2024 Lobbyist Registration Form - 300 West 42nd Street (Juan Carlos David) �� wG�. y�,� � .
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M I A M I B EAC H off;�e of�„e�;,Y�,e,k �; �oZ4
1700 Convention Cen�er Drive
Miami Beach, FL 33139 � . � '�',A�)I BEH"11
305.6737411 . ..., . . -;..._. .. "
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employetl or retained, whether paitl or not, by a principal who seeks to encouroge [he passage, tlefea[or
modifica�ion of any ortlinance, resoW�ion, aclion or tlecision of any mmmissioner; any ac�ion, decision, recommentla[ion of Ihe City
Manager or any City boartl or committee�, or any actioq tlecision or recommendation of any Gity personnel during[he time periotl ollhe
en�ire tlecision-making pmcess on such action, decision or recommentlation ihat foreseeably will be heartl or reviewed by �he City
Commission, or a City boartl or committee. The term specifwlly inclutles ihe principal as well as any employee engagetl in lobbying
activities. The term "Lobbyisf' has speci(c exclusions. Please reter to City Code Chap[er 2, Article VII. Division 3, en[itled "Lobbyists,"
tor atltlitional information.
Instmc[ions: Please complete all sections of Ihis form and submit Ihe completetl form, with the applicable(ee. to the Offce of ihe Ciry
Clerk. If you need more space to complete an answer, use a separate sheel(s) of papec If you have nothing ro report in a particular
sedion, yau mus� write "none" or "nla" in �hat section. Any change to any information originally filed, or any atltlitional City
Commissioner or personnel who are also sought�o be lobbietl shall require Ihat Ihe lobbyist fle an amentlmen[to the registration fortn.
The lobbyist has a con[inuing duly to supply information antl amend the forms fled lhroug�out �he period Ihat �he lobbying occurs.
Separate regisiration forms shall be requiretl for each principal representeG on each specifc issue.
I. LOBBYIST INFORMATION:
�QdicV StXN� �U/-�QS
NAME OF LOBBYI3T (LasQ (Flrst) (Mltltlle Name)
�C.D f�c1.:i�i
I°JSS �a� (Nc�c�1 � �t0�1 -1Micwi� Fl.- 3�I�S
LOBBVISTBUSMESSNAMEANDADDRESS (NumOerentlStreet) �CIIy) (State) �ZipCotle)
� -7a6- uN3-6"JSQ �uGv�cd��� �������c,�.csm
LOBBYISTBUSWESSTELEPHONENUMBER CELLUTARTELEPH ENUMBER EMAILAODRE55
II. PRINCIPAL INFORMATION:
D(M/�GI �Gv� CUr�O�
NAME OF PRINCIPAL (Lasp (First) (Mitltlle Name)
�LD p��G1:.he.C.1�
13f3S CcxGl Wu�n�► �oN - Mrow,� I�L 336`1S
PRINGIPALBUSINE95NAMEAN�A�ORE55 (Num�erantlStreep (Clly) � (S�a�eJ (LpCotla)
3oS285 u3� 3 7g6 u��6�t So ��<,v,c�� icdd��,h�
PRINCIPALBUSINESSTELEPHONENIIMBER CELWLARTELEPHONENUMBER EMA A RESS �'
Pursuan�to City Code Sec[ion 2-482(h�(i)(a�' A princiDal of any corporation, patlnership, or Whe�enlity wM10 appears as a IobCyisl on behalf of Ihal
entity,wi�hou�special compensalion or reimbursemenl tor Ihe appearance,whe�her Eirect,indirect,or confinganp to express suppotl of or opposition lo
an i�em s�ap registe�witM1 Ihe Cletic as required by IM1is subseclion but shall no��e reQuirecl�o pay any regis[ralion fees.
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c�: !I
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFIpARY(if none,write N/A�: �UG� � . �G1��✓'
• NAME OF ALL PERSONS HOLOING, DIRECTLV OR INDIRECTLV,A`5%�OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A�: ✓UG�I C• D�U��
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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 re est for proposal, invitation to bid, or public hearing number.
_�po5G1 0� /1A.w S�Oo��'F �x c�C�-� w�'�
c,�l n,ew Oc,�1•�.�nG � la,o�scu�O� _ 3cC� wes►��n�J st.
IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-082(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 f�om 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 Conlractual Relationship (If yes, ezplain) VES NO
Title o(Person to be Lobbietl
rds .b ���•
Pursuant to City Code Section 2-082(g), every registrent shall be required to state the extent of any
business, fnancial, 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 filed.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
a earance of im r nrie if none, write N/A :
� f"f
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-085.3):
n4 G��� +� o�,i �� �+;�,
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The following siz(6)questions MUST be answered:
1� Pursuan�lo City Cotle Section 2d88,en�i�letl"Prohibiletl Gampaign ConlribWions By Lobbyists On Pmcuremen[Issues':
_Ves�'jo: Are y I bb ' t d b'tl f d t t
oendinn award for aoods eouioment or sery ce'+
2) Pursuant lo City Gotle Section 2390, enlilletl "Prohibiled Campaign Con�nbutions By Lobbyists On Real Eslale Development
Issues'
_Yes�No: Are I bbv d ool' Y t D I t A t 'th th C't ol" t
for chan f d C h t th Ct ' F t L d U M �
3) Pursuant to Ciry Gotle Section 2-082(�), any person (except ihose exempt Gom the tlefinition of"lobbyisl" as set foRh in
Section 2-481)who only appears as a represen�ative of a nobfor-pro(t corporation or entity withoul special compensation or
reimbursement for ihe appearance,whether tlirect or intlirect to express support of or opposi[ion to any item,shall regisler with
the city lerk as required by this sec�ion, bW shall nol be requiretl to pay any registration fees.
_Ves�o: A T 4f - ft Y Cri 'lh t ' I o f
�� reimbursement?
4) Pursuan[ [o City Cotle Section 2d87, [he lerm "IobbyisP' specifically excludes Ihe tollowing persons�. Expert witnesses who
provitle only scientific, technical or other specializetl infortnation or[estimony in public meetings;any person who only appears
as a representative of a neighborhootl association without compensation or reimbursement for ihe appearance,whether tlirect
indirect or wntingent,to express support of or opPosition to any item;antl any person who only appears as a representative of
not-for-proFll community basetl or9anization for the purpose o( reques[ing a grant wi[hou[ special compensation or
reimbursement for the appearance.
_VesXNo: Are 'd' I ' Ef t h ' I th " I' tl ' f C ' '
�� representative ot a neiahborhood associa[ion withoul soec al comoensaCon or re'mbursement or
re f 4f - f't b d ' C ( th f C n t '[h t
soecial comoensation or reimbursement7
5) Pursuan� to Giry Code Seclion 2-097�1�, no campai9n consWtant shall lobby the Cily Commission for a periotl of 12 monlhs
following the swearing in of any electetl oHicial(s) for whom the campaign consultant provitletl cam0aign consulting services
within t_hg past eleclion cycle.See Section 2-491 for more information.
Ves(Wo: Have vou orov'detl camoa'vn consul(no serv'ces ro an 'neumb nt m b (th C'N C
within the oast election cvcle?If ves olease list the bcumbent memberls)o�the C'tv Comm"ss'on�
Ves No: If ves has 't been less than 12 months s'nce the electetl off'c" If 1 h 'd tl
consultina services was sworn in7
fi) PursuaN lo Giry Code Sec�ion 2-082(a�(4)a.. a lobbyist who has wi�hin �he past eledion qcle provitletl campaign consulting
services to an incumbent member of[he City Commission(which lobbying activiry is not otherv+ise prohibitetl by Cotle section
2-091) shall disclose such partiwlar service on hislher lobbyist registretion form antl shall orallv tlisclose such oartcular
service before lobb in �he Cit Commission at a ubllc mee�in .
_Ves No: Hav¢ you orovidetl camoaian tonsW[ino services to an 'ncumbent member of the C'tv Comm'ss'on
within the oast elect'on cvcle>If ves olease I'sl the'ncumbent memberlsl of the C'N C
_Yes_No: If ves were vou orom'setl or dtl vou rece"ve econom'c cons'tler t' h t
consultina services7
1 '�\11(:?aI SEI�� bCP TO BE LOMPLETED BY CRY CLERK'S STAFF ONLY
� Annual Registration fee: [ ]Ves f�/�No Amount Paitl S ' 1 MCR# Oate Pal� s �G
/` ! 1
Lobbyist Registra[ion Form receivetl and veri(ed by:
e\aea��,sau�,.�Farzns���oeaysrFoans�yobnyaeqcqrso-acionrormaewseao�-u-loaec.m. Reviutl03/11/30]0
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VI. SIGNATURES UNDER OATH:
ON FEBRUARV 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 CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBYIST HAS 6EEN ENGAG TO 088Y. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENS TI ING HE REPORTING PERIOD.'
Signature of Lobbylst�. Date ��I2�
I do solemnly swear or affrm tha II of the foregoing facts, statements, and disclosures in this form are irue and correct,
and that I have read or am fami ar it ihe provisions contained in Chapter 2. Art. VII, Division 3, entitled "Lobbyists" of
lhe Miami Beach City Cotle and all po i re ei emenis.
Signature of Lobbyist Da[e (ll
Signature of Principal: Date � �
s�
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State o( f/aVl�4 Sta�e of ��071 �y
County of: {��a�N I � teM County of: Y'�(ti.N I �t�
Swom lo (or affrmetl)and subscribed before me, Swom to (or aKrmetl)antl subscribed before me,
by means of� physical presence by means of,� physical presence
or 0 online nolarization, or O online notarization,
this�tlayof N�(iYo�1 pOL�by this $ dayof N�.Irc�t 20Z-`�by
JJa.� C. �JRU�� �/U� `. FltUlil
NAME OF LOBBVIST NAME OF PRINCIPAL
_Produced ID produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFICATION
�Personalty Kno q'� �Personally Known�
%% �/
�1 A
Signature� otary Public SignaWre otary Public
SuScxq �cwti.�11U( SuSf wC �c� Y���
Name of Notary, Typ , Printed r t Name of Notary, Typed, Printed or Stamped
SUS�x�ECNl.WR0.UA
(NOTARYSEAL °'° �., x �„yver��su�eai��onaa y�� sus.r+eea.wAwun
y`�`94:. (NOTARYSEAL) p�°c" NotaryPubl'i<�stattatFlonta
���.- Comm ssion/N��d1�011
My��,m,�pire5 Jul1, ��M1� C mmission�HH]E3009
ep tnroug�Navio�el NMary Assn. . MY Comm.1przes lui],30t]
' The term"IobbyisP'spe e ollowing pe5ons ��BmEea mrwqn na�ionai i+o�aryessn.
Eapeh wilnesses who provitle only scientifq technical or other specializetl information or�estimony in public mee�ings;any person who
only appears as a representative ot a neighborhood association without compensation or reimbursement(or the appearance, whether
tlirect, indirect or contingent, �o express support of or opposition to any item; and any person who only appears as a represen�alive oF
nobfor-proFit communiry based organization for�he purpose of reqvesting a gron� withou� special compensation or reimbursement(or
Ihe appearance.
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. . , � FAr-. N
City of Miami Beaah, I�00 Co��emlon Cenrer Drwe,Mlami Beach,Flonda 33139,www.mmmibeochfl.go�
Office of lhe Ciry Clerk
Rofoel E. Gmnado, Ciry Qerk CiryClerk�miamibeachfl.gov
�el�. 305.673 7d1 I, Fax: 305.6737254
NAME OF LOBBYIST: �U� C� �GW�GC
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 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-Dade County Commission on Ethics and
Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the
assessed fnes after notifcation.
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 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 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 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 Withdrawal with the Offce 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 October 1 of each year, and the fee for such annual registration shall be
$500 pur uant to Section 2-482 of the Miami Beach City Code.
3 S 7y1
Signature o obbyis Date
e�ciea�snr.�wroamsuoeerisr wameaoeev��wee�+,a�.o�F��aamsea m-�i-zo aeo ea�
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