Carter N. McDowell - Alton Sobe, LLC MIAMI BEACH
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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.
MCDOWELL CARTER N.
NAME OF LOBBYIST: (Last) (First) (M.1)
BILZIN SUMBERG BAENA PRICE&AXELROD LLP-1450 BRICKELL AVENUE,23RD FLOOR,MIAMI, FLORIDA 33131
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-350-2355 305-351-2239 cmcdowell @bilzin.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
ALTON SOBE,LLC
NAME OF PRINCIPAUCLIENT:
960 NE 74th Street Miami FL 33138
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
786-229-6498
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: Evergreen Overseas Holdings, Inc., Manager
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:Victor Uzan
II.SPECIFIC,LOBBY ISSUE:.
All land use and zoning matters regarding application(s)for property located at 929 Alton Road
Issue to be lobbied(Describe in detail):
ul.CITY AGENC ESANDLVIDUALS.T0 BE;LOBBIED:
Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date,stating the eneral nature of the subject contractual relationship.
Sec 2-482(a)(4) Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
Planning Board and Staff n/a
Historic Preservation Board and staff n/a
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. I _± r r
Sec 2-482 An Financial, Familial or Professional Relationship -`
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MIAMI 3749861.1 80555/43044 X1 001
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR
OTHER):
A) LOBBYIST DISCLOSURE:(Required)
Hourly/$650
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):(Required). Hourly/$650
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 section but, shall not be required to pay any registration fees.
❑ Yes No: Are you representinq a not-for-profit corporation or entity without special compensation or reimbursement. .
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28th OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH LISTING LOBBYING EXPENDITURES AS WELL AS COMPENS N RECEIVED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILE15,tVEN IF THERE-WAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist-Carter N.McDowell
I do solemnly swear that all of the foregoi facts are true and orrect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach ode and r g requirements.
Signature of Lobbyist:
Signature of Principal/Client:
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VI. LOBBYIST IDENTIFICATION• PRINCIPAL IDENTIFICATION:
❑ Produced ID _Produced ID -,tL- 5-0-1 '53'
Form of Identification Form of Identification 075-0
Personally known (Lobbyist) ❑ Personally known(Principal)
`°RY aoe IBIS DIAZ
VII. SIGNATURE AND STAMP OF NOTARY: * * MY COMMISSION#DD 994845
EXPIRES:May 24,2014
State of Florida, County of Miami-Dade aY P� State of Florida, C 01 rV4Tamft4�H&u Budget Notary Services
Sworn to and subscr' d before me ?°`:�•'••B`'� IBIS DIAZ Swor and subs ib b ore me
This �r day 20� * MY COMMISSION#DD 994845 is d o 2013
EXPIRES:May 24,2014 '
�l�IFOF F10�\O! Bonded Thru Budget Notary Services
Signatu ubrc Notary-Nt&4rFlorida Signatu lic Notary-StateNealorida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes( ]No Amount Paid$ - MCR#5 7 D Date Pa'
Lobbyist Registration Form received and verified by:
Revised 4/27/2012
MIAMI 3749861.180555/43044
/\,/VAM1 BEACH
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: Carter N. McDowell
I understand that no later than February 28th 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 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.
Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who fails to timely file a Statement and
in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be
assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on
Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after
notification.
Any lobbyist, who fails to file the required Statement by April 301h of each year, shall be automatically suspended from
lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and
Public Trust.
Signature: Date:
MIAMI 2964847.1 7000060139
7/2/13
MIAMI 3749861.1 80555/43044
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