David Bailey - JP Morgan Chase and Co. (Chase Bank) oz. , MIAMIBEACH rr
.0 b
City of Miami Beach Office of the City Clerk !l
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.
Bailey David
NAME OF LOBBYIST: (Last) (First) (M.I)
1211 North Franklin Street Tampa FL 33602
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
813.323.9233 813.323.9238 davidb(abdgsai.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
JP Morgan Chase and Co. (Chase Bank)
NAME OF PRINCIPAL /CLIENT:
4 New York Plaza, 19 Floor New York NY 10004
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
t r.s
c
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2 -482 (c)] ""� MIE
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Teresa Torres rrl --< "
�j.' w : ri
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST INcs9JCHZ
CORPORATION, PARTNERSHIP OR TRUST:
` CO
- C
CS
r-r? CJ;
II. SPECIFIC LOBBY ISSUE:
Design approvals for 6901 Collins Avenue; TC regulations; TC Design Guidelines
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES /INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual /Title B) Any Financial, Familial or Professional Relationship
Planning Department Staff, DRB *, Planning Board* and City
Commission None
* Unless an issue is legislative in nature, HPB, BOA, Planning Board, and City Commission members are not lobbied outside of a public hearing setting.
f •
1 IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) $ 27t Vi)-1 ee
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (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 X 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 X No: Are you lobbying on a pending application for a Development Agreement with the City or
application for change of zoning map 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 a not - 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 1
section but, shall not be required to pay any registration fees..
❑ Yes X No: Are you representing a not - for - profit corporation or entity without special compensation
or reimbursement.
V. SIGNATURE UNDER OATH:
ON OCTOBER 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED .'`„`
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATI4 Ind" ° .
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEM04,
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING . t "
REPORTING PERIOD. X o a
� ,
_� W o 03 '<
Signature of Lobbyist A N 7 c
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or a ► N p ° (6'
familiar with the provisions contained in Se '. 2 -482 of the Miami Beach City Code and all reporti • o 0
requirements. co T
s
4.
Signature of Lobbyist: �► i ;v
Signature of Principal/Client: AtfLrldr/r4.,as / 6 . . 1 e ; ii
A /2=V
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID El Produced ID ":;ma
Form of Identification Form of Identification
k'?„
V ersonally known (Lobbyist) Y'Personally known (Principal) " "
3
m
VII. SIGNATURE AND STAMP OF NOTARY: o 0,. 3
m a'
v+ m m
State of Florida, County Miami -Dade State of Florida, County of Miami -Dade m o
Sworn to . d s, bscri - - -- Sworn d subscribed b-fore me N
This 0 ' a f / j o i t i g ' : Y W. FUJIMURA This day of , 20
— : ,,V� , !„ � ON # DD 854043 Y
� j .� ! i'�r'i:► , s EXPIRES: April 2, 2013
4iC' f ' :� ;. Bonded Tin Notary Public Undenatiters 4.
Sign. e of Publi �� f , - . T. Signature of Public Notary — tate of Florida
Nota - zation of , • bbyist's signature Notarization of Principal's signature
FOR CLERK' USE ONLY 2„4, / � b.. Annual Registration fee: [ ] Yes [ ] No Amount Paid MCR # 6 +ate P ' .� ,,3
Lobbyist Registration Form received and verified by: �� Entered By: �� -
0
F: \CLER \$ALL \MARIA -M \Lobbyist \LOBBYIST fORM 05.doc Revised 12/08/04
I A
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfi.gov
CITY CLERK Office CityClerk @miamibeachff.gov
Tel: 305.673.7411 , Fax: 305.673.7254
LOBBYIST NAME: P$tV % (-e'(
I understand that no later than October 1st of each year, 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 farms 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 immediately notify the City Clerk's Office of lobbyist withdrawal in writing.
OLIAv ZO
Signature: Date:
F :ICLERILOBBYIST1Lobbyist Registration Form 32708.doc