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Terra Int'l Dev, LLC 11/19/01 .. , ,. tD ~. CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, FL 33139 citvclerk((i)ci. miami-beach. fl. us AFFIDAVU 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 ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, 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 AGENT, ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVmES FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL" 1) Lobbyist Name: Dougherty Lucia Last Name First Name A. Middle Initial Business Phone (305) 579-0500 Message Phone (_) Business Name and Address: Greenberg Traurig, P.A. 1221 Brickell Avenue No. Street Miami Suite Florida 33131 City State Zip Code Email Address:doughertyl@gtlaw.com 2) Principal Retained by: 214 West If different from above Terra International Developments, LLC Dixie Highway Street North Miami Beach City FL Suite 33180 Zip Code State (a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner, beneficiary or interests. 3) Subject Matter (Describe in Detail): Variance Application - 4.' Identify each individual (Commissioners, Board, CommittEe, Authority member or City staff) to be lobbied: Design Review Board 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): 0 The City Commission on .2001 0 City Commission Subcommittee on .2001 0 City Staff on ,2001 0 City Board or Committee on .2001 0 Personnel on ,2001 0 Identify Others on ,2001 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CI1Y CLERK A SIGNED SfATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CI1Y OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. I do solemnly swear that all of the foregoing facts are true and co ect and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Be City Code as amended, and all reporting requirements. Signature of Lobbyist: o Personally known o Produced ID Identify o Did take an oath, or o Did not take an oath State of Florida, County of Miami-Dade Sworn tttrIfJ SUbScri~ befO~ This I day of '.tIm 2001. LEYl.A M SALAS CsrATEOFFLORIDA COMMISSION NO. DI:106OO84 - MY COMMISSION EXP. SEP/' 24.2005 If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: [] ACCEPTED [] REJECTED DATE: If rejected, state reason: Registration fee paid: [ ] Yes [ ] No [] Not-far-Profit Organization [ ] Cash [ ] Check MCR # DATA ENTRY DATE: .2001 ENTERED BY: