2024 Lobbyist Registration Form - MBVCA Annual Grant Application (Brittnie Bassant) Mi3VGl� - qn��al Cso��t
. , /aS? � ''`'�}.on
RECEIVED
— orr�oeormecrcycie�k SEP 172024
1700 Convention Center Drive
Miami eeach, FL 33139 CITY OF MIAMI BEACH
305.fi739411 OFFlCEOFTHE GTVCLERH
LOBBVIST REGISTR4TION FORM
lobbyist means all persons empfoyed or re[ainetl, whether paid or no[, by a principal who seeks m encourage the passage, detea[ or
modification of any ordinance, resolution, action or decision of any commissioner; any actloq decisioq remmmendatlon of the City
Manager or any City board or commlttee; or any actlan,tlecislon or recommendation of any City personnef during the time period ot the
entire decision-making pmcass an such actloq decision ar recammentlation that fomseeably wifl be heard or reviewed by the Clty
Commission, or a City board or committee. The �erm specificallY indudes the principal as well as any emplayee engaged in fobbying
activitles.The term"LobbyisT'has specTc excWsions.Please reier to City Code Chapter 2,Ar[icfe VII,Dlvision 3,entltletl`Lobbylsts,"for
additlonaLlnformatlon.
Instmctions:Please mmpfete all sections of this form and submit the completed form,with the applicabla fee,m the Office of the Clry
6lark,-Fl-yeu�eetl more space to complete an answer,use a sepaate sheet(s)of papec If you have nothing[o report in a particular
section,yoa must write"nane"or"n/a'in that section.Any change to any Informa�ion originally filed,or any addltional Ciry
Commissioner or personnel who are also sought to ba lobbied shall requlre that the lobbyist flle an amendment to�he mgistration form.
The lobbyis[has a rontinuing duty to supply i nformation antl amend the forms flled ffirougho W the period that the lobbying occurs.
Separate registration farms shall be reqWred for eaoh principa!represented on oach speciflc issue.
L LOBBYIST W FORMATION:
DeLaPuente Krizia
NAMEOFL088Y6T (Las�) (Firs[J (MlddleName)
TheFactoryInteractive 3250ne1stave,suite305 Miami Rorida 33137
L068YIST9U51NESSNAMEANDADDRE55 (Numberand5�aet) (d�yJ (SWte) 2�ipCadeJ
305-752-9400 786-484-4447 krizia@thefacroryi.com
L000YISTBOSMESSTELEPHONENIIMBER CELWLHRT[�EPHONENUMBER EMAILND�RE55
II. PRINCIPAL INFORMATION:
Bassant Brittnie
NNMEOFPRINCIPAL (Lact) (Firs[J (MltldloName)
MiamiBeachChamberofCommerce 1920MeridianAvenue MiamiBeach Florida 33139
PRINCLPALBIl51NE55NAMEAN�ND�RE55 (Numberand5treet) �Ci�y) (Sta[e) QiPCode)
305-674-1300 786-973-4868 brittnie@miamibeachchamber.com
PRMLIPALBUSWESSIELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILA��qE55
Pursuant ro Ciry Cotle Sec�loo 2-402(h)(1J(a):F principal ot any corpo�ation,pa�lnership,or o�her entity who appears as a lobbyisi on behalf ottM1a�
en�lry,wi�bout special mmpensefion or ralmbu�sement fo�Ibe appearance,wM1e[M1er dlract,in4lrec�,o�mnlingent,�o express support of o�opposl[lon ro
an Item shall register wph ihe Qerk es requlred by thls subsecrton but shall not be repulred m pay any regishation fees.
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to Ci[y Code Section b482(c):
• NAMEOFCMEFOFRCER,PARTNER,ORBENERCIARV(ifnone,writeN/A�: NA .__.
NAME OF ALL PERSONS HOLDING,DIREQLV OR INDIREQLV,ASh OR MORE OW NERSHIP IMEREST IN SUCH
CORPORATION,PARTNERSHIPORTRUST�ifnone,writeN/A�:. .NA _. . . _
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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 ofa pending requestfor proposal,invitation to bid,or public hearing number.
VCA Grant for Tourism for the Miam i Beach Visimrs Center 2024
IV.CITV AGENCIES/INDNIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482�a)�4), list the City Commissioner or City personnel wught to be
lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) wi[h
said Cfty Commissioner or City personnel from 12 months preceding such commencement of service
with the City to the present date,stating the general nawre of the subject contractual relationship.
FuIlNameoflndividualand ConiracWalRelationshipQfyes,explain) VES No
Title of Person to be Lobbied
VCA eoard Members forTourism Grant one ✓
Pursuant to City Code Section b482(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.
List any Business, Financial,Fami ial or Professional Relationship,or other relationship giving rise to an
a ppeara nce of I m propriery Qf none,write N/A):
NA —
V. DISCLOSE RATE AND AMOUNT OF LOBBVIST COMPENSATION - Be Specifc. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2-4853):
Na
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The following six(6)questions NUST be answmed:
1) PursuanttoCdyCodeSection2-488,entitled'ProhibitadCampaignConhibutionsByLobbyistsOnProcurementIssues":
_Y2y_NO: Areyou lobbvinq on a present or pendlnq bld for qoods equlpment or services oron a present or
pending award for goods,eqwpmen[or serNce?
2) PursuanttoCityCatleSeo�ion2-49Qentitled"PmhibltedCampaignConhibutionsByLobbyistsOnRealEsta�e0evelopment
Issues":
_YeS�_N�. A�eVoulobbVinqonapefldlltqdppllCationfo�aDeveloPmentAq�e¢roEf1LWIth[hcClNo�apPlication
for change of zoninq map desiqnation or chanqe to the City's Fuwre Land Use Map?
3) Pam�4tmQay�4h�tie��4B2¢n�thedePinitianof"lobbylst"asset(orthin
Section 2481)who onty appears as a representa[Ive oi a not-for-profit corporatlon or entity wiffiout speclal compensation or
reimbursement for�he appoarance,whether tlirect or Indvect to express support of or opposbon m any Item,shall registar with
thJe�/city c1l.e�rk as required by thls sectlon,but shall not be required ro pay any regishation fees.
�c� e�l V O. A!G y0U rCpfesentinq a noAfoFploflt colpoldtiOfl Of Cf1tItY Without special compensation of
reimbursement>
4) P�a�ldmbpQ'atl'2�ti6oalQ�4RLludes the following persons: Exper[ wimesses who provide only scienCiflq technlcaf or
other specialized informa[ion or tes[imony In publlc meetings; any person who only appears as a roprasentative of a
neighborhood associa�ion without compensaGon or reimbursement for[he appearance,whether direct, indlrect or rontingen[,
to express mpport of or opposition ro any item; and any person who anly appears as a representative o� noEforprofit
community based organization for the purpose of requesting a grant without special mmpensation or reimbursement for the
appearance.
_Ye�NO: Are you proWdlnq onW scientiflc technical or other speclafized Information' appearinq as a
representative of a nelqhborhood association without sPeclal compensatlon or relmbursemen[or
represen4nqano4fo�-profltbasedorqanizationfor7iepurposeo reque;tmqagrantwithout �
special compensation or reimbursement?
5) pp��,�rip��qc�edtlSr�Nmtll�blf}1(i�eCltyCommisslonforaperiodofl2months
foflowing the swearing in of any elec[ed official(s)for whom the campaign consultant provided campalgn consulOng servlces
within the past election cycfe.See Section 2-491 for more'mformatian.
—Ves�[NO: Haveyouprovldedcampaiqmm�sulCinqservlcesLoanlncumbentmemberoftheCibComm�ssion
withi n the past election cVde? If ves please list the inc�mbent member(s�of the CiN Commission�
_Ves _NO: Ifyes, has it been lessthan 12 months slnw the elected official(s)whom vou provided campalan
si Irina servicas waa cwnm in'+
b) pa�tabYqf.9b�Nlntyl6�la�¢[�lirep"84t�1�Q4}acycleprovidedcampalgmm�sulting
services to an i ncumbent member of�he City Commission(which lobbying activiry is not offierwise pmhibited by Code section
2-491)shall disclose such particular service on hls/her lobbyist regishation form and shall orally dlsclose such particular
sarvice befora lobbying the City Commisslon at a publm meetmg
_Vesy{�f0: HaveYouprovidedcampaiqnconsWtinqservicesLoanincumbentmemberoftheCitvCommission
within the pas[elec[lon cycle�If yes please lis[Ne lncumbent member(s)ot the City Com misslon:
_Ves_N O: If yes,were Vou pmmised or dld you rewive economlc wnslderatlon In exchanqe for campalqn
i Jrino mrvira�>
TOBECOMP ETEDBVCIT'CLERK54AFFONLY -� /j �j
AnnualRegistrationfee:��Ves�ow[Patl$ 7��� MCR# N�� oatePaiA�� / /_.''/
LobbyistRegisha[ionPormre<eivedandverfetlby�L___ _. /
L aFO0.M5 LOBeY� FORM L b i 0. ' R vi 0 -11-30RE .tl c Revi5etl03/11/2020
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VI. SIGNATURESUNDEROATH:
ON FEBRUARV 28 OF EACH VEAR, EACH LOBBVIST SHALL SUBMIi'TO THE OFRCE OF THE CITV CLERK A
SIGNFnGT�T �F rll n Rn� u Grl rInRR 'I rFxoF nIrIIRFGAc� F I m PP m In
RECEI��Fn F(1R THF PR C' IIINf' !'AI FNIIAR V AQ ITH QF('ARf1T(l HF CPFC' q(' ISSI IF(lh \ HI!'H THE
LOBBVIST HAc RFFN FN(1qC1Ffl T(� I ORRV A cTATFMFNT�F,'AI I RF RI Ff� FVFN IFTHFRF HAC RFFI� NO
EXP OD.1
�' .¢D¢�,f/uuti 9/9J2024
SignatureofLobbyist: _'�_____ _ _ _ _ __________ _ _ _ Date_________ _
I do solemnfy swear or afflrm that all of the foregoing facts,statements,and disclosures in this form are true and correct,
and that I have read or am famillar with the provislons contained In Chapter 2,ArL VII, Dlvision 3, entltled "Lobbylsts"of
the Miami Beach Clty Code and all reporting requirements.
9/9/2024
Signature of Lobbyist: "'� �D� w Date
—_ __ __ — - - - - ____ — — - _____—__—_-- — — - _
SignatureofPrincipaC _ _ ____________ Date �/• �� • Y�
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRWCIPAL
State ot Flo�ida State of �L
countyot: Miami-Dade countyof: M �a1n; — /�V�6L
Swom to(or affirmed)and subscribed before me, Swom to(or afFlrmed)and subscribed before me,
hy means of c physical presenre by means of,�physical presence
or�online notarization, or o online notarization,
rn�s �zm dayor seotember zoza,by m�sl7dayor �.�ie+-.�� zo?Yey
Krizia De La Puente Brittnie Bassant
NAMEOFLOBBY6T
'�ProducedlD oL#o415-500-90-514-0 _ProducedlD_
FORM Of I�CRTIFICATIOP� FORM OF I�ENTIFICATION
_Personalty Known �Personalty Known
.A/Z�/t.Q��Cr.l�IL1'HbILG�
————'_ ____— — _____'_ ___ _ _- - - - —- ___________
SignaNreofNotaryPublic Si natureo NotaryPublic
Andrea Hammond _���,�
________ _ _ _ _ ___—______-- - - - _ _ - -
Name ofNofary, Typed, Prinfed or Name of Notarg Typed, Pnnted or Stamped
Stamped(N07ARYSEAL) ��� Y< m�x��p (NOTARYSEAL)
''��; xa.rvxwu.-m�urbm , w/4
�.�„�,,,��xxn�ez� �,±�"npUEZ „ . �i
r,r�.HN�a ioie
ri�p«'`�pU&IC�`•�.,
'Thaterm"lobbyisf'specificallyexcludesthefollowingpersons: ��:p�l •. +�
jO:p�e' (� �• =
Experlwimesseswhoprovideonlysciemific,technicalorotherspecializetlinformationor[estimonyinp�liciyeetings' �ny�yd
onlyappearsasarepresentativeofaneighborhoodassociationwithoutcompensationorreimbursemegtfo}�h?�@ as oe,w�F �
direct,indirect or mntingent,to express support of or opposition to any item;and any person who only pears`�{Q� present .
nobtor-profitcommunitybasedorganizationforthepurposeofrequestingagrantwithautspecialcomp s3(iob6rreimbur �r
the appearanre. y�Ah pf.,%
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` �, I � �.nr� � e
Ciry of Miami Beaah, V00 Comemian Cemer Ddve,Mlomi Beach,Fbrido 33139,www.miami6eachlLgov
Office of ihe City Clerk
Rafoel E. Gwnado, CIy Clerk CityClerk�miamibeachfl.gov
Teh 305.673 741 I,Fax: 305.6737254
NAME OF LOBBYIST:Krizia De La Puente
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1) LOBBYISTFEEEXPENDITUREANDCOMPENSATIONSTATEMENT
Pursuant to City Code Section 2-485(d), the City Cferk shall notify any fobbyist (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 2-455.1, a fine
of$50.00 a day shall be assessed for Statements filed after the due date.The City Clerk shafl
notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a
lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any
fobbyist, who faifs to file the required Statement by April 30th of each year, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miaml-Dade County Commission on Ethics and Public Trust I here6y
acknowledge that on February 28 of each year, I shatl 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) LOBBYISTWITHDRAWAL
Once an issue I have registered to lobby has conduded or I am no tonger lobbying on
that issue, I shall immediately file a Notice of Withdrawal with the Office of the City
Clerk.
ANNUAL LOBBYIST REGISTRATION FEE
3) 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.
� �a2 T>e /.�.Pcezntz 9-�9J2-�-2-4---------
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Signa re of Lobbyist Date
YVCLYNWPLLWOHA'ALOtlNY151MNM5VLnbbylsiHegu�alionb�mHwisetlN-ll20NE6.tloc
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