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Alexander P. Heckler - Terranova Corporation Ci 1 104- 6/ ctLA1 'rtvcr 4-L [off- beep 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. NAME OF LOBBYIST: (Last) (First) (M.I) 1-4514 JAW t BUSINESS NAME AND ADDRESS Number and Street) (City) , tate) (Zip Code)) (aT7D (o — a os)(69- i—a$ S h C- x? 'QOM TELEPHONE NUMBER: FAX MBER: EMAIL: Please:notify:this:office: f:your:contact:neormation changes,:address::phone,:ore:mail address. I. LOBBYIST RETAINED BY: NAME OF PRINCIPALICLIE t),Vien T: --rex-NraX a rn{ arct4i00-bn MAW 6oclf r- ed. s?,€(0D0 tli RM &ail FL BUSINESS NAM- 4ND ADDRESS (Namber and Street) (City) (State)../ (Zip Code) lob TELEP ;NE NU R: 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: 51..e QrQ.fl 15) I 8 IDENTIFY ALL PERSONS HOLDING/DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ,/V A ....................................................................... .................................................................. ll. tli i tit tie -bc 0)os-1-ALI-too q -kAti F a(v\ pobl‘C wilu 1r NIVCA-VC-C_ Issue to be lobbied(Describe in detail): 0•4e) LO\-' OrWi tON- %,+VV-e-e/n elTriAG :.t D U: L : E.: !E : - - 0Y) ,,� 1G.,� kteXiu 1 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 CA title of person to be lob ied I' "JA • 0.t , ( 5b1) - V�1 m awi\r Pursuant to City Code Sect 2-482(g)Every egistrant 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 IN4c- FACLERULL1aFORMS\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) ' NO WM,k.H.00 a\ co,a1v}n .‘-io,n ov tif wriefi- ocAirr- B) PRINCIPAL'S DISCLOSURE(OF LQBBYIST COMPENSATION (REQUIRED). IN d 40((y 64-1 Ulx OL\ c�� �ex-)5R-Han ova- C Lori ni-- olfze,tyryi . 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. 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 Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": 1S,Yes_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 Section 2-482(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. ®Ye S No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHA. S i IT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS : •MPEN TIO RECEIVE IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHAL BE FILED V IF THERE VE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. , Signature of Lobbyist I do solemnly swear that all o .- . :t t•inact -re ue and correct and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Bead k it •de and all r : rting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: •��y',L� PRINCIPAL IDENTIFICATION: t roduced ID �,V/44_,*1 ,r 77- Produced ID Form of Identification ''„M,,,`'* M Form of Identification ``���11111111l�,���d4' f`f n/"° Personally kn wn(Principal) `�� �.•'•M\ssio� o••\ Personally known(Lobbyist) 3 3 T o ;�coQ 13,20 l'. . „ a zs ' _ ;• co js A VII. SIGNATURE AND STAMP OF NOTARY: �++ c - ��� State of Florida,County of Miami-Dade h T d i State of Florida,County of Miami-Da 2 • a#EE1019u9 h.�.. Sworn to subscribed befor- me v�' a 1 Swor',�;1�:subscri s d bef,tre me . 99y'Aug,.0 •••r.• �9.,,� This day of 1;1110, ,20'1__ �.E 3 )4 This ix day of A_r� r 01 ��i/ p°BCIC,Sit 3 .�,- �, '10 IVI ,,,, JPINA ',/iimitiMktt Signature of Public Notary-State of Florida _14._4 Signature of Public ,oft- r; Flori l a Notarization of Lobbyist's signature Notarization of Prim. -: signature TO BE COMPLETED BY CI CLERK'S ST F ONLY C,f... : Annual:Registratiara fee:: [.:]'Yes.I s�:. Atxucaul9tPalit.$ fi?`-'55 MCR:# 71� : Date Paid:: .... . .... Lobbyist Registration Form receive and verified bar F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc City of Miami Busch, 700 C Invention Center Drive,}A:cirr.i Bench.Florida 33139,www.rniamibeach}}.gov CITY CLERK Office Rafael E. Granada. Ci y Clerk CityClerk rniarnibeochfl.gov Tel:305 673.7411 .Fox:305.673.7254 LOBBYIST NAME: P-(ey. cogpx P. 1Fec-. \e r 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 2-485 (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$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th of each year, shall be automatlicall sus ended •m lobbying until all fines are paid, unless the fine has been appeale the am Da•e • Commission on Ethics and Public Trust. HJDJJS I Signature: ate: F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc , •• . ••• • •,• .• .• • • • • •• ,, . .- ••. • • C P S /20.15 CIO 35 r • - • Miscellaneous Cash Receipt • 4 to -••:',:•••• • CITY OF MIAMI. BEACH No • .4 4 .1 . • • . . . . • . - " . . . • • • -1::]• Cash Credit Card. ,iCheok# •Z :••• •.$ 0• eti•Le. <6 • 20 1 • - Received of Atie,con Jet- {-1-41 ckfe . . . Address /30 I Ar414Q.t G o1fre U, 5tf, If 0 t 1°' . • - • For P3 4-t,..)6 cAct-ffC41.(4150■44ectid 0\e( ci-,1 11):14)SC4e .• . „ . . ••••••• •-•- • (THIS INFORMATION,MUSTBECOMPLETED) Office of Finance Director .• • . . . . -•ry • ; 01 1.- .000-'369.7. 4 ••• • • • - . By Account 455 tlf. Number. . • • - . • . • . . : • - • .• ...s (7- • 1.: .C. 1‹ - '0 CT::9Y 1 . . Preparer: a - - • Dept: . •-•.•( ,• • . - • . • ,...• - • • — -• • •-• • • • .;; • • • • . , •