2024 Lobbyist Registration Form - Billboards/Digital Signs (Capitol Outdoor LLC) 6iECEIVED
JAN 12 2024
A � �Ll. C �+, L
I�� II��iV�1� DL,/�'��� l�� i Of= MIAMIBEACH
� Ofilceo(iheCltyClerk C�G �F—�.�CITYC�Er�K
1�00 Canvention Center Drive �� � �
Miami Beach.FL 33139
305.873J411
LOBBVIST PEGISTRATION FORM
LoGbyist means all persons employetl or re�ainetl, whether DaiE or nol Dy a O��cipal who seeks to enmu2ge Ihe passaqe,defeat or
moComation of any oNinanre, rewWfion, action or tlecision o(eny mmmissioneq any actioq Decision, remmmenCation of Ne City
Menager or any Ciry ooaM or wmmittee:or any aclion,oecision or remmmendalim ot any City perwnnel tluring t�e time paiwtl N the
enlire tlecisiommaking pracess on such aclion, tlerision or recommentla�ion IM1at foreseeably will �e heaN or reviewetl by��e Ciry
Commission,or a Ciry boartl or rommitlee.The term specificaly Inclutles tlie pnna0al as well as any employee engagea In lobbyinq
activi�ies.The teim "�ob�yisf nas apecifc exclusions. Pleue refer to Clry Cotle Chaplor 2,Atlicle Vll, Oivision 3, enlitleE"Lobbyisis,'
foretldilionalinfortnalion.
ImWMions: Plaesecompleteallsactionsofihisformantlsubmitthemmpletetllortn,wilM1l�eappllcablefee.totM1eORIceM��eCny
CIeA. If you need more spar¢to mmple�e an answer, ose a separate sheel(5)of paper. It you �ave nolhing lo repotl in a paNcular
se�tion, you must wnte 'none' or "n/a' in IM1a� sedion. Any cM1ange ro any Inbrtnalion onglnalry OIeC, a any a0tli�ronal Giry
Commissioner or personnel w�o are also sougM m�e IOEbieO shan require Nat the Iob0yi5�file an amerMmen�to iM1e registrelion(orm.
TM1e bbbyist has a mntinuing tlury lo supply inbrma[ion ana ameM roe iortns ftled t�roughout t�e petloC Nat��e lobbying occurs.
Separa�e registrzlion farms shall be required for each O��cipal representetl on each specifc issue.
I. LOBBYIST INFORMATION:
PATHMAN, WAYNE M.
NPMEOFLOBBVIST (Lasp (Frsp (MitlaleName)
ONE BISCAYNE TOWER, 2 SOUTH BISCAVNE BLVD., SUITE 2400, MIAMI, FLORIDA 33131
LOBBVISTBOSWESSNAMEFNOFO�RESS (NumCereriJSlreeq (Cihl IState� (ZipCoEel
305379-2425
L098VISTBUSINESSTELEPYONEYUMBEP. CELLlIL1RTELEPHONENOMBER EMlIlAO�RESS
II. PRINCIPAL INFORMATION:
CAPITOL OUTDOOR LLC
NAMEOFPRWQPAL (Lasi) (Flnl) (MitltlleName)
3286 M Street, NW, 3rtl Floor, Washington, DC 20007
PRINCIGALBlI51NE55NAMERNOA0DRE55 (NumbaranOSireel� (Ci�y) (Slale) (LpCOEe�
202337-1839 john@capitoloutdoor.com
PRINGIPALBl151NE55TELEPHONENUMBER CE�W�ARTELEPHONENUM9ER EMAiLADORE55
Pursuant lo Cily Cotle Seqion 2-482��H�1(a�: A O�ncipal of arry corywalion, parNers�iO.or otM1er mtlly w�o appears as a be0yist on�e�alt ol Nal
enlity,wil�ou�specisl wmpevalim or relmbumemenl la�Me a00ee�e��B,wM1aMa�El�ecl Intlirect or mn4nqenl lo express suOWh a�o�oOMs���on lo
an I�em s�all�eglster wIN Na CIeA as requlretl�y IMs su�secfian[ul s�sll nd Ee requlreU to pay any regislrelron tees.
If !he principal is a Corporation, Partnership or Trust, the following infortnation MUST be provided
purouanl to City Code Section 2-482�c�:
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(H none,wtl[e NIA�: 'JOlifl POIIS
. NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5'A OR MORE OWNENSHIP INTEREST IN SUCN
CORPORATION,PARTNERSHIP OR TRUST�H none,wrMe NIA): N�p'
Page 7 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.
Marketing and advertising for billboards, digital signs and other forms of inedia.
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Cotle Sec[ion 2-482(a)(4), list ihe City Commissioner or City personnel sought to be
lobbied, and whether the lobbyist has entered into any contrectual 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 contractual relationship.
� Full Name oi Individual and ControcWal Relalionship Qf yes, explain) . �ES NO
Title of Pereon to be Lobbied
�-City Commission & Applicable Boards 8 Staff X
Pursuant to City Code Section 2-482�g), every registrant shall 6e required to state the e�Rent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearence of an impropriety, with any current City Commissioner or Cily personnel who is sought to
be lobbied as identified on the lobbyist registretion form filed.
iList any Business, Financial, Familial or Pmtessional Relationship, or other relationship giving rise to an
a earonce 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 Ciry Code Sec. 2•485.3):
$700/Hourly
Page 2 of 5
The tollowing siz(8)quesLons MUST be anawereE:
1) Pursuant to Ci�y Ce Sedion Y-OBB,en�illeC"Pmhibitetl Gampaign Contributions By Lobbyists On Procurement Issues".
Yes o: A I bb ' t d" b'tl f tl t �t r
pa d' awartlfor tl ' men[orservice7
2) Pursuant to Qty C e Section Y�490,en�i�led"Prohibiletl Campaign Gontnbutions By Labbyis�s On Real Estate Development
Issues"
Vea A I bb i tl' I' C ( D I t A t lh Ihe C'lv If H
f h ( i E " ti h t Ih Cb' F ture Lantl Uae Mao?
3) Pursuant to Cily Cotle Section 3d8P(h), any person (ezcept those exempt from the deMition of"lobbyist" as set fanh in
Section 2-481)who only appears as a representative of a noFfor-pmft corparation or entity wi�haN spedal compensation or
reimbursement for appearance,whe�her tlirec�o�intlirect to express support of aroppos�ion to any item,s�all register vnth
the ciry clerk quiretl by t�is section,�ut shall not be required[o pay any registration(ees.
_Yas_ A C t( oflt f �N 'lh t " I U n ar
reimbunamanl7
4) Pursuant to Ciry CaCe Seclion ]-�87, t�e�erm "lobbyisf'specifically enGuCes �he followrng persons'. Expe� wi�^wses who
proviEe only scienti(iq technical orother specialized informafion or testimony in public meetings:any person who only appears
as a represen�e�ive of a naighborhaotl association wil�oW compensation or reimbursemen�fortha appearance,whe��er tlired,
indirep or wntingent,to express suppotl of or opposition to any item;antl any person who only appears as a representative o(
not-for-pro(it mmmuniry �asetl organiza�ion far lhe purpose ot requesting a gran� without special mmpensation or
reimbu�seme r�heappea�ance.
Yes o: A 'd' I t'fi t h ' I M ' I' d i f C n' a a
p Wti f I hb M tl ' E 'th [ ' I ti r re'nmbunement or
re tl t( o ft b tl ' tl ( the o( eetlno rant without
I I f orreimburaement?
5) Pursuant ro Ciry Code Section 2-49�(��, no campaigm m�sultant shall lobby the City Commission for a penod M 12 months
�ollowing the swean in of any elected oRicial(s)far whom the campaign consWtant provitled campaign consulting services
within lhe pas� �ion cy�le. See Seclion 2-491 for more Intormation.
Vea . H 'tl C IG t be [ b f th GN C i '
'thl t� [ I ti I 91t I I'at Ihe ineumbent membeAsl of ihe CIN Commisaion:
Vea No: h �t be I th 12 Ih lh I t tl 1Fl I Ilsl whom vou orov'tled camoalun
consultina sery ces was swom in9
fi) Pursuanl to City Code Sedion YdeP�a)�4�a., a lobbyist who has vnihin ihe past election cycle provitle0 campaign wnsulting
services to an incumbent member o(the City Commission(which lobbying activity is not oNerv+ise pmhibi�ed by CoOe sec�ion
2-491) shall tlisclose such partiwlar service on his/�er lobbyist registration fortn tl h II II tl' I ch rt' lar
senice before I m Ihe Cit Commiss n at a ublic meetin .
Yea o: H 'tl tl I IC I t cumbent memher of Ne Cib Commisaion
IMI [h t I U I 11f I I' ith ' ^bs t berfslottheClNComm'aa'on:
Vea No: IT y tl did n m'c cansiderafon 'n eachanae for camoalun
wnsultinn servicea9
TO 9E COMPLETEO BY CITY LLERK'/S S'TAFF ONLY
nnual Eae. R11�'naJ� ft��eJ �SO MCRk'7.327�/� / -I��1
AnnualRaqistratlmfw: � ]Yes No AmouniPa}itl�l1 DatePaitl � �
Lobbyla[Repistratlon Form�eWivatl anA verifled by:( �1�
� �.c:a�.zau��aroamsµoesvisr>ouwz,wuoy:,ca:y. � + . . zc':r. Revise003/11/3020
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY PB OF EACH VEAR EACM LOBBVIST SHALL SUBMIT TO TXE OFFICE OF THE GITY GLERK A
SIGNED STATEMENT UNOER OATH LISTING L09BYING EXPENDIT R L TI N
RECEIVED FOR THE PRECEDING GALENDAR VEAR H REGARD TO THE SPECIFIC ISSUE ON WHICH THE
LOBBVIST HAS BEEN ENGA TO LOBBY. A S ENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
E%PENDITURE OR COMPENSA I URING TH ORTING PERIOD.'
SignatureolLobbyisf _.__,..'� Date �� ��- ���
I tlo solemnly sweer or affirm that f the foregoing/a s tatements,and disclosures in this form are tme and correIX,
and Ihat I have read or a iliar with lhe provisioy� �ained in Chapler 2, Ah. VII, Oivisian 3, entitletl "Lobbyisis" of
Ihe Miami Beach Ciry Cade an rting requi En ls /L
SignaWreofLobbyis�: ____ Da�e /� //z �
Signature of PrincipaP. � �ate 12 - Z� �- Z � . ..
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Stateot Flofida Stateo� o (� u� � Q.
CountyoE Miami-Dade coun�yor: ��f1
i
Swom to(or a�rmed)antl svbscribetl before me, Sworn to(or aKrmed)anC suCscribed betore me,
by means of fG�hysical presence by means of O physical presence
or O online noWriza�ion, or�anline notarization,
lhls y'y'�day of dle Cn mbst ,2Q��by �hisaV day o( �� ,1�W 20Zj by
Wayne M. Pathman John Polis l/ /
N4ME OF LOBBVIST NRME OF PRMCIPAL
_PraducedlD ProtlucetllD �•G �fI�GC�Sr.I(,e�n$Q
/ FORM OF IOENTIFlCATION �RM OF IpENiIFIG�TION
✓ Personally Known _Personally Known �
„ Y� nryM1��
gnatur�Pu i� SignatureofNolaryPublic +��epOUL ��•'�y M
r� ! s .... n �
A-IPxn;�,1�J4p�ht,.� Ht.c Aw�b�ou I �'l.o�+u, �%J;t'ti�.•"• � �''�i=:
Name of Notary,Ty ed, Pnn�ed or Slampetl Name of Notary, Typed, Prin�etl or Slampe0 i � � a�TAR�, ', m Y
NOTARV$EAL Nob Public Sltl�al FloiiO� f � I q -DI�IO}i : � e
( ) � �ei x�nara cMncY (NOTARV SEAL) ` , N
xn '"''c°"""'•"°" ""iJ°'° MZE AMBDOUL MOUNIB ` , ug"G •�e ii�
EcpirutONpl]Oxe ��) � /
DisVictoiColumbiallotaryPublic 's, A, '� ,_.-•• J,+ �
' Thetertn"IobEyisf'specifcallyexcWCesNefollowingpersons: MyCommissionExpiresApri130,2027 ' �� r,� C� ,d°
,,•Myryin�
Expart witncsses w!w proviEe only suentili4 teNnical or o�her speaalized informalion or teslimony in public meetings;any person wTo ������ '���
only appears as a re0resentalive o(a neighbo�hootl assxia�ion wil0au[campensa[ion ar 21m�ursemen��o�IM1e eppBaronCe,vfiB�M12�
direct,intlirttl or contingent,to exprass sopport of or opposlnon ro any i�em�,an0 any person wM10 only appears as a representa�ive o(
no4for4rofil wmmunity based organiza�ion lor Ihe purpose of requesting a grant wi�hout special mmpanSaUon or raimbursemeM lor
the aOPearenre.
Page 4 of 5
� � _ {
Ciry ef Miami Baach, I]00 Convenfion Cemer D�ive, M�om�Bmch,Florida 3313Q www.m�amibe«hA.gm
OHi<e of the Ciy Clark
Rolael E. Gronado,Ciy Clerk CiryClerk@miamlbeochfl.gov
Teh 305.673.7d1 7, Fox' 305b737254
NAME OF LOBBYIST: Wayne M. Pathman
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Seclion 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 [he Miami-Dade County Commission on Ethics and
Public Trust of [he failure o( a lobbyist (or principaq to fle the Statement or pay the
assessed fnes after notification.
Any lobbyist, who fails to file the required S[atement 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 the City Clerk a
signed Statement under oath lisling all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard lo the specifc 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
ihat 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 registralion shall be
$500.00 pursuant to Sectio 82 of the Miami Beach City Code.
/� _�� �
/
Signature of L� Date
r.¢�eawum�onus�oeans.�oaMsuoee��:i nro�:u:uo��re,m e.w.m m.��.zo nec eo�
Page 5 of 5
�- .
. ____-
Miscellaneous Cash Receipt
CIN OF MIAMI BEACH No. 432745
❑Cash ❑Credit Card ❑Check N $ �
20
Received of � �
Address
For
nneF
Miscellaneous-MCR-2024
00668SOOD Moises C...01112l2024 08'.19AM
MCR OPEN(MCR) .
_=,--_,-,..,..._-.. ___.__ Office of Finance Directo�
(THIS INFORMATION MUST BE COMPLETED) By
Account number. � �
Preparer: Dept: EXT:
�
' . �
�
�
�
f
u
k
k
,