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Murano Three, Ltd. m - aty of Miami Beach Office of the aty Oerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityclerk@d.rTV~"1i~beachif1.us.. ;,' LOBBYIST REGIstRATION "fORM ,.' ~.~ - . " : "Ii'- (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) i:l Check Box if an Amendment . ..0 ( Sqq(P S,,, -,0 ~t. BUSINESS ADDRESS: (Number and Street) M. (M.!) FL. ~~~"!;) (State) (Zip Code) C.h2v"\~ ~ '5'~CV'5uaV'c.."Z. ~Mt\IL . an::; h:, ,. c.c::t. CQ V\o'\ NAME OF LOBBYIST: "?o~ '21.4 '2.10~ TELEPHONE NUMBER: 4. Mi~1 (aty) ~~ ~14- ?AP.Ll FAX NUMBER: I. LOBBYIST RETAINED BY: -.M LJ V' a~~ ~.,.~c.. L~. ' NAME OF PRlNOPALjCUENT: 1 J'l."Z S A\-\-o V\ BUSINESS ADDRESS: (Number and Street) 12d. Mia""", ~ac.h FL. (City) (State) ~ tbD40 ~\4 FAX NUMBER: (Optional) ~\ 3,\ (Zip Code) ?JOb ~~ B~\D TELEPHONE NUMBER: EMAIL: (Optional) Fill out this sectlon If prindpal is a Corporation, Partnership or Trust [Sectlon 2-482 (en . NAME OF CHIEFOFFICE~, PARTNER, OR BENEAaARY: . UsT ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP. OR TRUST: , . "'" :""':'.' II. . ...SPEaFICLOBBY~\Hi:i ,..' .' ,", p"G~~",,-t2t\6~ ~O 'C~'~'~b~ M~"2WM\ ~-ac:.h ~.o;\~v;e~ ~uetobeIOb~ied(~. 'be. indetaU): ..... . .,.... ..Z" -.l .n,_ ~ ~oaV'O\}r~V"< M\)v'''~'''''O '-""\~-'h~,\Q\e.- r "laSt:...1..+-o "/ ;'.;, '.,. . III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of IndMdual/ntle B) Relationship OC.~~9 'lI'\ aC.v~ c.-..v f:>Q'evd IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA TRATE OR OTHER): A) LOBBYIST DISCLOSURE: Co V\ ~ -.c.t- .. '1 1> Q Oc.')6) . uD I B) PRlNOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): cll C;~O, 000. 00 ~ .... ", v. SIGNATURE UNDER OATH: .' t..; .."",.,-' _.'_ '" _.: .. . _",,' :",.,"'. ., ...': "/ _ -", ....- '.~' ON ocT6BER 1St OF EACH YElR,' EACH LOBBYisT'SHAlL SUBMrT TO 'rifE ~ CLERK A SIGNED' STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YiAR. . . " : : .\. ~ ~. . ':' i 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 con' 'n Section 2-482 of the Miami Beach City Code as amended, and all reporting requirements. VI. LOBBYIST IDENTl .'.- ;. Signature of Lobbyist: Signature of PrinCipal/Client:" ~,/C" .;;.~. ~.. "Il.. ',: I ~ .~.: . ~ , , ;.... ~~. CJ Produced ID Form of Identification ~ersonally Known VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Swom ,and SUbscrl7~ m.' This y? day of 2002. e ~ ... . ,. ...."'r. . f~' '. .." ,:"..,.'/ '.. Registration: ~EPTED [ ] REJECfED , ir f " 3 If rejected, state reason: ~ Registration fee paid: ~Ye [] No sh [ ] Check I'd DATA ENTRY DATE: 1 MCR ~Lf+slJ3 ENTERED B~ 2002 1 Arst Revision - OS/17/02