2024 Lobbyist Registration Form - Long Term Agreement (Maureen Bruckmayr) /�r�9 T�cm A9,ee.men+
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�ECtNED
MIAMI BEACH Offceof[heCi�yClerk SEP 232024
1700 Convention Center Drive
Miami eeach, FL 33i39 CITY OF MIAMI BEACH
305.673.7411 OFFiCF OF'��.iE�IITV CLFHk
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a pnncipal who seeks ro encourage ihe passage, defeat or
motlifcation ot any ortlinance, resolution, action or tlecision of any commissioner; any action, tlecision, rewmmentla�ion o( the City
Manager or any Ciry board or committee;or any action,decision or recommendation of any Ciry personnel during ihe time penod o(ihe
entire tlecision-making process on such ac�ion, decision or recommentlation �hat Poreseeabry will De heartl or reviewed by the Ciry
Cammission, or a CiTy board ar commillee. The term specifically inGudes the pnncipal as well as any employee engagetl in lobbying
aclivities. The term "LobbyisY' has spea�c exclusions. Please refer to City Cotle Chapler 2, Ahicle VII, Division 3, entitled "Lobbyists,'
for atltli�ional information.
Instmctions: Please complete all sec�ions of lhis form and submi�lhe completed form,wilh�he applicable tee, to the Office af lhe City
qerk. If you neetl more space to complete an answer, use a separate sheet(s)of paper. If you have nothing to report in a partiwlar
section, you must wnte "none° or "n/a° in that seMion. Any chan9e ro any in(ormation originally fleQ or any adtlitional Ciry
Commissioner or personnel who are also sought to be lobbietl shall require that Ihe lobbyis�fle an amentlment�o Ihe regis(ration form.
The lobbyist has a mntinuing tluty to supply information and amend the fortns filed Ihroughout lhe penod ihat the lobbying occurs.
Separate registration forms shall be requiretl for each principal represenletl on each specifc issue.
1. LOBBYIST INFORMATION:
�er�msrn �tSerf" S.
NAME OF LOBBVIST (Las�)� (Firs�) (Middle Name)
�W ,y� sfsf aYa/',�
��i- d �ar�mran f�v�-sJ�i'sino //!c. .a.,�. ��G/i�'F"t ,�3/�D
LOB9VIST BUSMESS NAME AND AODRESS (Numbere SVceI) (Ciry) (State) (Zlp COGe)
/�3o5� G73-Si�7 �,�ns) 795-3/ �7 baoaalrr�ana��r/�eranr/
L BVISTBUSMESSTELEPHONENUMBER GELWLARTELEPHONENUM9 MAILA �RESS
��m�J •Gar1
II. PRINCIPAL INFORMATION: ,/�
/�/ e
NA OF P CIPAL ) (First) (MiEEIe Name)
�� S���A ,S r
J9/'f , �/Kt�iY/e �d� i7l-/�n Gnan���'�l�/. NYNY/00�
PRINCIPALBUSMESSNAMEAN�A�OftE55 (Numberantl5(reet) (Ci�y) (Stat ' (ZiOCotle)
oi/-y/-S8_ aoG- �75/ Oi/-�/- q9-G/2 D�D3- Ma���Pn -,Flrr��,(�nar�
PRINCIPALBUSWESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILAOD SS
Pursuant to Ci Code Section 2482 M1 i '. A I of an Pio rtnershi ��SC���O�
ly O( )�a) pnncipa y corpora n, pa p, or o�M1er entity who appears as a lobbyisi on behalf of Iha�
entity,wit�out special compensation or reimbursemen�for roe app2arance,wM1elM1er tlirec[intlirect,or mnOngenl,to express support of or op0osi[ion lo
an i�em shall regisler wi�M1�he GIeM1 as requiretl Dy�his subsedion Oul s�all not be rcquiretl�o pay any regis�retion fees.
If the principal is a Corporotion, Partnership or Trust, the following infortnation MUST be provided
pursuant to City Code Section 2-482(c�: '/
• NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(H none,write NIA): N07/J�7rO/[7/ f Z
. NAME OF ALL PERSONS HOLUING, DIRECTLV OR INDIRECTLV,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): /�/��
Page 1 of 5
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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 request for propasal, invitation to bid, or public hearing number.
�o�/J 7iF1»'7 dGfeC/rAC!'17�'
IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4), list the 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 of Indivitlual and Contradual Relationship (Ii yes,ezplain) ' VES NO
Title of Person to be Lobbietl
�
Pursuant to City Code Section 2-482(g), every registrent shall be required to sWte the e�Rent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearance of an imprapriety, with any current Cily 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 ro rie if none,write N/A :
/�O//
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):
#P�<000�ua/ --
Page 2 of 5
The tollawing six(6)questions MUST be answeretl:
1) Pursuant�to Ciry Code Seclion Y-488,entitletl"Pmhibiled Campaign Contnbutions By Lobbyists On Pmcuremenl Issues"�.
_Ves✓No: Are o I bb ' t d" b'tl f tl t t
oentlina awartl for aoods eau"oment or serv'ce7
2) Pursuan�to City Code Sec�ion 2-490, entitletl "Pmhibited Campaign Contnbutions By Lobbyists On Real Estate Development
Issues"
_Yes_No: Are yo I bb ' tl' f tl f D I t A t 'th th C'N f ["
for chan f o d f h t th C"N' F t L tl U M 7
3) Pursuan� to Ciry Cotle Section 2-082�h), any person (except those exempt from �he tlefni�ion of "IobbyisP as set forth in
Section 2-481)who onry appears as a representative of a no4for-profit wryoration or entity without special compensation or
reimbursem nt For the appea2nce,whether direcl or indirect to express suppoM1 of or opposition to any item,shall register with
the city cl as requiretl by this sectian, but shall not be requiretl to pay any registration(ees.
_Yes No: Are f t-f - ft tl EN 'th t ' I f
reimbunement?
6) Pursuant to Ciry Cade Section 2-487, ihe�erm "IobbyisP specifically exdutles the following persons�. Expert witnesses who
provitle only scientiAq technical or other specializetl information or testimany in public meetings�, any person who only appears
as a representative of a neighborhootl association without mmpensa�ion or reimbureemen�tor the apPearance,whelher tlirec[,
intlirec�or mntingen�,to express suppoh of or opposition to any i�em;and any person who only appears as a representative of
no4for-prof mmmuniry basetl organization for Ihe purpose of requesting a grant without special mmpensation or
reimburs entforiheappearance.
_Ves_No: Are you orovid'na onlv ae'ent'fc techn eal r th ' I' d ' t C o0
representat've of a ne'ahborhootl ass ' C 'iho t ' I saC ' b e enl
reo F t-T - ft b tl ' C / N f C ( '(� t
soecial comcensation or re'mbunement�
5) Pursuant lo City Cotle Section 2-497�1), no campaign consultant shall lobby the City Commission for a penotl of 12 mon[hs
follovnng th sweanng in of any electetl oHicial(s)for whom�he campaign rsmsul�ant provitletl campaign consulting services
wilhin[he ast election cycle.See Section 2-491 for more information.
_V¢s_No: Hav¢ vou omvitletl eamoa on consulCna serv'ces to an 'n mbe t b f Ih C'N C
within th t I f <I 9 If I I' t th ' b t b A 1 f th C't Co
_Yes_N• o: If es has it been less l�an 72 months since the elected offciallsl whom vou nrovidetl camoalan
consultino services was sworn'n�
6) Pursuant�o City Cotle Section 2-482(a)�bJa., a lobbyist who has within�he pas�election cycle pmvitletl campaign cansulting
services to an incumbent member of ihe City Commission(which IoObying activity is not otherwise prohibited by Cotle section
2-491) shal isclose such particular service on his/her lobbyist registration form antl shall orallv tlisclose such �arlcular
ry b I bb - th Cb C � bf Y
_Yes_No: Have vou orovitled camoa an consulCno serv'ces to an 'n mbenl be t th C'N C
within Ne t 1 f I �If I f tth ' < b t beA ) f th CN C 'sa
_Ves_� No: If yes. were vou oromised or tl'd vou rece've econom'c c n 'd t' h t
consultina services?
TO BE COMPLETEO BY CITV CLERK'S STAFF ONLY
AnnualRegisVa�ionfea: ��Yes[ ]No AmomtPai/tl�E�MGRp 4�'��u�OatePaitl Z 20�
, LobbyislRegiSUaGon Porm receiveE anE ve�ifietl by: ]"S-�. �
I � � � ;�<..' � Rev'seA03/11/i020
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 Of EACH YEAR EACH LOBBVIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A
81GNED 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 ENG GED TO LO STATEMENT ALL 8E FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPE S O PERIOD.' � .
.r v 2 � >
Signature of Lobbyist Date �
I do solemnly swear or afirm that all of the f e�ng facts, statements, and disclosures in this form are Irue and correct,
and that I have read or am f ith th prov io s contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code d all � g r@ ir ts,
� � ('' y� Z
Signature of Lobbyist: Date
Signature of Pnncipal: � � /� le E )e.�� �-�1 � �c� y
/ /
VII. NOTARY SIGNATURE AND SEAL: 'h�����k � A-,� ri� / / �� `��
t(�' 6 1 n
LOBBYIST: PRINCIPAL��� SW�-��(��
State ot_�'l State of �L
Countyof:���/�f �/�� CountyoE ��4Mi�l ��,L
L� n
Swom to(or affrmed)and subscribed before me, Swom lo(or affrmed)and subscribed before me,
by means of O physical presence by means of�hysical presence
or❑ I notarizatJi�n, � � A/ or O online notarization,
this day of�20�qy this�day of S��20j� by
Lir��.��p( �t7tJ�kt�� l /v/ai�vPP�] �!�!/GK.///GI///�
����BBVI NAME O�PRINGIPAI
�L ��
Produced ID .�A�\�C ACPI(���— �Produced ID�"^"r�
FORM OF IDENTIFICATION FORM O'F �ENTIFl�
Persor�aHy-Kqown Per n ly Knawn
C �A_A1%
TL13C�l�il
otary Public ur f Nota ublic
�VCP �.�AJGc{l,� �\ce. l.c,.r�.C�
Name of Notary, Typed, Printed or Slamped Name of Nolary,Typed, Prinled or Stamped
(NOTARVSEAL) �-�—�-- � --- �� i (NOTARYSEAy
� ALICES.LAVPDO .__ . __.____
�f E MVCOMMISSIONRHH272560 q�ICES.lAVMO
PES JIINa6,2026 /,"" ¢
'p � MY COMMISSION xHH7TL560
'Thelerm"lobbyis ��Icad�v�l@��{i�� persons-. �^ E%PIP6S:JUNOQ2026
� '`� BCIbWNmuAh1st61alelBu2nce
Expert witnesses who provide anry scientifc, technical or other specializetl intormation ortesllmmry' person who
only appears as a representative of a neighborhootl association vi�thout compensation or reimGursement for ihe appearance, whe�her
tlired, indirect or contingent, to express support o(or opposition to any item; and any person who onty appears as a re0resentative af
nol-for-proft community based organiza�ion for Ihe purpose of reQuesting a granl without special compensation or reimbursement for
the appearance.
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Ciy of Miami Bsach, I]00 Convemlon Ce�b�Ddve, Mlaml Beoch,Florida 33139,www.miami6eachA.gov
Office of ihe Ciy Clerk
Rafael E. Gronodo,Ciy Clerk CiyClerk�miamibeachfl.gov
Tel: 305.673741 I, Fa.� 305.6737254
NAME OF LOBBYIST: �I?�.r� ,�• ( �p��jnd/)
7) 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 principap to file the Statemen[ or pay the
assessed fines after notification.
Any lobbyist, who fails to file lhe required Statement by April 30'" of each year, shall be
automatically suspended from lobbying until all fines 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 compensation
received, for the preceding calendar year with regard to 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
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 S ction 2-482 of the Miami Beach City Code.
� ° � '� � y-3 2
Signature of Lobbyist Date �
Facienun�naroams�oaev�sr FoaMs�000yim xegisvauo�Fo�w.�:.a aan-zo aeaeo�
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