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Pablo Acosta i r" C': ('. C \ \J E.I) ~ - - CIty of Miami Beach Ofllce of the CIty Oerk 1700 Convention Center Drive, Miami Beach, ~~31!l9:" B ,.,~; F ;. \: 3 5 EmaIl: dtyderk@d.mlaml-beach.f1.us '-' J .' LOBBYIST REGISTRATION FORM>,; 'i d(;<:S Off ICE (CIty of Miami Beach, aty Code Chapter 2, Division 3, Section 2-481) .oS Check Box if an Amendment Acosta NAME OF LOBBYIST: (Last) Pahln (Am) 2/5/03 (M.I) DATE QUAUAED AS LOBBYIST FT 33134 (State) 577-7001 (Zip Code) pacosta@steelhector.com EMAIL: 200 So. Bisc~ynp Rlv~ BUSINESS ADDRESS: (Number and Street) Mi ~ml r (CIty) (305 ) FAX N\lMBER: (305) 577-2828 TELEPHONE NUMBER: L LOBBYIST RETAINED BY: The Hillier Group NAME OF PRINOPAL/a.IENT: 500 Alexander Park CN 23, Princeton, NJ 08543 BUSINESS ADDRESS: (Number and Street) (aty) (State) (Zip Code) (215) 636-9999 (215)} 636-9989 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 OtIEF OFACER, PARTNER, OR BENEACARY: J. Robert Hillier ? UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SlJOi CORPORATION, PARTNERSHIP OR TRUST: J. Robert Hillier, Hiller employee stock ownership plan II. SPEaRe LOBBY ISSUE: RFP"No. 48-01/02 Planning, Design & Construction Manaqement Services Issue to be lobbied (Describe In detail): f . t . d ., or a c~ yw~ e Wayf~nd~ng Signage System. m. CITY AGENaES/INDIVlDUALS TO BE LOBBIED: A) Full Name of Individual/ntle B) Relationship c. r IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSAlJON (DISCLOSE WHETltER HOURL Y, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: $410.00 hourly rate B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): #q,o.atAn",l7 ~ V. SIGNATURE UNDER OATH: ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. 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 as amended, and all reporting requirements. Signature of Lobbyist: Signature of Prindpaljalent: VI. LOBBYIST IDENTlFlCAlJO .oS Producecl ID Form of Identification .oSX Personally Known VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Sworn to and subscribed before me This .,5-#'1 day of /Cbn M'l", 20Q). ~.uu~ ~ ature of Public Notary - State of Florida CD .IOS8'lNACASI1lO ~. . ~ Notary Pubic - Stale of Rorida , My Corrmlssion &pies NoY 1. 2Illl4 "r.c.f1 CommisSonltCC971188 .TnJ::.~T; n~ r~~+rn Print, stamp or type name of Notary Public FOR CLERK'S USE ONLY Registration: [ft; ACCEPTED [] REJECTED DATE: If rejected, state reason: Registration fee paid: 00 Yes [ ] No ~ L ~~~I~CheCk. MCR# v DATA ENTRY DATE: ~ 1 ~-S'-.03 I First Revision - 05/17/02