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2024 Lobbyist Registration Form - Wireless Telecommunications (Zachery Thomas Hodgin) W :�¢\¢ss Te,1e.Ga m�+v�.�.e.k n�ns , � � � ��� Office of the City Clerk �� 1 � �UL4 1700 Convention Center Drive Miami Beach, FL 33139 ',:".'�,,ylf RF?.GM 3058737411 LOBBYIST REGISTRATION FORM � Lobbyis[means all persons employetl or re�aineQ whether paitl or not, by a principal who seeks to encourage ihe passage, tlefeat or motlification of any ordinance. resoWtion. action or tlecision of any commissioner, any action. decisioq recommentlation o( the City Manager or any City board or committee; or any action, decision or recommentl3tion of any City personnel tluring ihe M1me period of!he enbre tlecisioo-making process on such actioq decision or recommentlation Ihat (oreseeably will be heartl or reviewed by the Ciry Commissioq or a City board or committee. The term specifically inclutles ihe principal as well as any employee engagetl in lobbying activities. The tertn `Lobbyist" has specific exclusions. Please refer to City Cotle Chapter 2, Artide VII, �ivision 3, entitletl "Lobbyists," for atltlitional information Instmctions: Please complete all sections of ihis form and submit the completea form, with�he applicable fee, to the Office of the Ciry qerk. If you need more space to complete an answer, use a separate s�eet(s) of paper. If you have nothing to report in a particular section, you must write 'none" or 'nia' in iha� section. Any change to any information originally filed. ar any additional City Commissioner or personnel who are also sought to be lobbietl shall require�hat the lobbyist file an amendment ro the registration form. The lobbyis� has a continuing tlury to supply information antl amend the forms filed thmughout the periotl ihat the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Hodgin Zachary Thomas NAME OF LOBBVIST (Lasp (Frsp (Mlntlle Neme) Toro Blanco Group, LLC 74 Howard St NE Atlanta GA 30317 I.OBBVISTBUSWESSNAMEANOA��RESS (NumbarendSVeep (Ci�y) �Slete) �ZlpCotle) 828-260-6238 zack@toroblancogrouo.cor� LOBBYISTBUSWESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS II. PRINCIPAL INFORMATION: Hodqin Zachary Thomas NAMEOFPRINCIPAL (Lasp �Flrst) (MiddleNeme) Toro Blanco Group, LLC 74 Howard St NE Atlanta GA 30317 PRINCIPAL BUSW E55 NAM6 AND AooRESS (Numeer and SVeel) (GIty7 (State) (Lip Cotle) 828-260-6238 zack(o�toroblancoqroup.com PRINCIPALOUSWESSTELEPHONENUMBER CELLULFRTELEPHONENUMBFR EMAILA�ORFSS Pursuant to C�y Cotle Seciion 2-482(M1)(1)(ap. A principal o!arry mrporelion, patlnersM1ip. or other en�i�y who appea5 as a lo�bylst on bebalf of ihat entiry,vnthout s0ecial compensafon or reimbursemeN�or�he appearance,whe��er tlirecL intlirect or contingent,�o express suOPo�01 or opposdion�o an item sM1ap register with�he Glerk as repuiretl by�his subsection bul shall not be requirM to pay any re9istra�ion fees. If the principal is a Corporation, Partnership or 7rust, the following intormation MUST be provided pursuant to City Code Section 2-482(c�: • NAME OF CHIEF OFFICER,PARTNER,OR BENEFIqARY(it none,write NIA�: �E z.Qflltldb NYJG l • NAME OF ALL PERSONS HOLDING, DIRECTLY OR IN�IRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCM CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA�:�' Zo.�oe� -fJqD-la +� ¢_ 7£ea�ilcE Page i of 5 �� � 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. Toro Blanco Group, LLC is proposing, as a wireless telecommunications infrastructure company, to install public and sports lighting in Lummus Park, for the joint uSe purpose of telecommunications facilities as well as for public safety and utility within the park. Toro Blanco Group, LLC would pay the ' City a monthly lease rate for the usage of the space and pay for and maintain all lighting infrastructure. IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-462(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 from 12 months preceding such commencement of service with the City to the present date, stating the general nature of the subject contrectual relationship. Full Name of Intlividual and Con[rac[ual Rela[ionship(If yes, explain) YES NO Title of Person to be Lobbied Kristen Rosen Gonzalez X Laura Domin uez X Alex J. Fernandez X Tanya K. Bhatt x David Suarez x __ Joseph Magazine � X Steven Meiner x Pursuant to City Code Section 2-462�g), every registrant shall be required to state 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 registration Form filed. ' List any Business, Financial, Familial or Professional Relationship, or o[her 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�: No c�.,pc,v<nr�P�i Page 2 of 5 The tollowing six(6)questions MUST be answered: i) Pursuant to Ciry Cotle Section 2-088.entitletl 'Prohibited Campaign Conlributions By Lobbyis�s On Procurement IssueS�. _Yes�No: Are Ibb ' t tl' b"tlt tl o 'o t � oendinaawartl(or000tls equ'omentorserv'ce7 2) Pursuent lo Ciry Code Sec�ion 2-490, entitled 'Prohibited Campaign Contrlbutians By Lobbyists On Real Estale Development Issues" _VesX No: Are y I bb ' o d' I' t' f D I t A t '[h th C'N al' t' tor chann f p tl 'q f h q t th C"N' F [ L d U M 3) Pursuant �o Ciry Code Section 2-082�h), any person (exwpt those exempt from Ihe tle(inition of"lobbyist' as set forih Ir Section 2-481)who only appears as a representative of a no4/or-profit wrporation or entiry without special compensation oi reimbursement for the appearance,whether tlirect or indirec�to express support of or op0osition�o any item. shall register with Ihe city derk as requiretl by this section. but shall not be requiretl ro pay any regisiration fees. _YesgNo: Are o f 4f - ft o f fN 'th t ' I C reimburs¢ment? 4) Pursuant ro City Cotle Section 2d81. lhe term "IobbyisY' specifically exclutles the following persons. Expert witnesses who provitle only scientific, technical oro�her specialized information or testimony in public meetings; any pe�son who onty appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether tlirect, indirect or contingent. to express support of or opposition to any item:antl any person who onty appears as a representative of not-for-profit wmmunity based organization /or the purpose o( reques�ing a grant without special compensation or reimbursement for ihe appearance. _Ves�No: Are vou orov'd'na anlv sc'ent'('c techn' I th 5 ' 1' tl ' ( t' o0 representafve of a n¢'ohborhootl assoc'aC n 'th t ' 1 t ' b t representino a not-Por-orolt basetl oruan'za['on f th o s f C o t 'th t soecial comoensalion or reimbursement? 5) Pursuant ro City Code Section 2-091��), no campaign consWtant shall lobby �he CIry Commission for a period of 12 months following lhe swearing in of any elec�ed official(s) for whom the campaign conSWtant provitletl campaign consWting services within the past election cycle. Sae SecCion 2-491 Por more m(ormaGon. _Yes%No: Have vou orovitletl camoaiqn consultino serv'ces to an 'ncumbent memb r t th C't C within[he uast election cvcle?Itves olease I'slihe'ncumbent memberlsl o(th C'N C _Ves_No: If ves. has it been less than 12 months s'nce the elaeMtl H' ' II 1 h "tl d consultina services was sworn'n� 6) Pursuant�o Ci�y Code Section 2<82�a��4)a., a lobbyist who has within the past election cycle providetl campaign consulting services�o an incumbent member of�he City Commission (which lo�bying activity is not otherv�ise prohibited by Cotle section 2-09�) shall tlisclose such pahicular service on his/her lobbyist registrotion form antl shall oralN disclose such oarfcular service before lobb � th Ct C t bl' ee�. _Ves](No: Have vou orovided camoainn consultino serv'ces to an 'ncumbent member ot the C'N C wi[hin the oast election cvcle?I(ves olease I'st the'ncumbent memberls)of th CN C _Yes gNo: If yes, were vou nromis¢d or tlitl vou rece"ve econom'c cons'tlereYon 'n x h a f a' consullina servicesl TO BE COMPLETED BY QTY CLERK'S STqFF ONLY P�;na;p<.� /7 � Annual Regishalion fee: � ]Yes�No Amount Paitl S��MCR p Da[e Paitl � LobbyislRegis�rationiormrecervetlanaverifetlby: DM (Le�('C�— 5�.�}o}ppq � � ^� Revisetl03/11/3020 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 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 BE FILED EVEN IF THERE HAS BEEN NO E%PENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.' — � Signature of Lobbylst X=-'."�i /��'`'� � Date 4-15-24 ��� v I do solemnly swear or aHirm that all of Ihe foregoing facts, s[atements. and disclosures in this form are true and correct, and that I have read or am familiar with ihe provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: i��->� Date4-15-24 � Slgnature of PrincipaP. �,�L-, -7-�,(-� Data4-15-24 �Z��T, VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL � I � Steteof ��� �� � ' Stateaf I�i�l I[� County ot ���� ������ County of�. ��i' �n� � � Swom to (or affi�ed)and subscribed before me, Sworn to(or affirr9ed)�and subscribed before me, by means of C3'physical presence by means of p physiwl presence or O o�ine notariza6 or 0 online notariza ion, th��]_day of�20�by this}�day of �r 20'�by � � �— � V '��,� =i �,l,�V "1 � C'� NAM�EOFLOBBVIST ' � ' NNMEOFPRINCIPAL '�Produced ID ��(�( I( 1 �1 '�Produced ID � �� �� . � '� FORM OF ID NTI ICAT�— FORM OF IOEN IFlCATION _Pe,rsonally Known __Fje�Sonally Known �� ��1 � �� ", , . . ; �i= (� .,'�� , Si nat e of Nota 51ic Sig �Fure Notary Public � � � i � ���� S� � � ,. Name of otary,Typed, Printetl r Stamped Name of ;ary, Typed, Printetl or amped - dF�iX SEAL �{� F ri�,;-. ) J (NOT�t,[kY��Y�GT-. �� � I`3�a... .:a : s. . i����tARy �! :` ,�,1 �OTARy �:. `j < '�he terrdlD6��gtQ.�eclficalty exclutles the following persons�. q.,�qAUpL�� . ` FP�g�,���.iC: ' �N 5 �U'�� E"��Sbg6.y`s mvitle onl scientifiG tachnical or olhe�s eaal¢ed mf 1 � �'� P Y p olaratiql�ppfeyAmony in public meetings�, any person who only aQ{Sb���9;°,a representative of a neighborhootl association withwt compenSatiorvtl7 reimbursement Por[he appearance, whether direct. inAFE'CTor contingent. to express support of or opposibon to any item'. and any person w�o only appeare as a representative of noFfoo-pmfit community based organization for the purpose of requesting a qrent without special compensation or reim0ursement for Ihe appearanw. Page 4 of 5 f � Ciy of Miami Beach, I]0�Co�.emion Cen�er Dme,Mlaml Beach,Flor.da 33139,www.mlamibeacnfl.go� Office o(rhe Clry Clerk Rafael E Gmnodo, C��y Clerk Ci�yClerk@mlomibeachfLgov TeL 305.6737411, Fox: 305.6737254 NAME OF LOBBYIST: Zachary Hodgin 1� LOBBYIST FEE EXPENDITURE AND COMPENSAiION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notity any lobbyist (or principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statemen� (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 principap 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 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 ihe 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 Office of the City Clerk. 3) ANNUAL LOBBVIST REGISTRATION FEE I understand annual registretion 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 $500.00 pursuant to Section 2482 of the Miami Beach City Code. ��^✓� —��--� 4-15-24 Sig re o obbyist Date F�c�a�mi��roevs�oeensr wams��pe;s�a�.��ano�Form a�,um m-i�-2o aee mo Page 5 of 5 . : �"�, �� � ,Q,?�`•J1i ��,�� � ..; �k:c:r�vrr� City of Miami Beach �P�� 1'i 2024 1700 Conven�lon Center Drive Miami Beach, Flortda 33139 - � '.�',al HEP.CH www.miamibeachfl_gov . . � . . �. _�„ Ciry Clerk's Office � � � ��� Tel: 305-673-7A�1 F2X: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Name: Zachary Hodgin Business Name: Toro Blanco Group, LLC Address: 74 Howard St NE Atlanta, GA 30377 Office Telephone Number: Cellular Telephone Number: 828-260-6238 Email Address: zackna.toroblancoqroup.com If more than one lobbyist, please list: 7)_ 2) 3) 4) 5) 6) 7) Submit this form ro the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. For City Clerk's Oftice Use Only MCR#:}�.- ;nc:=o� $e�� ,Qc?ce5¢n+a+;on Amount paid � Date paid: y 17 � Processed by: bM Date: FiCLGN�$ALL�nPORNS1LpB8YI6I hORMSWJNUA4 40BBY6'f Ht615IFUilON Fn2M.eq doa