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Alfredo J. Gonzalez/Tala Const. City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 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, dedsion, recommendation of the City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined in any manner In this section, 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 activ~ies. The tenn -lobbyists- has spedtle exduslons. Please refer tD Ordinance 2004-3435. Gonzalez Alfredo J. NAME OF LOBBYIST: (last) (First) (M.!) 1221 Brickell Avenue Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (05) 579-0500 TELEPHONE NUMBER: (305) 579-0717 FAX NUMBER: gonzaleza;@gtlaw.com EMAIL: I. LOBBYl51' RETAINED BY: Tala Construction Company NAME OF PRINCIPAL/CLIENT: Jr.Zl5 N.W. 12 Street BUSINESS NAME AND ADDRESS Miami (City) FL (State) 33126 (Zip Code) (Number and Street) (10,) 477-1116 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section If prlndpalls a Corpol'lltlon, Partnership or TRlst [5ecl:Ion 2-482 (e)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: Historical Preservation Application for Ocean V. Issue to be lobbied (Describe in detail): () 0 .s:- -< :II:: .~ ::,:... --< III. CITY AGENClES/INDMDUALS TO BE LOBBIED: ~ ' A) Full Name of Indlvldual/Tlt:le B) Any Flnandal, Familial or Professional Relal:lOnS~ .1- . 'h. 0 -F See attached ..,., '.p. -n n ~p 1Tl ::.:0 m o m < m I:) IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYlSf COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) $250.00 per hour B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $250.00 per hour Yes No: x Are you reDre5entina a not-for-Drofit CIOl'DOratlon or entitY without SDedal CIOmMnsatlon or reimbursement. Pursuant to Ordinance No. 2004-3435, 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2. Article VII. Division 5 Thereof Entitled "CampaiQn Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Procurement Issues": Yes No: x Are you Iobbvlna on a Dre5ent or DeIIdina bid for aoocIs. eaulDment or serv\cles, or on a Dresent or Mooing award for aoocIs. eauiDment or senlice? 2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5 thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues": Yes No: x Are you lobbvlna on a MOOina aDDlication for a DeveloDment AGreement with the at\' or aDDlication for change of zonlna maD designation or chanae to the CitY's Future Land Use MaD? Y. SlGNA1VRE UNDER OATH: ON OCTOBER 1 Sf OF EACH YEAR, EAat LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING NDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO D MPENSATION DURING THE REPORTING PERIOD. I do solemnly swear that all of the foregoing facts are true and orrect and that I have read or am familiar with the provisions con e i Sectio ~- 82 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYlSf IDENTIFICATION: PRlNCPAL IDENTIFICATION: Produced ID Produced ID -Form {)f ldeQtification Form of Identification Personally known (Principal) YD. State of Florida, County of Miami-Dade Sworn to and subscribed before me This ~ day of 20Rt State of Florida, County of Miami-Dade Swom and subscribed before me This _day of , 20_ Signature of Public Notary - State of Florida Notarization of Prindpal's signature FOR CLERI('S USE ONLY % t:::". I I n \ L Annual Registration fee: [ ] Yes [~No Amoun~ld I)..fj', 0-0 MCR # ~ ? L-/ loate Paid ~ Lobbyist Registration Form received ana.verlfied by: ~~ ' Revised 02{10{04 F: CLE~ ,LL\I,IAruj\-I"\L'[)BYIST\LOBBYIST FORM 04 Ureenberg - M1ami 0/;:1/2004 11:40 i-lAUJ:. ;:1/0 Highu'ax IV, ........ ....... 01 'IIIMI AIID AIIClUImI 01 u.ftIST CONJlIIIMr1OllI (MW'I......,... HOURLY, RAT !tA71' 011 lmIfIQ: 11) I.OII8'IJSTlllSCl.OSUR!:~ $250.00 per boUT Il) 1'llINClIW.'S DJSCl.OSURE (OF LOIIIII'lST lXINPEHSAnOHl: ~. $2SG.tlO per hoUT y_ No: x...VDII.....-nIIr....IIat.fDr.arallt~RIIlGJ".................~I~1llIIll. .... loW I'8IMIK-.4IL..1t. IVsuant to A.~...1Io. 2OCM-S435. 1) v_ Not 2) Yeti He: Y. PiIl'!lUl!l,*m~JIa.. ~_~ A~lnll MIAmI ~ atvr,.,.. ~tf!r2..~vn. DIwkIon!i 1lIl!n!d EnlIIIlld "almllllan FNIlCll! Rertlrm" VIa The Adclllon 01 /Moo l:N'tWI 2-488 - "ProhIbIted Camn:olnn CDnbIbulIOM Bv I nhhv1!ls On PrccuremenI: Jssues"- x ..._IU..IIIDr1.....t.........lIlIhlclf...n ~ "'-'-III'.-t~ .._.~ 111'...... --.lfIlr__~ClI'''''? Pu-.Jant to G..&'_1laa No ...,.......... Arni!!ndina MiIImf ~ ~ <'....... ~ 2.. Ar&:IB VII DIvWDn 5 lIE""" I:rtftIed "nunnallln FilaI1Cl! Reform", VIa The Addllan 01 rrdo! l:N'tWI 2-490 Fntfl...t "Prohlblb!d C"JlrnNlkIn 0VItrIk.ti0nI1ht 1 ~ On RMI ~ DI!veJoaI'ftri teet fIIttl!I. x AN VDU IAWMItG on........nna aBDIIc:at:km far. O::-te. ..... A8~""'1fNt t'Jtv Dr MIIIIm1tDn fer dmna8 flII IDI'IIIIB II'1II11 dell8lUltllm or LtIIInDete the aw............d OM ....." RlIM1VUUIIDIR OATH. ON OC'1'OBER 111' OF EAOf YEAR, EAQf L08IYI5I' SHALL SUIMET 10 1HE an' a.ER.K A SIGNB) "'''TI!MeNT UNDER CM11l, llSTING LOIIIIYING EXPENDITUIa!S, AS WIlL AS ClOMPENSA11Ol'I RECElYB), IN THE a1Y OF MIAMI IIEAOt FOR THE PREaDING CALENDAR YEAR. A srATBGNT SHALL lIE FD.ED (YEN If TltERI! HAVE BEEN NO EXPEN0111IRES OIl GOMPENSA11ON DUIUNG THE MJIOR1JIIIG PIRIIJD,. SIgI\IlIft ar La~ I do solermly swear that ell of tne foregoing racts lire true lIIId CIClmlCt end that I hllYe relId or 11m /'amlllar with the pmvlslons contained In Sectlon 2-492 of the Miami Beach Oty Code and all reporting requirements. ~ Slgnatue of l..obby(st: Slgnal\re of Pr1nclpaVOlent PlUflaPAL IllIImI'ICATlONI VL LOU'fI5T _...."""11Otl1 Procbied ID Produced ID Form of rderdlc:atlon PeI'SllllllIy known (LaIIbrIIQ VII. smNA11R! AND RAMP OF NOTAR.V: Stale of FIorlda, County of Mlamf-Dade SWorn to and SJb5aIled before me This ~of .20_ ~ of ldentlllcatlon I'ersonBIy known ~ SIgIlllI1n d PoiJIIc NalZIIy - StatE of Florida Ncltarlzlllgn of LDllllyl5t'a 5Igubn .~y~ ZULMA..I.ASSAEL .: MYCOMMISSIONIIf 00061328 ~ 01 ",,,' EXPIRES: September 30. 2005 1..acll).3.N()TARY R.. Notary Service & Bondng. Inc. !'lOR Annuel Reg/5IrItion fee: { l Yes t>.d No Amount Pold lllbbylst RI!lIIslntian fcrm re~tVecf.nd YmtI.d by: _led 02(IO/~ f: CLER\Al.l\ '16131{ \ Dall!Pold ~ 88YIST fOlU>l ~ Mayor David Dermer Commissioner Matti Herrera Bower Conunissioner Simon Cruz Commissioner Luis R. Garcia, Jr. Commissioner Saul Gross Commissioner Jose Smith Commissioner Richard Steinberg Jorge M. Gonzalez, City Manager Mayra Diaz-Buttacavoli, Assistant City Manager Christina Cuervo, Assistant City Manager Robert Middaugh, Assistant City Manager Mary Greenwood, Executive Assistant to the City Manager Ramiro Inguanzo, Chief of Staff Tim Hemstreet, Special Assistant to the City Manager Murray Dubbin, City Attorney Donald Papy, Chief Deputy City Attorney Code Complianee Division Al Childress, Division Director Eric Wardle, Jr., Assistant Division Director 305-673-7000 exl. 6787 Kristal Caron, Office Manger Fire Department Floyd Jordan, Fire Chief Planning and Zoning Department Jorge Gomez, Director William H. Cory, Director Design, Preservation and Neighborhood Planning Division Annando Valdes, Planning and Zoning Manager Thomas R. Mooney, AICP, Design and Preservation Manager Steven Green, Office Manager Chuck Taft, Boards Administrator April Hirsch, Secretary to the Board of Adjustment Juan Diaz, Planning Technician Antonieta Stohl, Receptionist Permit Review Process Ricardo Guzman, Planner, Planning & Zoning Kevin Perkins, Planner, Planning & Zoning Marija Surev, Planner, Planning & Zoning Christopher Dunn, Planner, Planning & Zoning Mark Sean Finnen, Planner, Planning & Zoning Planning Board Mercy Lamazares, Sr. Planner Stephen Foren, Sr. Planner, Planning & Zoning Board of Adjustment Annando Valdes, Planning and Zoning Manager April Hirsch, Secretary to the Board of Adjustment Historic Preservation Thomas R. Mooney, AICP, Design and Preservation Manager Shannon Anderton, Sr. Planner, Design & Preservation Design Review Board Thomas R. Mooney, AICP, Design and Preservation Manager Laura Quenelle, Sr. Planner, Design & Preservation Neighborhood Planning Joyce Meyers, North Beach Planning Coordinator Reuben Caldwell, Planner, Design & Preservation Charles Buckles, Sr. Plans Designer Katia Hirsh, Planner Public Works Fred Beckmann, Director < Michael Alvarez, Assistant Director Engineering and Construction Division Environmental Resource Division Bruce Henderson, Environmental Specialist Streets and Streetlights Division Transportation and Concurrency Management Joseph Johnson, Director Amelia Johnson, Transportation Coordinator Henry Johnson, Senior Planner, Debra Hart, Office Associate Water and Sewer Division Nathan Pope, Water and Sewer Utilities Superintendent John Kranick, Streets, Streetlighting and Stonnwater Superintendnet A.D.A. Compliance / Heidi Johnson-Wright, ADA Coordinator Building Department Phil Azan, Building Director Hamid Dolikhani, Assistant Director Richard McConachie, Chief Building Inspector Jeri Dee Goodkin, Senior Building Inspector Permit Counter Evelyn H. Sanchez, Office Associate IV Electrical Gary Ortega, Chief Electrical Inspector Plumbing Paul Elledge, Chief Plumbing Inspector Structural Mohammed Partovi, Chief Structural Plans Processor Mechanical Paul Raymond, Chief Mechanical Inspector MicrofilmlStorage Omar Castellanos, Building Records Manager Elevators John Antona, Chief Elevator Inspector Accessibility Gladys Salas, Chief Accessibility Inspector