2024 Lobbyist Registration Form - Convention Center Hotel 1901 Convention Center DR - David Martin (Principal) • LonY'�(l��on �c��f� �' �1•�t�
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Miami Beach, FL 33139 �
305.6737411
LOBBYISTREGISTRATIONFORM �
Lobbyisl meens all persons employed or�etainad, whalhor paid o�not, by a principal who seeks lo encourage Ihe passage,deleal w
modificalion of any ordinance, resolulion, action or dedsion oi any commisaioneq any aclion,tlecisioq recommendalion ot Ihe City
Manager or any Ci�y board o�cpnmillee;or any acCion, decisim or recommendalion of any Clty personnel during Ihe lime penod oi ihe
anlire declsion-making pmcess on such acllon, deGsion or recommendallon �ha�breseeably wlll be heard or raviewad by lhe Clty
Commission, or a City boa�d or commillee. The lerm speci�ically inclutles Ihe pnncipal as well as eny employee engagetl in lobbying
adivilles.The term"Lobbyis�"has specilic exclusions. Plaase rekr to Cily Code Chapler 2, Artlda VII, Oivision 3, enlitled'Lobbyis�s,"
(oraddilionalinbrmalion.
Inatmctlone: Please complele all seclions o(Nis lomi and aubmitlhe mmpleletl(ortn,wilh lhe applicable(ee, lo Ihe OFina o(ihe Ciy
Cierk. II you need more space lo complele an answar, use a sepe�ata shael(s)o(papec 1(you have no�hing lo report in a paificula�
secllon, you musl wrile "none" o� "nla" In Ihat seclion. Any change lo any Inbrmallon onginalty flad, o� any eddllional Ciry
Commisaioner or personnel who are also sought to be lobbied sha0 require Ihal ihe lobbyisl fle an amentlmenl lo Ihe regislrelion(ortn.
The lobbyisl has a conlinuing duty lo supply inlortnalion antl amend Iha Portns liled Ihroughout Iha panod Ihal�he lobbying occurs.
Sapa�ate regislrelion forms shall be reqN�ed(oreach pnncipal�epresenletl on each specl0cissue.
1. LOBBYIST INFORMATION:
Andrade, Rafael E.
NAME OF LOBBYIST (Lesl) (Flrsp (MlEtlle Neme)
Law ORices ot Rafael E. Andrade, P.A.
LOBBYISTBUSINESSNPMENNDAODRESS (Num�eraiMSrceQ (Clly) (Slale) (ZlpCotle)
(305)53�-9511 (305) 216-2028 ralph@randfadelaW.Com
LOBBVISTBUSMESSTELEPHONENUMBER CELLUTAHTELEPHONENUMBER EM4ILADDRE55
II. PRINCIPAL INFORMATION:
Matliq David
NHMEOFPRINQPAL (Lasl) (Flisp (MltltlleName)
MB Mixed Use Investmenl, LLC 331�Mary Slreet, Suile 302 Coconut Grove FL 33133
PRINCIPNLOUSINESSNAMEANDAOORE55 (Numbe�and51ree1) (Clty) (Slale) (ZlpCotle)
(305)416-4556
PRINCIPAL BUSMESS TEIEPHONE NOMBER CELLUTAR TELEPHONE NUMBER EMAIL AOORE55
Pursuenl W Clly CoOe SeGlon 2-984(M1)(t)(a): A principal W any coryorallon,pailne�sM110�o�a���en01y w1w appea�s a a lobbylst on beM1elf o�Iha�
enllly,wIO�aW npeclel compemallon or mlmbusamenl br tlte appearance,wneNar tlhecl,IMlrecl,or conOngml,lo evp�eas s�po�l of«oOVa+��lon to
an Ilem shell reglaler wll�IM C6�k m requlretl b/11�I5 subsecllon bul sM1ell nol ba requLetl lo pay any regisimllan leas.
If the principal Is a Corporatlon, Partnership or Trust, the tollowing Information MUST be provided
pursuant to City Code Section 2-462(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY Qf none,wrile N/A): DeVld MdRin
. NAME OF ALL PERSONS HOLDING,OIRECTLY OR INDIRECTLV,A 5%OR MOREpOW� ^NEIRSHIP INTEREST IN SUCH
CORPOftATIOI�N,PARTNERSHIPORTRU�S{T�Q�fn�on�e,.�w�tlt/eNlA): �-D�O r�/�'��� A
��/L �.h/�� �V<�.J�IC L�� ��f�E-�
Page 1 of 5
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III. ISSUE TO BE LOBBIED:
Descrlhe with as much detall as is practical, including 6ut not limited to a specific descriptfon where
applicable of a pentling request for proposal, invitation to�`bid, or p/ub�lic hearing numnber1.
Miami Beach comention center ho�el and related malters. / /J� [.r..� C�.�.� ��
IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482�a��4), Iist the Clty Commissloner or City personnel sought to be
lobbled, and whetherthe loh6ylst has entered Into any contractual relationship (pald or unpaitl) with
said City Coinmissioner or Cily personnel from 72 months preceding such commencement of service
with the City to the present date,statlng the general nature of the subject contractual relationship.
Full Name of Intllvltlual and Contractual Relatlonship pf yes,explain) VES NO
Tille of Person to be Lo66ied
Mayor and Ciry Commission x
All Ci� Boards and Commillees x
All City SIaH X
Pursuant [o qly Code Section 2-482(g), every registrant shall be required to stafe [he extent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearance of an improprlety,with any curren[City Commissioner or City personnel who Is sought to
be 1ob61ed as Identitied on the iobbylst registration form filed.
List eny Business, Flnancial, Famillal or Professlonal Relalionship, or other relallonahip giving rlse to en
a earance of im ro riet If none write NIA :
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):
$12,500 per month
Page 2 of 5
The fallowing slx(6)queetions M115T be answeretl:
1) Pursuanl to Cily Code Secllon 2a8B,an(illed Rmhibi(etl Campai9n Coniributbns By Lobbyisls On Procurement Issues":
Yesx No: A I bb I t tll bitl f tl I t r servl es r on a 1
paOtllnaaWeYtlfOftlOOtle e0U10111B0t0I9eryICB7
2) Pursuant lo City Code Section 3-690,antilled'Pmhibited Cempaign ConlribWions 9y Lobbyists On Real Eslate Deveiopmenl
Issues".
Yosx No: Are ou lobb In on a entl n a Ilcallon/or a�evolo ment A reementwllh ihe CI or a Ilca lon
1 ' h f I d I 0 h t lh CII ' F t L tl U M T
3) Pursuanl �o Cily Cotle Seclion Y<B]�h), any person (excepl ihosa exempt from Ihe tleilnllian o!"IobOyisP as set bhh in
Sedbn 2-481)who only appea�s as a reprasentative ol e nobia-pro0�carporelbn ar enlily wllhoul speclel compenee�ion or
relmburseman!for Iha appearence,whelher direct or Intllrec�to exprass suppotl o�or opposlllon lo any ilem,shall regisler wil�
Ihe city clerk es�equired by Ihls section,bul shail na�be�equired to pay any registra�lon fees.
YesK No: A�e vou reoresantinq a no4br-orofl[ coroonHon or en�ib wlthout aoeclal comoansallon or
reimbunementP
4) Pursoant to Qry Gode Sec�lon Y-4B1, the larm "lobbyisf'speclfceliy exGudes t�e following persws Expetl wi�nasses who
provitle only scianllliq technlcel or olner spaclalized intormelion or teslimony in public meelings;any parson who only eppears
as a represenlalive ot a neighborhood essaclalion wllhout mmpenselion or reimbu�sement!or iha eppaarance,whelhe�tlirecl,
indlrect or conlingenl,lo express suppoh o�aropposilion lo eny i�am',end eny person who only appeers as e repreaentelive o�
no4fo�-proli� communily based a�ganizalion (or Ne purposa ol requespng a grant withoul spadal compensa�ion or
�eimbursemenl!or Iha appearance.
Yesx No: A Idl I 1 tl/l t h I I M I II tl i f t ll n' I
re reaenlative o( e hoo lo w hou a eclal w a ea lo or �
reoreaenllno a no4for-omOt besatl omanlxatio� for lhe ouroose of reouealb�v a annl wilhaul
eoacial comoeneallon or reimbureemenl't
5) Pursaantto Clly Code Seclion 2-691�t), no cempaign consullanishelllobbytha Clty Commission br a periotl of 1Y monlhs
lollowin9 Iha sweenng in oi eny elacletl oHlcial�s)!or whom�he campal9n consullent pmvided campaigm m�sultiig services
wilhin Ihe past elecllon cycle.See Secllon 2-d91 lor more inlormatlon.
Ves% No: re I e i o a Iti se ican o C C s
wllhlnlheoaeteleclioncvcle7l(ves oleaaelblthelncumbanlmembetlaloltheClWCommlaelon:
Vea No: I e a t a I e then 12 monthe slnce the elecletl o�llcla s who o r
coneultlna eervlcea wea eworn In?
6) Pursuanl lo Cily Gotle Saclion 2-982(a)�4�a.,a lobbylst who has wilhin Iha past eleclion qGe pmvidetl cempelgn wnsulling
servlces lo an incumbent member of tha Clry Canmisslon(whlch lob�ying acGvity Is nol othereise pmhibl�ed by Code seclion
&491) shell tllsclose such patlicular service on �islha� IobEyisl reglsVadon fo�m and shall orellv tliscbse such oaNcular
serv'ce befora lobbvino lhe Citv Commission at a oublic meelina.
Yeax No: Hava ou mvitletl cam ai n cona Itln servicae ro an incum ent me ber a(th¢Cil Co eaio
Ithl th t 1 0 1 91f 1 II ttM1 1 b t belst fth qt C I I
Ves No: It e wer ou r Isa or dl ou recaivn economlc con Itlera lon I axch�n e r ce I
COIIBII�l�110 BBN�CB9�/
�•fNidVS, L i F�C�Gd T00ECOMPLETEOBYCITYCLERH'SSTAF�FO^N�LY p ]
AnnualRaBbhellonlea: � �Yes(V)No AmoimlPeltlb�� NCRA��eGd� �a�ePalJ-� �L/
ILobbyletfte01slm11onFo�mnulvetlentiveNllatlby: ��
I':\CL[R\S�LI\rFOfIMS\LO��YISTFOM1MS\LaUM1yISINallslrallonfnnnllevLe�10]-11-EOPE4.eloc RBVIBltl03/11/3030
Page 9 of 6
VI. SIGNATURES LINDER OATH:
ON FEBRUARV 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE OFPICE 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 8E FILED EVEN IF THERE HAS BEEN NO
E%PENOITURE OR COMPE ISATI� WGURING TH EPORTING PERIOD.'
Signalure of Lobbyist ata
I do solamnly swear or aflirm�hat all of ihe foregoing tacls, sta�ements, antl disc�osuras in Ihis form are Uue antl correct,
and that I have read or am(amiliar w pmvisions containatl i hapter 2, Art, VII, Division 3, en�iqed'Lobbyists" of
Ihe Miami Beach Cily Code an r ing requi nls� /
Signature of Lobbyisl'. Date v �
SignaWreofPrincipaC Date �� �
VII. NOTARY SIGNATURE AND SEAL:
LOBBYISTi. � PRINCIPAL
Staleot ���" "� Stateof ��
^1l � K-{,� ATA� -k��
Counly at A/�'r � /�/�J�� Caunty of.
Swom to(o�aJinned)and subscribed before me, Sworn to(or aff' ed)and subscribetl before me,
by means ofl3.physical presence by means of physical presence
or❑ line nolarizati �iy�/j�� 2 or❑{�n e notadzatipn�� �� �
�Ih' day of �'�/'"" Zd�. y �his j/li day of MfH�(.� 20�by
A�e( f�� �Ru�.b _!-lanrc�J
NAME OF LOBBYIST NAME Of PRINQPNL
Protlucetl I� _Pmduced ID
`/ FORM OF I�ENTIRCNTION FORM OF IDENTIFlCNTION
pP nall Kno �Personall�
�—��
u e ot ry Publi Signaly��of No�ta�y Public
(�.T 5�'-. l:A+�un �D. �wH'e-tx
ame o(Nolary T ed Print r Stam etl Nama of No[ary Typed Printetl or Stampetl
�
':•�. CHPRLESIOAGOSTM � �41 AL AIIIIII A 1
(NOTA Y�'. ��MISSION#HH165]05 (NOTARV SEAL)�� i �4 n� � v�� ii �y � �Fi d I
4 E%PIRES:OacemEer14.2U25 C n I�N nnu i I
��'�' Pud'CUn0.4wMxs �l V� MYl �-*V
___ ¶YlN01dIY M I 1l E4J4
�ThelBrm"106 . � . � .^.. ^ �.•: �•� .•.
Expetl wilnesses who pmvide onty sclenliliq�echnlcel o�o�he�specialized inPormelion or fesllmony in Oublic meelinga;ony penon who
ony appea�s as a represen�ellve of a nelghbo�hood assoclalion wilhout compensalion or relmbursemen�for lhe appearance,wM1ether
Oirecl, indlrecl or conlingenl,lo express support o!or opposlllon to any ilem:entl any pe�son who only appears as a representelive of �
nobfo�-p�o�i�community besed orgenizatlon br Ihe purpose ol requesling a grant without speciel compenselion o�relmbutsemen�!or
the eppeeranca,
Page 4 of 5
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Ciy ef Miami 9mah,V00 Canveniion Cenier�rive,Mlami Be«h,Fbrida dJ I A9,www.mivmlbeochil.gw
Olflca af ihe Ciy Clerk
Rafoel E.Gronado,Ciy Clerk CilyClerkBmiomi6eachlLgov
iel:305.673741 I,Fax�.305.6737254
NAME OF LOBBVIST: Rafael E. Andrade, Esq.
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuanl 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 Stalement
(Statement). In addition to any ather 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 dale. The City Clerk shall nolify lhe Miami-Dade County Commission on Ethics and
Public Tmst of the failure of a lob6yist (or principal) to file the Statement or pay the
assessed fines affer notification.
Any lobbyist, who fails to file the required Statement by April 30�^ of each year, shall be
automatically suspended from lobbying until all fines are paid, unless ihe fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust,
I hereby acknowledge that on Fe6ruary 28 of each year, I shall submit to the Ciry Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to ihe 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 flle a Notice of Withdrawal with the Office of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall 6e requiretl for each 12-month period
commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursu � �65ection 2-482 of the Mlami 8each City Code.
� y 2
ignature of Lo6byist Date
f1(:tfiP1SMLVFOflM540PflYIfiiFOPMSROW�falqqlalrellmFormPMeM 019APEGEa
Page 6 of 6
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� Misc�llaneGus Cash Receipt
CITY OF MIAMI BEACH No. 433205
❑Cash C7Credit Card OCheck N - $ - � � `�
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Ciry ot Miami Beach
. Miscellaneous- MCR-2024
006797-0009 Philip�...O710fi/2024 09'OOAM
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Payme`R Amount: 350.00
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