Chad S Friedman - Crown Castle NG East, LLC je,
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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.
Friedman, Chad S.
NAME OF LOBBYIST: (Last) (First) (M.I)
Weiss Serota Helfman, et al. 2525 Ponce.de Leon Blvd.,#700, Coral.Gables, FL 33134
BUSINESS NAME SAND ADDRESS (Number and Street)' (City) (State) (Zip Code)
305-854-0800 .305-854-2323 cfriedman @wsh-law:com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notlfy;tiils;offlce If"your contact lnformatlonrcliangese address,phone,or,e,mailaddress
I. LOBBYIST RETAINED BY:
Melissa P. Anderson
NAME OF P INC �A E T:
crown uastie Last ; LLC 8555 N.W. 64 Street, Miami, Florida 33166
BUSINESS NA E AND ADDRESS (Number and Street) (City) (State) (Zip Code)
786-899--5911
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:
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTI.Y,A 5A10 OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION;
PARTNERSHIP OR TRUST: exffct_c-Jot•
n:SPECIFIC'LOSSYISSUE!
Telecom Right-of-Way Ordinance and Telecom Request for Proposals
Issue to be lobbied(Describe in detail):
In.CITY_AG ENC.IE;S%iVDIV6DUALS'TO'IBELOBBIED,
Pursuant to City Code Section 2-482(a)(4)include the.commissloner 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 general nature of the.subject contractual relationship.
Sec 2.462(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
tItie.of person to be lobbied
City Commission, Mayor X
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
F:ICLERI.$ALL1aFORMS\LOBBYIST FORMSILobbyist Registration Form.doc
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.
Friedman, Chad S.
NAME OF LOBBYIST: (Last) (First) (M.I)
Weiss Serota Helfman, et al. 2525 Ponce de Leon Blvd., #700, Coral Gables, FL 33134
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
305-854-0800 305-854-2323 cfriedman @wsh-law.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:
Melissa P. Anderson
NAME OF P INC A E T:
Crown castle NU East, LLC 8555 N.W. 64 Street, Miami, Florida 33166
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
786-899-5911
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: Blake E. Hawk, Representative
•
PARTNERSHIP OR TRUST:HOLDING,DIRE C Ybik.,y,Duwi ied,a,5%a OR MOR,,,j=C l FRSHI INTEREST IN SUCH CORPORATION,
ii SPECIFIC`_LOBBY:^ISSUE:,
Telecom Right-of-Way Ordinance and Telecom Request for Proposals
Issue to be lobbied(Describe in detail):
Ill.CITY.AGENCIES/INDIVIDUALS TO CBE 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 general 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
City Commission, Mayor X
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 per'bnel who is
sought to be lobbied as identified on the lobbyist registration form filed. --
Sec 2-482(g)Any Financial,Familial or Professional Relationship 7;1
None. -- • -
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc =.
IV. DISCLOSURE OF TERMS AND AMOUNTS.OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE,OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) $475 per hour.
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED), $475 per hour.
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 XNo: Are• ou lob. in. one 'resent or•endin'.bid for•oods e'ui'mentor services or On a 'resei-t o .endi 1
award for Moods.egUlpment or•service?
2) Pursuant to Miami Beach City Code.Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On.Re_aI Estate
Development Issues":
_Yes XNo: 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 Section 2482(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.
YesXNo: Are ou re'resentin• a not-for rofit co .oration or entit •withouts'eclat corn.ensation or reimbursernen.
V. SIGNATURE UNDER OATH:.
ON FEBRUARY 28 OF EACH'YEAR,EACH LOBBYIST SHALL.SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER.
OATH,LISTING LOBBYING EXPENDITURES,AS WELL AS COMPENSATION RECEIVED,IN THE CITY OF'MIAMi BEACH-FOR
THE PRECEDING CALENDAR YEAR, A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR '
COMPENSATION DURING:THE REPORTING PERIOD:,
f � . ,g4toti
Signature of Lobbyist
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 2.482 of the Miami Beach.City Code nd all reporting.requirements. '
Signature of Lobbyist:- �i�
_72, ,
Signature.Of Principal/Client:
L
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION;
lip
Produced ID _Produced ID ,. r
Form of Identification Form of Identification 'q� _ ;g
sonally known(Lobbyist) ersonally known(Principal) %• tin'"',• `,`,
x
VII. SIGNATURE AND STAMP OF N -° - .. 3 3 _
•r Notary Public State of Florida RS 7 '2
State of Florida,County of Miami-Dade Lydia L Pimienta -i ate of Fiori a,County of Miami-Dade H • a
Sworn to and subscribed before me My Commission FF 008217 - orn an ubscrib d before.m. s P
This L day of ,201 Expires 60/03!2017 ) ' ,' . m
,, r' is /, ay of O m 3 w c
ig re of Public Notary.—State.of Florida. gnature of Pt bib No ary—Stat!•f Florida f N Fs
Notarization of Lobbyist's signature Notarization of,Principal's signature .u, o a.
a)p'
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY e
Annual Registration feet,[ ]Yes[ .J No -Amount Paid:1 Iwo',-MCA# _''? C Z'T G. • Date Paid' 1.Z--ll. Ill'
-
Lobbyist Registration Form received and,verifie'dlby c%o...■ �: {Z;.,,_.� - - - .
F:\CLLR\�•AI.L\uFORrIS\LOBf3YIST FORMS\Loubyl t Aiuiiial Regislratleii-Form(IOC,L . - . ' . - Revised O1/22/2014
F:ICLERi$ALLIaFORMS1LOBBYIST-FORMS\Lobbyist Registration Form.doc
L.
MA/\AI BE H;
City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov
CITY CLERK Office
Rafael E.Granado,City Clerk CityClerk @miamlbeachfl,gov
Tel:305.673.7411 ,Fax:305.673,7254
LOBBYIST NAME: Chad S. Friedman, Esq.
I understand that no later than February 28 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, or I am no
longer lobbying on that issue or for that principal, I am required to immediately notify
the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-486(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 2-486.1,a fine of$50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist,who fails to file the required Statement by April 30th of each year,shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
:/Z;‘)
Signature: Dat
F:ICLERI$ALL1aFORMSILOBBYIST FORMSILobbyist Registration Form.doc
•
City of Miami Beach-Florida
Finance Department
1 City Hall
1435020--1 12/16/2014 BR1 T130
Tue Dec16,2014 01 :10PM Trans#56-56
56 $850.00 MCRCLERK - MCR-City Clerk
* MCR#: 36256
1 ITEM(S): TOTAL: $850.00
Check (200006) PAID $850.00
Have a nice day!
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