Robert Eichner/Onboard Media RECEIVED
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Ema,: c~tyc~erk~d.m~am~-beach.,.us 03 JUL 29 ?~ 2:55
LOBBYZST REGZSTRATZON FORt4 r'~TYC,'~ ~'S
0
F
(City of Miami Beach, City Code Chapter 2, Division 3, sec~dn' 2~48'f)-
O Check Box/~//_..~if an Amendment
NAME OFLOBBYZST: ~La~~ (First) (~.1) DA~UA~FZED~LOBB~
BUSINESS ADDRESS: (Number and Street~ (Ci~)
~LEPHONE NUMBER: F~ NUNBER: ENAIL:
LOBBYZST RETATNED BY:
NAM[f OF PRINCIPAL/CLIENT:
BUSINESS ADDRESS: (Number and Street) (Ci (State) (Zip Code)
TELEPHONE NUMBER: F~ NUMBER: (Op~onal) EMIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFFICER, PARTNER~ OR BENEFICIARY:
· LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
SPECZFZC LOBBY ZSSUE:
Issue to be lobbied (Describe in detail):
CITY AGENCTES/ZNDZVZDUALS TO BE LOBBZED:
A) Full Name of Zndividual/Title B) Relationship
~, ~
FLA TRATE OR OTHER):
A) LOBBYIST DISCLOSURE:
B) PR]NC]PAL'S DISCLOSURE (OF LoBB~f~ST COMPENSATION): "~'~
1)
2)
Pursuant to Ordinance No. 2003-3393 Amendino Miami Beach City Code ChaDter 2, Article VII, Division 5
Thereof Entitled "Campaiqn Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Campaiqn Contributions By Lobbyists On Procurement Issues":
Are you Iobbyinq on a oresent or Dendinq bid for qoods, eauim~ent or services, or on a oresent
or pendinq award for aoods, eouiDment or service? Yes ~
Pursuant to Ordinance No. 2003-339~ Amendinq Miami Beach Cib/Code Chaoter 2, Article VII Division 5
thereof Entitled "Campaiqn Finance Reform", Via The Addition Of Code Section 2.490 EnUtled "Prohibited
Campaiqn Contributions By Lobbyists On Real Estate Development issues":
Are you Iobbvin= on a DendJnu aoolication for a Develonment Aareement with the City or
applicaUon-for chanQe of zoninq mad desionaUon or chanqe to the City's Future Land Use MaD?
Yes
V. SZGNATURE UNDER OATH:
ON OCTOBER IsT OF EACH YEAR, EACH LOBBY]ST SHALL SUBMrr TO THE cTrY CLERK A SXGNED
STATEMENT UNDER OATH, ~STI'NG LOBBY]NG EXPENDTrURES TN THE CTTY OF M~AMT BEACH FOR
THE PRECEDTNG 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 in Section 2-482 of the Miami Beach City Code as amended, and all
reposing requirements. Et_.
Signature of Lobbyist:
Signature of Principal/Client,
Vi. LOBBY'f-ST ZDBN'fZFZCATZON: ..... .~_~-
~ Produced ID ~rsonally Known~
Form of Identification
SZGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This ~ day of.Jc/~-~ ,2003.
~'~ Commission # CC 916334
~,~ E~irea M~h 6, ~4
'4~.~'~ .a.~;~ ~n~ Co: Inc.
Registration: .[~ACCEPTED
If rejected, state reason:
Registration fee paid:..~Yes [ ] No
2nd Re¥ision
..,~2~'~:,, Sl~..on Cham~d~in
FOR CLERK'S USE ONLY
[ ] R~E~D DA~:
EN~RED BY: //~Y~