HomeMy WebLinkAboutsubmittal-Disclosure of Consideration-Mark A. SiffinCITY OFML4,MI
7f' DISCLOSURE OF CONSIDERATION PROVIDED OR COMMITTED FOR AGREEMENT TO
SUPPORT OR WITHHOLD OBJECTION
The City of Miami requires any person or entity requesting approval relief or other action from the City Commission or any of its
boards, authorities, agencies, councils or committees, to disclose at the commencement (or continuance) of the hearing(s) on the
issue, any consideration provided or committed, directly or on its behalf, to any entity or per -son for an agreement to support or
withhold objection to the requested approval, relief or action. "Consideration" includes any gift, payment, contribution, donation, fee,
commission, promise or grant of any money, property, service, credit or financial assistance of any kind or value, whether direct or
implied, or any promise or agreement to provide any of the foregoing in the future.
Individuals retained or employed by a principal as a lobbyist as defined in Sec. 2-653, and appearing before the City Commission or
any of its boards, authorities, agencies, councils or committees solely in the capacity of a lobbyist and not as the applicant, or owners'
legal representative are not required to fill out this form.
NAME: Mark A. Siffin
(First Name) (Middle) (Last NarneT—
HOME ADDRESS: 527 E. Di Lido Drive
(Address Line 1)
CITY: Miami Beach
(Address Line 2)
STATE: Florida El ZIP: 33139
HOME PHONE: 3055356667 CELL PHONE:
EMAIL: siffin@maefield.com
BUSSINESS or APPLICANT or ENTITY NAME
BUSINESS ADDRESS:
Maefield Holdings, LLC
FAX: 3178050777
250 East 96th Street, Suite 580
(Address Line 2)
1. Please describe the issue for which you are seeking approval, relief or other action from the City Commission, board,
authority, agency, council, or committee.
Ordinance creating Omni Media Tower regulations, and Development Agreement regarding
CitySquare.
2. Has any consideration been provided or committed, directly or on your behalf, to any entity or person for an agreement to
support or withhold objection to the requested approval, relief or action?
If your answer to Question 2 is No, do not answer questions 3, 4 & 5 proceed to read and execute the Acknowledgment. It
your answer to Question 2 is Yes, please answer questions 3,4 & 5 and read and execute the Acknowledgement.
—
0("- CI4."5-3.7 f,— br,,;+
0
_J -- —a.LL !
U III[ %;%A it; W l.. F . -
record in connection with
item PZ.16 & PZ.17 on 07-22 .10
Priscilla A. Thompson
City Clerk
3. Please provide the name, address and phone number of the person(s) or entities to whom consideration has been provided
or committed.
Name Address
a. BDB MIAMI, LLC, 4401 Davidson Avenue, Atlanta, GA, 30319
b. Florida Carpenter's Regional Council, 295 W. 79 PI., Hialeah, FL 33014
c. Venetia Condominium Association, 555 NE 15 St., Miami, FL 305-373-0557
* Additional names can be placed on a separate page attached to this form.
4. Please describe the nature of the consideration.
a. agreement not to construct big box retail
b. offered labor agreement (not executed)
c. agreement to support building becoming part of "Herald Square" environment
5. Describe what is being requested in exchange for the consideration.
Suport for media towers.
ACKNOWLEDGEMENT OF COMPLIANCE
Plionc#
I hereby acknowledge that it is unlawful to employ any device, scheme or artifice to circumvent the disclosure requirements of
Ordinance 12918 and such circumvention shall be deemed a violation of the Ordinance; and that in addition to the criminal
or civil penalties that may be imposed under the City Code, upon determination by the City Commission that the foregoing
disclosure requirement was not fully and timely satisfied the following may occur:
1. the application or order, as applicable, shall be deemed void without further force or
effect; and
2. no application from any person or entity for the some issue shall be reviewed or
considered by the applicable board(s) until expiration of a period of one year after the
nullification of the application or order.
PERSON SUBMITTING DISCLOSURE.
Sworn to and subscribed before me this t da}. of l 200 /0 . The.foregoing
instrument wear acknowledged bgfore ine b}=f A;-_ A who hos ,produced
as identification at s persona lv now tom +nd who didldid not take on oath.
STATE OF FLORIDA
CITY OF MIAMI , J -&,Notary Public Slate of Ploridz
Ana Hernandez
MY COMMISSION,, 0My Commission D0668383
EXPIRES: dF Expires 04(2912011
Print Name
Lndosure(s)
Submitted into the public Paget
record in connection with
item PZ.16 & PZ.17 on t)7-22�10
Priscilla A. Thompson
Citv Cleric
3.
d.
e.
f.
.1
h
4.
d.
e.
f.
9.
h.
Labor International Union, 799 NW 62 St., Miami, FL 33150
Plumber's Local Union # 519,14105 NW 58 Ct., Miami, FL 33014
Weitz Construction, 4000 Hollywood Blvd., Suite 120, Hollywood, FL 33021
The Grand, c/o S. R. Kalb & Assoc., 150 W. Flagler St., Suite 1525, Miami, FL
33130
International Assoc. of Bridge, Structural, Ornamental and Reinforcing
Ironworks Local Union #272,1201 NE 7 Ave., Ft. Lauderdale, Fl, 33301
offered labor agreement (not signed)
offered labor agreement (not signed)
offered labor agreement (not signed)
agreement to support building becoming part of "Herald Square" environment
offered labor agreement (not signed)
`y TO THt
On-,Vp�
..A PP r�a
rn