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Augusto E. Maxwell/Ernesto Arguello, Lincoln Group, LLC~~' ? , City of Miami Beach Office of the City Clerk ZQ~~ OCT - I PM 3~ 28 1700 Convention Center Drive, Miami Beach, FL 33139 c~rY c~~~;,~s Q1=~-~c~ 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 derision 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 board 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 20043435. L~-- vG4~ NAME OF LOBBYIST: (Last) (First) (M.I) /4 ~;Uw1u~t St .tferf:f7 D~t.c SG 3 r.1 /3+~ • ~/i.o-~s~ ~c 33/,~i BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) "jOC ~ ~C.~- r32'~ ,QO,T ~ 3 ~`~ ~'~~ Rv4vr~.~~,c,c..~IIG~CK~at~/i~~ TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: nct~b ~ q vc llis / G ,Y+ coat ~~ (~v~P, L [~ NAME OF PRINcINAUCLVt_IV I L/hG0lA G~ouP G.GC '9`~~'~! !''v!l~NS A'!/G,'~ 2/13 /Y1~a~rr~'GSeca~4. ~L 3319b BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) section if principal is a or Trust [Section 2-482 (c)] NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: u.SPECIFIC LOBBY ISSUE: L~ USC ~yS~~lwrr.~ to be lobbied (Describe III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: (Pursuant to city code section 2-48z1s1 include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise 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) Any Financial, Familial or Professional Relationship K~ sfo„-uJ P/~G/v u-!~v:a, l~ok,-~ Nc,.asi ~i! ~~ ~~v~ s w ,6 ~o~ ~~~,~.. ~`~ IV. DISCLOSURE OF TERMS AND AMOUNTS C RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required) B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPI (Required). The following information must be answered: F LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT f-hot.~tl)~ ~~I0.00 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes ~ No: Are you lobbvina on a present or pending bid for goods, equipment or services, or on a present or pending award for goods. eauipment 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 lobbyinp on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the Citv'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 ~ No• Are you representing anot-for-profit corporation or entity without special compensation or reimbursement. . V. SIGNATURE UNDER OATH: VI. My Commission DD75t1094 ', ..Fxoires 03!2012012 ersonally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworry to and subscribed before me This/J~ day ofC~t ~s~, 2008 ~.~ ~~~ Signature of Public Notary -State of Florida Notarization of Lobbyist's signature PRINCIPAL IDENTIFICATION: ^ Produced ID ,~,/' Form of Identification L~' Personally known (Principa =~~~ Mn ~P~~ State of Florida ~ My Commission DD758094 ~~a~' EzWres03l20l2012 State of Florida, County of Miami-Dade Sworn and subscribed b o e me This ~~day of t~ ~~ 2008 Signature of Public Notary -State of Florida Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: es [ ] No Amount Paid . MC # Date Paid Lobbyist Registration Form received and verified by: ~.~c~ ra~LC~asvz~'r~Lata~yE~t ~ erz~ 3at(i8.s3a~ Revised 03/27/2008 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 82 of the M~ each City Cod and all reporting requirements. Signature of Lobbyist: ~^ m City of Miami Beoch, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.741 1 ,Fax: 305.673.7254 LOBBYIST NAME: ~U l~ sTy ~ ~'4 7cw,E L `-' I understand that no later than October 1st 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 addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. ~ ,,,-mac , o ~ ~ / og Signature: Date: ~:~~.;1«c~ee~Ir~L ~