Jose K. Fuentes - Osman Ihab oa 0 -06, Nb
RECEIVED
CIAAA1BEACH OCT 25 2022
Office of the City Clerk
1700 Convention Center Drive OF MIAMI BEACH
Miami Beach,FL 33139 CI 'n-
iG CITY CLERK
305.673.7411 OFFIr
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°Lobbyist'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 °nla" 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:
Fuentes, Jose K.
NAME OF LOBBYIST (Last) (First) (Middle Name)
Becker&Poliakoff, P.A., 121 Alhambra Plaza, 10th Floor, Coral Gables, FL 33134
LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (Stets) (Zip Code)
(305)260-1018 (305)299-4900 JFuentes@beckerlawyers.com
LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
II.PRINCIPAL INFORMATION:
Osman, Ihab
NAME OF PRINCIPAL (Last) (First) (Middle Name)
Ross&Baruzzini, Inc. 201 Alhambra Circle,suite 900, Coral Gables, FL 33134
PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(800)404-7677 n/a iosman@rossbar.com
PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS
ursaarit m ,section 2T4B2(hj('I)(a• A , n •; of( co• .on ri Q are .•• es CI lii6b s p l jlg1T• f
s FlC., �a Frye+ fru Chu iz�t Cii [ci •m_ LPt tts
rogeterlw. aCierkasrr'"1'�','n )lhissubsection but•allenL r]berequiredtopayoyf T�{' te 3 f+i �7
If the principal is a Corporation, Partnership or Trust, the following information MUST be provided
pursuant to City Code Section 2-482(c): ;;;1 ttt'���, (�
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(If none,write NIA): C r ol\ P• 1 v CLc
• NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION.PARTNERSHIP OR TRUST(If none,write NIA): DAR Holdings, U.S.A.,,Inc.
Page 1 of 5
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.
Contract negotiations - CCNA Contract No. 2020-096-ND for Security and Safety Enginerring
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
Alina T. Hudak nla X
Lester Sola nla 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
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):
N/A
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):
$3,500 a month
Page 2 of 5
The following six(6)questions MUST be answered:
1) Pursuant City Code Section 2.488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues":
Yes s o: Are y u lobbying on a present or pending bid for goods.eauioment Or services.or on a present or
—
pending award for goods.equipment or.service?
2) Pursuant to City Code Section 2490,entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development
Issues":/
_Yes No: Are you lobbving.on a pending application for a Development Agreement with the City or application
for change of zoning inap.deslanatlon or change to the Citv's Future Land Use Map?
3) Pursuant to City Code Section 2482(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 cityrk as required by this section,but shall not be required to pay any registration fees.
Yes No: Are you representing a notrfar-prgfit cornoratlon or entity without special compensation or
reimbursement?
4) Pursuant to City Code Section 2.481,the teat"lobbyist'specifically exdudes 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
reirnbursyment for the appearance.
Yee VNo: Are you providing only scientific. technical or other specialized information: smearing as a
representative of a neighborhood association without special compensation or reimbursement or
'epresanflna a not-for-profit hatred oraenizstlon for the purpose of requesting a Grant without
special.coingensatlon 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 offidal(s)for whom the campaign consultant provided campaign consulting services
within the st election cycle.See Section 2-491 for more information.
—Yes No: tfavil you provided campaign consulting 4ervlgos.to an Incumbent lnembgr Of the City Commission
within the past efeetton.cvcle?Ryes.please list the incumbent membertsiof the City Commleafon:
_Yes. o: [ "tii7itifeq' t the—LTAI t s—T'irr-'1t raTMaara4trr tiiititehtun 11111 it e4 a mo9 pi
uitfnose ices was sworn in?
6) Pursuant to City Code Section 2.482(a)(4)e.,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
2491)shall disclose such particular service on his/her lobbyist registration form end shall orally disclose such oarticuter
service bdtom lobbying the City Commission at a public meeting.
_Yes r No: Have you provided campaign consulting services to an Incumbent member of the City Cominlasrion
within the mast election circle?lficea.please tietthe Incumbent menrberfs1 of the City Commission:
Yee No• a rc::t -y .r . r ,.�I %. .. . . iG '` tiers'• in a.ch ..- 1�?T TPI C
bansuitingrservtass
TO BE COMPLETED 8Y CITY CLERK'S STAFF ONLY
0 Registration(LB g,DSZDE El MD IsrrerilUffeif~i �JS' "C�Nt+>Rs 0 n , i k
Lobbyist Registration G e ClCi i17 r.Jt))
•
.1 £#t.. . .lib ii�0i3 vm� +7�i lam] REG.coc ' Revised 0.3ItS 2020
Page 3 of 5
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 2 OF EACH YEAR.EACH LOBBYIST SHALL.SUmMtT TO THE OFFICE OF THE CITY CLERK A
SiGNED.STATEMENT UNDER OATH. LISTING LOOMING- EXPENDITURES. AS.WELL AB cOMPENSImOI4
RECEIVED.FORjE 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 COMPENSATOR DURING THE REPORTING PERIOD.'
! Signature of Lobbyist: ) Date 9/27/2022
r
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 and all reporting requirements. �+
Signature of Lobbyist: �v Date 1 -- ` 9`u
! Signature of Principal: , �'"f '0 Date Cri.jedjit%?+ ) ')
rj i
VII" NOTARY SIGNATURE AND SEAL:
1
LOBBYIST: ' PRINCIPAL
State of PBMW-
��LllbY V State of t 1
S s r .(
County of: 7M (Ai..`' County of:
1
Sworn to(or affirmed)and subscribed before me, Sworn to(or affirmed)and subscribed before me,
by means of physical presence by means of thysical presence
or[]cube notarization. or E] a notariAgi
4 this .Il'bay of ,iIT Vrni9 e1 ,2Oeby this ay of 1- / a 2¢
iJ OtSC Vs. Rv -.S /A is rytam ,.
NAME OF LOBBYIST NAME OF PRINCIPAL
Produced ID Produced 10
FORM OF IDENTIFICATION / FORM OF IDENTIFICATION
;Personally Known _ rsjnaey Known
(1k40
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Signaturepf Notary Public Sig of otary Public
pot►\lC � �-f5 a k 6.0/a.)
Name of Notary,Typed,Printed r =mped Name of Notary,Typed, rinted or Stamped
`la; ;'RY SEALOINIAC sTtS (NOTARY SEAL)
��.,��••. �cota:frlsslo�:�:>7.,asn5o4 � ,..,�.,
::u- :..1 EXPIRES;Hovemtor 4.?A24 ,oltytY PUB', CASSA DRATHIE[E
ttaderxrtil� :2.� G�% My Co mtission Expires
r T;: : -• . - . •: I e following persons: *: .• Apr11242023
Jefferson Coudy
Expert witnesses who provide only scientific,technical or other specialized Information or testimonftli tingsCe
only appears as a representative of a neighborhood association without compensation or reimburse At Tar the appearance, firer
372
direct,Indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of
notfor-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for
the appearance.
Page 4 of 5
MIAMIBEACH
City o1 Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.ndamibeachA.gov
Office of the City Clark
Rafael E.Granada,Cily Clerk CiiyClerk@miamibeachfl.gov
Tel:305.673.7411,Fax:305.673.7254
NAME OF LOBBYIST: Jose K. Fuentes
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.
My lobbyist, who fails to file the required Statement by April 300' 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
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
$500.00 pursuant to Section 2-482 of the Miami Beach City Code.
9/27/2022
Signature of Lobbyist Date
F:ICIERi$ALL1.001U U.OaBY18T FORMAStabbyta%Rptd4ntlen Fort,Roland D3-11-20 Backe
Page 5 of 5
R&B to DAR USA
Dar Hol dings U.S.A.,Inc.
36-4171164
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Ross&BarunIn;Inc.
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23 Nov1992
Dar Hold-ings U.S.A.,Inc.
36-4171164
(DE5/5/97)
198.99 a
Ross&Baruzzini,Inc.
43-0737438
(MO 7/24/62)
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