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2024 Lobbyist Registration Form - Traffic and Signal Synchronization (Tai Kreisler) RECE�v�n JAN OSZ02d ?�:/1� ���i� ����v � � y .;�� =,�..�� ,. QcH � ORice of the Cit Clerk ��- �ERK 1700 Convention Center Drive Miami Beach, FL 33139 305873 7411 LOBBYIST REGISTRATION FORM Lobbyist means all persons employetl or retained, whether paitl or not. by a principal who seeks ro encourage ihe passage, tlefeat or motlifcation of any ordinance, resoNtion, action or tlecision of any commissioner any action, decision, recommentlahon o! the City Mana9er or any City board or committee�, or any action, tlecision or recommendation of any City persannel during the time period of Ihe entire decision-making pmcess on such adion, tlecision or rewmmentlation that foreseeably will be heartl or revrewed by ihe City Commission. or a Ciry Oaartl or committee. The term specifcally inGutles t�e principal as well as any employee e�ng`a ed `1Lobb bsts9' activities. The term "LobbyisC' has speci8c exclusions. Please refer ro Ciry Cotle C�apter 2. Article VII, Division 3, Y foraddi�ionalinformation. Instmctions: Please compkte all sections of this form antl submit the campletetl fortn,with the applicable fee,b the Office of the City qerk. If you need more space ro complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular sectioq you musl write "none" or "nla" in that section. Any change to any inPormation originalty fled, or any additional City Commissioner or personnel who are also sought�o be lobbietl shall require ihat lhe lobbyist�le an amendmen[to fhe regisl2tion form. The lobbyist has a continuing tluN �o suppty information and amentl che fortns filetl throughout ihe periotl lhat the lobbying occurs. Separate registretion fortns shall be required for each principal representetl on each specific issue. I. LOBBYIST INFORMATION: Lbrente, Michael �nn;mie r+amel NAME oF LOBBYIST (Lasi) (Flrst) LSN Partners 3800 NE 1st Ave, Suite 200, Miami, FL 33137 LOBBVISTBl1SMES5NAMEANDADDRE55 (NumberentlSVeetl (Ctry) (State7 (ZlpCotle) 305-673-2585 michaeLllorente@IsnpaAners.com I.OBBVIST BUSMESS TELEPHONE NUMBER CELLU�HR TELEPHONE NUMBER EMAIL ADDRE55 II. PRINCIPAL INFORMATION: �ft 1 bl-tJ TCai �mddi N i NAMEOFPRINCIPAL (Last) (F��s�� 335 Madison Avenue New York NY 10017 � No-�a{��, V.S. lvi C- s� > tzoca ) PRMCIPAL BUSWE55 NAME AN�ADDRESS (Number and Streep (��Y) � +g72547652790 tal@notraffic.tech PRINCIPAI BUSMESS TELEPHONE NUMBER CELLULARTELEPHONF.NUMBER EMAILA�DRESS Pursuanl�o Cify Cotle SeQion 2A82(M1)(1)(a): A pnndpal ot any wrpwalion, partnership, or dher enliry who appears as a lobbyist on bebal�of tha� ¢Mify,witnout speciai mmpansafon or reimburument for ibe appearance.whetM1er direct.inairect,or contingenL�o express supPod of or opposltion�o an item shail register Wtlh the CIeM as required Oy t�is su�seclion bul shaii not be requireG m pay arry registration fees. If the principal is a Corporation, Partnership or 7rust, the following information MUST be provided pursuant to City Code Section 2-082(c): Mr. Tal Kreisler(Chief Oificer) . NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write NIA�: . NAME OF ALL PERSONS HOLOING,DIRECTLY OR INDIRECTLV,P 5%OR MORE OWNERSHIP INTEREST IN SUCH Tal Kreisler,Uriel Katz,Or Sela Lool II VenWres LP. ( �: CORPORATION,PARTNERSHIP OR TRUST if none,write NI Page 1 of 5 "� K 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 pendin9 request for proposal, invitation to bid, or public hearing number. Traffic and signal synchornization IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-462(a)�4�, list the City Commissioner or City personnel sought to be tobbied, 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 Intlivitlual and ConVactual Relationship(If yes, explain) VES NO TiUa oT Person to be Lo6bietl Mayor & Staff NIA ✓ Commissioners & Staff NIA ✓ City Officials & Staff NIA ✓ Pursuant to City Code Section 2-482(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. �4st any Business, Financial, Familial or Pmfessional Relationship, or other relauonship giving rise m an a earance of im ro rie 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): �0 0.l�G��`�-lt� �� tL� Mi0.w�� �'fjPcLrl Page 2 oi 5 T�e Tollowing six(6)queslions MUST be answeretl: 1) Pursuant to City Cotle Section 2-088.entitled'Prohibited Gampaign Contributions By Lobbyists On Procurement Issues"�. Ves XNo: A 1 �bv a ❑ t o d' 9 b'tl fo d ti OT¢Ill OI S2IV fl d Df¢S¢Ill Of — — p d' rd t tl e ' ment or service? p) Pursuant to Gity Gode Section Sd90,entitled'Pmhibitetl Campaign Contributions By Lobbyisls On Real Estale�evelopment Issues" YesXNo: A I bb d oof t f D I o lAareementwithth C'lv f ['on f h f d 'a t h t lh CNSFuNreLandU eM o 3) Pursuant lo City Cade Saction 2382(h�, any person (except thoee exempt from the tlefinition af"IobbyisT' as sel fotlh in Section 2-481)who only appears as a represenlative of a not-tar-pm(t corporation or entity without special compensation or reimbursement for ihe appearance.whether tlired or intlirect lo express support of or oppositian lo any ilem,shall register with the city clerk as required by ihis section, but shall not be requiretl ro pay any regisVation fees. Ves xNo: A o b a t( o ft p t ntn wilhout s ' I m ensatian or reimbursement7 4) Pursuant to City Cotle Sec[ion 2b81, ihe tertn "lobbyisf' specifcally excludes the following per�sonsersoP who lonly appears provide only scientific, technical or other specialized iniortnation or lestimony in public meetings, Y P ,Hhether tlired, as a representative of a neighborhootl association wi�hout compensation or reim0ursement for the appeaance, intlirect or wntingent,to express support of or opposition to aosa eof�r�e uesfi�� a��ant w houtP special�campensat'o�n or not-forpm(it community based organization for ihe purp Q 9 9 reimbursement for the appearance. Ves XNo: A o tl a Iv ' tlf t h ' I lh o �alizetl infortn f o 'n ai a re resentative o( a nei hborhood assaciation withoul s ecial com ensah n b re resentin a nobfor- roft basetl o anization for Ne ur ose of re uestin a rzn( without ' I o ation or reimbursement7 5) Pursuant lo Gity Gode Section 2d91�1�, no campaign consWtant shall lobby ihe Ciry Commission for a periotl of 12 months following the sweanng in of any elected oKcial(s) Por whom the campaign consultant pmvitled campaign consul[ing services within the past eledion cycle. See Sedion 2-091 tor more iniortnation. b nt member o(Ih C'N Commission Yes XNo: H v o tl d a �l � — th th t I 4 I If I I t th b t memberlsl of the C N C Ves x No: N e h rt I tha �1 a �h m � led ofF 'allal whom vo o vide0 camoaian — — �Iti a fv' es s swom in? g) Pursuant to City Cotle Section 2<84�a)(4�a., a lobbyist who has within the past electlon cycle provitled campaign consulting services to an incumbent member of the Ciry Commissian (which lobbying activity is not otherv+ise pmhibitetl by Chtloartwl�ar 2-091) shall tlisclose such particular senice on his/her lobbyist regisiration (orm tl h II II C I D fo I bb ' th C b C t p bl c meetinq. Yes xNo: H v a d A a �a If a 'c t bent member o(lh C'N Comm'asion th lh t I t I I( 1 I t th b t emberlsl of Ih C ri C Yes XNo: I s d d tl ' e o c itl 2f n 'n ezchanp¢ for wmoaiun — — Itino services9 �0� 1 _ �,� TO BE COMPLETEO BY CITY CLERK'S STAFF O�N/LV MLe�1y�� Yes No AmountPaidS���•o, MCRC��77I ��s� DaMPaiC��� '�"� Annual Re9isVat on lee: 1 I 1 LobbyislRe9�stmtrooFomireceiveEantiverlfiedEy �� ,. , . ,, Revised03/11/3020 . F `.+tt�tt4LOtl6Y[�,tFi'•� Lt �hY�tx�v,c� ,tu.!"� :nR�. Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH VEAR EACH LOBBVIST 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 LOBBVIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENOITURE OR COMPENSATION DURING THE REPORTING PERIOD.' Signature of Lobbyist Date I do solemnly swear or affrm that all of Ihe foregoing facls, statements, and disclosures in Ihis form are true and correcL and that I have read or am familiar with the provisions contained in Chapter 2, AR. VII, Division 3, entitled "Lobbyists" of Ihe Miami Beach City Code and all reporting requirements. Signature ofLobbyist Date Signature of Principal� � Date���� � VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of State of QM���� County of: County of: N«°^^` —rT'�' Swom to (or affrmed) and subscri6ed before me, Sworn to (or aff�rmed)and subscribed before me, by means of O physical presence by means of�d'physical presence or O online notarization, or 0 online notarization, p03�b this_day of 20_, by this b day of t�r in�� Y •1 I�VClbl�f _ NAME OF�OBBVIST NAME OF PRMCIPAL ProducedlD _Pro ucetllD — FORM OF I�ENTIFICATION FORM OF IDENTIFlCATION Personally Known _Personally Known Signature of Notary Public SignaNre of N tary Public v„i,..,,, n.,� n Name of Notary, Typed, Printetl or Stampetl Name of Notary,Typed, Pnnted or Stamped (NOTARVSEAL) �J ' vrviEr+arvEao (NOTARY SEAL) P� �'+,. Houry Putr smee o��iodaa ��`..'i�g" Cwnmisso sHNt3a�93 qp.. MYComm.[IIp P GeEti.2035 _ — � ��BanGM lM1�ouy�Nalional Notary 45sh 'The lerm"IobbyisT'specifically excludes ihe following persons�. Expert witnesses who provide onty scientifc,lechnical or other specialized information or testimony in public meebngs: any perso„ew�ho only appears as a representative of a neighborhood association without wmpensation or reimbursemenl for ihe appearance, tlirect, indirect or contingent. lo express support of or opposition to any item; and any person who onry appears as a representative of nob�or-pm(it communiry based organization for lhe puryose of requesting a grant without special wmpensation or reimbursement for the appearance. page 4 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITV CLERK A SIGNED STATEMENT UNDER OATH LISTING 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 STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATIO DURING T IE EPOR ING PERIOD.' SignaWre of LobbyisC Date �Z� ZfJ �Z'� I do solemnly swear or affirm th all of th oregoing facts, statements, and disclosures in this form are Irue and correct, and that I have read or am familiar with the provisions contained in Chapter 2, Ad. VII, Division 3, entitled "Lob6yists" of the Miami Beach City Code and all r portin requi ents. SignaWreofLobbyisC Date �21 RO f2'� SignatureofPnncipal- � Date VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL Stateof f-�(MC.�G Stateof County of�. M 1GNl11-nGG12 Caunty of: Swom to (or affJi+T�ed)and subscribed before me, Swom to (or affrmed) and subscribed before me, by means of e`i physical presence by means of a physical presence or O online nofarization, or� online notarizatioq ihis�C7 day of (�LLfiMbCl . 20?�by this_day of 20_, by I"�1C1f1A4� � �r �ie. NAME OF LOBBVIST NAME OF PRINCIPAL Produced ID _Produced ID FORM OF IDENTIFlCATION FORM OF IDENTIRCATION _"Personally Known Personally Known � SignaWre of Notary Public Signature of Notary Public v�VIPVY� QUrr m Name of Notary, Typed, Printed or Stamped Name of Notary, Typed, Prinled or Stamped '�� vIVIEN FIVEAO (NOTARVSEAL) p/`^�,y�.�!i;, soca�yp�ouc s�aieot.�a,;ca (NOTARYSEAL) ���,e`- CammissionYHHt30rS3 . My[wnm.Expiret:pbt1,t015 �3anEeC tproug�ea0onal eoter apin. ' The term"lobbyisC'specific Expert witnesses who provitle anly scientiFiq technical or other specializetl information or teslimony m public meetings�, any person who only appears as a represen�ative of a neighborhood association withoul compensation or reimbursement for Ihe appearence, whether tlirect, indirect or contingenl, to eapress support of or opposition to any item�, and any person who only appears as a representative of nat-for-pro(it community based organization for Ihe purpose of requesting a grant wilhoul special compensation or reimbursement for the appearance. Page 4 of 5 MIAMI BEACH Ciy o/Miami eeaah, I�00 Convemio�Cemer DGve,Mloml Beach, Flonda 33139,www.mlomibeachfl.gov OHice of Ihe City Clerk Rafael E. Graoado, Ciy Clerk GtyClerk@mlomibea<hfl.gov Tel�. 305.673J411, Fan: 305.673725d NAME OF LOBBYIST: M�fY�CI��Ilke niC� 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION 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 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 fled 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 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 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 compensalion 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 LOBBYIST REGISTRATION FEE I understand annual regis�ration of all lobbyists shall be required for each 12-month period commencing October 1 of each year, and the fee for such annual registra�ion shall be $500.00 pursuant to Section 2-482 of the Miami Beach City Code. � i2i wi23 Signatu e of Lq bw t Date V e�c�eA�sn�.aroamsioeeris.wnms�oeev,•�aae�s,ano�ro,�aa.,:eo m.'va vec m= Page 5 of 5 '. . � �,� � c � T� a � �on `�K' rnc � �i. �R � �° Fz �a A �� A � � � F om > g 4 = - `m � i o z i� o a 6[ f O O � � �3 =__ � om_ 3 .. N m I �.{ -p � 0 3 B CJ � x O �3�[: �ND OQSC � � 3 V1 iC N 3 � �� � a v A ~ £ ���� T i o �€ = a m' c �?� � s 4' a r, � � _ � m m �-•� :�J o — � ro � � � K � — a � _ � wm wi _ � �-= g _ m v K � _ . i....��� � O �. o O O � �' 4 I C _. . o j o0 o I -. Miscellaneous Cash Receipt CITY OF MIAMI BEACH No. 432741 ❑Cash ❑Credit Card �C�lCheck N � $ 20 � Received of � � � � � Address For � � . . . . � MBF �. Miiscellaneous-MCR-2024 � 0�665G0001 Moises C...01/09I2024�7329AM - . P1CR OPEN(MCft) � aaymema�,�o��,r: asr,co Office of Finance Director � (THIS WFORMATION MUST BE COMPLETED) By Account number. � � � �. Preparer. �� Dept: EXT:_ � �f F � � � 1