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Neisen Kasdin/Lanier Parking Solutions0 --. ~ ~-? ~.~~ti ~ ~ :___ t,~ ._ ~"` ® 17QO Cotnventoln Center DrOecMamhBea hCFL 33139 ~ ~l ~`~~f` °`~ {~r~ ~'~4~-,f ~~- ~ _;~ 4` l'' LOBBYIST REGISTRATION FORM ~ a-- cV C~~ 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. Kasdin Neisen p, NAME OF LOBBYIST: (Last) (First) (M.I) Akerman Senterfitt, P.A. One SE 3`d Ave., Suite 2500 Miami FL 33131 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 374-5600 (305) 374-5095 neisen.kasdin@akerman.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Walsh Timothy NAME OF PRINCIPAL/CLIENT• (Lastl (First) (M I) Lanier Parking Solutions of Florida 233 Peachtree Street, NE, 2600 Harris Tower Atlanta, GA 30303 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (404) 881-6076 (404) 881-0677 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 ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: City of Miami Beach Parking Services RFP Bid No. 41-08/09 Issue to be lobbied (Describe in detail): { M2850062;1 III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: A• Full Name of Individual/Title B. Any Financial, Familial or Professional Relationship City Commission and Mayor None Saul Francis, Director of Parking Dept. None Jorge Gonzalez None IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLATRATE OR OTHER): A. LOBBYIST DISCLOSURE: (Required) $550.00 hourly B. PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required) Same 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 By Lobbyists On Real Estate Development Issues": ^Yes ®No: Are you lobbying on a pending application for a Development Agreement with the City or application for chance of zoning map designation or chance 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 anot-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 representing snot-for-profit corporation or entity without special compensation or reimbursement. {M2850062;1 } 2 V. SIGNATURE UNDER OATH: ON OCTOBER 1sT 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 PRECEDING CALENDAR YEAR. A STATEMENT SHALL BEj~FIILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION D/~//! NG THE REPORTING PERIOD. Signature of Lobbyist I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained in Secti~tl` 2-482 of the Miami Beach City Code and all reporting requirements. /~/~/~ Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: ^ Produced ID Form of Identification ersonally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn t and subscribed b~me This day of ~" _, 2009 ~~v~; Signature of Public Notary -State of Florida Notarization of Lobbyist's signature ~c~~~i. Notary Public State of Florida Ann Condon My Commission OD758094 ~or ~d'~ Expire PRINCIPAL IDENTIFICATION: ^ Produced ID Form of Identification ^ Personally known (Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This -day of , 2009 Signature of Public Notary -State of Florida Notarization of Principal's signature FOR CLERK'S USE ONLY Annual Registration fee: ^Yes ^No Amount Paid MCR # Lobbyist Registration Form received and verified by:_ Date Paid Revised 12/08/04 { M2850062;1 } 3 V. SIGIYATUREUNDEROATH: QN t?CT(?BER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT Tp THE. CITY CLERK A SIGNED STATEMENT UNf)ER OATH, LISTING LOBBYING EXPENI3ITURES, AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH'FOR THE PRECEDING CAL,ENpAR YEAR A STATEMENT SHALL BE FILED EVEN` III' THERE.. HAVE BEEN NO EXPENDITi1RE5 OR COMPENSATION. D NG THE REPORTING PERIOD. ~ ~,, f l da solemnly swear that aII of the far+ familiar with the provisions contained reporting requirements.. Signature of Lobbyist:: Signature of PrincipaVClient: VI. LOBBYIST" IDENTIRICA7T1 Signature: of Lobbyist facts are true and correct andt I have read or am x~~~2-4$2 of the Miami lie ,'City Code and alt. [] Produced ID ~ -Farm o Identification ersanally known (Lobbyist) VII, SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-L3ade Sworn i and subscribe befa a me This day of .. ~~~ , 24Q9 Signature of Public Notary -State of Florida Nptarizafian of Lobbyis#'s signu#ure PRINCIPAL Produced ID .Farm of Identification Personally known (Principal) ~ is ib ~ ~ * 1 State ofa, County of >~s Sworn and subscribed before me l,~, This$~day of , ~(~ y~ ~~~ ~A~~~ Si ature of Fublic Notary - State o ~Ieri~a No#ari~atiion of Principal's signature U~ ~~ Noiary p`UGtiC 518 of ~tariGa Ann Cmc~n +~ MY COmmissiptt DD758i7g4 y+pir EX~Nre .FOR CLERK'S' USE Q1VLY Annual'Regi~iratian fee: Yes ~No .Amount Paid ~~T~ MCR ~ Date Paid ~d Lobbyist Registration Farm received and verii'aed by: T= Sal ti Revised 121t?8/Q4 {M2l35(-462; T l ~r • .~ Miscellane s Cash Receipt CITY OF MIAMI BEACH • CTi? No. , ~, . '~ '± 4 4 ^ Cash ^ Credit Card heck # ~~~~~~~ $ ~~ ~, ~ /~ 20 Received of ~ fj i N l ~ I A / ~ f _ ~ .. / _ For ~~ {THIS INFORMATION MUST BE COMPLETED) Office of Director Account Number: ~l/ ~~~ R 3~ ~~~ ~ By Preparer• ~'~ ~-~~~/'(~~~1~ Dept: ~G ~~2.°,~~ ~. ~o ~'r~