Richard S. McCalla/Bay Drive Villasb~ ~ ~ v~'
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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 "Lobbyists" has specific exclusions. Please
refer to Ordinance 2004-3435.
(Last)
(First) (M.I)
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BUSINESS NAME AND ADDRESS (N
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and Street) (City) / (State) (Zip Code)
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I. LOBBYIST RETAI BY:
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NAME OF PRINCIPAU LIENT:
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BUSINESS NAME AND ADDRESS (Number an Street) (Ci ) ate) (Zip ode)
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Fill out this section If principal is a
or
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Cy,~O" ~ e ~[ /~'n /~ I`~ ! (~~
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OROR M~~C~NEJ~S,HIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST: ~ e. Q / ``~~,~j //~~
II.S~ECIFIC LOII~BY ISSUE:
Issue to be lobbied (Describe in detail):
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III. CI~1( /4~€1~CIE8/~1~11~1{~Ui~LS TO ~ ~. ~' Pursuant to City Code Section 2-482(8) include
a statement of the extent of any business, financial, familia pr ssional or other relationship, giving rise to an
appearance of an impropriety with any City personnel sought to obbied -- further, pursuant to Clty Code Section 2-
482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding said Clty
personnels' commencement of service with the City to the present date, stating the general nature of the subject
contractual relation.
A Full Name of Individual Title B) Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A)
B) PRINCIPAL'6 DISCLOSURE (OF LOBBYIST COMPENSATION): V
(Required).
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 LK No: Are you lobbying on a present or pending bid for goods, eguiament or services, or on a
aresent or pending award for goods, eguiument or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes ~NO: Are you lobbvino on a pending aaalication for a Develoament Agreement with the City or
agulication for change of zoning maa designation or change to the City's Future Land Use
Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of snot-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 clerk as required by this
section but, shall not be required to pay any registration fees.
^ Yes ~NO: Are you rearesenting snot-for-arofit comoration or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
Produced ID ~ ~~ /I~QV ^ Produced ID
orm of Identification
~ ^ Personally known (Lobbyist)
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VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn t and subscribe efor e
This ~_day o , 2009
Signature of Publi of Florida
Notarization of Lob i nature
Form of Identification
Personally known (Principal)
County f Miami-Dade
scrib ~e~fo~e me
of /''`7 , 2009
of Pu c otary -State of Florida
ono ri ci al's signature
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TO BE COMPLETED BY CITY CLERK'S STAF O Y
Annual Registration fee: [ ]Yes [ ] No Amount Pald S Date Pald
Lobbyist Registration Form received and verified by: 17C.-
F: jCLEFY`$~LL''srC?RF75V,LC366YI~T LC3rtG{,Lut;hyisl R^yitit ..,scan Ftrrm zz~o~.~ssa:. Revised 02/11/2009
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I do solemnly swear that all of the fore ng facts are true and correct and that I have read or am familiar with the
provisions contained in Section 2-48ei Be~ch~'fty~ode and all reporting requirements.
Bay Drive Villas LLC. Ownership
George Heinlein CEO 60%
Steven Sanders 10%
Alan Weinstein 10%
Robert Lawrence 10%
Paul Lawrence 10%
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City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office CityClerk@miamibeachfl.gov
Tel: 305.673.7411 ,Fax: 305.673.7254
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LC~bBY15T NAME : /G~ ~ ~ ~ /~
I understand that no later than Maier 1st a~f eoc-h fir, I must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
1) Lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, I am required
to immedify the City Clerk's Office of lobbyist withdrawal in writing.
nature:
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