Michael J. Marrero - Don Peebles (1)
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8/15/2019 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
C:\
Users\
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AppData\
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Microsoft\Windows\
Temporary
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Content.
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83LGQDDH\
Lobbyist Registration
Formrevised
5-
30-2012.
doc
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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
-
8/15/2019 Michael J. Marrero - Don Peebles (1)
3/4
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
67K7 COLLINS D
VELOPKENT
CORPORATION.
a Florida eorporatinn
Madison State
USA Haldings Cnrpnration. it
Florida
corporation
100%
Owner
mom
MADISON USA
HOLDINGS
STATE USA HOLDINGS, 1AMITEU,
LIMITED. uti
Ontario
Carporatian
an
Ontario
Corpar
Lion
5vip
owncr
1014; Owae.r
Miguel
Strger,
Cltairtttt"
I
Barry Z,ngdattski. Chairnum
369 Rnurock Road
3700
Durfarin Sirerm, Unit
34
Tomato,
Ontario
M3J. 402
Ttimnto, Omprio M6B
473
COUNTRY
OF
CANADA
ss:
PROVIYC'E 01- O,N UARIt) )
T h e r o re g o In g i m a r t i l t i e l t
w ;
I s o c k n o w l e d g c d
h-
o r e
m e
t h i s
L a m (
b y 4
l'
J i m e ,
2 D 1 3 .
b y ; . ` i i g u e l S i n g e r .
as
President
o
6747
Collin.,
Devaloprt;
erit
Curpun.
tion.
u
Florida corporation,
on
beltnir
nt-
mid
tmaity,
1 1 e is
p-
mionully
known
to
nx
o
produwcd
nS id0atlfica,
yrt,
1
neiic: Sd/ I l-
r,O,
NoUry
Public,
Country
oC : oi
idl
h[?
ov»
rn5st
n'
xpt
s:
Cumminsion No.
TH E
dept/ 3354/
3354•
9/
i.
1129428G.
DOCx.
I