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Ralph Choeff - Are Traasdahl i ) /'\AIAW\ IE BEACH _.,-,_.:--_ City of Miami Beach Office of the City Clerk 1700 Convention Center'Drive, Miami Beach, FL 33139 ._ , , LOBBYIST REGISTRATION FORM r. • 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. NAME OF.LOBBYIST (Last) (First) (M.I) 1-02C-Ate' 4- Ciz∎l t' P. A . 8426 4 tsC/4r 't f.\rn 4re101 t4 r'>,n4,1 . ,. -3( 8 .BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) ( S 4.34-@ 336 ��6\692-SZq 2- rchcle eci.� (e,44 , c�orv/ TELEP NE NUMBER: F NUMBER: EMAIL. 1 Please notify this office if your contact information changes:address,phone, ore-mail'address. :: :`- - I. LOBBYIST RETAINED.BY ' V46 S n , —A(. NAME OF PRINCIPAUCLIENT 5200 0.025T i * ems r i et*I e , a. . 33139 BUSINESS ME AND ADDRESS (Number and Street) (City) (State) Zip Code) q I'I 941 - X604 art e:TAePc� . cow) TEL PHON UMBER: 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 s, u:SPECIFIC LOBBY:ISSUE: . 'WPrl l+✓ Of' - t �° 0 � 4.-peo v Or,00 1J l iJ. ,i. 1, eccf,.>( 57' aie Issue to be lobbied(Describe in detail): C") N III.CITY AGENCIES/INDIVIDUALS TO BE.LOBBIED.: -=� ° .{ Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whetherthe I gists entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months gteceilifig sijch person's commencement of service with the city to the present date,stating the general nature of the subject contractual relat}onstflpu ,-y ,.Sec.2-482(a)(4) Full Name of Individual and Contractual Relationship(Expla r') YES NO , ,title'of p rsoon.to be lobbied c.f.) �, N -moo © 71 D NAP S :� Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied.as identified on the lobbyist registration form filed. Sec 2-482(g)Any-Financial, Familial or Professional•Relationship 0.1- Nkitti -r' T-t ci. i t. a, T ( S lco ' Eci( .r. t--S \O-Itikf<ka- Pe2--b\iKRPO -k- ISM Psab kT Kati IV DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER). A) LOBB�I$zDl LO RE. e ui e 1 f`7° . PA =L � (OF O Y T� PENSA— (Required). `` ll%ll e ( H"-m `m o) eac JS- atmy The following in fot;"ra be answred: €'t cr o da5r (,0 1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues" ❑ Yes VNo: 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? . . N,,. 2) Pursuant to Miami Beach City Code 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues", . , ❑Yes y 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 section but, shall not be required to pay any registration fees. ❑ Yes IXNo: Are you representing a not-for-profit corporation or entity without special compensation-or reimbursement. . V SIGNATURE UNDER OATH: ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHA SUBMIT TO THE CITY CLERK A SIGNED"STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES,AS WELL C• PENSATION RECEIVED, IN THECITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMEN H' BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PE' 2•. ;". AieAt■ gnat -rf Lo:•‘st I do solemnly swear that all of the foregoin• - - are tru: and correct an. at I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beach Ci 1•• nd - I re•ortin• x%• ements. Signature-of Lobbyist: /,I 1; Signature of Principal/Client: �ti ' ekiAt I ; ls c 1 bb 's VI. IDENTIFICATION IDENTIFICATION: 1 Produced ID Gt- On' h �11 , II.-roduced ID LPL C/OU-7al 8 L� Form of Identification Form of Identification ;` ❑ Personally known (Lobbyist) ❑ Personally kno .w il;'-.. ISABEL SATCHEL INSOME SAMUELS MY COMMISSION#DD879891 VII. SIGNATURE AND STAMP OOF NOTARI'�!r -� EXPIRES:April 13,2013 Public - State of New York l "•: ,r Bonded ThruNotaryPublic Underwriters NO. 01 SA6182976 o State of Florida, County of Miami-Dade State of Florida, Cou Sworn to a d subscri.- Qualified In Bronx Co iy d bef re me �' Sworn and subscribed'before me �� ,r ^_ Fly Co mmisslon Expires I i his day of J��`C' This day • � `x" , 20�;:t'��,�g,,,,,� � j mbEe,.2011 af c F ) ) Si gnat e of Pu ' Nota —State of Florida Signature of Public Not.ry State of-F+onela 1�1 �ur-{c g ry Notarization of Lobbyist's signature Notari tion of Principal's signature TO BE COMPLETED'BYCITY CLERK'S STAFF ONLY Annual;Registration fee: ;[ ]Yes•[ ;]No ,Amount-Paid:$���• 'MCR# 5. ✓ Date Paid l�—�s.,.,—.f Lobbyist Registration Form received and verified by J`/(-a/t' f','2 ,f . F:\CLER\BALL\aFORMS\LOBBYIST FORMS\Lobbyist AnnuaI,Registration:FormAck Revised:1/11/2011 :fL-v/%q. Pre-i ....1- 0 Y+ 4 3 a '€' 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 LOBBYIST NAME: `4- P (-Jkc-'€ I understand that no later than February 28th of each year, I must file the following form, 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 and Compensation 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 immediately notify the City Clerk's Office of-lobbyist withdrawal in writing. Sigh re: 'Date: