2024 Lobbyist Registration Form - Seawalls (Timothy K Blankenship) SCqW s\\S
I \l 1 I � :I \/ 1 I !7 F A� H RECEIVED
otroe otme ary cierk JUL 23 2024
1700 Convention Center Drive
Miami Beach, FL 33139 CI1Y UF MIAMI BEACH
305.6737411 OFFICE OF THE CITY CLERK
LOBBYIST REGISTRATION FORM
Lobbyis� means all persons employed or reiained,wfielher pai0 or not, by a principal who seeks lo encourege�he passage, defeat or
modification of any ortlinance, resolution, aclbn or decision of any wmmissioner; any aclion, decision, recommentlation of Ihe Cily
Manager or any Ciry boarA or commitlee;or any action,decision or recommenda[ion of any City personnel during the time period of the
en[ire decision-making process on such action, Oecision or recommendation lhat foreseeably will be heard or reviewetl by Ne City
Commission, or a City board or commitlee. The term specifically includes Ne pnncipal as well as any employee engaged in lobbying
activities. The tertn "Lobbyist" has specifc exclusions. Please refer to City Code Chapter 2, ANde VII, Division 3, entiHed "Lobbyists,"
for additional into�mation.
Instructions: Pleasa mmplate all sections of this�ortn an0 submit the completed fortn,with the applicable fee,to ihe ORce of tl�e City
Clerk. If you need more space to complete an answer, use a separate sheet(s)of paper. If you have noMing to report in a particular
section, you must wnte "none' or "n/a" in fhat section. Any change to any infortnation onginally fled, or any additional Ciry
Commissioner or personnel who are also sought to be lobbied shall require Ihat lhe lobbyist fle an amendment to ihe regisiration form.
The lobbyist has a continuing dury to supply information and amend the forms filed Mroughout the penod that the lobbying occure.
Separete regist2lion forms shall be required for each pnncipal representetl on each specifc issue.
I. LOB YIST INFORMATION:I /�
2n-/"PJ �l U,`�? I� .
NAME OF LOBBVIST (Last) (FirsQ (MldCle Name)
l,��c%r. `F- �iJl�'ukoF�,/�-� a5.� � Ponu de �ec.� �lr�Q. �r8�ti (�„BI �a�1�� 1�L
LOBBVISTBUSINESSNAMEANDADDRESS (NumberantlSheeQ (Ciry) (State) �ipCotle)
3� 3�
ao�" - 3c9� ._ iol � gas -��t9 - 5�900 ',�'✓F„a�,�� he� ke�
LOBBVIST BUSINE55 TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMr11L ADORESS
��[Y�YP/S�Co�'1
II. PRINCIPAL INFORMATION:
/3�✓fMK/sNsifiP �r�r�an1� �;
NAME OF PRINCIPAL (LasQ (Firs�) (Mitltlle Name)
/'nar'Pn�Y" '/r'%GiroL 2937 5w ����' /�U/s„ Srr /oi/1 MI,�Fn71 /�L 33/-'� 3
PRINCIPAL BUSINESS NNME NN�ADDRES$ (Numberantl 5�eet) (City) (Stale) (Zip Code)
3c i, 2�U, i� 2`F 3�'-5 �i 73 33� (c Tl1.a�Jk,�NSiHi'��,�t'�1✓ic�ix,
PRINCIPALBUSINESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMP.ILADORESS �M
PursuaM to Ciry Cotle SecUon 2-0ffi(hxiNa�: h pnnapel of any w�poiation, pannersNp,w other entlry who appears as a lobbyist on be�aH of ihat
entity,xi�hout special compense4on or reimWrsamaM tar the app�a�e,whether Olrect,indirect,or con4ngeM,to express suppa[o(w opposition to
an item shall register wMh Me Clerk as reQuirea by Nis subsection�ut shall rqt be required M pay arry regishalion/ees.
If the principal is a Corporation, PaRnerehip or Trust, the following information MUST be provided
pursuant to City Code Section 2-462�c):
. NAME OF CXIEF OFFICER,PARTNER,OR BENEFICIARY('rf nw�e,wrife NIA): �%��G N��Glf�L
• NAME OF AlL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A Sq OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION,PARTNERSHIP OR TRUST(if none,wtlte N/A�:T��% N���b�- G�M/l V /a�/j'S
�/'Ao �,Mnrrs�� � � °o o�.ur-�asili�� i� i4rM�INpr;% �3 owkr',-k�
/.3 r' :n�°�o�;>f S idn�9/� �lotr�r, S z-�� �r>55 /���
Page 1 of 5 �
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111. ISSUE TO BE LOBBIED:
Describe with as much detail as is pradical, including but not limited to a specifc description where
applicable of a pending request for proposal, invitation to bid, or publie hearing number.
R�ci N��, z���9 - z3�1- -nr�/J r-Nc=i�r�=,/���✓c- � �R✓�c:s ���1
5��w,4Lys ,4/Jb ���'iti'C%— �,�R�L/Nl35
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 contractual relationship (paid or unpaid) with
said City Commissioner or City personnel from 12 months preceding such commeneement of service
with the City to the present date, stating the general nature of the subject contradual relationship.
Full Name of Individual and Contractual Relationship(H yes, explain) VES NO
TRIe of Person to be lobbied
GnG
— e �' / �C'I � �S
Pursuant to City Code Section 2-482(g), every registrant shall be required to state the eMent of any
business, financial, familial or professional relationship, or other relationship giving rise to an
appearance of an impropriety, with any cunent City Commissioner or City personnel who is sought to
be lobbied as identified on the lobbyist registretion form flled.
List any Business, Financial, Familial or Protessional Relationship, or other relationship giving rise to an
a earence of im ro rie if none,write NIA :
/� O h�i a�
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Snecific. (Note that a
contingency fee is prohibited pursuant to City Code Sec. 2�85.3):
� �K i
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The following six(6)Questions MUST be answered:
1) Pursuant to City Code Sec�ion 2�88,entitled"Prohihited Campaign Contnbutions By Lobbyisls On Procurement Issues":
_Ves%No: Are vou lobb I a o a M d b'tl fo 000d t se/v te t o
pandinn award for noods.eauiomeM or service?
2) Pursuant to Ciry Code Section 2d80, entitletl"Prohibite0 Campaign ConMbuGons By Lobbyists On Real Estate Development
Issues":
_Yes�No: Am vou lobb ina on a oe d' o aool'wtion for a De I t Aureement dh the CHv ool'cation
for chanae of zonina mao desionadon or chanae to the CiN's Future Lantl Use Mao?
3) Pursuant to City Code Section 2�82�h), any person (except those exempt fmm the defnilion of 'IobbyisP as set forth in
Section 2�81)who only appears as a represenlative of a not-for-profit coryoration or enliry without special compensa[ion or
reimbursement tor�he appearance,whether direct or indirect lo ezpress support of or opposition to any item, shall register with
Ihe ciry c�lerk as required by ihis section, but shall no�be required to pay any registretion fees.
_Yes✓No: Are vou reorasentina a nob(or-orofit comoration or entitv wilhout soac'al comoensaEon or
reimbursement'+
4) Pursuant to City Cotle Section 2I81, �he term "IobbyisY specifcalty ezdudes �he Pollowing persons Ezpert wdnesses who
pmvide only scienlifc, lechnical or other specialized infortnation or testimony in public mee[ings; any person who only appears
as a represenfative of a neighborhoad associalion without compensation or reimbursement for�he appearence,whelher direct,
indirect or contingent,to express support of or opposition to any item;and any person who only appeare as a representative of
not-for-profit communiy baseA organization for the pwpose of requesting a grant without special compensation or
reimbursement for the appearance.
_Ves`�No: Are vou orovidina onlv sc'entif' tech ' I othe scec'al' d 'Mo t' � aocea 'na as a
reoresentaUve of a nelahborhood association wiMoul soeclal comcensat'on or re'mbursement or
reoresentinu a nobfor-orofil basetl oraanizatian for Me ouroose of reauest'na a nrent w'thout
soecial comoensation or reimbursement7
5) Pursuant to City Code Section 2<91(i), no campaign consWtant shall lobby�he Ciry Commission for a penod of 72 months
following ihe sweanng in of any eleded offcial(s)for whan [he campaigm m�sullant provided campaign consulting services
within theipast election cyde.See Sec�ion 2-091 for more infortnafion.
Yes�No: Have vou orovitlatl camoaian consultino services to an incumbent member of the CiN Commisslon
within the oast eled'on cki H v ole I'st t�e' cumbent be f 1 of the Citv Commissfon�
Ves� No: If vas. has if been less than 12 months since iha elacted o�cialfs) whom vou orovitletl camoaian
consultina sarvices was sxrorn in?
6) Pursuant to Cdy Code Seclion 2382(a�(4Ja., a lobbyisi who has within t�e past election cyde providetl campaign consul�ing
services lo an incumbent member of lhe Ciry Commission (which lobbying activity is nol otherwise prohibited by Code seclion
2�91) shall disclose such particular service on his/her lobbyist regisiralion fortn and shall oraliv disciose such oartcular
service Defore lobb in Ne Ci Commission at a ublic meetln .
Yes No: H_a_re you orovided camoaion consultina services to an incumben� member of Na CIN Comm'ss'on
wlthin the oasl elaction cvclaT It ves,olease Ilst the Incumbent memberlsl of ihe Citv Commisslorc
Ves`� No: N ves. were vou oromised or did vou receive economic consideration in exchanae for camnaian
— — consultina servicesT
TO 8E COMPLEfED BY CITY GLERK'CS,STAFF ONLY
IlnnualRagisVa[ioniae: � ]Yes�No AmouMPa��id7f�3s!�� MCR) % �1�70� DataPaitl 7�Z3 /zH
Lobbyisl RuglsVatlon Form reqhretl and w�ified by: 1� . . 'lG/'b�Lw
F:\CLER\4ALL\aFORMS\LOBBYISTFORMS\Lobbyis[RegishationPo�mNevised 03-11-20REG.tloc R8V16ldO$�IZ�'LO'LO
Page 3 of 5
!
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR. EACH LOBBVIST SHALL SUBMIT TO THE OFFICE OF THE CITV 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
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPENSATION DURING THE REPORTINCa PERIOD.'
SignatureofLobbyisC !�� Date `9(-ZZIZy
.� �_�.
� i
I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are hue and correct,
and that I have read or am Tamiliar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of
the Miami Beach City Code and I reporting requirements.
9 Y �^ � ,�,� sx 4
Si nature of Lobb isC Date
e
Signature of Principal: � slt1M Da[e 7 Zz Z-`{-
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of F�Jf�L�� State of F�J✓�'cQ tv(��
Countyof: ��oti'r(N� Countyof: �i�u�unk
Sworn to(or affi�ed)and subscribed before me, Swom to(or aifirmed)and subscribed beTore me,
by means of[�Iphysical presence by means of�hysical presence
or O online notanza[ion, or�online notanz tion,
ihis��day of �cr�202�by this alday of ����20���by
�os� K� F��c„t�s �r-�.y��' /-Jt,�lrv�tr'rt�5ifi�
NAME OF LOBBVIST NAME OF PRINCIPAL
_Produced ID _Produwd ID
FORM OF IOENTIFICATION FORM OF IDENTIFICATION
�Personally Known c.Personally Known
L� �� P�e� /'�e,e�- �°P��
Signature of Notary Public Signature of Notary Public
�`.c�` Ie.Pv� �caPluw� (`r)l1ee � l--_'L� � ��y.�
Name of Notary,7yped, Printed or Stamped Name of Notary, Typed, Printed or Stamped
(NOTARY SEAL) (NOTARY SEAL)
<^.':�i>T. COLLEEN LAPLANT
�� ` MYCOMMISSION#HH099832
' T�e tertn"IobbyisC specifically exdudes the following persons: ::;���;._;' EXPIRES:Ju�78,2025
.......,.,
-' BOMeOThr�N WpIkVnGnMlue
Expert wi�nesses who provide only scienGfiq technical or other specializetl informa6on or testimony in public meetings; any person who
only appears as a reD��n�ative of a neighbo�hootl associa6on withou�compensation or reimbursement for ihe appearance, whether
direct, intlirect or contingent, to ezpress support of or opposition to any item; and any person who only appears as a representaHve of
no4for-profit communiry based organization (or ihe puryose of requesting a grant without special compensation or reimbursement for
the appearence.
Page 4 of 5
� �� � � � ���:-1 I B EAC H
Ciry ef Miami laach, V00 Conrontion Cenror Drive,Miomi Beoch, Fbridv 33139,www.miami6eachN.gov
Office of ihe Ciy Clerk
RaFael E. Gmnado, Ciy Clerk CiyClerkOmiamibeachfl.gov
Tel: 305.673741 l, Fax: 305.6737254
NAME OF LOBBYIST: _ �os e K . �J P wi»
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 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 principal) to file the Statement or pay the
assessed fines after notification.
Any lobbyist, 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 2S 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
$500.00 pursuant to Section 2482 of the Miami Beach City Code.
�
�Ia`�IZ�
Signature of o yist Date
�..
F'.\LLER15KVaFORMSLLOBBVI$T FCRMSV.oLLy19 Regiabetion Fpm RaNSN IXN1-1p REG Ecc
Page 5 of 5
� Miscellaneous Cash Receipt
CITY OF MIAMI BEACH rya, 433703
❑Cash ❑Credit Card .�Check# 5
20
Received of � � � ��
Address
For
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Miscellaneous- MCR-2024
0077760018 Cartnen V... 0iR3I207_4 iC41qP.�i
mcR oaeN�MCP) Office of Finance Director
Payment Amcunt: 70C 00
(THIS INFORMATION MUST BE WMPLETED) � By
Account number:
Preparer. � � Dept: EXT:_
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C,ity Hall
IlOd Convefdinn Glnter li:.
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007175-0015
MISCF.I.tAN�OUS
Rrierenee I : PIC@4s:;lu:i
Mi:R iIPEN (MCR)
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