2024 Lobbyist Registration Form - Trolly Services (Michael Phillip Ralsky) —rrotly Sc.�r: t,e.s
, RECENED
MIAMI BEACH OKceoflheCityClerk ��L 102024
1700 Convention Center Drive
Miami Beach, FL 33139 CITY OF MIAMI BEACH
305.fi737411 OFFICE OF THE CITV CLERK
LOBBVIST REGISTRATION FORM
Labbyisl means all persons employed or reUined,whe�her paitl w no�,by a pnncipal who seeks lo encourage Ihe passage,tlefeat ar
modifca�lon o(any ordinanca, remlulion, aclion or Oecision af any commissioner; any aclian, declsion, recommendaibn o/ Ihe City
Manager or any City board orcommittee;orany action,decislon or recommendetion al any City penonnel dunng Ihe lima panotl ollhe
entire tlecision-making pmcess on such aclion, dacision or rewmmendatlan Ihal foreseeabry vnll be heard or reNewed by tha City
Commission, or a Ciry boaN or commitlee.The term speufically InGudes Ihe pdnclpal as well as any employee engaged In lobbying
aqivilies. The tertn'LobbyisC has sped(w exGusions. Pleese refer to City Code Chapler 2,ANicle VII, Division 3, en�i�led'Lobbyisls;
for adtlitional information.
�nslrucHona: Please wmplete all sections of iMs form antl submit ihe tnmpleted torm,wilh Ihe applicable fee,to ihe Otfice of ihe City
Clerk. If you neeE more space lo camplete an answer, use a sepaate sheel(s)oF paper. It you have nolhing ta report in a particular
seclion, you mus� wn[e 'nona' or 'n/a' in Ihel seciion. Any change �o any intormalion originally fled, or any addilional City
Commissloner or personnel who are alw sough�lo be Iobbie0 shall require Ihat ihe lobbyisl fle an amentlmenl fo�he reglsVailon Porm.
The lobbyisf has a wntinuing duty to suppty intormalion and amend ihe lorms filed ihroughout ihe period Ihat Ihe lobbying occurs.
Separa�e ragislro�ion(orms shall be required tor each pnncipal representaA on each specllm Issue.
I. LOBBYIST INFORMATION:
�chSt�e,r, Ma�
NAMEOFL09BYI5 (Last) (Firsl) (MiJtlleName)
�C�ercPol�aKo� a52s �ce � �con 6u��z �'2s Coral C�ah►u F) 33i3�
LOBBVISTBUSINESSNAMEAN�A�ORE55 (NumbereMStree�) (City) (S�a�eTCode)
r3�s)a�o - io�q �aos) 8��- ao9a m rn►��v��-���,��. r�.�
L088VISTBUSINESSTELEPHONENIIMBER CELWLA0.TElEPHONENIIMBER ` EMAILA DRESS
II. PRINCIPAL INFORMATION:
/S�«�% ��i�h'�EL �i7iLG/�
NAME OF PflINCIPAL (Lxs�) (Finl� (MitlEle Name)
Mv 7���ORI/�'l/a2 //✓C. ,�-7///L/jtq/NLG f/�/Iuv D/{L�,�tJ TK 7r.��y
PflINCIPALBOSMESSNAMEqNOFDDftE55 � (Numberantl5lreel) � (Cily) (Sla�e) (ZipCoda)
(97�� 3 `�/ - �1�av ��i�,} Bd3-3s6'i �.�i,�s�c_2��i�s,��v;�ro;c�,
PRNCIP LBUSMESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMFILAODRE55
Punuant to Cily Code Saclion 2-0ffi(M1J(1)(a): A pnncipal of any mryomlian,patlnersM1lp,or o1M1er enlity who appears as a lobbyls�an behatt of Ihal
enlily,vnlhoW speclal campense�ion or reimbursemenl for Ihe appearance,vfiether tlirecl,intllrecl,or conllnqanl,lo express suppotl ol ar epposllion�o
an Ilem sM1ell regis�er wi1M1 iM1e CIeM as�equired by IMs subseclion but sM1ail na�pe reqNred lo Day any regislralion fees.
If ihe principal is a Corporatlon, Parinership or Trust, the following information MUST 6e pravided
pursuant to Cily Code Section 2-482(c�: � /
• NAME OF CHIEF OFfICER,PARTNER,OR eENEFICIARY Q(none,wrlle N/A�: ����� Lz�wd��
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR IN�IRECTLV,A S2Ye OR MO'/RE OWNERSHIP INTEREST IN SIICH
CORPORATION,PARTNERSHIP OR TRUST(Ii none,wtlte N/A�: /� �-LC�f �-�'��(J�
�Fyr;�� ��ooF
Page 1 0(5
�
;
III. ISSUE TO BE LOBBIED:
Describa with as much detail as is practical, including but nat Ilmited to a specific description where
applicable of a pending request for praposal, Invltation to bid, or pu6lic hearing number. .
�7}�111YOYYLPJ"1�' l>� fil�l)���U CS{X1�1(:.2�d
IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Sectlon 2-482(a)(4), Ilst the Cfty Commissioner or City persannel sought to be
lobbied, and whethar lhe lob6yist has entered into any contractual relatlonship (paid or unpald) with
said City Commissioner or City personnel from 12 months preceding such commencement of service
with tha City to the present date, stating the generai nature of the subject contractual relatlonship.
Full Name ol Individual and Contractual Relatlonship(IT yes,axplain) VES NO
Title of Person to he La6bied
ana '
Pursuant lo Ciry Cade Section 2-482(g), every registrent shall be requlred ta state the extent of aay
business, financial, familial or professianal relatlonship, or other relationship giving rise ta an
appearence ot an impropriety, with any current City Commissioner or Cily personnel who is sought to
6e Iobbled as Identi(ied on the lobbylst registratlon form filed. �
List any 8usiness, Pinancial, Famillal or Professional Relationship, or o�her relaHonshlp glving rise to� an
a earance oT im�ropriery('f n it 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):
� I11 _
Page 2 of 5
.
The fallowing six(6�quections MUST be anaweretl:
t) Pursuanl ip Cily Cade Section Yd88,entilled'Prohibi�ed Campaign CoNribulions By Lobbyists On Procurament Issues':
Vea Jo: A I bb I P � dl bltl( d I � r servlces or on e orasenl ar .
p di wardtoraaods eaulomentorservlce9
2) Pursuanl City Code Section 2-99�,enlitletl"Pmhibiled Campaign Coninbulions By Lobbyisls On Reel Estale �evelopment
Issues":
Ves No: A V I bb I tll II tl f 0 I t Aa t with Ihe CIN ot aoolicallon
f h f i q d Iq ❑ h l lh GIl 's FUWre Land Use Mao9
3) Pursuanl lo City Code Sec�lon 2-0BY(h�. any person (ezcap� Ihose exempt fmm Iha defnilion of"labbyist" as se� fotlh in
Seclion 2-481)who anly appears as a represeNalive ot a no4for-profll wrporatlon or en�iry wilhoul speual mmpensalion or
reimburs ent for Iha appearance,whe�he�direct or Indi�ecf�o express suppotl of oropposillon lo any i�am,shall registerwith
Ihe cily erk as�equired by Nis sec�ion,bu�shall no��e requl�ed�o pay any�egisiralion teas.
Ves No: A v tl t f Ill tl tlt ilh t I I ansatlon ar
relmburaemenl7
4) Pursuant�o Cily Code Sec�ion 2�481, Ihe �ertn 'IobbyisP speci�cally ezcludes�he lollawing pereons: Expetl wilnesses who
pmvide only scien�ifiq technical or other specialized In(ormalion or teslimany In public meelings;any person who only appears
as a representalive of a neiBhborhood assoclalion wilhaul compansatian or reimbursement for Ihe appearenca,whether dimct,
indirect or wnlingant,lo express supPort o(ar oppositlon ro any Item;entl any person who onlyappears as a representative of
nob(arpryyfl wmmunlly based arganizalion for the purpose of reques�ing a granl wl�haul speGal compansalion or
reimburd-ment for lha appearance.
!
Yes�No: A idl I i titl t h I I th I II tl I (o matlon� aooearino as a
t 11 ! i hb a d I 11 Ilh t I 1 om ensatlon ar relmbunement or
p 11 p t f Tit b d 1 11 f Ih f uestino a arant without
p I leom atlanorrelmbureement4
5) Pursuanl to City Cotla Section Pd91�7�, no campalgn consullanl shall lobby Ihe Ciry Commis:ion for a period of 12 mon�hs
folbvnn�e sweanng in af any elecled o�clal(s)for whom�he campaign wnsullanl pmvided campalgn consWting services
wilhin Ih past election cycle.See Section 2-491 for more Informe�ion.
Ves No: H Id d I tll I t i b t member o(lhe Gifv Commission
wllhl th t I 11 n V I 71f al II tlh I 6 1 berlslofiheClWCommisslan:
Ves No: If h 't b I th '12 Ih I ih 1 t tl R' I If 1 h rov'ded camoaian
sultlnA sery ies was swom In4
6) Pursuant lo City Cotle Sectlon 2dB2�a)(4)a.,a lobbyisl who has wilhin Ihe past elaclion cycle provided campaign consulling
services to an Incumbenl member of I�e Cily Commisslon(which lobbying activity is nol olheiwise pmhibl�ed by Code seclion
2-091) shall dlsGose such perticular service on his/her lobbyisl regislration (orm d h 11 II dscbse such oaNkular
service fore lobb 'n Ihe Ci Commission a�a ublic meelin .
Ves No: H id d iq Ili q t i b t member of�he Cltv Commisslon
ithl Ih 1 I tl I 91f 1 II I�h I b � b 11 fiheCltvCommisslan.
Ve� No: If p ' d d'd v 'd 1' chanae for camoainn
consWHnn servicas?
TO BE COMPLETEO 9Y CIN CLERK'S STAFF ONLY// C-
AnnualReglstrellonlee: I lYes� �No AmountPid�ll � MCRMy�� �/ J Oa�ePald7 �� �L�
LobbyistReglslrallanFormreceivedandverl0edby: �I�I
F:\CLER\SAIqaFORMS\WBBYISTFORMS\tohLy'u[Reglsb�a[IonPorinRevketl0]�11-30rtEG.tloc R¢v�5ed03/11/2020
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH LOBBYI3T SHALL SUBMIT TO THE OFFICE OF THE CITV CLERK A
�IGNED STATEMENT UNDER OATH LISTINO LOBBYINO EXPENUITURES AS WELL AS COMPENSATION .
RECEIVED FOR THE PRECEDING CALENDAR YEAR WRH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS BEEN ENGAGED TO LOBBV A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOO!
Signature of LohbyisC � �� � Date ��2�24
I do solemnly swear or aKrm thal all of the foregoing lacts, slalemenls, and disclosures in this form are Irue and conect,
and that I have reatl or am familiarwith Ihe provisions contained in Chaptar 2, Atl.VII, �ivision 3, entilled 'Lobbyisls" of
Ihe Mlami Beech City Code and all repohing requiremenis.
7/2/24
Signalure ol Lobbyist � � Dale
SignatureoFPrincipal: ��� Dale � � ����
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Slaleof IUY���-/� Sla�eof�T(Q'�,�vS
Counryol: �iyrYdr Counlyot: V✓cIISS
Sworn 10(or a med)and subscribed before me, Swom to(or a(fiJmed)and subscribed before me,
by means of physical presence by means a/4'physical presence
or O o m notarizatio or O online no[adzation,
�his�day of�1'�U) ��20a�by Ihis�day of J 2�by
M4X l,uS�' r� U
NRMEOFLOBBVIST NAM/EOFPRMq AL . I
Produced ID ' V Produced ID T/V ,�f�JPPS i�eNS(.'
`/ FORA1 OF IOENTIFICATION FORM OF IDENTIFICATION
=P irelly�g� � —Pe�t Know �
Signature of Notary Puhlic • SignaWre of Notary Public
�(,�I VI I R �St15 d
Name of Notary,Typed, , of Notary 7yped Printed or Stamped
.;�.:.� pAINIPCVSTIS
'' MYLOMMISSIONMHHG60 � �f UANIfLtAALONi
�NOTARV SEAL) �� . �Fl ARV SEAL
;%�;o, �(pIRES:Novemberq20
�.: � dt BaMeERrvNoIarYPUCI¢U• . - �� +1.' N t N� bl' tif � fT xas
' . .:�b ll C c n o�n zon
�Tha taim'lobbyisl'spec�wlly axcludes Ihe folbwing penons: Not ry lo I J�s6 I nt
Expert witnesses wfio provide anly scienti0c,�echnical or olher speclallzetl Informa�ion or testimony in publlc meelings;any pereon who
only appears as a represenfative of a neighborhootl assoGalion wilhou�compensa�lon or reim�u�sement(or Ihe appeare�e,wheiher
dlrect, indirecl w wnlirgent,to express wpporl ot or opposl�lon�o any i�em; and any person who anly appears as a represenlalive of
no4for-profit communiy besetl organizalion for�he purpose of mquesling a gronl withou�speciel compansa�ion or reimbursemen�for
Ihe appeatan[e. �
Page 4 of 5
MIAMIBEACH
City of Miami Beaah,V00 ConvenHan Cenk.Dnva,Miami Baoch,Fbrida 99179,www.mlomibeachA.gov
OI(ica of Ihe Ciry Clerk
Ralael E.Gronado,Ciy Clerk CilyClerk�miamibeachfl.gov
Tah 305 677741 I,Fax:305.673725d
NAME OF LOBBYIST: M l/�� W�� Itii
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 Expendilure and Compensation Statemenl
(Statement). In addition to any other penallies that may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed afler the
due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and
Public Trusl o� the faiWre ot a lobbyist (or principal) to file the Statement or pay ihe
assessed fines after notification.
Any lobbyist, who fails lo file the required Statement by April 30'^ of each year, shall be
automatically suspended from lobbying until all fines are paid, unless lhe (ine 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 ihe City Clerk a
signed Statement under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year wi�h regard to ihe specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I have registered lo lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Notice of Withdrawal with lhe Offce of the City Clerk.
3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-monih period
commencing Oclober 1 of each year, and ihe fee for such annual registration shall be
$500.00 pursuant to Section 2482 of the Miami Beach Cily Code.
i��� � 7/2/24
Signature of Lobbyist Date
i WLEPW1L�eFONMSLOB9YI5tiOXA4LLo��y:slFepklnlwniwmPmsM OI-IVAREGJac
Page 5 of 5
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