Nicholas J. Rodriguez-Caballero - Elaine R. Levine Living Trust DocuSign Envelope ID:CB3C4D8O-DACC-47E5-BF49-C13211B5DD4A 33 3 Awz_
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Office of the City Clerk .
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1700 Convention Center Drive CITY OF
Miami Beach, FL 33139 OFFICE OF THE CITY CLERK
305.6731411
'LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whetherpaid 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"Lobbyists 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 forrmand submit the completed form,with The applicable fed, 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 “p/a" in that sectron. 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 spedifio issue.
I. LOBBYIST INFORMATION: -
Rodriguez-Caballero Nicholas
NAME OF LOBBYIST (Last) (First)" (Middle Name)
Bercow Radell Fernandez Larkin&Tapanes, PLLC 200 South Biscayne Blvd.,Ste. 300 Miami, Florida 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number and.Street) '(City) (State) (Zip Code)
(305)374-5300 nrodriguez@brzoninglaw.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR.TELEPHONE NUMBER EMAIL ADDRESS
if. PRINCIPAL INFORMATION:
„ Levine Alan . . W..
NAME'OF PRINCIPAL '(Last) (First) (Middle Name)
Elaine R. Levine Living Trust 3350 Mary Street Miami Florida 33133: •
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (CitY) (State) - (Zip Code)
305-3.72-1350 „ „ . awl@levinelawfirm.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 2482(c):
* NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY,(if none,write N/A): Successor Trustee, Alan Levine
• NAME OF ALL PERSONS.HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): Please see the attached.
•
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Lobbyist Registration Form - NR - executed.pdf
DocVerify ID: F0D85831-60C9-48F3-873B-C9B63CA81 D86
Created: December 08, 2021 08:31:20 -8:00
Pages: 6
Electronic Notary: Yes /State: FL
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E-Signature Summary
E-Signature Notary:Diana Ramos(dra)
December 08,2021 08:32:38-8:00[C010A0785836][162.244.152.118]
dramos@brzoninglaw.com 11
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I IIIIIII IIII IIIII IIIII IIIIII IIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
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ii visible electronic signatures contained in this document are symbolic representations of the persons signature,and not intended to be an accurate depiction of the persons actual signature
as defined by various Acts and/or Laws.
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DocuSign Envelope ID:CB3C4D80-DACC-47E5-BF49-C13211B5DD4A
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..
Development.Approvals &Planning.Issues,including b ut not limited to the Historic Preservation Board,
Design Review Board,Planning Board,Board of Adjustment, Land Use Development.,City Commission,
and any City Workshops.or Committees,if necessary,relating to the property located at 3333 Garden
Avenue in Miami Beach, Florida.
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
Staff for the Planning &Building Department None X
Public Works &City Admin.istration,,PB HPB,BOA None X
DRB,City Commission, and Mayor as necessary None X
Land Use &Sustainability Committee None 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
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):
None
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):
$210 per hour
Page 2:of 5
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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 qoods, equipment or services, or on a present or
pending award'for goods,equipment orservice?
2) Pursuant to City Code Section 2-490, entitled"Prohibited Campaign•Contributions By Lobbyists On Real'Estate Development
Issues
_Yes xNo: Are you lobbying on a pending.application for a.Development Agreement with the City or application
for change of zoning mapdesignation 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;far-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 xNo: 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 XNo: Are you providing only scientific, technical or other specialized information: appearing as a
representative of a neighborhoPd 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 ieimburseement?
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 whomithe campaign consultant provided campaign consulting services
within the past election cycle. See Section:2-491 for more information.
Yes xNo: Have you provided campaign consulting services to an incumbent member of the City Commission
within the pastplection cycle?If yes,please.list the incuinbent.member(s)of the City..Commission:
Yes X tvo if yes tins i#been less than 12.Months since the'elected otfioiai s).whom:you provided 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 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 at a public meeting.
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 listthe incumbent member(s)of the City Commission:
•
_Yes:X No: If yes were you prop ised'+ r did.you receive`economic-considerations in exchange.for'campaign
consulting services't.
TO BE;COMPLETED,BY'CITY CLERK'S STAFF ONLY
f
Annual Registration fee [ I Yes[ No Amount Paid 6 d MCR# l . 1�}iZO Data Paid-''( Z
Lobbyist Registration Form,receivedxand verified by.; - a
0:Ndi , $A1-1,AaFOiti siLtiai3YISTyc.?Rtb15 I.iabbyi fi if giakraGo»i=orm rta i e4,9X26 i8 C3Efii dr+e,,. ;R vised;o9lzojaoas
Page 3-of 5
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Vt. 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 COMPE IONnOURING THE REPORTING PERIOD.'
Signature of Lobbyist: leoetvir,-) aate 12/08/2021
1.11A8bD5439244EC •
I do solemnly swear or affirm that all of thaforegoing facts, statements, and diacloautes in this form are true and correct,
and that I have read or am familiar with the provisions contained in Chapter 2, Art VII Division 3,'entitled.ul_obbyists" of
the Miami Beach City Code any - ctuptcrtfrirequirements.
Mth. re/1 •
Signature oftobby0:. Date 12/08/2021
AmplAbb1.1543914•EL..
Signature of Principal: ‘*!1!inalme Date /-)- 21
VII. NOTARY SIGNATURE AND.SEAL:
LOBBYIST: PRINCIPAL
State of Florida State of Florida
County of: Miami-Dade „ County cif: Miami-Dade
Sworn to.(or affirmed)and subscribed before me„ Sworn to or affirmed)and subscribed before
by means of 0'physical presence by means of 0,physical pretence
or E online notarization, or V4, me notarization;
this R day of December ,2021, by. this, • day of December , 2021, by
Nicholas ROdrignez-Caballero Alan W. Levine
NAME OF LOBBYIST NAME OF PRINCIPAL
Produced ID Produced ID.
FORM OF ioENTIFioKrioN FORM OF IDENTIFI ATION •
x personally Kno X Personally n
Signature of Notary Public. Signature Of Note Publie
Diana Ramos -Ziana-Ramos ertijeS
Name of Notary, Typed, Printed or StaMped Narrie of Notary.,Typed, Priritad or StamPed
(NOTARY : MERCEDES LPEREi
Diana Ramos MYCOMMISSIONSIGG849928
Commission#GG 308355 4 •-r•
EXPIRES:February 16,2024
Ootary Public-State of Florida , Boded ThruNotaryPublicUndeiwatera
gy Commission Expires Apr 10,2023
T ca persons:
, 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:
Page 4 of 8,
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City of Miami Beach,1700 Convention Center Drive}Miami Beach,Florida 33139,www.miamibeachfl.go4
Office of the City Clerk
Rafael E.Granado, City Clerk CityClerk@miamibeachfl.gov
Tel:,305,673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: 'Nicholas Rodriguez-Caballero
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section .2-4485(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 Hof 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 Tcplendar 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
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
,—DocuSigned by:Mda.
l U15
12/08/2021
\—piAB3D3439244EC
Signature of Lobbyist ...
Date
F:\CLERISALUaFORMS\LO88YIST'FORMStLobbyist RegisVelion Farm Revises 03-11-20,R1:G.doc
Pages.of 5
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Disclosure of Interest for.Elaine R. Levine Living Trust
Name Percentage
Trustee, Elaine R. Levine
3350 Mary Street
Coconut Grove, Miami 33133
Successor Trustee, Alan Levine
3350 Mary Street
Coconut Grove, Miami 33133
Beneficiaries:
Alan Levine 25%
3350 Mary Street
Coconut Grove, Miami 33133
Kenneth Levine 25%
3350 Mary Street
Coconut Grove, Miami 33133
Robert Levine 25%
3350 Mary Street
Coconut Grove, Miami 33133
Tina Fitch 25%
3350 Mary Street
Coconut Grove, Miami 33133
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