2024 Lobbyist Registration Form - 350 Lincoln RD (Nicole Thompson-Floyd) 3$0 �;hGo)n �-
� - Es o� ta2a
. � � � � � �� �� �ce of the City Clerk
1700 Convention Center Drive � �� � � �
Miami Beach, FL 33139
305.673.7411
LOBBYIST REGISTRATION FORM
Lobbyist means all pereons employetl or retaine�, whether paitl or not, by a principal who seeks to encourage the passage, tlefeat or
modifration of any ordinance, resoNtion, action or dedsion of any commissioner; any actian, decision, recommenCation of the City
Manager or any City board or committee;or any action, tledsion or recommentlation of any City personnel during lhe Ume period of the
entire tlecision-making process on such action, decision or recommendation that foreseeably will be heartl or reviewetl by the City
Commission, or a City board or committee. The term specifically inGudes the principal as well as any employee engaged in lobbying
activities. The tertn "LobbyisP' has specific exclusions. Please reter ro City Cotle Chapter 2, Article VII, Division 3, entlNetl "Lobbyists,"
/or additional infortnation.
Inatmctione: Please complele ell sections of[his form and submit ihe completed Porm,vnth ihe applica6le fee, to the Office of the City
Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. It you have nothing to report in a partiwlar
seclion, you must wrile "none" or "n/s" in that section. Any change to any inkrmation onginelly fled, or any a0tlitional City
Commissioner or personnel who are also sou9ht ro be tobbied shall require that ihe lobbyist file an amendment to the registration tortn.
The lob�yist has a continuing dury to supply information antl amend the forms Flled Mroughout the penod that the lobbying occurs.
Sepamte registretion forms shall be requiretl for each pnncipal representetl on eac�specific issue.
I. LOBBYIST INFORMATION:
Madrid Vanessa
NAMEOFL08BVIST (Las�) (Firsq (MiCdleName)
Holland and Knight LLP 701 Brickell Ave, Suite 3300 Miami FL 33131
LOBBYIST BUSINESS NAME AND ADDRESS (Number aM Streeq (Ciry) (State) (Zip Cotle)
305-789-7453 vanessa.madrid@hklaw.com
IOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II. PRINCIPAL INFORMATION:
Thompson-Floyd Nicole
NAMEOFPRINCIPAL (Lesq (Firsq (Mltl�leName)
TD Bank Two Portland Square Portland ME 04112
PRINCIPAL BUSMESS NAME AND ADDRES$ (Num�arantl StreeQ (Ciy) (State) �Zip Catle)
813-335-5043 Nicole.Thompson-Floyd@td.com
PRINCIPAL BUSMESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
Pursuant to City Cotle Section 24ffi(�)(1)(a): A pnnrapel of arry mrporetion, DaMeia�ip, or other entiry who ap0ears as e lobbyist on behalf of t�et
en�iry,withou[special mmpeneation o�reimbursemerM1 for ihe eppearance,whe�he�dired, intlirect or coMingent,to ezpress support of o�opposilion�o
an item s�all register with ihe Clerk as require0 Cy this subsection but shall nat be requlretl to pay any regisirelion feee.
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482�c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARV(If none,wrlte WA): N/A
• NAME OF ALL PERSONS HOLDING,OIRECTLY OR INDIRECTLV,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPoRATION,PARTNERSHIP OR TRUST(If none,write N/A): PUb�IC�Y tfBdBd COfTipBfly NY$E:T�
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III. ISSUE TO BE LOBBIED:
Describe with as much detail as Is practical, including but not Ilmited [o a specific description where
applicable of a pending request for proposal, invitation to bid, or public hearing number.
Development approvals&permitting issues, including but not limited to Members of City Administretion, Members
of City Staff and Members of HPB, PB, DRB, BOA, City Commission and Mayor, relating to the
property located at 350 Lincoln Road, Miami Beach (Folio 023234-019-0820)
IV. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED:
Pursuant to Ci[y Code Section 2-482(a)(4�, Ilst the City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contractual relatlonship (paid or unpaid) with
said City Commissioner or City personnel from 72 months preceding such commencement of service
with the Clty to the present date, stating the general nature of the subject contractual relationship.
Full Name of Individual and Contrectual Relationship (If yes,explain) YES NO
Title oi Pereon to be Lobbiad
Members of City Administretion and Members of Ciry Staff X
Members of Historic Preservation Board (HPB) X
Planning Board (PB), Design Review Board (DRB) X
Board of Adjustment(BOA)Cily Commission and Mayor X
Pursuant to City Code Section 2482(g), every registrant shall be required to state the extent of any
business, financial, familial or professional relatlonship, or other relatlonship giving rise to an
appearanee of an Impropriety, with any current City Commissioner or Ciry personnel who is sought to
be lo6bied as identifled on the lobbyist registratlon form ffled.
List any Business, Financial, Familial or Professionai Relationahip, or other relationahip giving rise to an
a earance of im ro rie if none write N/A :
N/A
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Soecific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-485.3�:
$750 per hour
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The following eix(6)questionn MUST he answered:
1) Pursuent to Ciry Code Section 2�88,entitled'Prohibitetl Cempaign Contnbutions By Lobbyists On Prowrement Issues"'.
Yea XNo: A u lobbvl a o a ore e t or oentlina bitl for aootla eauloment o ae 'cea or on a oreaent o
oentlinaawartlforaooda eaulomantorservice9
2) Pursuant to City Code Section 2-490, entitled"Prohibited Campaign Contn6utions By Lobbyists On Real Estate Development
Issues"'
Yea xNo: Are vou lobbvina on a oandina aoolicetion for a Develooment Aareement with the CIN or aoollcaUon
for chanae of zonlna mao tlesianatlon or chanoe to the CIN's Future Lend Uae Mao?
3) Pursuant to City Code Section 2482�h), any person (except those exempt from the definition of "lobbyisf as set forth in
Section 2-081) who onry appears as a representative of a not-for-profit coiporation or entity without special wmpensation or
reimbursament for ihe appearance,whether direc[or intlirect to express support of or opposition to any item, shali regisler with
the ciry clerk as raquiretl by Uis section, but shall not be required to pay any re9istration fees.
Yea xNo: A ou reoreaentl n bior-oroBt c ooratlon ar entlN without acec'al c oe satlon or
reimEunement7
4) Pursuant to Ciry Cotle Section P-487, the term "IobbyisP' spacifiwlly ezcludes the Following persons: Expert wiNesses who
provide only scientifiq technical or other specialized inkrmation or testimony in public meetings; any pereon who only appears
as a representative of a neigh6orhood association without compensation or reimbursement for the appearance,whether tlirect,
in0irect or contingent, to ezpress suppoR of or opposition to any item�, and any person who only appears as a re0reuntative of
not-br-profit community basetl organization for the puryose of requesting a grant without special compensation or
reimbursement for the appearence.
Ves xNo: Are vou orovldinn onlv scientiflc technlcal or olher aceclalized inbrtnaUon: aooearino as a
r tatl f i h6 rhood assxiatlon Itho t acectal e ati n or relmburaemeM or
r rea nlin a not for- rofR basetl o anl n t r Me r ot re uestin a nnt without
soecial comoensaLon or relmbunement?
5) Pursuant to Ciry Code Section Y-491�1), no campaign consultant shall lobby the Ciry Commission for a penod of 12 months
Pollowing the sweanng in of any electetl otficial(s) for whom the campaign consultaM provided campaign consul6ng services
within the past election cycle. See Seclion 2-091 for more inkrmation.
Yee XNo: Have vnu arovitletl camoaia COOH Itl� EBNI a to an incumbent membe of the CIN Commisalon
wiMin the oaat eleclion cvUe7 If ves olease Iinl the Incum6ent mem6eAs1 of the qN Commlasion:
YeaXNo: If vea has It bean laea than 72 montha alnce the elected otticlallsl whom vou orovidetl camoaian
consultina aervices was svrorn in?
6) Pursuant to Ciry Code Section 7.182(ap4)a., a lobbyist who has within the past eleMion cycle prov�detl campaign consulling
services to an incumbent member of the Ciry Commission(which lob�ying activiry is nW otherv+ise prohibite0 by Cotle section
2-491) shall Aisclose such particular service on his/her lob�yist registratlon form and shall orallv disclose such oarticular
i ef r I in th Ci ommi i nata ublc tin .
Yas XNo: Heve vou orovitletl camoaian connultina servicea to an Incumbent member o/the CIN Commlacion
wlthin the oast eie tlon cvclelli I a Ilat the inc mbent membeNsl ot the CIN Co mission�
Yea No: It ea were ou oro Ised or tlltl vou recel e eco omic co altleiation in exchanae Tor camoalan
conaultina servlcea9
L TO BE COMPLETEO BY CITY CLERK'3 STAFf ONLV
Pco�;as�y e�� � o L/3�o1� a�' 1 ' 'Z/
Annuel Ragietmtion iw: [ ]Yea� ]No Amounl Paltl 5 3 S MCR t Date Pai
Lobbyial Ragiatrotion Form reeeivetl anE verifletl Ey: ��
mi� . r�� - c. ,=r-. Revieetl 03/11/2020
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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
LOBBYIS7 HAS BEEN ENGAGED TO LOBBY A STATEMENT SHALI 8E FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.' �
signature of Lobbyist: '�G� L"��r-� /ni�.'+'� �+� ' oate � L 4' /L�^
I tlo solemnty swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct,
and thal I have read or am familiar wi Ji the provisions contained in Chapter 2, Art. VII, Division 3, entdled "Lobbyists" of
the Miami Beach Ci Cotle an�I r orti re iremen .
� f a�r z
Signature of Lo6byist: /� 9 Date �
Signature of Principal�. Date �
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
sm�eor Florida s�a�eof f lo�idG�
co���v or: Miami-Dade County of: ����n� V�
Swom to (or affirmed) and subscribed before me, Swom to (or affyned)and subscribed before me,
by means of O physical presence by means of C3�physical presence
or O online notarization, or O online notarization,
this,g�day of TAr� 20� by this�' day of ,"fAnl✓a . 20��/, bY
Vanessa Madrid Nicole Thompson-Floyd
NAME OF LOBBVIST NAME OF PRINCIPAL
ProducedlD _ProducedlD
FORM OF IpENTIFlCATION FORM OF IDENTIFICATION
�Personally Known ✓ Personalty Known
''� C �G E`����t,c.�
Signat of Notary ublic Sign re o otary Public
�At�ntl�1 l NGw�AS ����� �����
Name o(Notary,Type4 Printed or Stamped Name of Notary, Typed, Printed or Stamped
pqrnEu�rrion7FlS NOTARYSEAL) "'"" Kama✓�oEaK
(NOTARY SEA � �-_ � � � P. �"r.
: MYWh1MIS510f! H�1198705 � 1 NohryGUCM1c SuteolFbnda
� ; EXPIRES'.�ecember172026 �,���' Comm'ssionNXHllEAS
�� B tledTM1 NalatyF hF L 'Jz;s My Comm.Esplrev wr El,t031
'The term"lobbyisf'sped ica y e:c u es e ollovnng persons:
Expert witnesses who pmviEe only suentific,technical or other specialized inPormetion or testimony in puElic meetings; any person who
only appears as a representative of a neigh6orhood association without compensation or reimbursement for the appearance,whether
dired, intlirect or wntingent, ro express support of or op0osition to any item-, antl any person who only appears as a representative oF
no4for-proFlt community based organizalion for the purpose of requesting a 9rant without special compensation or reimbursement for
the appearance.
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Ciy of Miami Beach, V00 Convemion Cenrer Drive,Miami Beach, Fbrida 33139,www.miomibeochll.gov
Office of Ihe Clry Clerk
Rafael E. Granado, Cify Clerk CltyClark�miomibeachfl.gov
Tal: 305.673.7411, Fax: 305.673.7254
NAME OF LOBBYIST: VaneSSa Madrid
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 aker 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 fhe
assessed fines after notification.
Any lobbyisl, 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 ro 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 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
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
���a�il�— � l Z �- lz�-
Signature of L byist Date
F\CLEfl�SALL�9FORMSLLOBBVIST FORM51LMOyre1 Repulnlbn Fo�m PeWNO OJ�1L]0 REG Eoc
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Miscellaneous Cash Receipt
CIN OF MIAMI BEACH Na, 433016
❑Cash ❑Credit Card OCheck N $
20
Received of � � �
Address
For
MBF
. Miscellaneous- MCR-2024 .
OO6i10.0019 Adrian V... 02/072024 09:13AM
rncR oaeN�Mce� Office of Finance Director
Pzymen[Amoune f 200.00
(THIS INFORMATION MUST BE COMPLETED) By
Account number. �
Preparer: Dept: EXT:_
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