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Christina Labuzetta (2)s. ~tE~ m MIAMIBEACH 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 prinripal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or derision of any commissioner, any action, derision, recommendation of the City Manager or any rity board or committee; or any action, derision or recommendation of any dty personnel during the time period of the entin; derision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the rity commission, or a rity board or committee. The term sperificelly indudes the prinripal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435. Labuzetta Christina NAME OF LOBBYIST: (Last) (First) (M.I) 301 Ocean Drive, Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305) 794-2873 (305) 604-3993 Christina@locationresources.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: Miami-Dade Historic .Neighborhood Preservation Coalition, Inc. a non-profit charitable organization NAME OF PRINCIPAUCLIENT: 1224 Washington Ave, Miami Beach, Florida 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) (305) 352-0501 MDHNPC@gmail.com Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)] • NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Christina Labuzetta • IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: u:SPECIFIC LOBBY ISSUE: Preservation of the Simone Hotel and related matters Issue to be lobbied (Describe in detail): ul. CITY AGENCIESIINDIVIDUALS TO BE LOBBIED.: Pursuant to City Code Section 2-482(9) Include a statement of the extent of any business, financial, familial, professional or other relationship, giving rise to an appearance of an impropriety with any City personnel sought to be lobbied -further, pursuant to City Code Section 2- 482(a)(4) include a statement of any contractual relationship (paid or unpaid) from 12 months preceding said City 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 An Financial, Familial or Professional Relationship Historic Preservation Board None Building Department None City Manager's Office None Planning Department Mayor and Commission None None ~~ ~l ~~~, .,,,. ~Io :S ~a g- 8~3oioz i"1' rk~"5 ~~ f IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required(! Gratis B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).Grat 1S The following information must be answered: 1) Pursuant to Miami Beach City Code Section 288 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": ^ Yes ®No: Are you lobbying on a present or sending bid for goods, eguiament or services. or on a aresent or pending award for goods, eguiament 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 aaalication for a Development Agreement with the City or a~~lication for change of zoning maa designation or change to the City's Future Land Use Maa? 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. reimbursement. . V. SIGNATURE UNDER OATH: 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 Section~2 of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: ~ ~ VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: ^ aProduced ID ~ ~ L-' Form of Identification ^ Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Swom to nd subscrib t~ fore me ~ This _~day of ~~~G'euC~,se, 20 9 Signature of Public Notary -State of Florida Notarization of Lobbyist's signature Produced ID ~/ ~ L~ Form of Identification ^ Personally known (Principal) \`\\~\~\~1MIRfo~~T ~i, `\\, ~~ ~ ~ GOMMISS/O,v •.~ '~ Nary r8 _~ ~ . ~ m'0 a a ~ State of Florida, County of Miami-Dade W ~' ~ =Z : •.® Sworn and subscrj)~d before me (a This day of OO , 2009' ~ °=~ ~Dp83~s~ ~ ~- ec,.,• . 9 ~,~ : ~. ' ` ..~ i . `''id tl1N : Qc R / ` ,~/~~f ~`y~ Si nature of Public Nota g ry- Stat of Florida rOf j ea ~f~µe> Notarization of Principal's signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ ]Yes [ ] No Amount Paid $ R ~ Date Pald Lobbyist Registration Form received and verified by: .:~.Y.r, a ~~ F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form 21104.doc Revised 02/11/2009 ~" /f~ `D ~ , ~,~o~ t PERIOD. A / ~-/ Signature of Lo yist