javier f. aviño - west collins land investors

8/15/2019 Javier F. Aviño - West Collins Land Investors

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City of Miami Beach

Office

of the City

Clerk

1700 Convention Center Dr ive, M i am i Beach

W Alf,,.,C

LOBBYIST

REGISTRATION

FORMIC

1

1

C L

E r = , ,

Lobbyist

means a ll persons employed

or

retained,

whether paid or not,

by a

principal who seeks to

encourage the

passage,

defeat

or

modfication

of

any

ordnance, resoution, action or

decision

of

any

commssoner;

any

action,

decision,

recommendation

of

th e City

Manager

or any city board or committee; or any action,

decision

or recommendation

of

any city

personne

during

the time period

o

the entire

decision-

making

process on such action,

decision or recommendation that

foreseeably

wll

be heard or

revewed

by

the

city

commsson, or

a

city

board

or

commttee.

The

term specifically

includes the

princpa

aswel as

any

empoyeeengagedin

lobbying

activties.

The

term "

Lobbyists"

has

specficexcusons. Please

refer to Ordinance 2004-

3435.

Av06 Javier

F.

NAME

OF

LOBBYIST:

Last)

First) M. 1 )

Bilzin

Sumberg

Baena

Price& Axelrod LLP, 1450 Brickell Avenue, Suite 2300, Miami, FL 33131

BUSINESS NAME AND ADDRESS( Number andStreet) (

City)

State)

Zip Code)

305-

350-

7202

305-

351-

2275 javino _bilzin.com

TELEPHONE NUMBER: FAX

NUMBER:

EMAIL:

I. LOBBYIST

RETAINED BY:

SEE ATTACHED EXHIBIT"A"

NAME OF PRINCIPAL/CLIENT:

BUSINESS

NAME

ANDADDRESS

Number

and

Street

City)

State

Zip

Code

Y)

P )

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:

IDENTIFY

ALLPERSONS HOLDING,

DIRECTLY

OR

INDIRECTLY, A 5%

OR MORE OWNERSHIP

INTEREST

IN

SUCH

CORPORATION, PARTNERSHIP

OR

TRUST:

See Attached Exhibit"

B"

e

II.

SPECIFIC

LOBBY

ISSUE:

All land use/zoning and permitting matters regarding property at 2377 Collins Avenue, 2340 Collins Avenue and 2322 Collins

Avenue,

Miami

Beach, FL

Issue to

be

lobbied(

Describe in

detail):

III.

CITY AGENCIES/INDIVIDUALS TO BE

LOBBIED:

Pursuant to City

Code

Section

2-

482(

a )(

4 include the

commissioner

or personnel

sought

to be lobbied, and whether

the lobbyist

has

entered into

any

contractual

relationship( paid or unpaid) with said

city commissioner

or personnel

from

1 2

months

preceding such

person'

s commencement

of

service

with the city to the

present

date, stating the

general nature

of the subject contractual relationship.

Sec 2-

482(

a)(4) Full Name

of

Individual and Contractual

Relationship(

Explain)

YES NO

title of

person

to be

lobbied

City

ofMiami Beach

Planning

Department

staff

and

Zoning

x

Department

staff

City

of

Miami

Beach

Commissioners,

Planning

Board, and

x

Board ofAdjustment

Pursuant

to

City

Code

Sect ion

2-

482(

g ) Every

reg is t ran t

sha l l be r eq ui re d t o

s ta te th e

extent o f

a ny

business, f inanc ia l , fam i lia l or

professional relationship, or

other

relationship giving rise to a n

appearance

of a n impropriety, with any currenticity c o m m k s ion,erlor

city personnel who is sought to be lobbied a s identified o n the lobbyist registration form filed.

Sec 2-

482(

g) Any

Fnancial,

Familial orProfessional

Relationship

1 , ,

s

none

L-

airy

U

MIAMI

3840444.

179794/42069

d


2/14

IV.

DISCLOSURE

OF

TERMS

AND

AMOUNTS

OF

LOBBYIST COMPENSATION ' DISCLOSE WHETHER HOURLY,

FLAT

RATE

OR OTHER)

A)

LOBBYIST

DISCLOSURE: (

Required)

475/hr

B)

PRINCIPAL'

S

DISCLOSURE(

OF

LOBBYIST

COMPENSATION):(

Required). 475/hr

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

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

Miami

Beach

City

Code 2-

490

Entitled "

Prohibited Campaign Contributions

B y

Lobbyists

On R e a l

Estate

Development

Issues":

Yes

VNo:

Are you

lobbying

on a pending application for a Development Agreement with the Cty or application

for change of zoning map designation

or

change

to the

Cty'

s

Future

Land

Use

Map?

3)

Pursuant

to M ia m i B ea ch City

Cod e

2-

4 8 4 ( h )

A n y p er so n ( except those

exempt fro m th e defini t ion of" lobbyist a s se t

forth

in Section

2 - 4 8 1

above) who only appears

a s

a representative

of

a

not -

for-

profit corporation

or

entity

without

speca

compensaton

or

rembursement

for

the

appearance,

whether direct, or

indirect, to

express support of or

opposition

to

any i t em,

shal l

register

with

the clerk as required by this section

but , shal l

not

be

required

to

pa y any

registration fees..

Yes

No:

Are

you

representing

a no-

or-

profit

corporation or

entity

wthout

speca compensation or

rembursement?

V.

SIGNATURE UNDER OATH:

ON

FEBRUARY

28T

OF EACH YEAR, EACH LOBBYIST SHALL

SUBMIT

TO THE CITY CLERK A SIGNED

STATEMENT

UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, IN THE

CITY

OF MIAMI

BEACH FOR

THE PRECEDINGCALENDAR

YEAR. A STATEMENT SHALL

BE

FILED EVEN IF THERE HAVE BEEN

NO

EXPENDITURESOR COMPENSATION

DURING THE REPORTING

P IOD.

Sig

ture

o

Lobbyist—Javier F. Avino

I d o solemnly swear that a ll of th e foregoing facts a re true a n d correct

a n d

that I h a v e r e a d or

a m

familiar w ith th e provisions

contained in Section

2- 4 8 2 of

th e M ia m i

B e a c h

City Code

a n d a ll

reporting requirements.

Signatureof Lobbyist:

Javier

FQ n

MIAMI

3840444.

179794/

42069


3/14

f

2377

Collins Resort,

L.

P. , a Delaware limited partnership

B y : 2 3 7 7

Collins Resor t

G P, L .L .

C.,

a-

Del'

limited

bility company,

its

G e n e r a l

B y:

f

Camille

D •

las

VI.

LOBBYIST

IDENTIFICATION:

r

1 ' V;,,

Im

PRINCIPAL IDENTIFICATION:

L

Produced

ID

0

Produced

ID

Form

of

Identification

Form of Identification

Personally

known

tLobbyist)

Personal ly

known( Principal

VII. SIGNATURE AND STAMP OF NOTARY:

State

of Florida,

County

of Miami-Dade

State

of

N e w Y o rk , C o un ty

of

N e w Y o rk

Swo

t

and sub

bed befo

me

S w o r n

subscribe

before

e

Ths

20 )

This

S w o r n

o 20

Signature

of

ry—

State

o

FI

Signature

o

Public

o —

State of New York

Notarization

of

Lobbyist'

s

sgnature

Notarization

of

PrInerpare

signature

pRY

Pie

IB IS DIA Z

MY COMMISSION#

DD

994645

N o

Vb *

EXPIRES:

M a y

24 ,

2 0 1 4

N0 . a1MA5MMO

FF̀

39

B o n d e d T h r u B u d g et N o t ar y S e r v i c e s

tn

M W A0 1 4

TO BE COMPLETED B Y C IT Y CLERK'S STAFF ONLY

Annual Registration

fee.

Yes(

No Amount

Paid

MCR

N

Date

Pai

Lobbyist

Registration

Form

n=

lved and verified by:

Revised

4/

27 / 2012

MIAMI 3800121.

179794140353


4/14

MIAMIBEACH

City of

Miami

Beach, 1 7 0 0

Convention

Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov

CITYCLERK

Office [email protected]

Tel:

305.

673.

7411 ,

Fax:

305.673.

7254

LOBBYIST

NAME:

Javier

F. A066

I

understand

that

no

later

than

February

28h

of

each

year,

I must

file

th e following

forms,

pursuant

to Section 2-

485

of

th e

Miami Beach City Code, with

th e

City

Clerk'

s

Office for

a ll active

lobbying issues.

1 )

Lobbyist Expenditure Form and Compensation Form

Failure

to file these

forms on

a

timely

basis

will

result in m y

name

being transmitted

to the

M i a m i -

D a d e County Commission on Ethics a n d for

code

violation evaluation.

In

addtion, oncean issue I

have

regstered

to

lobby

on

has

been

resoved,

I am

required

to

immediately notify

the

City Clerk'

s

Office

of

lobbyist withdrawal in writing.

Pursuant to Section

2-

485 (

d),

the

City

Cerk

shal

notify any

lobbyist (

or

princpa)

who fails to

timely file

a

Statement a nd

in addi t ion

to any other

pe n altie s w hic h m a y

be imposed

a s

provided

in

Section 2-485.

1 ,

a fine

o$

5 0 . 00 a

day

shall be assessed for a ll

Statement(

s) filed after the due

date.

The City Clerk

shall

notify th e M ia m i-

Dade

County Commission

o n

Eth ic s

a n d

Public Trust

of

the failure

of

a

lobbyist (

or princpa)

to file th e Statement or pay the assessed fines after

noification.

Any

lobbyist,

who fails to

file the

requred

Statement

by

April

301h

o

each year,

shall be

automatically

suspended

from

lobbying

unti l

a ll fines are

paid ,

unless

the

fine

has been

appealed

to the Miami-Dade County Commission o n Ethics a n d Public Trust.

3-

S'

natu e:

Date:

MIAMI 3840444. 1 79794/

42069


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14/14

javier f. aviño - west collins land investors

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