by
•
�F}'H'h Glt1 S. A rui l�0 t`�: •)Qrll - lO 2t tJ
NAME OF LOBBYIST : :NAME OF PRINCIPAL '
Produced ID • Produced ID • . .
• • ' •, ' • •FORM OF IDENTIFICATION. FORM OF IDENTIFICATION ' . -
s' ersonally.Known P rsonally Known. • . ' '
•
Signature of Notary Public. : Signature of Notary Public
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Y A,I.J t ne✓ L '22. . ; . Pt,tcre. .o,�e2 - . .
Name of Notary,Tyrrd_ -riot - orStanioed. __ m:Nae of Notary, Typed,.Printed or Stamped •
tar. •• PAULINE LOPEZ I .. .
' - • NOTARY:SEAL i?Q: Notary Pubur State of Florida . NOTARY SEAL) • a►+''.. • PAULINE LOPEZ : I . •
(. ) I I ( . �:. .
. _o` Commission#HH 132456 . i fr q, Notary?Olio-State of.Florida
: : : : . I or'.a'' .My Comm.Expires May 30,2025.I : : : . : • ,� e_ • Commission#HH 132456
Booed through National Notary Assn. :rop My Comm.Expires May 30,2025
. • • - Bonded through National Notary Assn. I
' '•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;end'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. . . . . . . . . .
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I 'I: I EACH
City of Migmi Beach;1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
Office of the City Clerk
Rafael E.Granada,City Clerk : CityClerk@►miamibeachfl.gov
Tel:305.073.7411,Fax:305.673.7254
NAME OF LOBBYIST: Barnard, Matthew, S
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 LOB: REGISTRATION FEE
unde and an al registration of.all lobbyists shall be required for each 1:2-month period
co • encing ictober 1 of each year, and the.fee .for such annual registration shall be
• . ',.00:00.p uant to Section 2-482 of the Miami Beach City:Code.
January 24, 2022
Signature of Lobbyist: Date
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