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Tiramesu, Balans, etcOb/of Miami Beach Office of the Ob/ 1700 Convention Center Drive, Hlami Beach, FL 33139 Ema[l: db/derk~d.mlaml-beach.fl.us LOBBY/ST REGZSTRATZON FORM (Ob/of Miami Beach, Ob/Code Chapter 2, Division 3, Section 2-481) a Check Box If an Amendment ROSEN HAROLD NAME OF LOBBYIST: (Last) (first:) MIAMI BEACH, 407 T.T~nT.~ ~n~n p~l,,'~munr,~ q ~ BUSINESS ADDRESS: (Number and Street) "(CI~) (305) 534-4757 TELEPHONE NUMBER: (M.I) DATE QUALJJ-u:u AS LOBBYIST FLORIDA 331 39 (sta~) (Zp co~) (~Nfi) ~_~n~ FAX NUMBER: EMA[I.: LOBBYT. ST RETAZNED BY: NAME OF pPJNCZPAL/CLIENT: ' / 721 LINCOLN ROADr MIAMI BEACHr FLORIDA 33139 BUSINESS ADDRESS: (Number and Sheet) (Ob/) (State) (2]p Code) TELEPHONE NUMBER:, FAX NUMBER: (Optional) EMAIL: (Optlo~a;) Fill out bgis secUon If prlndpal Is a Corporation, Partnership or Trust [SecUon 2-482 (c)] · NAME OF CH~F OFFICER, PARTNER, OR BENEFICIARY: GRAZIANO SBROGGIO · I.[ST ALL pERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP IN I tJ"EST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: SPEC~FZC LOBBY ZSSUE: Issue b~ be lobbied (Describe in detail): ,[,.3, m ( AGENC~ES/TNDZVZDUALS TO BE LOBBZED: A)FullName~Z~dual/Tlfle B)Rdatton~ip FINANCE COMMITTEE CITY OF MIAMI BEACH CITY COMMISSION D~CLOSURE OF TERMS AND AMOUNTS OF LOBBy'r-ST COM~'ENSATJ[ON (D~.qCLOSE WHETHER HOUJU.Y, *~ FLAT RATE OR OTHER): A) LOBBY~DISCLOSURE: $2: 500 FLAT FEE E) PR/NC~PAL~DISCLOSURE(OFLOBBY~STCOMPENSATLON): $2,500.00 FLAT FEE V. S~GNATURE UNDER OATH: ON OCTOBER 1; OF EACH YEAR, EACH LOBBY[ST SHALL SUBM~'r TO THE ~.~ i ~' CLERK A S][GNED STATEMENT UNDER OATH, LTbi~NG LOBBYZNG EXPENDTrURES IN THE CZTY OF M~AMX BEACH FOR THE PRECEDING CALENDAR YEAR. ! do solemnly swear that all of the foregoing facts are true and correct and that [ have read or am familiar with the provisions contained~-Section 2-482 of the Miami Beach City Code as amended, and all Signature of Principal/Client: V~. LOBBYIST TDEN'I~I~CATZON [3 Produced ID E~'Personally Known Form of IdenUficafion V~. S/GNATURE AND $TAHP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Swom to and subscribed before me This I ~.~ .day of ~ 2003. P~giWatio~: A~~D If rejected, state reason: Registration fee paid: ~[ ½ NO 2nd Revision U27/03 FOR CLERK'S USE ONLY · 2003 ENTERED BY: F:\d:L'1~HATL\LobbylstsYegistration03.doc