2024 Lobbyist Registration Form - 94 Palm Ave (Jamie Mandel) '�l/ (�o.lti� J� � �
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1700 Convention Cenler Drive
Miami Beach, FL 33139
3056737411 CITYGFMIAMIBEACH
LOBBYIST REGISTRATION FORM OFRGE��T!iF CI-+CL=,-,-
Lobbyist means all persons employetl or retainetl, whether paitl or not, by a pnncipal who seeks �o encourege�he passage, tlefeat or
modi�wtion of any oNinanca, resolution, ac[ion or Gecision of any commissioner, any ac�ion, decision, recommentlaNan of the Ci[y
Manager or any City boartl or commitlee;or any action,decision or recommentla�ion of any Ci�y personnel during lhe�ime Oeriotl of Ihe
eNire tlecisionmaking pmcass on such action, deusion or recommenda�ion tha� fareseeably will be heard or reviewed by �he Gity
commission, or a Ciry board or commillee. ihe [ertn specificalry includes tha pnncipal as well as any employee engaged in lobbying
aclivi�ies The tertn "LobDyis(s" has specific esclusions. Please refer�o Ciry Code Chap�er 2, ANcle VII, Division 3,en�i�letl"Lobbyis�s,"
for atldi[ional intorma�ion.
Inalmc�ions: Please comple�e all sections of Ihis form antl su�mi��he comple[ed fortn,wi�h the applicable fee,lo�he Office of the Ci�y
Clerk. If you naed more space to comple�e an answer, use a separa�e sheet(s)of papar. I!you have nothing lo report in a paNcular
section, you must write "none" or "nla" in tlia� sec�ion. Any change �o any infortnation ariginalty filetl, or any atltli�ional City
Commissioner or parwnnel who are also sought b be lobbietl shall reQuire Iha��he lobbyis�file an amentlment lo�he regis�re�ion torm.
The lobbyis� has a con�inuing duty �o supply informa�ion and amentl �he forms filed �hroughou� the pariotl �ha� the lobbying occure.
Separate registration forms shall be requiretl for each principal represen�ed on each specific issue.
I. LOBBYIST INFORMATION:
Bor�es Reinaldo
rvnME oF�oeensr (�asp Iwrsp (Mieaia Name)
BorRes& Associates 237 S Dixie Hiyhway,Suite 919 Coral Gables Florida 33133
LOBBYISTBUSINESSNAMEANDADORESS (Numbe�entlSVeeQ (Gty) (S�a�e) (ZiDCotle)
305374-9216 rborgesOborgesarchitectacom
LOBBVIST BUSWESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL AODRESS
II. PRINCIPAL INFORMATION:
Mandel Jamie
NAME OF PRINCIPAL (Las�J (Flrsl) (Mitltlle Name)
Palm Island Residence Trust 94 Palm Avenue Miami Beach Florida 33739
PRINQPAL BUSMESS NAME AND AD�ftESS (Numberantl 3�reet) (Gty) (S�e�e) (Zlp Cotle)
786-535-1066 Ibmande118QgmaiLcom
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NIIMBER EMAIL ADDRESS
Pursuant m Ciry Cotle Section 2-082(M1)(1)(a): A pnncipal of any mrporation, patlnership, or o�M1er entiry wM10 appears as a IODUyIst on beM1ali oi ihat
entity,wit�oul special wmpensalion or reimbursement frn tM1e appearanca,vRielM1er tlired, In0lrect,orcontingenl,�o expres suppotl N or opposltion to
�. en item s�all regk�er wit�IM1a Clerk as reQuiretl by[�is suLsec�ion but s�all not�e requlretl�o pay any reglstration fees.
' If the principal is a Corporetion, Partnership or Trust, the following information MUST 6e provided
pursuant to City Code Section 2d82�c�:
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): lamie B.Mandel,AUNiorized Penon
- • NAME OF ALL PERSONS HOLDING,DIRECTLY OH INDIRECTLV,A 5%OR MORE OWNERSXIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR THUST(ii none,write N/A): P�2252 522 t�12 d[I2Ct1Ed.
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III. ISSUE TO BE LOBBIED:
Describe with as much detail as is practical, including but not limited to a speciTic description where
. applicable of a pending request(or proposal, invitation to bid, or public hearing num6er.
Development Approvals & Permitting Iss�es, including but not limited to the Historic Preservation
Board Design Review Board Planning Board, Board of Adjustment, Land Use Development, City
Commission, and any City Workshops or Committees, if necessary, relating to the property located
at 94 Palm Avenue in Miami Beach,Florida.
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
lob6ied, and whether the lobbyist has entered into any con[ractual 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 generel nature of the subject contrectual relationship.
Full Name of Individual and Contractual Relationship (If yes,explain) vEs No
Title of Person to be Lobhied
Staff for the Planning&Building Department None X
Public W orks & Ci AdministraHon,PB, HPB, BO None X
DRB, Citv Commission, and Mayor as necessary None X
Land Use&Sustainabili Committee None X
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 registretion form filed.
List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an
� a earance of im ro riet if none write N/A :
None
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2�85.3):
szso
- $ .00 per hour
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The tollowing six(6)puestions MUST be anaweretl:
1) Pursuanl to City Code Section 2-488,entitled"Prohibited Campaign Contnbutions By LobGyisis On Procurement Issues":
� Ves xNo: A I bb ' � ce d' a b'A f d u ' t or on a reaen[or
�d' ward tor aoodz eau'oment or service?
2) Pursuant�o City Cotle Section P-490,en�itled 'Pmhibitetl Campaign Can�nbutions By Lobbyisis On Real Eslate Development
Issues":
Ves X No: A I bb ' d 1' ! � D I t A nt w'th the C'N or aool'caCon
T h u ( ' a P tl f hanfle to the C N's FuNre Land Ose MaoY
3) Pursuan� �a Cily Gotle Sec�ion 2-C82(h), any parson (excep� �hose exempl from the defini�ion at "IobbyisC as set fohh in
Sec�ion 2381)who only appears as a represenWliva of a noFfor-pm��corpore�ion or en�iry wi�hoN special wmpensa�ion or
reimbursement for lhe appearence,whether direct or indirect lo express support of or opposition to any item,shall register wilh
[he ciry clerk as requiretl by ihis section,bu[shall not be required to pay any regisiration fees.
YeszNo: C ti aft ro f fN 'th t ' 1 o fon or
reimbursement7
4) Pursuan� �o Ci�y Code Sedion &481, the �ertn "lo�byis�" spacifically exdutles �he tollowing persans Expetl witnesses who
pmvide only scientific, lachnifal orather specialized infortna�ion or tes�imony in public meetings;any person who only appears
as a represen�ative of a neighborhootl associa�ion wi�hou�compensation or reimbursemen�for�he appearance,whe�her direc�,
intlirec�or contingent,to express support of oropposition lo any item�,and any person who only appears as a representative of
whfor-profi� communi�y based organization for �he purpose of requesting a gran� withoW special compensation or
reimbursement(or the appeardnce.
Ves xNo: A o 'tl' I t'f' t h ' I th p ' I' d ' i t' ear'n as a
o t 1' i ' hb a d 'at'an w thout soei al eomoensation or reimbursement or
p t' tT f't b tl ' f / th / f a t 'ihout
ecial com n at on or reimbursement?
5) Pursuant�o Ci�y Code Sedion 2d97�1), no campaign consultan�shall lobby�he City Commission br a panod of 12 months
following lhe sweanng in of any elec�etl of�cial(s)for whom �he campaign consul�an� provided rampaign consul�ing services
within�he pas�election cycle. See Seclion 2d91 for more Intorma�ion.
Ves XNo: H 'tl d if rv'ces to an 'ncumbent member of the Citv Commission
'th' ih t I [' I 4 IT pl e I'st the'ncumbent membertsl of ihe CiN Comm�ssion:
Ves x No: ^ h 't be I th 12 Ih lh I t tl off'i al(sl whom vou provitled camoaian
consultina aervices was awarn in7
6) Pursuanl lo City Code Sec�ion 2-A82�a�(4�a., a lobbyisl who has wi�hin�he pas�elac�ion cycle provitled campaign consul�ing
servicas�o an incumbent member of�he City Commission(which lobbying activi�y is not otharwise pmhibited by Code seclion
2<91) shall tlisclose such parlicular service on hislher lobbyisl regisVation form ntl shall orallv dsGose such oarticular
b f I bb � Ihe Ct Comm�ss on at a oubl c meetina.
Ves X No: H �d d if t an 'ncumbent membet of the Gitv Commission
'th' ih t I F I 7 H I I'st the'ncumGent member(sl of ihe CiN Commiesion:
- Ves x No: If t tl d"d m'c eons'CaraCon 'n ezchanne 7or camoaian
- CalISuI�111A SBrvi[e5?
- TO BE COM LETED BY CITY CLERK'S STAFF ONLY
''� } 6
Annual Regiatratlon(ee: [�Yes[ �Na Amount Pai f �1 sIb � MCRfII J—S� � Date Paitl 3 c�
LobbyiatReglstrationFomi�eceivedantiverifetlby: � �/�'1
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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 E%PENDITURES AS WELL AS COMPENSATION
RECEIVED FOR THE PRECEOING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE
L0B8YIST HAS BEEN ENGAGED TO L08BY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMP b URING THE REPORTING PERIOD.'
Signa W re of Lob6yisC.
��' ���f Date oaizarzo2a
I do solemnly swear or affirm that all of ihe toregoing facls, statemenls, and disclosures in this form are tme and correct,
and Ihat I have read or am familiar with the provisions contained in Chapler 2, Art. VII, Division 3, entitled "Lobhyisis" of
�he Miami Beach Ciry C BNaepoding requirements.
SignaWre o(Lobbyist:
�� �r�$ oe=�s�c..ae�: Dale
i w`
SignatureofPrincipal: "�� �����_ Dale oerzaizoza
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Stateof Florida S�ateof Florida
CounryoE Miami-Dade CounryoP. Miami-Dade
Sworn b(or affirmed)and subscribed before me, Swom ro(or affrtmed)and subscribed before me,
by means of O physical presence by means of O physical presence
or IXonline nolarization, or[Xonline notarizatian,
�his_day o/ nnnnnnaa . 20_, by Ihis_day o/ . 20_, by
Reinaldo Bor�es lamie Mande]
NAME OF LOBBYIST NAME OF PRINGPAL
Produced ID _Produced ID
FORM OF IOENTIFICATION FORM OF IDENTIFICATION
X Personally K� %Personally�ry�� ��p'�
,_...L ,..=-a•-.• � L».-,.:--....a
I - SignaWreo(NolaryPublic SignaWreofNolaryPublic
� - Diana Ramos Diana Ramos
- Name of Notary, Typed, Printed or Slamped Name of Notary, T ped, Printed or Stamped
� oiana Ramoc Diana Ramos
Commission M HH 3869D Commisaion N HH 3869D
Nolary Publlc-Sta�e of FIo�iEa Nolary Pu01ic-Slale of FlonEa
My Commission Expires Apr i6,202] My Commission E�ires/+pr i6,209
� ' ThB Persons: ..�,...,e...�.e.�o., ..e,..,
Experl wi�nesses who pmvide only scien�ific,�echnical or olher specializetl infartna�ion or tes�imony in public mee�ings;any person who
' only appears as a represen�ative of a neighborhood associa�ion wi�houl compensa�ion or reimbursemem for Ihe appearance,whether
tlirecl, indirec�or conlingent,�o ezpress sup0ort of or opposition lo any i�em;and any persan who only appears as a represenlalive of
- no4for-pmft communiry basetl organization for the puryose of reques[ing a gran�wilhout speaal compansa�ion or reimbursemenl for
` ihe appea2nce.
Page 4 of 5
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OHlce oF Ihe Ciry Clerk
Rolael E Granado, Ci�y Clerk CiyClerk@mlamibeach5.gov
Teb. 305 673 J411, Fax- 305.6737254
NAME OF LOBBYIST: Reinaldo BorQes
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 fle 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 pnncipal) to file the Statement or pay the
assessed fines after notifcation.
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 Counly 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 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 immediatety 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 pursuaM to Section 2-482 of the Miami Beach City Code.
_ � �. ,o
��'�'�Y���'S oeisenozn
- Signature of Lobbyist Date
i II.LYN6u i w�ORMSLOHtlVIb I lORNSY o��yinl Hapin�aWn�mm Rorv¢� 0]11 YV RFP Jon
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DISCLOSURE OF INTEREST
TRUSTEE
If the property that is the subject of the applimtion is owned or leased by a imst, Ilsi any and all trusrees and baneficiaries of
�he tmst and the percenmge of inrerest held by each. If the owners consisl of one or more wrpomtions, partnerships, husts,
- pormerships or o�her mrpomte entitles, the opplican� shall foriher disdose the identiy of �he IndHidual�s� (notuml persons�
having fhe ulfimare ownership interest In fhe entiy.
Palm Island Residence Trust
TRUST NAME
NAME AND ADDRESS % INTEREST
Palm Island Holdinqs LLC as Trustee �%
251 Little Falls Drive, Wilmington, DE 19808
Beneficiaries:
David Centner 50%
Leila Centner 50%
3921 Alton Road, #465, Miami Beach, FL 33140
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