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Jeffrey Andres - Clear Channel Outdoor Odor �� 3 MIAMIBEACH City of Miami Beach Office of the City Clerk ' 0 �9, �� G''t i 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. Andres Jeffrey NAME OF LOBBYIST: (Last) (First) (M.I) Clear Channel Outdoor 5800 NW 77 Court Miami FL 33166 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-592-6250 305-714-3480 jeffandres @clearchannel.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: Clear Channel Outdoor NAME OF PRINCIPAUCLIENT: 5800 NW 77 Court Miami FL 33166 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 305-592-6250 305-714-3480 inffanrIrAR nIparnhannPl nnm TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:( ptional) 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 INDIRECTLY,A 5%OR MORE O ,NERSHIP NTEREST IN SU H CORPORATION, PARTNERSHIP OR TRUST: Le /q-G F °SPECIFIC LOBBY ISSUE:; - Outdoor Advertising Issue to be lobbied(Describe in detail): III CITY AGENCIES/INDIVIDUALS TO 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 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 Mayor X City Commission X City Manager/Staff 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 N/A F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc �-4/ IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) No Additional compensation/St ,e,� B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): No additional compensation/S k CA. Q 1`fQ e(REQUIRED). 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": X Yes_No: Are you Iobbvinq 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": _Yes •lo: 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. YesXNo: 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 SHALL UBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES,AS WEL AS CO • :NSATIO RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT S'. •L V '-' EVE F THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. 44111,1041 , Signatur'f L' 1 ist - I do solemnly swear that all c\th ore Ao b*acts k- true and correct and I at I have read or am familiar with the provisions contained in Section 2-482 of the Miami =,-a it - ., . r-sorting requirements. Signature of Lobbyist: ■ '∎ 1_. 1 9 Y _ r■ Signature of Principal/Clien: . Ai ;° VI. LOBBYIST IDENTIF ATION: / ;° y PRINCIPAL IDENTIFICATION: o ONaQ '� __ O f`v .... pl o � � 0 > Z Produced ID o ° o Produced ID z Q z W �, 0 N a - W .r W c Form of Identification a a W -, Form of Identification 0 y ` it, CD y ii % W V O. C Personally known(Lobbyist) y•`-' x o. i Personally known(Principal) °a i= .y o ill O a • H 8 >, E E►_- a • .— o ,. o E , VII. SIGNATURE AND STAMP OF NOTARY: E E " c' c0 c. 0 V0'0 ZZ c m State of Florida,County of Miami-Dade = z m State of Florida,County of Miami-Dade ,,,,I..!'';; Sworn o and subscribe before me ff �..��"':h',,� Sworn d subscrib-d before me Q.b***•!� This day of ,2010 :QUO`+'*'_��o: This ' day of _.,,_ ,2016 ��14 Nu- K, ti . yylJp Signa ure of Public Not —State of Florida ,,,,,,�,5,,,, Sign c644.- re of Public ot.i,—Statf� a ofFlorida Notarization of Lobbyist's signature Notarization of Princip. 's,signature TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: ( ]Yes[ ]No Amount Paid$ 6°0-c CR# 6 61 b Date Paid OF) - 1‘ Lobbyist Registration Forth v D` received and verified by: C�, ✓ J 1 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014 F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc MIAMI EA City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E.Granado,City Clerk CityClerk @miamibeachfl.gov Tel:305.673.7411 ,Fax:305.673.7254 LOBBYIST NAME: Jeffrey Andres 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 automatically suspended from lobbying until all fines are paid, unless the fine has been ppeal-'• to the ami-Dade County Commission on Ethics and Public Trust. ////,/, Signa : Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc Detail by Entity Name Page 1 of 4 FLORIDA DEPARTMENT OF STATE DIVISION OF ORPORATIONS n r •, s ,1r • Detail by Entity Name Foreign Profit Corporation CLEAR CHANNEL OUTDOOR, INC. Filing Information Document Number F96000002318 FEI/EIN Number 86-0801051 Date Filed 02/23/1996 State DE Status ACTIVE Last Event DROPPING DBA Event Date Filed 11/27/2006 Event Effective Date NONE Principal Address 200 East Basse Road San Antonio, TX 78209 Changed: 04/15/2013 Mailing Address 200 East Basse Road San Antonio, TX 78209 Changed: 04/15/2013 Registered Agent Name &Address CT CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Name Changed: 09/16/2011 Address Changed: 09/16/2011 Officer/Director Detail Name &Address Title Senior Vice President-Tax Bick, Scott T. 200 East Basse Road San Antonio, TX 78209 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/14/2016 Detail by Entity Name Page 2 of 4 Title CFO, Director Bressler, Richard J. 200 East Basse Road San Antonio, TX 78209 Title Senior Vice President, Treasurer and Assistant Secretary Coleman, Brian D. 200 East Basse Road San Antonio, TX 78209 Title Director, Executive Vice President and Secretary Walls, Robert H., Jr. 200 East Basse Road San Antonio, TX 78209 Title VP, Assistant General Counsel and Assistant Secretary Dean, Lauren E. 200 East Basse Road San Antonio, TX 78209 Title Executive Vice President, General Counsel and Assistant Secretary Gangi, Craig 200 East Basse Road San Antonio, TX 78209 Title Executive Vice President Real Estate/ Operations Parker, Bryan A. 200 East Basse Road San Antonio, TX 78209 Title Executive Vice President and Chief Financial Officer-Americas Sailer, David 200 East Basse Road San Antonio, TX 78209 Title Director, Executive Vice President and Secretary Sturek, Toby 200 East Basse Road San Antonio, TX 78209 Annual Reports Report Year Filed Date 2013 04/15/2013 2014 04/14/2014 2015 04/16/2015 Document Images http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/14/2016 Detail by Entity Name Page 3 of 4 04/16/2015 --ANNUAL REPORT View image in PDF format 04/14/2014 --ANNUAL REPORT View image in PDF format 04/15/2013--ANNUAL REPORT View image in PDF format 04/04/2012 --ANNUAL REPORT View image in PDF format 09/16/2011 -- Reg. Agent Change View image in PDF format 04/19/2011 --ANNUAL REPORT View image in PDF format 04/27/2010 --ANNUAL REPORT View image in PDF format 10/22/2009 --ANNUAL REPORT View image in PDF format 04/30/2009 --ANNUAL REPORT View image in PDF format 04/29/2008 --ANNUAL REPORT View image in PDF format 05/01/2007 --ANNUAL REPORT View image in PDF format 11/27/2006 -- Dropping Alternate Name View image in PDF format 04/10/2006 --ANNUAL REPORT View image in PDF format 02/17/2005 --ANNUAL REPORT View image in PDF format 04/29/2004 --ANNUAL REPORT View image in PDF format 03/17/2004 -- Reg. Agent Change View image in PDF format 04/07/2003 --ANNUAL REPORT View image in PDF format 10/23/2002 --ANNUAL REPORT View image in PDF format 03/06/2002 -- Name Change View image in PDF format 12/27/2001 -- Reg. Agent Change View image in PDF format 01/26/2001 --ANNUAL REPORT View image in PDF format 08/16/2000 --ANNUAL REPORT View image in PDF format 05/10/1999 --ANNUAL REPORT View image in PDF format 07/07/1998--ANNUAL REPORT View image in PDF format 01/27/1998 -- Reg. Agent Change View image in PDF format 05/14/1997 --ANNUAL REPORT View image in PDF format 04/16/1997 --ANNUAL REPORT View image in PDF format 02/23/1996 -- DOCUMENTS PRIOR TO 1997 View image in PDF format Copyright©i)and Privacy Policies State of Florida,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/14/20 1 6 Detail by Entity Name Page 4 of 4 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/14/2016 [.i 41, -,.. .:::'1:'''''.-• t • i. ° a -n a M n• CITY HALL CASHIER OFFI c 0 0 �• A) 1700 CONVENTION CNTR DR tr 7D _ -j cto' MIAMI BEACH, FL 33139 �n 0 C v� p •• n � C 01/14/2016 13:34:00 D G tD CO y . CREDIT CARD v"1 z c =r---) a o E �.".h n d MC SALE �- c - • c , C) Cl) F.CARD# XX.XX XXXXXXXX7084 INVOICE 0001 ( OQ ) ,r - m vt SEQ#: 0001 t) ❑ C) Batch#: 001331 O - - rMCeI 3 Approval Code: 439900 y. ? o. Entry Method: Swiped r :`` :.5 Mode: Online rnv [ -, 4- ± _ Tax Amount: X0.00 v _ Cust Code: F L� SALE AMOUNT $ 700.00 i S ~ C CUSTOMER COPY D c,— (' t-- \ C- (�} - O E -� i3 Z r , -f _ ,-: rn - m \ as 5 U C: : G.,J .. C- m , 0 ' E- �,= Q o a- m t`i`p • •