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2024 Lobbyist Registration Form - Bus Shelter Technology (Brian Shuford bu5 Sl,��,� -r�n olu9�J -;r . �; MIAMI BEACH o,��eof�he��Y��e� »�G 1700 Convenfion Center Drive Miami Beach, FL 33139 . � .. . .. '- ":!.:H 305.6737411 .. . . . . ' , '�°k LOBBYIST REGIS7RATION FORM Lobbyist means all persons employed or relained, whelher paid or not, by a principal who seeks to encourage the passage, defeat or modfication 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,tlecision or recommendation of any City pereonnel dunng the time penod of Ihe antire tlecision-making process on such action, decision or recommentlation ihat foreseeably will be heard or reviewetl by Ihe Ci�y Commission, or a City boaN or committee. The term specifically inclutles lhe pnncipal as well as any employee enga9ed in lobbying activities. The term"Lobbyist" has spacifc exclusions. Please refer lo City Code Chapter 2, Article VII, Division 3, entitletl 'Lobbyists," (or adtlitional information. Instrvctlons: Please complete all sections of Ihis form antl submit the completed form,with Ihe applicable fee,to the Office of�he Ciry Clerk. If you need more space to complete an answer, use a separate sheeQs) o(paper. If you have nothing to report in a particular section, you must wnte "none" or "Na" in that section. Any change to any infortnation onginaly fled, or any additional Ciry Commissioner or pereonnel who are also sought lo be lobbied shall require ihal lhe lobbyist file an amendment to�he registralion form. The lobbyist has a continuing duly to supply informa�ion and amend �he forms fled lhroughout lhe period iha� Ihe lobbying occurs. Separa�e regislration fortns shall be required for each pnncipal represen�ed on each specifc issue. I. LOBBYIST INFORMATION: Llorente, Michael NAMEOFLOBBVIST (LasQ (FirsQ (MidEleName) LSN Partners 3800 NE 1st Ave, Suite 200, Miami, FL 33137 LOBBVISTBUSINESSNAMEANOADDRESS (NumberantlSVeel) (Ciry) (Stale) (ZipCOCe) 305-673-2585 michael.11orente@�snpartners.com LOBBVISTBUSINESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILADORESS II. PRINCIPAL INFORMATION: c NAME OF PRINqP L (Lasi) (First) (Mitldle Name) �.�sPGs �015 Qev,t Ve�Ls�c.r �.J s�„-csu) Mr�nt rt�l Qc �13n,�P5 PRINCIPALBUSMESSNAMEAN�A�DRE55 (Numberantl5treet) (Qty) (St t ) (ZpC tl ) 9�11 - qlN - �'S25 gnunC��ncicp .�_ PRINCIPAL BUSME55 TELEPHONE NUMBER CELWLAR TELEPHONE NUMBER EMAILA�DRESS Pursuant�o City Code SecU4�2�2(hxi)(a): A pn^cipel of arry coryoratlon peMerehip,w othel.entity who appeers as a lobbyiri w behaH ofiha� antiry,withnut spedal mmpensetbn or reimbursemeM for the�eppearence,whether direck��recl,or contingenl,lo exPress�eupport of or opposition lo an IUm shell reguler with.ihe CIeAc es reQuireE by�his subsection Int shall not be reQulretl to pey aery regisiratlon fees. If the principal is a Corporation, Partnership or Trust, the following information MUS7 be provided pursuant to Cily Code Section 2-082(c): `1 • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): l(AI��0.� �^�li�� . NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLV,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): \I r'htta g-y�p�y.^ Page 7 of 5 ` �� 7l_ , „ —JC� J 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. IV. CITY AGENCIESIINDIVIDUALS 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 contrectual 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 generel nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship (If yes, explain) VES NO Title of Person to be Lobbied Mayor& Staff N/A ✓ Commissioners & Staff N/A ✓ City Officials & Staff N/A ✓ Pursuant to City Code Section 2-082(g�, every registrant shall be required to slate 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 registralion form filetl. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an a earance of im ro riet if none,write N/A : 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): �4 � a�/rrmitn � Page 2 of 5 The following six(6)questions MUST be answered: 1) Pursuan�to City Code Sectian 2d88, entitletl"Pmhibited Campaign ConUibutions By Lob6yis�s On Procurement Issues": Yes XNo: ou I bb ' a a t o d'na b'd f o d q 'o t erv'ces or on a oresent or pend a artlf q ds ea 'o lorservice'+ 2) Pursuanl to Cily Code Section 2-090, entitled 'Prohibited Campaign ConVibutions By Lobbyisls On Real Es�ate �evelopment Issues": Yes XNo: A v lobbv' a a o d' u ol' C f r a � I ame t Au me t 'th the C'tv ool'cat'on f cha a f n' a a d s'a t' ch o t the C'tv' F t re Land Use Mao9 3) Pursuant to City Code Sec�ion 2d82(h), any person (excep� those exempt from lhe defnilion of "IobbyisP as set foRh in Section 2-481)who only appears as a represen�a�ive of a no4forprofit corporation or enii�y wilhout special compensa�ion or reimhursemenl for�he appearance, whether direct or indirect lo express suppoA of or opposition to any i�em, shall regisler wilh Ihe city clerk as required hy this seclion,bu�shall nol be required lo pay any registra�ion fees. Yes XNo: A e v eores f n a bf -p ofl o aFon or enftv w'thout soecial comoensation or reimbursement? 4) Pursuan� Io City Code Secfion 2d81, Ihe term "lobbyisf' specifically excludes the following persons Expetl witnesses who provide only scienlif0. lechnical or olher specialized informalion or testimony in public meetings: any person who only appears as a represenlalive of a neigh6orhood associalion without compensation or reimbursemenl for the appearance,whe�her dired, indirect or con�ingenl, lo eapress support oi or opposition�o any item; and any person who only appears as a representative of no4for-prof� community based organiza�ion for �he purpose of requesting a grant withoul special compensa�ion or reimbursement for the appearance. Yes XNo: A v a o 'd q I sc' t'f' tech ' I oth o 'al'zetl 'nformat'on� appearino as a ep t tve f 'ahbo h d assoc' t' 'thout o �al como ton or reimbursement or p senf a t fo o ft 6asetl a � atio f the ou o f rea F u a aront w thout oecial como nsalion or reimbursement� 5) Pursuanl to City Code Sec�ion 2-491(1), no campaign consullant shall lobby the Ciry Commission for a period of 12 mon�hs following lhe swearing in of any elec�ed official(s) for whom the campaign consWlant provided campaign consulting services wi�hin the past election cycle. See Seclion 2-491 for more information. Ves XNo: H o 'd d mo 'a IC q ' es t mbent member of the Cilv Commission 'th� th o t I cf I � Ii v pl I' t th ' mbent membeds)of the CiN Commission: Ves X No: If v s has 't b en less th 72 mo th 'nce the I tetl off'c'allsl whom vou orovided camoaian consult na serv'ces was sworn in? 6) Pursuant lo City Code Section 2d82(a)�4)a., a lobbyis� who has within �he past election cycle provided campaign consul�ing services to an incumbent member of the Ciry Commission (which lobbying activity is not othervvise prohibi�ed by Cotle seclion 2-491) shall disclose such particular service on his/her lobbyist registration form d hall orallv d'sdose such oaM1icular b f I bbv th Civ C t bl Cn . Ves XNo: H e v o �detl c o ' n co Il' e t �ncumbent member of the Citv Commission 'th' th ast I cf I 7 If I f t th " b t member(sl of the CN Commisson: Ves XNo: If v e e v omised dd vou e' e eco rti c cons'deration in ecchanae for camoaian consultina services7 � GY COV S P f TO BE COMPLETEO BV CITV CLERK'S STAFF ONLY l eu p S- � Annoal Registratlon fee: [ ]Ves[y'No Amounl Paid�0� MCR .J3� -� Date Pal� / �" Lobbyist Regislrotion Form recelvetl antl verifletl�y: L�'J_ F:\QER\§All\dFOkMS\LOBBTISTFONM$\Lobbyis<Regis[ra[imFo�mReai5etl0341-20REG.Uo< Revise003J11/2020 Page 3 of 5 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 LIS7ING LOBBYING EXPENDITURES AS WELL AS COMPENSATION RECEIVED FOR THE PRECEDING CALENDAR VEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A S7ATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION URING THE PORT NG PERIOD.' SignaWre of Lobhyist Date 31 U� 1 zy I do solemnly swear or affrm that I�of th regoing facts, statements, and disclosures in this form are Vue and correct, and that I have read or am familiar wifh Ihe provisions contaned in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all rep ing require ats` SignatureofLobbyist Date 3�O1 � 2� SignaWre of Principal�. Date VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of 'F�DY�G State of County of: p..�lnuv�l -(7ar�t County of�. Swom to (or affijr^ed) and subscribed before me, Swom to(or affirmed) and subscribed before me, by means of B'physical presence by means of O physiwl presence or O online notarization, or� online notarizatioq this�_day of t�IQVL� . 20� by this_day of 20_, by I"�1c1f�QC� 1 ��iC, NAME OF L09BVIST NAME OF PRINCIPAL Produced ID Produced ID FoaM oF ioENnFicnnoN Foam oF ioENnFicnnoN �rsonally Known / Personaly Known �`� SignaWre of Notary Public Signature of Notary Public �\y1f'M '�-\Vf�VO Name of Notary, Ty e ri �= Name of Notary, 7ypeQ Printed or StamOed �� NVIEM PfVERO (NOTARYSEAL) �/`��-, N � noum��s�nreorrmdea (NOTARVSEAL) y��p'' canmissianxHH23a�91 �!;.tiy. x.yComm.Expiresfeo»,303h � 3ME¢GNIWqhNafl0nalNGlaryAi4n. ' The term"IobbyisC specdically excludes the following persons�. Expert witnesses who provitle only scienfific,technical or other specializetl infortnation or testimony in public meetings�,any person who only appears as a represenlalive of a neighborhood association without compensation or reimbursement for the appearance, whether tlirecL indirect or contingent, ro express support o(or op0osition to any item�, and any person w�o onty appears as a representative of not-forvpmft communiry based organization for the purpose of requesting a gran�withoul special mmpensation or reimbursement for the appearance. Page 4 of 5 VI. SIGNATURESUNDEROATH: ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMI7 TO THE OFFICE OF 7HE CIN CLERK A SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPEN�ITURES AS WELL AS COMPENSATION RECEIVED FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH 7HE LOBBYIST HAS BEEN ENGAGED 70 LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD' Signature of Lobbyist: Date I do solemnly swear or affrm that all of the foregoing facis, statements, and disclosures in this form are true and correct, antl that I have read or am familiar with ihe provisions contained in Chapter 2, AA. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all reporting requirements. SignaNre of Lobbyist: �ate Signature o(Principal: Date��ori VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of State of I ✓ i Countyof: Countyof: Ur��'✓� Swom to(or aKrmed)and subscribed before me, Swom to(or affj�ed)and subscribed before me, by means of 0 physical presence by means of C�physical presence or O online notarizalion, or O on ne notari� �on, lhis_day of 20_, by this ��day of n✓C- Z�Z�bY Vl ta NAMEOFLOBBVIST N ME FPRINCIPAL Praduced ID �roduced ID V I V -S�e FORM OF I�ENTIFICATION FOR OF IDEN IFICATI N _Personally Known P onally Known SignaWre o(Notary Pu61ic Pu ic 0 Name of Notary,Typed, Printed or Stamped Name of Nofary,Ty ed, Printed o 5 amped (NOTARY SEAL) (NOTARY SEAL) ��"�\ JOSFPH�PAC^I �� . � Co^�r.. i '^'- �"� r 'The term"IobbyisP specifcally ezcludes lhe following persons: �� - ��,owry 1'u� c E.�.-. �.�-�- Ezpert vritnesses who provitle only scientifq lechnical or olher specialized information or testimony in public meetings;any person who only appears as a represenlative of a nei9hborhood association wilhoul compensation or reimbursemen�for�he appearance,whet�er Oirect, indirect or contingent, to express support of or opposition to any item; and any parson who only appears as a represen�a6ve o( no[-for-proft communiry based or9anizalion for the purpose of requesting a grant without special compensation or reimbursement for the appearance. page 4 of 5 MIAMIBEACH Ciry el Miami Beaah, 1]00 Con.emlo�Ce�ter Dd�,Mlamf Beach, Fbdda 33139,w+n..mlomibeachlLgov OHice of the City Clerk Rafael E Granado, Cly Clerk CityClerk@mlamibeachH_gov Tel: 305.6737411, Fax: 305.6737254 NAME OF LOBBYIST: N1�MUfI 'UCt�'NC� 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 Stalement (Statement). In addition to any other penallies lhat may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed afte� 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 fle the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30�" of each year, shall be automatically suspended from lobbying until all fnes are paid, unless the fne has been appealed to the Miami-Dade County Commission on Elhics 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 specifc 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 fle a Notice of Withdrawal with ihe Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-monlh period commencing October 1 of each year, and the fee for such annual regisUation shall be $500.00 pursuant to Section 2-482 of the Miami Beach City Code. aia� iZ�t Signa u of Lobb s Date F1G�EH15P�lleFONmSLOB9YI5iFORM6LLoeoyutHepvslal�onFormRevlsee 999 2o�Guoc Page 5 of 5 : Miscellaneous Cash Receipt �. .. CITY OF MIAMI BEACH � No. 433202 ; � ❑Cash ❑Credit Card 'SaCheck i1-� �� ' ' S .�� ,�� 1.� , ----;:.� — ' Received of �% � � Z� �- � � Address �".� :ti � � � � , � � � For` i � C�7y of Miami Beac� � � Miscellaneous-MCR-202q �� 0087950003 Grmen V...05/OS@024 05:79AM MCR OPEN(MCR) � '' P'y"1BM^'^o�M: aso.00 Uffice of Flnance DireRor �� (7HIS INFORMAT�ON MUST BE COMPLEifD) gy ; d n n —�y� �z co � x o , F �6 � �F m' c3-, �'aA � � �n� � ¢ F m s�n -+ L� � �� s oc�i� r�..' m � � � F r� =� � I = z Q ao�� - =o A N3 -� N � O � n C O .Z➢1 �G CJ �� C3] �p ' O � L I I � N A vL 3 ON(� � �' M O � N ST l � I � O N m �S'`C I s�pc I � N 3 O �� S i � � I R� � � � _ � N f R��. �� O ry � I �� i . � O S �b � 3 b' « _ E �I, o o � o s , o ss o , �