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2024 Lobbyist Registration Form - Seawalls (Timothy K Blankenship) , SGaW a�\ S p /� RECEIVED �� /-�I V 'i � CJ�.(-'t� � office of ihe ciry clerk JUL 23 2024 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI BEACH 305.6737411 OFFiCE OF 7HE CITV C�e�K LOBBYIST REGISTRATION FORM Lobbyist means all persons employetl or retainetl, whether paid or not, by a pnncipal who seeks to encoura9e lhe passa9e, Oefeat or motlfication of any oMinance, resoNtion, ac�ion or tlecision of any wmmissioner; any ac�ion, tlecision, recommendation of the Ciry Manager or any City board or committee;or any action,tlecision or recommendation of any Ciry personnel during the lime period of ihe entire decision-making process on such aclion, tlecision or recommendalion that foreseea6ly will be heard or reviewed by the Ciry Commission, or a Cily board or committee. The term specifically inGutles the pnncipal as well as any employee engaged in lobbying activities. The term "LobbyisY has specific exclusions. Please refer lo Cily Code Chapter 2, Article VII, Division 3, entitled "Lobbyisis, foradditionalintortnation. Instructions: Pleau complete all seclions of this fortn and submit Ne complete0 fortn,with lhe appliwhle fee, to the Offica of Ihe Ciry Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular section, you must wnte 'none' or "Na" in that seQion. Any charge to any information onginally fled, or any additional Ciry Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to Me registration form. The lobbyist has a wntinuirg duty to supply information and amend the forms filed throughout the penod ihat Ne lobbying occurs. Separete registretion fortns shall be required for each pnnppal represen�ed on each specific issue. I. LOBBYIST INFORMATION: �()S/1�/ {��Il� � NAME OF LOBBVIST (Last) (Frsl) (Mitldla Name) �'C�'r,� �"u�if}iro�F�9� �1C��a�cP r��n�A ��dr�, S� ��Yo�('z�hl�1. LOBBVISTBUSWESSNhMEAN�ADDRESS (NumberaMStreeQ (Cily) � (Stale) � (ZipCade) � �yl �-��(7 �{ Q -�"L �3r � � L�fiVIS�INE�ELEP/OON��BER ��GEL��RT E�ON�`U�ER rn/),��E�ADDR��UlY� II. PRINCIPAL INFORMATION: �6�iv/�( i;h'�;'//� 1��Mdi7�✓ /< NAMEOFPRINCIPFL (Lasp (Firs�) (MitltlleName) /}�lo �/=�rTx/GIGifOc- 2R375W 27�/;uGSrF �oiA �WI�IMI �L 3� j33 PRINCIPAL BUSINESS NAME AN�ADDRESS (Number and StreeQ � (CRy) (Sta[e) (2ip Cotle) 3C "� �Z 3G� / `� ��' '�v5 C3 � � >� ,%�' TL�-h��'rN.'�rll�'✓�iL%;A,liYN,nlnc, PRINCIPALBUSINESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILA�DRESS GCM Pursuant lo Cily Cotle Sedion 2482(hxi)(a): A pnnupal of any wryo�atlon, part�rship, or other enOty who appears as a loppyct m behatt of Net entiry,wRhoul special compensation or reimWrsemaM fw the app�ance,whether tlireIX,intlired.or can4ngeM,to express support M w opposi4m M an item shall register vAh ihe Clerk as repuireA by ihis subsection but shall not be requiretl to pay arry regisVaHonlees. If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-462(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY('rf none,write N/A): �-a�G N � GHG� �-- . NAME OF ALL PERSONS HOLDING,DIRECTLY OR INOIRECTLY,A SYe OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(H none,write N/A�: �f�' N��NU L /%/F1'Ylly iV lI/}5 /I�'i�r2c�(�iVI��iT,—L� 6 � �< o.dN/iRS/t>o T7Fr Rl=/NFHND/,� /5 rWNr� ��'� s�MV«;ri.r� 5i1�Ar>f�tv[)r S t "� �rs5 r�uf Page 1 of 5 / III. ISSUE TO BE LOBBIED: Describe with as much detail as is pradical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid, or public hearing number. R r-�.� Na zo z�r- z��t - N�0 rN�=�N�=c�3�� s:>i�v��;�=s �-ti/� ��c-;�w�u-> n�v� �.,v,,�C- �r��=��5 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 contraetual 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 Individual and Contractual Relationship (If yes, explain) YES NO Title of Person to be Lobbied � ec. f-c-� � i�c �� ( 5 Pureuant to City Code Sedion 2-482�g), every registrent 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 ident'rfied on the lobbyist registretion form filed. List any Business, Financial, Familial or Vrofessional Relalionship, or other relationship giving rise to an a earance of im ro ri if�one write NIA : � i V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Soecific. (Note that a contingency fee is prohibited pursuant to City Code Sec. 2�85.3): �� Page 2 of 5 The following six(6)questions MUST 6e answered: 1) Pursuant to Cily Code Seclion 2-488,enMled"Prohibited Campaign ConMbutions By Lobbyisis On Procurement Issues": _Ves ^No: Are vo I bb ' a orese t ce d a b'd for nood a iome t rv'ces n a oresent or r pend'nn awartl for uootls.eauiomeM or service? 2) Pursuant to City Code Section 2J90, entitled "Pmhibited Campaign Contributions By Lobbyisb On Real Estate Development Issues": _YesY No: ou lobb 'na o oendina aool' fon fo a D alooment Au eement 'th the CRv o ool'cation �� for c�a n of zo " u ao tles'a t'on or chanue to the C'tv's Future Land Use MaoT 3) Pursuan� to City Code Section 2�82�h), any person (except those azempt Irom the definilion of "IobbyisC as set forth in Section 2-081)who only appears as a represenfative of a not-for-pmfit coryoration or enliry wifhout special compensation or reimbursement for the appearance,wheMer direct or indirect�o express support of or opposition lo any item,shall register wilh the ciry clark as required by fhis saction, bul shall not be required b pay any registretion fees. Yes�No: ou o esenF a not for o oft coroo t' or ent'tv 'thout soe ' 1 comoe t' or /' reimbursement7 4) Pursuant lo CiTy Code Section 2-981, ihe term 'IobbyisY' specifically exGudes the following pereons: 6cpert wilnesses who pmvitle only scienlitc,technical or other specialized inFormation or testimony in public meetings; any person who only appears as a representative of a neighhorhootl association wit0out compensalion or reimbursement for the appearance,whether dired, indirect or contirgent,to express support of or opposilion to any item;and any person who onry appears as a representative of no4for-proft community based organization for lhe purpose of requesting a granl wi�hout special compensation or reimbursement for Ihe appearance. _Yes�No: Are v oro 'd' n nl sc' ffic tech ' 1 or ot�e oe 'alizetl 'nformatlorc aocearina as a reo sentatl f a nelah6orh o0 auo 'at'on with t oecial co ce ation or reimbursement or reores tl a a t f roilt ba d oraa ' t' fo fh o se of o stina a urant w'thout spe �al como atlon or reimbursement? 5) Pursuant lo City Cotle Section 2d97�1). no campaign consulWnt shall lobby the City Commission for a penod of 12 months following the swearing in of any electad offcial(s)for whom the campaign consultanl provided campaign wnsulting services within the pasl election cycle.See Section 2-491 for more information. _Yes XNa: Ha vou oro id d camoa'a consult' a rvices to an 'ncumbent member ot the CiN Commission l 'thin th oast ele t' cvcb? If v s oleas 1'st the incumbent memberls)of the CiN Commission: Ves No: " ••^� h it bee I s tha 12 months i e tha elected ofliclallsl whom vou orovidetl camoaiun consult'na services was sworn in7 6) Pursuant lo Ciry Code Section 2-082�a)�4)a., a lobbyist who has within the past eledion cycle Drovided campaign consWting services to an incumbent member of llie City Commission (which lobbying activdy is nol otherwise pmhibited by Cede section 2-091) shall disclose such particular service on his/her lobbyist registration form and shall orallv d'sclose such oarlicular service before lobb in lhe C ly Comm'ss'on at a oubfc meelino. Yes No: Ha ou o o 'detl camoa'an consult' n serv'ce t an incumbent member ot the CIN Commisslon 'th'n the o t elect'o v 1 91f ve ol ase Iist th 'nc mbent memberlsl of ihe Cilv Commission: Yes No: If v wa v oromi d ditl vi celve e o mic considerallon in exchanne for camoaian consuttina servicea? TO BE COMPLETED BY CRY GLERK'S STAFF ONLY MnualRagieVaConiee: [ ]Yas�No AmountPa�ldS_JS MCR)%� ��7�...] DabPaid 7/�L3fzy Lobbyiat Registratlon Fwm raceivetl and veAfletl by: I` I Y"�7�C.(_ F\CLER\EFLUaFONMS\LOBBYI4FORM5\Lobbyis[Regislra[ionFormRevisetl 03-11-300.EG.tloc Revisetl03/11/3020 Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH VEAR EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY 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 DURUJG THE REPORTING PERIOD.' - Z.� SignatureofLobbyisC �"��--;�� :1-f -+ — Da[e� �� I do solemnly swear or affrm ihat all of the foregoing facts, statements, and disclosures in this fortn are true and correct, and that I have read or am familiar with the provisions contained in Chapter 2, AA. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all reporting �quiremgMs. ,/ / a�a7 `} Signature of Lobbyist: � �a Date SignaNre of PrincipaC � /L�2 �h+N'� Date �ZZ 2� VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State ot ��'1 r��'� Sta[e of ��0 /':cQ+�. Countyof: 1Jn��uX�� Countyof: � 4J�x � Swom to(or atfirmed)and subscribed before me, Sworn to(or affiJr�ed)and subscribed before me, by means oLG physical presence by means of LL�Yphysical presence or O online notarization, or 0 online notarization this�day of _�202�by this�22 day of J..�.� , 2p2�y 0 �,�v �,oshP / �i/MorJ1✓ 3s✓NY<s,r-NS�f/� NAME OF LOBBVIST NAME OF PRINCIPAL Produced ID _Producetl ID FORM OF IOENTIFiCATION FORM OF IDENTIFICATION ✓ Personally Known `�Personally Known % / C7�,c'�� n?`a P� l� �—�- ��r�� Signature of N� ublic Signature of Notary ublic 1 '� � �e�E_v� � L�I (A� �'YJ��Ee �.G P�QvT� Name ot Notary,Typed, Printetl or Stamped Name of Notary,Typed, Prin[ed or Stamped (NOTARY SEAL) ( ,,, '✓n!`'. COLLEENIAFLANT "�� ' MYCOMMISSIONMNH093831 .�'S��p: EXPIRES:June18,2025 'The�erm"lobbyisl"specificalty exciudes Ihe fdlowing persons: �'?P,�,Et°'` BordW mmwotryPuukurAma+lwn Expert witnesses who provide onty scientifiq technical or other specializetl information or leslimony in pu0lic meetings;any Derson who only appears as a representa6ve of a neighborhood associffiion withou�compensation or reimbursement for Ne aDDearance, whe[�er tlirect, indirect or wn6ngent,to express support of or opposition to any item; and any person who oniy appears as a represen�ative of noPfor-profit communiry based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 ` i�✓� IBEACH Ciy of Miami lwah, V00 Conmmion Cenbr Drive,hVami Beoch, Florida 33139,www.mlomibeochA.gov OHire of tha Ciry Clerk Rofael E. Gmnado, Cily Clerk CiyClerk�miamibeachfl.gov Tel: 305.673.741 l, Fax: 305.673.7254 NAME OF LOBBYIST: �� I 9`r � G/ 5/V� 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 Tine 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'h 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 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 specif c 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 2-482 of the Miami Beach City Code. �/,�, � ��L�— � �'� � Signature of Leg yist Date F:\LLERWLLNFORMSLLOBBVIST FCRMSLLOEENsI PeplArelu^Fo�m FeNsed 03-fl-]�REG.ticc Page 5 of 5 � Miscellaneous Cash Receipt CITY OF MIAMI BEACH No. 433703 ❑Cash ❑Credit Card �Check# � � � $ 20 Received of � Address � � � � For .;:^>o� �.,......� .,..�... Miscellaneous-lviCR-2024 0071750018 Car:neo V...07723l2024 1 C ai A�d Mctt oaeN�rncR) Office of Finance Director PaymentAmcunt. ]00�0 (THIS INFORMATION MUST BE COMPLETED) By Accountnumber. � Preparer. � Dept: EXT:_ � � Cliy 01 M7dAl1 tleaCfl I;itY Hall 1100 Cmive.riti�m Center lir. � Mf�mi Ne.�r:h : H �f139 305-6'l3-741u `j Welrnme u7/Y3!2024 IO:AtAM Carire;n V. Uu7 P5-p010 NISCEU.ANF.(ltki Refernnce 1: MCn4J370i hlCk t�PEN (MCR) 20?4 Itenc MCI, 1 (� $10U.0000 �I M�;R uPGN (Mr,R) 'Wluii.na � .__ .Z70U.(t0 St�Ltol.al $70U.00 Tutal $700.00 � CHCCK �� fhack NUmGef039179 � CtianU: Jue ___._.._$G.00 � PdiJ I'iy: BI_i:BkN R POI.fAKOFI= P.N. 4 Y ��IIIi�I��I��iVII�I��II��C��ll�ll�l��ll'�lil��llllil�l�l' ' - _ rrr-__..._.. . ...:.�.,..�.: