Loading...
Emily Balter - Azenda Properties LLC daS DocuSign Envelope ID:424CD49A-4960-459E-955A-31922BB228CE S A /460.1/b Or RECEIVED M I AM I BEACH Office of the City Clerk JUL 06 2022 1700 Convention Center Drive Miami Beach, FL 33139 305.673.7411 CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 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 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 City Code Chapter 2,Article VII, Division 3, entitled"Lobbyists," for additional information. Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee, to the Office of the City 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 write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Baiter Emily NAME OF LOBBYIST (Last) (First) (Middle Name) Bercow Radell Fernandez Larkin&Tapanes,PLLC 200 South Biscayne Blvd.,Ste. 300 Miami,Florida 33131 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)374-5300 ebalter@brzoninglaw.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Pulido Gonzalo NAME OF PRINCIPAL (Last) (First) (Middle Name) Azenda Properties LLC 205 East San Marino Drive Miami Beach Florida 33139 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-898-3293 gonzalo@proalpet.com • PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to city Code Section 2-482 h)(1 (a): La principal of any corporation, part ership, o other entity who appears as a lobbyist on behalf of that entity,Cara special compensation cy'I i - - for MG appearance direct,indirect,Cy contingent t i-n ••• C C11 o••osition to an item shall register with the Clerk as required by this subsection but shall not be required to .ay an registration fees. If the principal is a Corporation, Partnership or Trust, the following information MUST be provided • pursuant to City Code Section 2-482(c): 5 • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): G. Pulido • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH co CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): Please see the attached. fh Page 1 of 5 Raunnss��m — p-5D99F1EC1D56 Page 1 of6 15D99F1EC1D56 'III OM'I III DocuSign Envelope ID:424CD49A-4960-459E-955A-31922BB228CE 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. Development Approvals&Planning Issues,including but not limited to the Historic Preservation Board, Design Review Board,Planning Board,Board of Adjustment,Land Use Development,City Commission, and any City Workshops or Committees,if necessary,relating to the property located at 205 East San Marino Drive in Miami Beach,Florida. 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 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 Staff for the Planning&Building Department None X Public Works&City Administration,PB,HPB,BOA None X DRB,City Commission,and Mayor as necessary None X Land Use &Sustainability Committee None X Pursuant to City Code Section 2-482(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 N be lobbied as identified on the lobbyist registration form filed. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): None 0 5 rn rn u2 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): m 65 M $375.00 per hour Page 2 of 5 DocVerify ID:35E89518 3289 48B0 8635-5D99F1 EC7 D68 Page 2 of 6 25D99F1 EC1 D56 ,III �'I II I www.docverify.com DocuSign Envelope ID:424CD49A-4960-459E-955A-31922BB228CE The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes x No: Are you lobbying 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 City Code Section 2-490, entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes x No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481)who only appears as a representative of a not-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 city clerk as required by this section,but shall not be required to pay any registration fees. _Yes xNo: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: Expert witnesses who provide only scientific,technical 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 the appearance,whether direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. _Yes x No: Are you providing only scientific, technical or other specialized information; appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(1), no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services within the past election cycle. See Section 2-491 for more information. _Yes xNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: _Yes XNo: If yes, has it been less than 12 months since the elected officials) whomyou provided campaign consulting services was sworn inr 6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. _Yes X_No: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: N N N _Yes XNo: If yes, were you promised or did you receive economic consideration in exchange for campaig consulting serviced LL TO BE COMPLETED BY CITY CLERK'S STAFF ONLY co Annual Registration fee: [ ]Yes It]No Amount Paid$- 5 MCR# 776Date Paid th Lobbyist Registration Form received and verified by: . N F;\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18,REG.doc Revised 09/20/2018 Page 3 of 5 DocVerify ID:35E89518.3289-4880-8636-51399F1 EC1 D56 Page 3 of 6 35D99F1 EC1 D56 ,III ER NI NIIII L www.docverify.com DocuSign Envelope ID:424C049A-4960-459E-955A-31922BB228CE VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR, 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 COMPENSATIOttOURING THE REPORTING PERIOD.' Signature of Lobbyist: .. Date 06/28/2022 C1A,A 1496944CG... I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct, and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code artcPail ing requirements. Signature of Lobbyist: i� baUvr DocuSigned by: Date 06/28/2022 bl Kb%144`Jb'J44tb... Gowf,alo PlAtih Signature of Principal: ,As3Co6DD3r�.4... Date 06/28/2022 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida County of: Miami-Dade - County of: Miami-Dade Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of 0 physical presence by means of 0 physical presence or E online notarization, or Ckonline notarization, this ,R day of June ,20 22 by this 28 day of June ,2022 by Emily Batter Gonzalo Pulido NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION x Personally Know X Personally Kn •-•� Signature of Notary Public Signature of Notary Public Diana Ramos Diana Ramos Name of Notary,Typed, Printed or Stamped Name of Notary,Typed, Printed or Stamped / Tana Ramos O 1 Commission#GG 308355 1 Qlana Ramos w IDS otary Public-State of Florida 1 1 Commission#GG 308355 LL / It,1y Commission Expires Apr 10,2023 1 1�otary Public-State of Florida O 0 1 oy Commission Expires Apr 10,2023 • 1 Th ng persons: 1 CO Expert witnesses who provide only scientific,technical 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 the appearance,whether direct, indirect or contingent, to express support of or opposition to any item; and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 DocVerify ID:35E89518.3289-48B0.8635.5D99F1EC1D56 Page 4 of 6 45D99F1EC1D56 1111 N 'I III www.docvenfy.com - — DocuSign Envelope ID:424CD49A-4960-459E-955A-31922BB228CE MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E. Granado, City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Emily Baiter 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 30th 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 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 immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE 0 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 $500.00 pursuant to Section 2-482 of the Miami Beach City Code. DocuSigned by: ',• ��L�� o I f'attu'' 06/28/2022 1)1A1A 449.,944Co... Signature of Lobbyist Date 0 N F:ICLERI$ALL1aFORMSILOBBYIST FORMSILobbyist Registration Form Revised 03-11-20 REG.doc Page 5 of 5 DocVwww.docverify.comerify ID:35E89518.3289-48B0-8635-5D99F1EC1D56 Page 5 of 6 55D99F1EC1D56 1111 E 'I II I DocuSign Envelope ID:424CD49A-4960-459E-955A-31922BB228CE Page 6 of 8 DISCLOSURE OF INTEREST CORPORATION, PARTNERSHIP OR LIMITED LIABILITY COMPANY If the property that is the subject of the application is owned or leased by a corporation, partnership or limited liability company, list ALL of the owners, shareholders, partners, managers and/or members, and the percentage of ownership held by each. If the owners consist of one or more corporations, partnerships, trusts, partnerships or other corporate entities, the applicant shall further disclose the identity of the individual(s) (natural persons) having the ultimate ownership interest in the entity. AZENDA PROPERTIES LLC NAME OF CORPORATE ENTITY NAME AND ADDRESS %OF OWNERSHIP GONZALO PULIDO 100 2020 N BAYSHORE DRIVE APT 3201 M IAM I FLORIDA 33137 NAME OF CORPORATE ENTITY NAME AND ADDRESS %OF OWNERSHIP 0 0 N Cl] 0 0 m N 0) ❑ 0 LU W rn 0 N U, 0 If there are additional corporate owners, list such owners, including corporate name and the name, address and percentage 7, of ownership of each additional owner, on a separate page. /4,),( N CO ch We are committed to providing excellent public service and safety to all who live,work,and alav in our vibrant,trooicol, historic community. DwocVerify ww.do elrfycom89519-3289.48B0-8635-5D99F1EC1D56 I Page 6 of 6 I 65D99F1EC1D56 I ,II rsopstol M �� g MBF Cit► Hall N ,F. iii„;;;-1 1700 Convention Center D . .-n sr Miami Beach , FL 33139 305-673-7420 I Welcome a . 005569-0004 Esther G 07/05/2022 09:38AM -a: r; n n MISCELLANEOUS l a Reference 1; 428788 ID } 2022 Item: NCR . MCR OPEN (MCR) 700.00 y° .. 700.00 ` .. I . Subtotal 700.00 Total 700.00 ya .. ,` `' CHECK 700.00 �,t y . ,, Check Number001293 "• � r " _.e ,� ,• ;m om . Change due 0.00 . ,J Paid by: Azenda Properties LLC y .,-. %9„1/4,4 ,. . ` W LA Y I , N--..JP.N/ _ __;ci?ca Y.S `A.` ,/ ' ,., 2F.tE3lJdelk3 tar.tr at mi3i.1'S ' ' t •"1. „ fi. 0 Thank you for your payment ` r �... C..f -: 4 L ...5. . CUSTOMER COPY 'x x ..,�