Larry Gene Fields II - Fantasy Theartre Factory, Inc. CA-& GfAime
RECEIVED
MIAMI BEACH Office of the City Clerk MAY -5 2022
1700 Convention Center Drive
Miami Beach,FL 33139 CITY OF MIAMI BEACH
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 indudes 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.
)nstructlons: 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:
Fields II Larry Gene
NAME OF LOBBYIST (Last) (First) (Middle Name)
Fantasy Theatre Factory, Inc. 6103 NW 7th Ave Miami FL 33127
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-284-8800 786-356-6347 larry@ftfshows.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Fields II Larry Gene
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Fantasy Theatre Factory, Inc. 6103 NW 7th Ave Miami FL 33127
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-284-8800 786-356-6347 larry@ftfshows.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
l ursuant to Cit4Cale Se'dloi2^-I82(ti)(1)'(a): A principal of a corporation,partnership,or other entity�who appears as a lobbyist on t ehaff of(thal
tity without special compensation or reimbursement for the appearance,whether direct,Indirect,or contingent,to ex eau a"it of• . j -t
i)=Oa re!later with the( 1J2lD r o u red iwn subsection(x,,3an 3CD r-�ulred cif)a =•istratton
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): Larry Gene Fields II, CEO
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): 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 proposal, invitation to bid,or public hearing number.
Fantasy Theatre Factory is a not-for-profit touring theater company.We submit grant applications for program
support for programs that will serve Miami Beach venues.We attend grant panel meetings and communicate
with department staff as necessary to administer our grants and to assist with any issues related to the application.
We deal primarily with the Department of Tousism and Cultural Development.
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
Brandi Reddick, Cultural Affairs Manager X
Julio Rodriguez,Cultural Affairs Grants and Operations Administrato- 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 flied.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
appearance of impropriety(if none,write WA):
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):
There is no lobbyist compensation paid.
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1
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 XNo: 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 Rio: 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 Citv'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.
XYes_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.
XYes_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 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 XNo: 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: IM. If yd'"es�has7itabe®�11than�l2i nthTin�theTelectedFrifticiai(s)Twhom you provided campaig
consulting servi es was sworn In?i
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 XNo: 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: yes, were you promised or did you receive economic consideration in exchange for campai�_n.
consuitingEservices?{
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
1Sjn ntflRegistration=B g""''ulr"�'1 i tPald$ 4. '` " CR# '&+ �' Date Paid, •
Lobbyist( 1 ,J receiv•dQ 'veri ed( • •''`. a Pest^ 4 + � ;
P:ActEp.k ►LLNakORMS\LOBBYIST FORMS,Vpbby,i Regi_ratio'nlF.�o m Rey 03.11e2OWterdoc r, + Rtivised 0341/2020 _)
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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 CALENDA: YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOB: .A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DU' •'G THE : -• -TIN ' RIOD.1
Signature of Lobbyist: I Date
I do solemnly swear or - •-' all . t e foregoi•• =. -, atements, and disclosures in this form are true and correct,
and that I have read • - -miliar wit he pr. ' io s con in Chapter 2,Art.VII, Division 3, entitled"Lobbyists" of
the Miami Beach C' i e and all orting e .
Signature of Lobbyist Date --C/(( )-O 2 Z
Signature of Principal: Date S I t / G �,L
VII. NOTARY SIGNATU AND SEAL:
LOBBYIST: PRINCIPAL
State of l j (D A State of D 01 0 A
County of: I I•IVA)-14erpg County of: R1 A'IM) --t*D
Sworn to(or affi ed)and subscribed before me, Sworn to(or affi )and subscribed before me,
by means of physical presence by means of kkofhysical presence
or 0 on ine notarization or 0 online notarization,
this day of M.Q.I 20 by this day of IL(i A ( 20 by
£cr 6y Q(Lr 7 Lw—. � �- cI&
NAME OF LO YIST NAME OF PRI CIPAL
_Produced ID Produce ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
V Personall Kn _• '• .IIy Known
Signatu No Ty P Si, aAte of Notary Public
Ar
Name of tary,Typed, nted or Stamped ame of Note' ,Typed,Pri "-• or Stamped
Ors
` COMMISSION#06297178
COMMISSION#06297178
• •-1 •' d le following persons:
�1 y 30,
' boded Tha Iwo M
Nobly �' . • '
Expert witnesses who provide only scientific,technical or other specialized in •rrnati r ► stimoony in08pu'61 c rffeetings;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.
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i
MIAMI BEACH
City of Miami Batch,1700 Convention Center Drive,Miami Beach,Florida 33139,Hww.miamibeachfl.gov
Office of the Ciiy Clerk
Rafael E.Granada,City Clerk CityClerk@miamibeachfl.gov
Tel:305.673.7411,Fax:305.673.7254
NAME OF LOBBYIST: L AP 6c ,.sCC lJc
*-
1) LOBBYIST FEE EXPENDITURE A 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-Dad 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 Statemen , 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 y4ar, I shall submit to the City Clerk a
signed Statement under oath listing all lobbyist exp nditures, 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 Wthdra ` al 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 Oct er 1 of each year, and the fee for such annual registration shall be
$500.00 pursu to Section 2-482. f the Miami Beach City Code.
_____74_61:. . .__
S' at of Lo Date
F:ICLERI$ALL1aFORMSLLOBBYIST FORMSLLobbyist Registration Forth Revised 03-11-20 REQdoc
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