Joaquin E. Vargas/TBS Realty Tudor South Beachm MIAMIBEACH
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the
passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action,
decision, recommendation of the City Manager or any city board or committee; or any action, decision or
recommendation of any city personnel during the time period of the entire decision-making process on such action,
decision or recommendation that foreseeably will be heard or reviewed by the city commission, or a city bond or
committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The
term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
Vargas Joaquin E.
NAME OF LOBBYIST: (Last) (First) (M.I.)
c/o Traf Tech Engineering, Inc. 8400 North University Drive, Suite 202 Tamarac, FL 33321
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(954) 347-7341 (954) 582-0989 Joaquin@traftech.biz
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
TBS Realty, LLC; Tudor South Beach Resort Condominium, Inc.; and Tudor South Beach Resort-North
Condominium, Inc.
NAME OF PRINCIPAL/CLIENT:
1111 & 1119 Collins Avenue Miami Beach, FL 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
__(212) 474-9865 N/A jstein@hh-r.com
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Rabinder Pal Singh and Jay Stein
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY CR INDIRECTLY, A 5% OR MORE
OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
See Exhibit "A" attached. c~
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II. SPECIFIC LOBBY ISSUE: ''~~ v '""`
c`? -v =!
NIE Conditional Use Permit for ground floor restaurant and rooftop lounge c, -r= •~
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Issue to be lobbied (Describe in detail): -f' ~--
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III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to City Code Section 2-482(g) include a
statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an
appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding the
commencement of service of City personnel to be lobbied.)
A) Full Name of Individual/Title B) An Financial, Familial or Professional Relationship
City of Miami Beach Planning Board None
City of Miami Beach Mayor/Commissioners None
City of Miami Beach Committees None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
B) PRINCIPAL' ISCLOS RE (OF ~O
(Required). ~ U rZ~ l.,t
The following information must be answered:
PENSATION):
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^Yes ®No• Are you lobbvinq on a present or pending bid for goods, equipment or services, or on a
present or pending award for Goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^Yes ~ No• Are you lobbvinq on a pending application for a Development Agreement with the City or
application for chance of zoning map designation or chance to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of snot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
^Yes IRl No• Are you representing snot-for-profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1St OF EACH YEAR. EACH L<
STATEMENT UNDER OATH. LISTING LOBI
RECEIVED. IN THE CITY OF MIAMI BEACH FOF
BE FILED EVEN IF THERE HAVE BEEN NO EXI
PERIOD.
~. do solemnly swear that all of the regoing facts
~, a rovisions contained in Section 2-48 of the Miami
°T~ I
~ ~ s c Signature of Lobbyist: l
¢°o"'~
° '~ ` ~ Signature of Principal/Client:
Z °' ~ .
`-'-' ~ i I. LOBBYIST IDENTIFICA I N:
ono
'~~X ~~
Y L1.1 `~ .
z ^ Produced ID -L r
... N_, Form of Id ification
Personally known (Lobbyist)
of Lobbyist
correct and that I hive read or am familiar with the
ode and all reporting requirements.
RINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
^ Personally known (Principal)
I. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscrib fo me
Thi ~ day f ~,.cp~ 8
S' nat a of b is Notary -State of Florida
otarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This _ day of , 2008
Signature of Public Notary -State of Florida
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLEKK'S U5t UNLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # $ Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\LOBBYISlILobbyist Registration Form 32708.doc Revised 03/27/2008
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required).
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues':
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
^Yes ®No Are you representing a not for profit corporation or entity without special compensation or
reimbursement.
V. SIGNATURE UNDER OATH:
PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the
provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client: i~ti~~
Rabinder Pal Singh on
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
® Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This _ day of , 2008
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
TO BE COMPLETED E
Annual Registration fee: [ ]Yes [ ] No Amount Paid $
Lobbyist Registration Form received and verified by:
~f TBS Realty, CL~
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
[~ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This 2 ~ day of~(r- , 2008
w, ~,,r.>,~.--~-
Signature o Public Notary -State of Fder+e#a N`•
Notarization of Principal's signatur~ U N I R A H M E D
CITY CLERK'S USE ONLY Notary Public State of New York
Date Paid ~~ Expires A~arch 20.ID
MIADOCS 2972884 1
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER
HOURLY, FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
(Required).
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
^Yes ®No• Are you lobbvinq on a present or pending bid for goods eauipment or services, or on a
present or pendina award for Goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^Yes 6~ No• Are you lobbvinq on a pending application for a Development Agreement with the City or
application for chance of zoning map designation or chance to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
^Yes ~I No• Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement.
Signature of Lobbyist
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the
provisions contained in Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client: ,l`'r
Jay Stei on.6eh f of Tudor
Resort-I~rth Condominium, Inc.
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
® Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
Condominium, Inc. and Tudor South Beach
PRINCIPAL IDENTIFICATION:
^ Produced ID
Form of Identification
[~ Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This -day of , 2008
Signature of Public Notary -State of Florida
Notarization of Lobbyist's signature
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~ day of ~, 2008
Signature of Public Notary -State of Ffer+da N`~
Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S USE ONLY
Annual Registration fee: [ ]Yes [ ] No Amount Paid $ MCR # $ D~totary u is a e et New Yor
Lobbyist Registration Form received and verified by:
F:\CLER\LOBBYIST\Lobb ist Re istration Form 32708.doc Rev d X953
\O
MIADOCS 2973020 1
V. SIGNATURE UNDER OATH:
m MIAMIBEACH
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.oov
CITY CLERK office CityClerk miamibeachfl.gov
Tel: 305.673.7411, Fax: 305.673.7254
LOBBYIST NAME:
Joaquin E. Vargas, PE
I understand that no later than October 15t of each year, I must file the following forms, pursuant to Section 2-485 of
the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County
Commission on Ethics and for code violation evaluation.
In additi n, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the
City Cle k's Office for lobbyist withdrawal in writing.
,, ~ ~~ ~
Date:
MIADOCS 2970025 1
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