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Allan Shulman - 418 Meridian, LLC ID MIAMI BEACH 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. Shulman Allan NAME OF LOBBYIST: (Last) (First) Shulman and Associates, 100 NE 38th Street, Space 2, Miami Florida 33137 BUSINESS NAME AND ADDRESS (Number and Street) (City) `—`——`-- - (State) (Zip Code) (305)374-9216 (305)374-9217 TELEPHONE NUMBER: —"- ��---- - FAX NUMBER. EMAiL: Please notify this office if your contact information changes:address,phone,or e-mail address. 1. LOBBYIST RETAINED BY: 418 Meridian, LLC c/o Roberto D. Colmenero NAME OF PRINCiPAUCLIENT: Same La Pampa 1534 3 A(C1428AQ0) Buenos Aires,Argentina BUSINESS NAME AND ADDRESS 9 4706.0209 (Number and Street) (City) (State) (Zip Code) _ n/a diego_@urbanica.com `�� a TELEPHONE NUMBER: FAX NUMBER: Optional) EMAIL: Optlonal LAJ • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY: Roberto D.Colmenero e I • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 51%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION;•. PARTNERSHIP OR TRUST.See attached ii.SPECIFiC LOBBY ISSUE: ' a Development Approvals and Permitting issues concerning 498-425 Meridian Avenue Issue to be lobbied(Describe in detail): llr.CITY AGENCIEVINDIViDU.ALS' "S 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, ting the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and title of person to be lobbied Contractual Relationship(Explain) YES NO Staff of Planning Department,Building Department.and Public Works None DenaEtmenj PB.HPB.BOA.City Commission.as necessary None 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 r istration form filed. Sec Z482(g)Any Financial,Familial or Professional Relationship None. FACLERI$ALLWORMSILOBBYIST FORMS%obbyist Registration Form.doc fsr c:,t-• �RY,4•� r [: (� jo F A JIJ� I It C0111VO-1111011 CCh1CT Drive,Miami Beach.Florida.3-1139,%v%v%v.miajjjibear_jjjl.g0V CTI'Y CLERK Office CitvClei-kfariniainibeachil.gov Tel:305.673.7411 .Fax:305.673.7254 LOBBVISI' NAM E: Allan Shulman I Understand that no later than February 28th of each e- r, I must file the following form, pursuant to Section 2-4.85 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. I) 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 oil 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 oil Ethics and Public Trust of thAl 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 30th, 2014, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been �Wcaled to the Miami-Da County Commission on Ethics and Public Trust. Signafure: Date: F-\C LER\$Al.,L\aFO RM S\LOB BY IST FORM S\Lobbyist Registration Forrn.doc ' 1 Z i= F Z •�• F ` 3 h _ _ Z 1 - -- —•. ai Lu LU U: - U -a 4 � � a ' o { S