Michael J. Marrero - Don Peebles (1)

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    City

    o

    Miami

    Beach

    Office othe

    City

    Clerk

    s

    3

    1700 Convention

    Center

    Drive,

    Miami

    Beach, FL 33139

    y

    LOBBYIST

    REGISTRATION FORM

    Lobbyist means al l persons employed or retained,

    whether

    paid or not, by

    a

    principal who seeks to encourage the passage, defeat or

    modification

    of

    any

    ordinance, resolution,

    a ction o r decision

    of

    any commissioner;

    any

    action,

    decision,

    recommendation of the City

    M a n ag er o r an y city

    board

    or committee; or

    an y

    action, decision or recommendation of

    an y

    city personnel during

    th e time p er io d

    of

    the

    entire

    decision-

    making

    process on such acion,

    decision or recommendation tha t foreseeab ly will

    be

    heard or reviewed

    by

    the

    city

    commsson, o

    a

    city

    board o

    commttee.

    The

    term

    specifically

    includes

    the principal as

    well

    as

    any

    employee engaged in

    lobbying

    acivties The term " Lobbyists"

    has

    specficexcusons. Please refer

    to

    Ordinance 2004-

    3435.

    Marrero Michael

    J.

    NAME

    OF

    LOBBYIST:

    Last)

    First)

    M.

     

    Bercow Radell & Fernandez, PA 200 South Biscayne Blvd.,

    Suite 850 Miami, Florida

    33131

    BUSINESS

    NAME

    AND

    ADDRESS

    Number and

    Street) (

    City)

    State)

    Zip

    Code)

    305)

    374-

    5300

    305) 377-6222

    mmarreroa-brzoning

    law.com

    TELEPHONE

    NUMBER:

    FAX

    NUMBER:

    EMAIL:

    Please notify

    this office

    ifyour

    contact information

    changes:

    address,

    phone,

    or

    e- mail address.

    I.

    LOBBYIST

    RETAINED

    BY:

    Don Peebles

    NAME

    OF

    PRINCIPAL/

    CLIENT:

    Bath

    Club

    Entertainment,

    LLC 550

    Biltmore

    Way,

    Ste. 970

    Coral Gables, Florida 33134

    BUSINESS

    NAME

    ANDADDRESS

    Number

    and

    Street) (

    City)

    State)

    Zip

    Code)

    305)

    442-

    4342

    305)

    442-4345

    peeblesl(

    d)-

    aol.

    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: Don Peebles

    IDENTIFY ALL

    PERSONS

    HOLDING,

    DIRECTLY

    OR

    INDIRECTLY,

    A

    5% OR MORE OWNERSHIP INT

    EST

    IN SUCH CORPORATION,

    PARTNERSHIP

    OR

    TRUST:

    So

    e

    tz

    I

    ii.

    SPECII=

    IC

    LOBBY

    ISSUE:

    Board

    o

    Admustment

    A

    eal

    regarding

    Use of Pool

    Deck

    and Facilities

    Issue to

    be lobbied(

    Describe in detail):

    CITYAGENCIES/ 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

    contractua

    relationship (

    pad or unpad)

    wth sad

    city

    commssoner or

    personne

    from

    12 months preceding such

    person'

    s commencement of

    service

    with

    the

    city to

    the present

    date,

    stating the

    general nature of

    the

    subject

    contractual relationshi .

    Sec 2-482(a)( 4) Full Name o

    Individual

    and Contractual

    Relationship(

    Explain)

    YES

    NO

    title of person to be

    lobbied

    Commission,

    Planning

    Staff,

    Development Boards

    NONE

    Pursuant to

    City

    Code Section

    2-

    482(

    g)

    Every

    regsrant

    shal

    be requred

    to

    saethe

    exent

    o

    any

    business,

    financial,

    familial

    o

    p ssiq

    relationship,

    or

    oher

    relationship

    giving

    riseto

    an appearance

    oan

    impropriety,

    wth

    any

    current

    city

    commssoneror

    city

    person

    o is

    sough

    to

    be lobbiedas

    identified

    on

    the

    lobbyist

    regstraionform

    filed.

    Vo,

    Sec

    2- 482(

    g) Any

    Financial,

    Familial

    or

    Professional Relationship

    NONE

     

    A

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    IV.

    DISCLOSUREOF TERMS AND AMOUNTS OF

    LOBBYIST

    COMPENSATION( DISCLOSE WHETHER

    HOURLY,

    FLAT RATE OR OTHER):

    A)

    LOBBYIST

    DISCLOSURE:(

    Required):$

    395.

    00

    B)

    PRINCIPAL'

    S

    DISCLOSURE( OF

    LOBBYIST COMPENSATION):$

    395.00

    REQUIRED).

    Th e

    following information must

    be

    answered:

    1 )

    Pursuant

    to Miami Beach City Code Section 2- 48 8 Entitled Prohib ited Campaign

    Contributions

    By

    Lobbyists O n Procurement

    Issues":

    Yes

    X

    No:

    Are you lobbvina on a

    present or

    pending bid

    for

    goods.

    equipment

    orservices. oron

    a

    present or pending

    award for

    goods.

    equipment orservice?

    2)

    Pursuant to M ia m i B e ac h C ity Code Sect ion

    2-

    490 Ent itled Prohibited Campaign

    Contributions By

    Lobbyists O n Real Estate

    Development Issues":

    Yes X

    No:

    Are you

    lobbying

    on a

    pending application

    for

    a

    Development

    Aareement

    with the

    City

    or

    application

    for

    change

    of

    zoning

    map designation or change to the

    City's

    Future Land

    Use Mang

    3)

    Pursuant

    to M ia mi B ea ch C ity C od e

    Section

    2- 482 (

    h)

    Any person (

    e xcep t th os e e xe m pt fr om th e

    definition

    of lobbyist

    as set

    forth

    in

    Section 2-

    481

    above)

    who

    only appears as

    a

    representative of

    a not-

    for-

    profit

    corporation

    or entity

    without

    speca compensaion o

    rembursement

    for

    the appearance,

    whether direct, o indirect,

    to express

    support

    of or

    opposition

    to any i tem, sha ll

    register

    with

    the

    c le rk as requ ired

    by

    t his sect ion but, shal l not

    be

    required

    to

    pa y a ny

    registration

    fees.

    Yes

    X No:

    Are you

    representing a not-for-profit corporation or entitywithout

    special

    compensation or

    reimbursement.

    V.

    SIGNATURE UNDER OATH:

    ON

    FEBRUARY

    28 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

    EM

    THE PRECEDING

    CALENDAR YEAR, A

    STATEMENT

    SHALL BE

    FILED

    EVEN IF

    THERE HAVE BEEN NO

    EXPENDITURES OR

    COMPENSATION

    DURING THE

    REP

    ER1011

    Signature

    of

    Lo byist

    I do

    solemnly

    swear

    that

    all o

    the

    foregoing

    f cs

    are

    true

    an

    d _

    rect

    and

    that I have

    read or am familiar

    with the

    provisions

    contained

    in Section 2-482

    o

    the

    Miami

    Beach

    City

    C

    de eportquremens

    Signature

    of

    Lobbyist:

    Signature.

    o

    Principal/

    Client: "

    Zu_

    _

    VI.

    LOBBYIST

    IDENTIFICATION:

    PRINCIPAL

    IDENTIFICATION:

    n

    w

    Jr

    o

    Produced

    ID

    Produced

    ID

    0

    Form

    o

    Identification

    a,

    c

    Form

    o

    Identificatio .°

    0

    M - , .,

    Z

    e r s o n a l l y

     

    3

    Oi

    P e r s o n a l l y

    known(

    Lobbyist)

    R • 0

    Personally

    known (

    Principal)

    A

    3 -

    m

    g

    N

    3

     

    0N.3

    N

    2 j U c a

    VII. SIGNATURE AND

    STAMP

    OF

    NOTARY: '

    a 0

    Q

    m

    i

    o

    H

    3

    ci

    m

    N

    j

    N

    Cn

    O O D +

    State oFlorida,

    County

    o

    Miami-

    Dade

    N

    m

    State o

    Florida,

    County

    o

    Miami-

    Dade

    cc

    Sworn

    to andsubscribe before

    me

    N

    Sworn ci

    subscribed

    A

    m

    T

    y

    o

    tWL4V-,

    2012

    co

    0

    This

    day

    o

    2012

    Sig

    aure

    o

    Public

    Notary—

    State

    o

    Florida

    Signature

    oPublic

    otary—

    State

    of

    Florida

    Notarization oLobbyist'

    s ignature

    Notarization of

    Principal'

    s

    signature

    TO BE COMPLETED

    By

    CITY

    CLERK'

    S_

    ST F

    QN

    Annual

    Registration fee: Paid$ MCR#

    Y

    p

    Yes

    DatVqaid

    r

    Lobbyist

    Registration

    Form received and verified by:

    C: \ Users\clerhatl\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\83LGQDDH\Lobbyist Registration

    Formrevised

    5-

    30-

    2012.

    doc

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    F

    ct

    F

    istration

    Form.

    doc

    Revised 04/

    27/

    2012

    M

    M B,

    H

    City

    oMam

    Beach, 1700

    Convention Center Drive, Miami

    Beach,

    Florida

    33139, www.mianiibeachfl.

    gov

    CITY

    CLERK Office

    Rafael E.

    Granado,

    City

    Clerk

    CityClerkamiamibeachfl.gov

    Tel: 305.

    673. 7411 ,

    Fax:

    305. 673. 7254

    LOBBYIST NAME

    Michael

    J. Marrero

    I

    understand

    that

    no later

    than

    February

    28

    ofeachyear,

    I

    must

    file the

    following form,

    pursuant

    to

    Section 2-485

    o

    the

    Miami

    Beach

    City

    Code,

    with the City Clerk's

    Office

    for all

    active lobbying

    issues.

    1 )

    LOBBYIST EXPENDITURE AND COMPENSATION FORM

    Failure to file these forms on a

    timely

    b as is w ill result in m y na me being tra nsm itted to the

    Miami- Dade

    County

    Commission

    on

    Ethics

    and

    for

    code

    violat ion evaluat ion.

    In addtion, once

    an

    issue

    I have

    regstered

    to

    lobby

    onhas

    been resoved, or I

    am no longer

    lobbying

    on

    that issue

    or

    for

    that princpa,

    I

    am

    required to

    immediately

    n otify th e C ity Clerk' s

    Office of lobbyist withdrawal in writing.

    Pursuant to Section

    2-

    485 (

    d),

    the

    City

    Clerk

    shal

    notify any

    lobbyist (

    or

    princpa)

    who

    fails to

    timely

    file

    a Statement

    and

    in addition to

    any

    other penalties which

    may

    be

    imposed as

    provded

    in Section 2-

    485.

    1,

    a

    fine

    of

    50.00 a day shall be assessed for

    all

    Statement(

    s)

    filed

    after

    the

    due date. The

    City

    Clerk shal

    notify

    the Miami-Dade

    County

    Commission onEthics andPublic

    Trust

    of

    the

    failure ofa lobbyist (

    or

    princpa)

    to

    file the Statement

    or

    pay

    the assessed fines after

    notification.

    Any

    lobbyist, who fails

    to

    file

    the requred

    Statement

    by

    April 30th, 2012, shal be

    automatically

    suspended

    from

    lobbying

    until

    al

    fines are

    pad,

    unless the fine has been

    appeaed

    to the

    Mia '

    Dade County Commission on Ethics and Public Trust.

    Signature:

    ae:

    C: \

    Users\clerhatl\AppData\Local\ Microsoft\Windows\Temporary Internet Files\ Content.Outlook\83LGQDDH\Lobbyist

    Registration

    Formrevised

    5-

    30-

    2012.

    doc

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    EXHIBIT" B

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