2024 Lobbyist Registration Form - Il Villagio (Jose Villarello) � �i v; �i.�; �
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MIAMI BEACH OffceoflheCityClerk ��N 42oZ�
1700 Convention Center Drive
Miami eeach, FL 33139 I;ITY OF idllAMl BEACH
305.6737411 OFFICF OF -�HE CITY CLERK
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retaineQ whelher paitl or not, by a pnncipal who seeks lo encourage t�e passage, tlefeat or
moCifcation of any ortlinance, resoNtion, aclion or tlecision of any commissioner, any aclion, decision, recommentlation of the City
Manager or any Ciry boartl or committee;or any adion,decision or recammentlation of any Ciry personnel tluring the time penod of the
entire tlecision-making process on such action, decision or recommendation that foreseeably will be heaM or reviewetl by the Ciry
Commission, or a City board or wmmittee.The term specificalq inclutles lhe pnncipal as well as any employee engagetl in lobbying
activilies. The tertn "LobbyisC' has specifc ezclusions. Please refer�o City Cotle Chapter 2, Ahicle VII, Division 3, entitled "Lobbyisis,"
for atldi�ional informa�ion.
Instructions: Please complete all seclions of lhis form and submit�he completetl form,with lhe applicable(ee, �o Ihe Office of Ihe City
Clerk. If you need more space to complete an answer, use a separale sheet(s)of paper. If you have nothing to report in a particular
section, you must wnte "none" or "n/a" in thal seclion. Any change to any information onginally fled, or any atltlitional Ciy
Commissioner or personnel who are also sought lo be lobbied shall require that lhe lobbyist file an amendmenl lo Ihe registralion form.
The lobbyist has a con�inuing tlury to supply information and amend the (orms tiled ihroughoul Ihe penotl tha� lhe IobGying occurs.
Separate regislration fortns shall be reQuired for each pnncipal representetl on each specific issue.
I. LOBBYIST INFORMATION: �
��Q�'aQ �A
NAMEOFLOBBVIST (Ws�) (Flrs�) (MidCleNeme)
S�{a' �ro�p i�n �-e�l SW lL1i" C�-_2.0(. �n�-.i � �4 331�,rj
LOBBVISTBUSMESSNAMEANDADORESS (Num�erarMSVeM) ( �ty) (Slate) (ZipCotle)
�8�0 • 3� � ' '3 71 Se�.c Anabeel.e � uc�W.cw-i
LOBBVISTBUSWESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EI�ALAD�RESS
II. PRINCIPAL INFORMATION:
�,,I �
�1��Q�('J�O JO S�.�
NAME OF PRINCIPAL (Las�) (First) (Mitltlle Name)
Y 1/,/QSq�� f�SS t7�PUN�"i✓� h�a�..�� &a{J� ("L 33� 3 4
PRINCIPALBU SNAMEANOAODRE55 (NumEe�antl5lreeQ (Q�y) (Sle�e) (LpCotle)
3�s . � q� • c 9�ri M,�a,�.�p;��.s��,�.�
PRINCIPALBUSMESSTELEPHONENUMBER CELWLARTELEPHON NUMBER � EMAILADDRESS
Pursuan�to Ciry Code Sec�ion 2-082�h�(1)la): A pnncipal of any corpora�ion, Oartne�ship, 0�olhe�en�i�y who appea�s as d IO��yis�on bEh31(o(�ha�
entity,wi�hou�special compensalion w reimbursement for Ne appearance,wheNer tlirect,Indlrect or contingent,to express suppotl of or oppos0on�o
an item shall register witM1 Pe GIeM1 as require0 by IM1is subsec6on but s�all nM be requiretl to pay any mgisVation fees.
If the principal is a Corporetion, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c):
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARV(H none,write NIA�: h� �
• NAME OF ALL PERSONS HOLDING, DIRECTLV OR INDIRECTLY,A 5%O MORE OWNEfiSHIP INTEREST IN SUCH
CORPORATION, PARTNERSMIP OR TRUST(if none,write N/A�:
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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 proposal, invitation to bid, or public hearing number.
��nV�(�l� -�I�Ir1f� �'Ca� ��C(�'El�y�_r,rV ���� C��S `� �'-1�;��_
� 11 r(�AI�i�V kf� � �C .C ��I�'� ����rl� C�C�l1 �?�P�-F(Y
f`��" �-� �/i��C���e��
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 Individual and Contractual Relationship (If yes, explain) YES NO
Title of Person to be Lobbied
Clty's Lend Uee Boerde x
Ciry Adminstration x
Pursuant to City Code Section 2d82(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 lo6byist registration 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 :
11�!
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):
rlf�
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I
The following six(6)questions MUST be answered:
1) Pursuant to Ciry Cotle Section 2188,entitled'Prohibited Campaign Contributions By Lobbyisis On Proarement Issues°�.
_Yes�lo: Are vou lobbvina on a oresent or oendina bitl for aootls. eauioment or services. or on a oresen[ar
oendino awartl for aootls.eauioment or serviceT
2) Pursuant to Ciry CWe Section 2d90, entitled "Prohibiled Campaign Contributions By Lobbyists On Real Esfate Development
Isaues"
Ye�lo: Are vou lobbvino on a cendina aoolication far a Develooment Aareement with the CiN or aoolication
tor chanoe of zoninu mao tlesicnation or chanue lo lhe Citv's Future Land Use Mao7
3) Pursuant ro Ciry Cotle Section 2-082(h�, any person (except those exempt from ihe tlefini�ion of "lobbyisf' as set fonh in
Section 2-481)who only appears as a representative of a no4for-profit corporation or entity without special compensation or
reimbursement for the appearance,whether direct or indired to express support of or opposition to any item,shall register with
the cit clerk as required by this sec[ion, but shall not be requiretl to pay any regishation fees.
Ve�o: Are vou reoresentinn a not�for-orofit corooration or antitv without soecial eomoensation or
reimbursement9
4) Pursuant to City Code Section 2-487, ihe term "IobbyisT' specifirally excludes ihe following persons: Expert witnesses w�o
provide only scientific,technical or other specializetl infortna�ion or testimony in public meetings;any person who onry appears
as a representative of a neighborhootl associa�ion without compensation or reimbursement(or ihe apPearance,whether direct,
intlirect or wntingent,to express support of or opposition to any item;antl any person who only appears as a representative of
no4for-profit community based organization for the purpose of requesting a grant without special compensation or
✓�imbursement for ihe appeardnce.
'es_No: Are vou orovidina onlv scientifc teehnical or other soecialized information: aooearinn as a
reoresantat've of a neinhborhood association without soecial comoensalion or reimbursemen[ or
reoresentino a nobfor-orotit basetl oraanization for the ouroose of renuestinu a urent without
soeelal comoensation or reimbursement9
5) Pursuanl to City Cotle Sec�ion 2d91(1), no campaign consullanl shall lobby �he City Commission for a period of 12 months
following the swearinq in of any elecled oRicial(s)for whom the campaign consWtant providetl campaign consWling services
within t�past election cycle. See Section 2-491 for more information.
Yes o: Have vou orovitletl camoaion consultina services to an incumbent m¢mber of the Gitv Commission
within ihe oas[elec[ion cvcle7 If ves.olease list the incumbenl member(sl of[he Citv Commission:
_Ves�lo: If ves has it been less [han 12 monlhs since the elected oHicial(sl whom vou orovitletl camoaian
consultino services was sworn in7
6) Pursuant to City Code Section 218P�a)(4)a., a lobbyist who has within the past election cyde provitletl campaign consWting
services ro an incumbent member of lhe City Commission (which lobbying activiry is not o�heiwise prohibited by Code section
2-491) shall tlisclose such particular service on hislher lobbyist registration form and shall orallv disclose such oatlicular
service before lobb 'm the Clt Commission at a ublic meetin .
Yes No: H 'd d IG t b t b (lh C'N C ' n
'th' th t I f I ?If ol I' t th ' b n�m mber(s)of the C't Comm'ss'on'
_Yes�lo: If ves were vou oromis¢d or did vou receive economic consideration in exehanqe for camoaian
consultina services7
y� .� % y{.
/f �'O /7/ TOBECOMPLETEOB CRYCLERK'SST FONLY
Annual ReBistra[ion tee: [ ]Yes�I�No Amount Paitl 5 MCR# Date Paitl
Lobbyis[Regis[ration Form receivetl antl verifietl by:�
F',\RER\SALL�,aFORMS\L06BVISTPoRMS\Lobbyis[ftcg�ztrabonF �TR¢v15¢E W'11-10REG.Qoc 0.eviu003/11/]020
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VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH L08BVIST 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 WI7H REGARD TO THE SPECIFIC ISSUE ON WHICH THE
L088YI5T HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMPE S TION DURING THE REPORTING PERIOD.'
Signature of Lobbyist �' < <�� Date ��'7���
I do solemnly swear or affrm that all of the foregoing facts, statements, and disclosures in lhis form are tme and correct,
and ihat I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, eMitled "Lobbyists" of
the Miami Beach City�ode and all reponing requirements.
���j/ �,/
SignaWreofLobbyist:� / /'/�lC� Data ��� " /
SignaNre of Principal: , `���+�� �'� � Date�/ �X 1
�
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
Sta�e of �`Uii�A State of �l r��o
County of: ���� County of: .(�/..�
Swom to or affrm and subscribed before me, Swom to or affrm nd subscribed before me,
(
by means of ysical presence by means of ysical presence
or 0 online notarizatIqo, or O online notariz_ayoP
this_�day of �l.wn.>- . 2Q�L by this�day of J..nr. . 20_, by
�fl ��N/='/7 �GrF3�_- �ar. � �ol�i��e.i
NAME OF LOBBVIST NAME OF PRINCIPAL
_Produced ID _Produced ID
FORM OF IDENTIFICATION FORM OF IDENTIFlCATION
Pe�� erso Ily I n Y
i
Signa u of Notary Public SignaNre of Nota;ry Public
c}...�n. d�'YJ�O� � cllYy?�"-
Name [ary,Typed, Printed or Stamped Name of ry, Typed, Printed or Stamped
Jerty Johnson L
(NOTARY SEp�) �. : Comm.:NH 513829 (NOTARY SEAL) " Jeny Johnsan L
��' F Expi2s:Apr. iQ 2028 ��" Comm:HH 513829
'ID No�ary Puhlio�Stete ol Flotldo �e` FBPires:Apr. 10,2�28
..,..-' IJolaryPuhlic-StateofFlori9a
�The term"IobbyisY'specifcally eadudes Ihe following persons'.
Expert witnesses who provitle onty scientific,lechnical or other specialized information or testimony in public meetings;any person who
only appears as a representative of a neighborhood association without compensation or reimbursement for ihe appearance, whether
tlirec[ indirect or contingent, to express support of or opposition to any item; antl any person who only appears as a representative of
nobfar-pmfi�communiry basetl organizalion tor�he purpose of reques�ing a grant wilhout special compensa�ion or reimbursement for
the appearance.
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, . (� S" ,/� (' �!
Ciry d Miami Bsad, V00 Convannon Camer Drive,Miomi Beoch, Florida 33139,www.miamibeachA.gov
Office of Ihe Cily Clerk
Rafael E. Gmnado,Cily Clerk GlryGlerk�miomiheachfl.gov
Tel�. 305.673 7411, Fax�. 305.673 7254
��
NAME OF LOBBYIST:
1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
PursuaM 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 Statemen[s filed after [he
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 fne has been
appealed to [he 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 [o 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 immedia[ely file a Notice of Withdrawal with the Office of[he 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.
�,G�w- ,G/¢�z�
Sign t e of Lobbyist Date'�
F\QERIEALL�ePoRM5LLO8BVI5T FORMS\Lob�yls�Regls4allon Porm RevlseE 011 F30 REG tlm
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